Epidemiological Updates of MPOX: An Emerging Disease

MPOX is a zoonotic disease caused by orthopoxvirus. The disease is endemic in African countries, but major outbreak was reported in the early 2022 outside the endemic countries and subsequently spreading in the whole world following which it was declared as a Public Health Emergency of International Concern on July 23, 2022. MPOX is a self-limiting disease with symptoms generally lasting from 2 to 4 weeks. Vesiculopustular skin rashes begin 1 to 3 days after prodromal symptoms and can last up to 4 weeks. Transmission can occur from animal to human as well as from human to human via body fluids, close contact with respiratory secretions, skin lesions, contaminated material etc. As there is no specific treatment for MPOX, isolation of the confirmed cases is the key modality to control the spread of the disease

Development and validation of a questionnaire in Hindi language to assess Parental Knowledge, Attitude and Practices regarding Calcium and Vitamin D deficiency in children

Background: Despite being in temperate zone, India is endemic to nutritional rickets. However, very little has been studied on knowledge, perception and cultural practices of Indian communities, towards calcium and vitamin-D deficiency in children. Aim & Objective: The study aimed to develop and validate a questionnaire in Hindi language for the assessment of knowledge, attitude, and practices of parents towards calcium and vitamin D deficiency among children. Methodology: We searched electronic databases for item generation. The questionnaire was developed in Hindi language by five experts in the field of pediatrics, pediatric orthopaedics and community medicine using Delphi method. After language correction from Hindi language experts, a convenient sample of 30 participants filled the questionnaire and tested for internal consistency and test-retest reliability. Results: The overall Cronbach’s alpha value for the finalized 46-item scale indicated an acceptable reliability (alpha = 0.91). The internal consistency reliability for six domains created was acceptable. The results revealed ‘high’ test-retest reliability, and there was no statistically significant difference noted between any of the first test and re-test corresponding values (p>0.05). Conclusion: The present questionnaire developed in Hindi Language to assess knowledge, attitude and practices (KAP) of parents towards Calcium & Vitamin-D deficiency in children, has a good validity and reliability. This newly developed instrument could prove its use to highlight the gaps that may exist among parents. The use of this tool may help clinicians, health educators and policy makers to identify key areas of intervention with regards to Calcium & Vitamin-D deficiency in children

Static Foot Pressure and Percentage Contact Area of the Foot as an Assessment Tool for the Success of Anterior Cruciate Ligament Reconstruction: A Cross-sectional Study

Introduction: Anterior Cruciate Ligament (ACL) plays a vital role in gait balancing and lower limb kinematics. Any injury to the ACL leads to gait imbalance and alterations in foot pressure distribution. The stability and biomechanics of the lower limb after ACL Reconstruction (ACLR) can be measured through foot pressure analysis, gait analysis, and percentage contact area of the foot, among others. Aim: To evaluate the static foot pressure and percentage contact area of the foot in ACL deficient group, comparing it with the ACLR group and the normal healthy individual group. Materials and Methods: An analytical cross-sectional study was conducted at the Department of Sports Medicine, King George Medical University, Lucknow, Uttar Pradesh, India from March 10, 2021 to March 15, 2023. A total of 15 patients in each group (ACL injury, ACLR patients, and normal healthy individuals) were included in this study. Foot pressures (static) were recorded in all three groups using the BTS P-WALK system with BTS Biomedical software, which included high-density sensors and a plate size of 700 × 500 × 5 mm. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software version 26.0. Chi-square and linear regression tests were used to analyse the differences between the groups. Results: In the intragroup analysis, ACL deficient patients’ ipsilateral limbs showed lower foot pressure in the mid-foot (7±3.4), hind-foot (40.33±10.08), and whole foot pressure (110.19±34.7 Pascal (N/M2)) (p-value>0.05) compared to normal healthy individuals (126.06±19.4 Pascal (N/M2) (p>0.05) and ACLR (125.06±14.3 Pascal (N/M2)) (p-value>0.05) groups, which suggested insignificant differences. The percentage contact area of the foot was significantly lower (43.15±3.4) (p-value<0.001) compared to normal healthy individuals (49.82±0.84) and ACLR (49.02±0.91) groups. However, in intergroup comparisons, the differences in mid-foot, whole foot pressure, and percentage contact area of the foot were significant (p-value <0.001) within the groups. Conclusion: Although there is a wide range of variation in the values of static foot pressure and percentage contact area of the foot in ACL deficient patients, after ACLR, these values become nearly similar to those of normal healthy individuals at around one year after ACLR

