Physical, mental, spiritual and social wellbeing of urban population during the COVID-19 lockdown phases: a cross-sectional study

Background: COVID 19 pandemic created immense mental & physical agony among human beings worldwide. The present study was conducted to assess the physical, mental, social and spiritual wellbeing of young adults and the elderly, during the lock-down phase of COVID-19. Methods: The cross-sectional study was conducted among 227 healthy adults in Bhubaneswar, capital of Odisha. Data was collected using a self-administered questionnaire pertaining to the physical, mental, social and spiritual health of participants. Results: During the lockdown, around two-thirds (65.4%) of the participants reported feeling helpless. The elderly felt more helpless than the young adults. One-third (73, 32.6%) of the participants experienced health issues during the lockdown period. The majority of the study participants (83.8%) mentioned that their family members shared tasks during lockdown which was a very positive sign observed in this study. Faith in God for the elderly and family support for the young adults made them mentally stronger. Conclusion: Managing pandemic needs a multipronged approach. But focusing on psychosocial health will prevent future unseen mental health pandemics and improve the resilience of mankind

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Disaster Management: Learning from Experience for Public Health Professionals

India is highly vulnerable to natural disasters; losing about 2% of the GDP every year. India has a coastline of around 7516 kilometres surrounded by the Bay of Bengal, the Arabian Sea. As the surface temperature is more than that of the Arabian Sea, Bay of Bengal generates more severe cyclone. As per the data of India Meteorological Department (IMD), India weathered as many as 305 cyclones of severity severe and above in last 126 years.(1) An estimated 1.9 million deaths are caused by tropical cyclones worldwide.(2) Nine out of the top ten devastating tropical cyclones hit the coast of Bangladesh and India.(3) The Bhola Cyclone is deadliest in the list causing maximum damage to Bangladesh on 11th November 1970 claiming around 5,00,000 lives and producing massive destruction.(4) The deadliest one of the list hitting the coast of India was in 1999, the super cyclone in Odisha which struck the state of Odisha on 29th October 1999 claiming around 10,000 lives and leaving millions homeless and extensive damage to property and environment.(4) The condition is only likely to get worse as climate change increase the sea surface temperature

The top 100 cited articles in menstrual health among adolescent girls: a citation analysis

Abstract Background Menstrual health is an important public health concern where it is still considered a taboo, and adolescent girls often lack knowledge about menstrual health, face limited access to sanitation facilities, and struggle with the affordability of sanitary materials. Every year numerous articles are published; however, only a few of them would be influential in the evolution of a particular field. The number of citations received by an article serves as a quality factor for the impact of the article in a particular field. Citation analysis analyses the relationship between citations received by articles. From the literature search, no citation analysis was conducted on menstrual health. Hence the objective of the study was to identify the articles which received hundred or more citations and also to identify the leading countries, journals, study designs, and departments conducting research on menstrual health. Methods Citation analysis was done with search terms pertaining to adolescent and menstrual health using Google Scholar as a database in Publish or Perish software. The articles retrieved were exported to Microsoft Excel. Articles that received a hundred or more citations were screened for the type of article, department, and country where the study was conducted. A descriptive analysis of the hundred or more cited articles was done in Microsoft Excel. Results A total of 982 articles pertaining to menstrual health among adolescent girls were retrieved. There were hundred articles with hundred and more citations pertaining to the menstrual health of adolescent girls. Cross-sectional study design, Obstetrics and Gynaecology department, India and USA countries, and PLOS ONE journal had the most citations in research on menstrual health among adolescent girls. The top ten articles were on menorrhagia, menstrual hygiene practices, Water, Sanitation and hygiene (WASH), stigma on menstruation, and education on menstrual health. Conclusion The hundred cited articles on menstrual health among adolescent girls were mainly from high-income countries and were of more observational in nature than interventional. Thus, highlighting the need to strengthen experimental studies on the menstrual health of adolescent girls in Lower-middle-income countries

Ocular manifestations of HIV infection/AIDS in South Indian patients

Purpose: To evaluate the nature and prevalence of ocular manifestations in a group of patients with Human Immunodeficiency Virus (HIV) infection/Acquired Immunodeficiency Syndrome (AIDS) from South India, and to elaborate the impact of the disease on existing health agencies. Methods: We examined 19 consecutive patients with AIDS (Group-A) who presented to our centre. After counselling, HIV screening tests were also performed on 8 individuals related to the patients and those who were seropositive (Group-B) were examined for ophthalmic lesions. Results:In Group-A, HIV retinopathy was present in 34%, CMV retinitis in 39%, Herpes Simplex-related Acute Retinal Necrosis (ARN) and retinitis in 11%, tubercular choroiditis in 11%, while Herpes Zoster retinitis and presumed P. carinii choroidopathy each were observed in 2.5% of the eyes. Results of screening tests in Group-B revealed HIV-seropositive asymptomatic status in 6 (75%) of them with no ocular manifestations. Conclusion: HIV retinopathy and opportuninstic ocular infections were common in AIDS patients. Heterosexuality was the most common mode of transmission. Since no effective management is readily available, prevention through proper counselling appears to be the only defence against AIDS in India

