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Background: Mental health is one of the critical health requirements that society needs to address in the present century. Accredited Social Health Activist (ASHA) can play an important role in identifying mental health problems at the earliest and help in improving community health status. Objectives: The objective of this study was to evaluate the effectiveness of a mental health education program on knowledge, attitude, and practices (KAP) of ASHAs. Materials and Methods: An intervention study was conducted to empower ASHAs for providing mental health services at a district located in Western India during 2016 and 2017. A semi-structured questionnaire was administered to assess KAP regarding mental health in intervention and control groups before and post intervention. An educational program was imparted in two batches. Hybrid methods for imparting teaching/training were utilized. \"Paired t-test\" was applied to compare pre- and post-results in intervention group and \"unpaired t-test\" for baseline comparison. Results: There was a statistically significant improvement in KAP of ASHAs after intervention. Majority of ASHAs referred cases of mental health problems to government tertiary care hospitals. Conclusions: The study indicates that it is possible to empower ASHAs with a short course related to mental health to achieve effective outcomes in terms of improved knowledge, attitudes, and practices.

Studies follow a hierarchy in terms of the quality of evidence that they can provide. Randomized double blind placebo control (RDBPC) studies are considered the \"gold standard\" of epidemiologic studies. And the same is discussed at length in this paper taking example of a real journal article employing this study design to answer the research question; \"Does once daily dose of Valacyclovir reduce the risk of transmission of genital herpes in a susceptible partner?\" RDBPC studies remain the most convincing research design in which randomly assigning the intervention can eliminate the influence of unknown or immeasurable confounding variables that may otherwise lead to biased and incorrect estimate of treatment effect. Also, randomization eliminates confounding by baseline variables and blinding eliminates confounding by co-interventions, thus eliminating the possibility that the observed effects of intervention are due to differential use of other treatments. The best comparison is placebo control that allows participants, investigators and study staff to be blinded. The advantage of trial over an observational study is the ability to demonstrate causality. Hope, this will be useful to neophyte researchers to understand causal hierarchy when critically evaluating epidemiologic literature.

The objective was to assess cognitive impairment (CI) in adults older than 59 years, residing in rural and tribal population and to assess family burden of those who had significant CI. This cross-sectional study was conducted among adults residing in the rural population of a block in a district located in Western India in 2015. A total of 240 households from 12 villages of the block were selected by multistage and random sampling method. Mini-mental state examination and Zarit Burden Interview tools were used to assess CI and burden. Data were entered in MS Excel 2007 and analyzed with descriptive statistics and Chi-squared test. A total of 212 adults aged over 59 years were studied. The overall prevalence of CI was 42.92%. There was a statistically significant difference seen in CI among females as compared to males. Interview of primary care taker showed that 32 (35.16%) caregivers had little or no burden, 53 (58.24%) had mild-to-moderate burden, and 6 (6.59%) had moderate-to-severe burden, while none had a severe burden. Enabling caregivers to provide at home care for longer periods before hospitalization would decrease the burden of CI.

Diet plays a very important role in growth and development of adolescents, during which the development of healthy eating habits is of supreme importance. There is a dual burden of undernutrition and overnutrition in this age-group. The study assessed the food habits, food preferences, and dietary pattern of schoolgoing urban adolescents in Baroda, India. Both quantitative and qualitative methods were used in this study. A quantitative survey was carried out using a pre-tested self-administered structured questionnaire among 1,440 students from class 6 to 12 in 7 English medium and 23 Gujarati medium schools. Focus group discussions, 5 each with adolescent boys and girls, were held, along with 5 focus group discussions with teachers of Gujarati and English medium schools. Nearly 80% of adolescents had consumed regular food, like dal, rice, chapati, and vegetables, including green leafy vegetables. Nearly 50% of them had consumed chocolates, and about one-third consumed fast foods. Nearly 60% of adolescents had their breakfast daily while the remaining missed taking breakfast daily. Nearly one-third of adolescents were missing a meal once or twice a week. A large majority had consumed regular foods. However, more than half of them had consumed chocolates, soft drinks, and over one-third had taken fast foods.

