Knowledge, attitude and practices regarding World Health Organization surgical safety checklist and the challenges in its implementation at a teaching hospital in North India

Background: The WHO in 2009 published the surgical safety checklist (SSC) for reducing the surgical complications. For its successful implementation it is imperative to identify the current knowledge, attitude and practices of the involved personnel and explore the anticipated barriers. Objective of this study was to evaluate the knowledge, attitude and practices of the participants about the SSC and determine the possible challenges in its implementation.Methods: This study is a descriptive, cross-sectional study involving the use of a pre-tested questionnaire carried out in a teaching hospital. All personnel involved in the operation theater who gave their written consent were enrolled.Results: Awareness regarding the SSC is high and existing practices are favorable towards patient safety amongst Hospital personnel. Attempts should be made to educate all personnel to gain complete knowledge regarding the checklist. The anticipated barriers, of which lack of knowledge was found to be the most prominent, should be dealt with.Conclusions: A strategy aimed at proper education, stepwise implementation, alleviating the hindrances and regular feedbacks can result in decreasing the surgery related complications and morbidities through implementation of the surgical safety checklist

Land Use/Land Cover Change and Environmental Impact Analysis of Ramgarh-Naudiha Region in Uttar Pradesh, India through Geospatial Technology

Rapidly changing LULC scenario with growing population is of great concern in the modern world. The present study was undertaken to evaluate the changes in LULC pattern in Ramgarh-Naudiha region of Sonbhadra district, UP, over 20 years during 1998-2018 using datasets from the Landsat Thematic Mapper (TM) 5 and Landsat 8 (OLI/TIRS) satellites. LULC map for the chosen period has been generated by unsupervised classification with maximum likelihood algorithm. Results indicate that the study area is vulnerable to such LULC changes due to its sensitive geographic location. It is found that the major changes did happen in agriculture, forest, wasteland and water bodies. Agriculture and Forest areas have decreased by similar to 2 and 6.56% respectively in the study period. The wastelands had increased fast from 5.08% in 1998 to 18.87% in 2018 at the cost of the forest cover and agricultural land respectively. In 1998, water bodies were 7.49%, whereas, it has decreased to 2.04% in 2018. On the contrary, urban fringe area has grown from 0.33% in 1998 to 0.49% in 2018 especially due to population growth. The present study concludes that this LULC analysis will increase awareness and help in taking necessary action in appropriate land use planning and management

A comparative study of attitudes towards COVID-19 vaccination in the rural and urban population of Uttarakhand, India

Background The public is hesitant about getting vaccinated for COVID-19, and a few people are still avoiding it. The aim of this study was to evaluate the attitude towards COVID-19 vaccination among rural and urban populations of the Dehradun district in Uttarakhand, India. Materials and methods A cross-sectional survey was conducted from April to June 2021 in selected urban and rural areas of the Dehradun district, yielding 770 responses (385 from both rural and urban areas). The attitudes towards COVID-19 vaccination were collected via questionnaire and analysed using descriptive and inferential statistics. Results There were no rural-urban differences in the mean score of attitude towards COVID-19 vaccination (49.22±12.89 vs 50.01 ±11.88; P=0.379). The majority of participants had a neutral to positive attitude, and very few had a negative attitude towards COVID-19 vaccination, equally in the rural and urban population. A significant positive association was found between attitude scores with COVID-19 vaccination and mortality among participant’s relatives and friends in rural areas, while participant occupation and number of family members in the urban area were associated with a more positive attitude. Conclusion These results suggest mainly neutral attitude among the rural and urban populations towards COVID-19 vaccination. Therefore, it is important to design and implement innovative and efficient communication strategies to influence the neutral and offset the negative attitudes regarding vaccination drive to facilitate immunisation outreach and coverage

Prevalence and determinants of unprotected sex in intimate partnerships of men who inject drugs: findings from a prospective intervention study