Mass Drug Administration (MDA) for Elimination of Lymphatic Filariasis: Experiences from Nayagarh District of Odisha, India

Background: India has adopted MDA strategy for elimination of lymphatic filariasis since 2004. It requires constant efforts on a nationwide scale particularly in the endemic areas for interruption of transmission of this neglected tropical disease. Aims & Objectives: This study aims to assess the coverage and compliance along with factors affecting compliance regarding MDA implementation in Nayagarh district of Odisha. Material & Methods: A cross-sectional descriptive study was conducted in November 2016 for evaluation of filariasis elimination activities carried out in the district. A pre-designed, pre-tested semi-structured interview schedule as per National Vector Borne Disease control Programme (NVBDCP) guidelines was used. A qualitative component was added to determine the perceptions and attitudes of the study population regarding MDA implementation. Data was analysed using simple proportion and percentages. Results: A total 120 households (90 rural and 30 urban) were surveyed, covering a population of 590. Overall coverage rate of study population was found to be 91.47%. The effective coverage rate was 71.1% (77.8% in rural areas and 48.8% in urban areas). The overall coverage compliance gap was 22.2, being higher in urban than rural areas. Conclusion: There is a felt need for health education activities to increase acceptance among the population coupled with supervised on the spot consumption of DEC for decreasing the coverage compliance gap. The issues regarding compliance need to be addressed for realizing the global target of eliminating lymphatic filariasis by 2020

Xanthogranulomatous colloid cyst of the third ventricle

Colloid cyst in the third ventricle is a common entity, whereas a variant of it, namely xanthogranulomatous, is quite rare. The closest imaging differential diagnosis is a purely third ventricular craniopharyngioma. We herein describe a case of xanthogranulomatous colloid cyst presenting with hydrocephalus

Effectiveness of school-based sexual and reproductive health education among adolescent girls in Urban areas of Odisha, India: a cluster randomized trial

Abstract Background Various studies revealed that adolescent girls have limited knowledge pertaining to sexual and reproductive health (SRH). The current study assessed the effectiveness of SRH education among adolescent girls in urban areas of Odisha, India. Methods The study design was a cluster randomized trial, where the clusters composed of eight Odia (regional language) medium government girls’ high schools in Bhubaneswar, the capital city of the state of Odisha, India. For the selection of study participants, adolescent girls who were studying in the ninth and tenth standards were recruited from each school. Eight schools were randomized through restrictive randomization at a 1:1 ratio, with four schools each in the intervention and control arm. Baseline and end-line assessments were done using a pre-tested, semi-structured questionnaire. Following baseline assessment, an intervention was given with the help of handbooks developed by the study authors to the schools in the intervention arm. Outcomes included change in knowledge, attitude and practices pertaining to SRH. Results In our study at baseline, there were a total of 790 students, where 469 (59.4%) students were in the intervention arm, and 321 (40.6%) students were in the control arm. At baseline, only 282 (60.1%) in the intervention arm and 171 (53.3%) in the control arm were aware that physical bodily changes due to puberty were normal. After the intervention, there was a statistically significant increase in knowledge in intervention group 367 (94.8%) (p-value < 0.001). Most students used sanitary pads as absorbent, 97.2% in the intervention group and 98.4% in the control group. However, after the intervention, the use of other absorbents reduced to zero in the intervention group with a statistically significant difference (p < 0.05). The number of students having awareness on different methods of contraception increased from 51 (10.9%) to 337 (87.1%) in the intervention arm (p < 0.001), and of those having awareness on STIs/RTIs increased from 177 (38.2%) to 371 (96.1%) in the intervention group (p < 0.001). Conclusion From our study, there is a significant proportional change in knowledge, attitude, and practices pertaining to SRH. Our study recommends policymakers and program managers for the implementation of comprehensive SRH in the regular school curriculum. Trial registration CTRI/2021/01/030490, registered on January 15, 2021. Prospectively registered at https://ctri.nic.in/Clinicaltrials/login.ph