Cognitive Functioning Among Community-dwelling Older Adults in Rural Population of Lucknow and Its Association with Comorbidities

Background: The transitional state between normal aging and dementia is known as Cognitive impairment (CI) where a person has memory complaints and objective evidence of CI but no evidence of dementia. With the globe undergoing a “demographic transition,” the magnitude of neurodegenerative disorders is rising. In India, 27.3% of older persons with comorbidities had CI. Early identification of CI will likely help initiate proper remedial intervention, leading to better overall outcomes. In order to determine the prevalence of CI in older persons and whether it is associated with co-morbid conditions, this study was designed. Methods: A descriptive cross-sectional study was conducted among 350 older adults aged ≥60 residing in rural areas of Lucknow, selected using multistage cluster sampling. The Hindi Mental State Examination (HMSE) scale was used to assess cognitive function. A pretested semi-structured questionnaire was used to collect information on sociodemographic characteristics and comorbidity status. Results: Among 350 participants, with mean ± SD age 70.66 ± 9.53 years, the prevalence of CI as per HMSE (<23) was 24.9%. Overall, the mean HMSE score was less in individuals with (25.2) than without (27.19) comorbidities. Those with comorbidities had significantly lower mean scores in all individual domains of HMSE. Conclusion: CI affects one-fourth of the older adult population. Risk increases with the presence of comorbidities. Hence, screening, and early treatment are recommended

Effectiveness of educational interventions on knowledge and behavioral practices of adolescents for prevention of noncommunicable diseases in low- and middle-income countries: A systematic review protocol

Introduction: The rising burden of noncommunicable diseases (NCDs) is a dominating public health crisis, globally causing 38 million of 57 million deaths annually, with 85% of these deaths occurring in low- and middle-income countries (LMICs). However, while addressing NCDs, adolescents have been largely overlooked, who have a notable share in the NCD burden globally. Adolescents are vulnerable for developing high-risk behaviors, which puts them at high risk of NCDs such as ischemic heart diseases, diabetes, and stroke. Objective: The objective of this systematic review will be to identify the effectiveness of educational interventions on the knowledge and behavioral practices of adolescents for the prevention of NCDs in LMICs. Methodology: Five electronic databases such as PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Embase, and Scopus will be utilized for generating pooled evidence. Two reviewers will individually screen the titles and abstracts for eligibility, and in case of any disagreement, the help of a third reviewer will be taken. Recognized studies will be critically appraised for methodological quality using the Cochrane risk-of-bias tool. Data will be extracted from the studies included in the review for author's name, year of study, study setting, study design, study participants and their age, sample size in the intervention group, NCD domain covered by the study intervention, intervention details, measure of outcome, etc. For data synthesis, studies will be pooled using RevMan software and effect sizes will be depicted using forest plots. The Grading of Recommendations, Assessment, Development, and Evaluation approach to grade the certainty of evidence will be followed for assessing the quality of evidence. Publication bias will also be checked using funnel plots and Egger's test. Clinical Relevance: To the best of our knowledge, this will be the first systematic review that will assess the empirical evidence and evaluate the effectiveness of educational interventions for the prevention of NCDs among adolescents of LMICs. This review will assist the public health experts and policymakers in designing effective intervention for preventing NCDs among adolescents. Results and Conclusion: The results of this systematic review will provide an in-depth insight of the existing country-specific educational policies and interventions for the prevention of NCDs among adolescents in various LMICs. This will help in the replication of such cost-effective educational models or interventions in other LMICs followed by advocacy in their school policy reforms and other related programs focusing on NCDs