Unprotected sex, common among people who inject drugs, puts them and their partners at risk of sexually transmitted infections including human immunodeficiency virus (HIV). This analysis assesses the changes in sexual risk behavior with regular female partners (RFPs), among married men who inject drugs, before and after implementation of a HIV prevention intervention, and identifies correlates of unprotected sex. People who inject drugs (PWID) were assessed at three points: baseline, preintervention follow-up visit (FV)1, and postintervention FV2. Descriptive analysis was used for reporting changes in sexual behavior over time. Generalized estimating equation assessed the population-averaged change in self-reported unprotected sex with an RFP, attributable to intervention uptake. Multivariable logistic regression determined correlates of self-reported unprotected sex with an RFP at FV2. Findings suggest that the proportion of men reporting any unprotected sex remained high (baseline = 46.0%, FV1 = 43.5%, FV2 = 37.0%). A reduction was observed in unprotected sex after the intervention phase, but this could not be attributed to uptake of the intervention. Higher odds of self-reported unprotected sex with an RFP in the past three months at FV2 were associated with self-reported unprotected sex at baseline, living with family, and being HIV-negative. Married male PWID should receive counseling for safe sex with RFPs, especially those who are HIV-negative and live with their families

Women and substance use: a qualitative study on sexual and reproductive health of women who use drugs in Delhi, India

Objectives: To explore contextual factors that increase vulnerabilities to negative sexual and reproductive health (SRH) outcomes and possible differences in SRH-related behaviours and the needs of women who use drugs (WUD) through non-injecting and injecting routes. Design: Qualitative study design using semi-structured in-depth interviews. Participants: Twenty women who injected drugs in the past 3months and 28 women who reported using drugs through non-injecting routes in the past 1month. Setting: Interviews were conducted at community-based, drop-in centres in Delhi, India. Results: Study findings illustrate that WUD were sexually active and had multiple sex partners including clients of sex work. Transient relationships were reported and many participants engaged in unsafe sex. Factors which affected safe sex behaviours included: gender power imbalance, limited agency for decision-making, lack of accurate information for correct self-risk assessment, and being under the influence of drugs. Despite high awareness, low and inconsistent contraceptive use was reported. Some participants were coerced to conceive while a few others reported their inability to conceive. Violence was a key determinant for SRH outcomes. Perception of certain adverse health outcomes (such as infertility) to be ‘common and expected among WUD’ influenced access to healthcare. Further, healthcare providers’ stigmatising attitudes and lack of women-centric services deterred women from uptake of healthcare services. Conclusion: Findings highlight that SRH-related behaviours and needs of this group are a complex interplay of multiple determinants which need to be addressed at all levels: individual, family, community and institutional. It is imperative to roll out a ‘one-stopshop’ for a comprehensive package of health services. Expansion of existing drop-in-centres could be considered for setting-up community-based women-centric services with appropriate linkage to drug dependence treatment and reproductive health services

High HIV incidence among male injection drug users in Delhi, India

India has a large injection drug user (IDU) population estimated at 177,000. The overall national HIV prevalence is around 7.2 percent in this group, the highest among all key populations in the country. There is limited HIV incidence data among IDUs in India. In collaboration with Arise—Enhancing HIV Prevention Programs for At-Risk Populations, the Population Council initiated a prospective cohort study at five centers in Delhi to examine HIV incidence and behavior change both pre-introduction and post-introduction of HIV prevention services among IDUs. HIV transmission risk remains high among IDUs in Delhi despite targeted prevention interventions. Despite the widespread availability of free sterile needles and syringes from needle exchange programs and targeted interventions with harm-reduction messages, HIV risk is primarily associated with risky drug injection practices. Targeted intervention programs must find ways to increase regular access to harm-reduction services and ensure that use of services translates to changed behaviors. This study demonstrates that a large number of IDUs can be enrolled into a prevention study with reasonable rate of follow-up. Thus, this population should be considered for future HIV prevention trials

Prevalence of HIV, hepatitis B and C, and co-infection in a cohort of male injection drug users in Delhi

