Designing and Validating a Multimorbidity Assessment Questionnaire for a Rural Indian Community

Introduction: Multimorbidity, has received its undue attention in the recent years, because of its hidden impact on the patients and their families, especially in environments with little resources. There is no data available on the prevalence of multimorbidity (for both oral and systemic) in Uttarakhand to the best of our knowledge. The aim of this study is to develop a multimorbidity questionnaire in a rural Indian community. Methods: The pilot study was conducted in Kurkawala, Dehradun, Uttarakhand, India in February 2023. Results: Our sample had mean age of 46 years, with 54.2% females. 88.5 % of the participants were found to be with any morbidity, whereas 31.5% participants were found to be with only oral morbidity. 57.9% participants were found with Oral Morbidities along with One systemic Morbidity followed by 21.1% participants with Oral Morbidities along with Two systemic Morbidities. 25.8% participants were found to have with both Hypertension and Oral Conditions, followed by Acid peptic disease and Any Chronic Bone/Joint Disease; Any Neurological and/or Psychiatric Disorders (19.4% respectively). Discussion: Developing a stronger evidence base of the knowledge of risk factors and their determinants as well as implementing proven effective strategies (both at individual as well as societal level) for multimorbidity risk reduction hold the key to lower multimorbidity burden and improve quality of life globally. Conclusion: Our findings show that this questionnaire is a reliable and trustworthy way to assess multimorbidity in a community setting with a range of chronic illnesses (both systemic and oral)

Comparison of exponential smoothing and ARIMA time series models for forecasting COVID-19 cases: a secondary data analysis

Background: In order to manage outbreaks and plan resources, health systems must be capable of accurately projecting COVID-19 case patterns. Health systems can effectively predict future illness patterns by using mathematical and statistical modelling of infectious diseases. Different methods have been used with comparatively good accuracy for various prediction goals in medical sciences. Some illustrations are provided by statistical techniques intended to forecast epidemic cases. In order to increase healthcare systems readiness, this study aimed to identify the most accurate models for COVID-19 with a high global prevalence of positive cases. Methods: Exponential smoothing model and ARIMA were employed on time series datasets to forecast confirmed cases in upcoming months and hence the effectiveness of these predictive models were compared on the basis of performance measures. Results: It was seen that the ARIMA (0,0,2) model is best fitted with smaller values of performance measures (RMSE=4.46 and MAE=2.86) while employed on the recent dataset for short duration. Holt-Winters Exponential smoothing model was found to be more accurate to deal with a longer period of time series based data. Conclusions: The study revealed that working with recent dataset is more accurate to forecast the number of confirmed cases as compared to the data collected for longer period. The early-stage warnings through these predictive models would be beneficial for governments and health professionals to be prepared with the strategies at different levels for public health prevention

Adverse events following immunization among children during primary immunizations in selected health facility of Himachal Pradesh

Background: Vaccine related problems are commonly reported after immunizations and are a matter of concern for health care professionals. A study on the pattern and rate of incidences of vaccine related problems was conducted among children undergoing primary immunizations. Materials and methods: The study was conducted in Zonal hospital, Solan, Himachal Pradesh. 150 mothers and their children undergoing immunization were enrolled in the study using systematic random sampling and followed on every immunization event until nine months. Vaccine related problems were enquired at every immunization events namely birth, six weeks, ten weeks, fourteen weeks and nine months using a self-structured tool to assess vaccine related problems among children. Results: Pain at vaccination site, redness and swelling, excessive crying, fever, and sleep related problems, feeding problems and fever were common AEFIs reported by mothers among children. Conclusion:  AEFIs are frequent and need to be reported. None of the child had any severe reaction or hospitalization after immunization

Navigating Risks: Exploring Sexual and Reproductive Health and Contraceptive Awareness among Adolescent Girls in in District Dehradun