Iodine deficiency disorders (IDDs) are one of the worldwide public health problems of today. IDDs are endemic in various districts of Gujarat. We undertook this survey in Panchmahal district of Gujarat to study the prevalence of goiter in a sample of school children, to asses the level of iodine in salt samples, and to determine median urinary iodine concentration in a sample of children. In a cross-sectional study, 15,900 school-going children in the age group of 6-12 yr were studied from 10 talukas. A total of 15 clusters were selected by cluster sampling method. Goitre was assessed in the children and urine and salt samples were studied for iodine concentration. The overall prevalence of goitre was 20.5 per cent among the children examined. The median iodine concentration was 70 mg/l indicating mild iodine deficiency; also 61 per cent of the urine samples examined showed iodine insufficiency. Iodine content was found to be adequate in 54.3 per cent of salt samples. Our study showed that goitre is still an important public health problem in the district. This calls for identification of factors to strengthen NIDDCP and the need to reimpose ban on sale of non-iodized salt in Gujarat.

To identify the reproductive health issues associated with adolescence and the readiness to avail services like Adolescent Friendly Clinic (AFC) among urban school going children. A quantitative survey was carried out using a self-administered structured questionnaire among 1440 (748 girls and 692 boys) students from classes 6 -12 in 7 English medium and 23 Gujarati medium schools. Focus group discussions, 5 each with adolescent boys and girls and teachers were held from Gujarati and English medium schools. A higher proportion of boys and girls could identify visible external changes in the opposite sex as compared to the changes not seen outwardly. The sources of information on human reproduction for most of the boys and girls were schoolbooks, television, teachers, friends and parents in the same order. Over two-thirds of the boys and girls expressed a need for more information on reproduction. Teachers also perceived that adolescents, though curious, lacked opportunities for open discussions to answer their queries related to reproductive health. One-third of the boys and one-fourth of the girls had heard about contraception. Two-thirds of boys and girls had heard of HIV/AIDS, and about half of them correctly knew various modes of transmission of HIV. Majority of the adolescents expressed their readiness to use the services of Adolescent Friendly Centre. Information on the human reproductive system and related issues on reproductive health need special attention. Teachers' sensitization to adolescent health care is required.

Objectives: To identify the reproductive health issues associated with adolescence and their readiness to avail services like Adolescent Friendly Clinic (AFC) among rural school going children. Materials and Methods: A quantitative survey was carried out using a self-administered structured questionnaire among 768 (428 boys and 340 girls) students from 15 schools by systematic random sampling from schools (3 schools from 5 talukas). Focus group discussions, 5 each with adolescent boys and girls and teachers were held. Results and Discussion: Only 31% of the boys and 33% of the girls mentioned that they had heard about contraception. More than half of the adolescent boys and girls knew correctly about various modes of transmission of HIV/AIDS. A large proportion of boys and girls have mentioned changes in the opposite sex such as increase in height, change in voice, breast development, and growth of facial hair, growth of hair in private parts, onset of menstruation in girls, etc. Nearly 70% of adolescents were ready to use AFC. Teachers perceived that adolescents become curious about the changes taking place in them, but they lack information and opportunities for open-discussions to get answers to their queries related to reproductive health. They are willing to take help from teachers but teachers are not equipped with knowledge nor are they comfortable discussing these issues with their students. Recommendations: Information on the human reproductive system and related issues on reproductive health need special attention. Teachers' sensitization to \"adolescent health care\" is required.

Sir, This communication describes the feedback received from the participants of a Reproductive Tract Infections (RTI), Sexually Transmitted Diseases (STD) and HIV/AIDS prevention related training at a hospital and medical college, in Gujarat. The feedback of participants in all the three categories suggest that training leads to capacity building; however, the felt need was to reduce the gap between skills and infrastructure/facilities and material supplies for better implementation of the program.

Treatment with heat-stable carbetocin after vaginal delivery was noninferior to oxytocin for prevention of blood loss of at least 500 ml or use of uterotonics. Noninferiority was not shown for prevention of blood loss of at least 1000 ml, but event rates were low.