India has a large injection drug user (IDU) population estimated at 177,000 nationally with an HIV prevalence of 7.2 percent. Historically, the presence of IDU populations and associated HIV infection was concentrated in the northeastern states of the country. Recent evidence documents IDU populations in other parts of the country. Delhi has an estimated 17,000 IDUs and the second highest HIV prevalence in India at 18.3 percent. The probability of becoming infected with HIV after using an infected syringe ranges from 0.34 percent to 1.4 percent. By comparison, the risk for hepatitis C (HCV) ranges from 1.5 percent to 5 percent. Several studies have documented high prevalence of HIV-HCV co-infection among IDUs in the high HIV prevalence states of India, but there is little evidence from the low HIV prevalence states in the country. The Population Council and partners implemented a project to avert HIV infections among IDUs and their sexual partners in Delhi. As part of the project evaluation, an assessment of the prevalence of HIV, hepatitis B, and HCV infection was conducted in a cohort of male IDUs in Delhi. This document presents a research update

Selective Autophagy and Xenophagy in Infection and Disease

Autophagy, a cellular homeostatic process, which ensures cellular survival under various stress conditions, has catapulted to the forefront of innate defense mechanisms during intracellular infections. The ability of autophagy to tag and target intracellular pathogens toward lysosomal degradation is central to this key defense function. However, studies involving the role and regulation of autophagy during intracellular infections largely tend to ignore the housekeeping function of autophagy. A growing number of evidences now suggest that the housekeeping function of autophagy, rather than the direct pathogen degradation function, may play a decisive role to determine the outcome of infection and immunological balance. We discuss herein the studies that establish the homeostatic and anti-inflammatory function of autophagy, as well as role of bacterial effectors in modulating and coopting these functions. Given that the core autophagy machinery remains largely the same across diverse cargos, how selectivity plays out during intracellular infection remains intriguing. We explore here, the contrasting role of autophagy adaptors being both selective as well as pleotropic in functions and discuss whether E3 ligases could bring in the specificity to cargo selectivity

Land Use/Land Cover Change and Environmental Impact Analysis of Ramgarh-Naudiha Region in Uttar Pradesh, India through Geospatial Technology

Rapidly changing LULC scenario with growing population is of great concern in the modern world. The present study was undertaken to evaluate the changes in LULC pattern in Ramgarh-Naudiha region of Sonbhadra district, UP, over 20 years during 1998-2018 using datasets from the Landsat Thematic Mapper (TM) 5 and Landsat 8 (OLI/TIRS) satellites. LULC map for the chosen period has been generated by unsupervised classification with maximum likelihood algorithm. Results indicate that the study area is vulnerable to such LULC changes due to its sensitive geographic location. It is found that the major changes did happen in agriculture, forest, wasteland and water bodies. Agriculture and Forest areas have decreased by ~2 and 6.56% respectively in the study period. The wastelands had increased fast from 5.08% in 1998 to 18.87% in 2018 at the cost of the forest cover and agricultural land respectively. In 1998, water bodies were 7.49%, whereas, it has decreased to 2.04% in 2018. On the contrary, urban fringe area has grown from 0.33% in 1998 to 0.49% in 2018 especially due to population growth. The present study concludes that this LULC analysis will increase awareness and help in taking necessary action in appropriate land use planning and management

Beneficiation of Clays from Ramgarh-Naudiha Region of Sonbhadra District Uttar Pradesh, Impart Improved Properties for Ceramic Industries

Chemical and physical properties of clay samples collected from the deposits in the Ramgarh-Naudiha of Sonbhadra district, Uttar Pradesh were examined for their utilisation in ceramic industry. The raw clays from the deposits were found to be siliceous ball clays, contained less kaolinite, non-plastic and were unsuitable for making ceramic items. These clays have been subjected to standard beneficiation techniques which removed the free quartz. The beneficiated clays were less siliceous, had improved properties that can be used as partial replacement material in making ceramic items