Background: Adolescence brings about significant changes in the life, making it crucial to develop lifelong healthy habits. However, societal norms often restrict open discussions on sexual and reproductive health (SRH). In India, access to accurate SRH information and healthcare remains limited for many adolescents. Aim & Objective: To study trend in risk taking behavior related to sexual & reproductive health of adolescent girls and to find out awareness about and use of contraception in the study population. Settings and Design: A cross-sectional study was conducted in two randomly selected intercolleges in district Dehradun. Methods and Material: A total of 400 unmarried school-going adolescent girls (classes 9th–12th) were surveyed with a focus on SRH. Statistical Analysis Used: Percentages and chi-square test. Results: The mean age of respondents was 15.62 (±1.557) years. Teachers were the primary source of SRH information, but only 26.2% respondents had attended sex education classes. While most had heard of HIV/AIDS, knowledge about other sexually transmitted infections was low. Awareness of condoms and oral contraceptive pills was higher than other methods and improved with age. Conclusion: The study highlights inadequate access to accurate SRH information and the need for comprehensive education programs to promote informed decision-making

Extent of awareness and prevalence of adulteration in selected food items in rural Dehradun

Background: Adulteration of food items is common phenomenon in India. It includes both willful adulteration to improve texture and quality of food items and supply of substandard food items. The usual outcomes is outbreak of food borne illness. Aims & Objectives: i) To estimate the prevalence of food adulteration in selected food items ii) the awareness of subjects regarding food adulteration act and iii) their buying practices. Material and Methods: Samplesize:150 households was sampled, based on prevalence of adulteration to be around 50%, with 95% confidence interval and absolute allowable error of 10%. Sample household were drawn from the selected villages randomly. Pre-designed and pretested questionnaires was administered to fulfill the objectives and food items were tested using NICE food adulteration kit. Data were analyzed by numeral with percentage, Pearson’s correlation test and F test. Results: In 59.3% households, housewives purchased the food items for the house. The prevalence of adulteration ranged from 17.3% to 66.2% in selected food items. Loose product was purchased by 54.3%. The food labels on packed items was not read by 86.3%. Mean percentage of purity was highest among literates (57.3 ±12.3) than illiterates and those having primary education. Statistically significant F ratio was seen for mean percentage of purity and respondent’s literacy status. Conclusion: Adulterant is rampant in poor strata of  society due to consumer’s illiteracy and lack of awareness towards food safety rules

A Cross Sectional Study Evaluating the Knowledge, Practices and Attitude of The General Population on Antibiotic Use

Assessing knowledge, attitude, and practice (KAP) towards antibiotic use in the general population is indeed crucial in the fight against antibiotic resistance. This step-by-step guide provides a comprehensive framework for conducting such evaluations. By clearly defining objectives and conducting a thorough literature review, researchers can pinpoint gaps in understanding and design effective studies. The present study has been designed, development of a well-structured questionnaire, and careful sampling ensure the study\u27s validity and representativeness. Data collection, analysis, and interpretation allow for meaningful insights into public perceptions and behaviors regarding antibiotics. Ultimately, the study should yield actionable recommendations for interventions and awareness campaigns, contributing to responsible antibiotic use. Ethical considerations, expert involvement, and follow-up assessments further enhance the study\u27s credibility and impact. Sharing findings with relevant stakeholders ensures that the research contributes to informed decision-making and public health efforts in combatting antibiotic resistance

Time Series Analysis of COVID-19 Data- A study from Northern India

The continuing new Coronavirus (COVID-19) pandemic has caused millions of infections and thousands of fatalities globally. Identification of potential infection cases and the rate of virus propagation is crucial for early healthcare service planning to prevent fatalities. The research community is faced with the analytical and difficult real-world task of accurately predicting the spread of COVID-19. We obtained COVID-19 temporal data from District Surveillance Officer IDSP, Dehradun cum District Nodal Officer- Covid-19 under CMO, Department of Medical Health and Family Welfare, Government of Uttarakhand State, India, for the period, March 17, 2020, to May 6, 2022, and applied single exponential method forecasting model to estimate the COVID-19 outbreak's future course. The root relative squared error, root mean square error, mean absolute percentage error, and mean absolute error were used to assess the model's effectiveness. According to our prediction, 5438 people are subjected to hospitalization by September 2022, assuming that COVID cases will increase in the future and take on a lethal variety, as was the case with the second wave. The outcomes of the forecasting can be utilized by the government to devise strategies to stop the virus's spread

Are Health Caregivers safe from workplace violence? A cross sectional study on workplace safety from Tertiary Care Hospital of Uttarakhand

Background: The prevalence of workplace violence in the healthcare sector is a problem that is frequently ignored and underreported. The performance of healthcare workers who have been the target of violence may suffer, which may have a negative effect on patient satisfaction and health. Aims & Objectives: The purpose of the current study was to determine the prevalence of workplace violence (WPV), risk factors for violence against healthcare workers, and their experiences regarding the same. Methodology: It was a cross-sectional study conducted on 157 hospital staff at Tertiary Care Medical College of Uttarakhand. Data was gathered using a semi-structured, self-administered questionnaire that was modified from the ILO, ICN, WHO, and PSI. Data were analyzed using SPSS software (version 20). Results: Factors like age, gender, job profile, lesser work experience, night shifts, and fewer staff on duty were found to have a positive association with workplace violence. It was observed that the majority of incidents took place in the ward, and the patient’s relatives were the attacker in most of the cases. It was also seen that the majority of Hospital staff did not get bothered by the incident except by staying super alert while dealing with other patients or their relatives. Conclusion: The study concludes that while caring for patients, Hospital staff are at risk of being victims of aggressive and violent situations. To reduce this problem, strategies like training staff in order to handle such incidents in the future should be brought into practice. Laws should be made stricter & assaulting staff on duty should be made a cognizable offense with serious consequences & heavy penalties. Also, the young budding MBBS students should be trained by incorporating these strategies, laws & policies in the CBME curriculu

WOMEN UNDER DURESS: A CROSS-SECTIONAL STUDY ON VIOLENCE AGAINST WOMEN IN DISTRICT DEHRADUN

Introduction: Violence against women is a significant public health problem, as well as a fundamental violation of women’s human rights. It is one of the most common forms of violence globally and includes physical, sexual, emotional and economic violence. Aims and Objectives: 1.To study the prevalence of Violence against Women (VAW) amongst ever-married women of reproductive age group in district Dehradun.2. To study their awareness regarding protection from such violence. Methodology: The community-based, cross-sectional study was conducted using multistage random sampling method, amongst 880 ever married women aged 15-49 years, in the rural & urban areas of district Dehradun. Results: Out of the surveyed sample of 880 women, receiving obscene phone calls was reported by 11.8 %; eve teasing by 9.4 %; being followed home by 5.7% and unsolicited advances by 3.9%. About 1.0% women reported being forced into unsolicited sexual activity by a person other than a spouse. Overall only 19.2% women had any knowledge about protection laws and agencies for victims of VAW. Conclusion: Nearly 37% women in our study reported suffering from any harassing activity ever in life, it was disheartening to see that only one-fifth had knowledge regarding protection laws. Primary prevention in this scenario becomes very important to disjoin VAW from cultural acceptance

An epidemiological evaluation of predictors of overweight and obesity in Garhwal region of Uttarakhand.

Background: Overweight and obesity are now considered to be a very serious public health problems, contributing to a number of preventable non communicable diseases and are among the most significant contributors to ill health.Material & method: A cross sectional study was carried out with a total sample size of 632. Multistage stratified random sampling and “Kish” method was applied for selection of study area and selection of study subjects (21-60 years). WHO STEPS for NCD Risk Factor Surveillance, was used to gather the necessary information. Percentage, Chi square, & logistic regression analysis was calculated and significant level was taken at p<0.05.Results: As per Asia Pacific classification 49.3% (majority) of subjects while as per WHO classification 33.3% of subjects were found to be overweight or obese (BMI > 23kg/m2). It was nearly 2 times higher in urban males. Central obesity was more commonly observed in urban subjects (male: 38.9%, female: 77.6%) as compared to rural subjects (males: 17.8%, females: 59.4%). High (at risk) WHR was recorded in 55.9% of total subjects. High (at risk) WHtR was recorded in 66.8% of total subjects while in 54.4% & 79.1% among rural & urban subjects respectively. All the predictors showed higher percentages in females and in urban area.Conclusion: The present study reveals that, there is high prevalence of overweight and obesity in the study population. Certainly, there has been a considerable shift in their dietary and lifestyle profile.  The dietary profile is changed to a mixture of rural and urban diets, with higher consumption of saturated fat and low intake of fibre.