Background: The effect of childhood well-being programs is commonly interconnected with a change in mortality trends. The proportion of disparity shows that inequality in child mortality is more collective in the similarly evolved states than the poorer states in India. Objective: To estimate and compare the health inequality of under-five mortality in Empowered Action groups (EAG) states of India. Methods: Data from the National Family Health Survey (NFHS-4) was used only for the EAG States of India. Under-five mortality rates (U5MR) were calculated for associated background characteristics by using the life table method. Wealth inequality was assessed separately for all EAG states by calculating measures of concentration index (CI). Concentration curves (CC) were also plotted to see the difference in inequality. Results: Higher U5MR was observed in all EAG states compared with estimates for overall India. On comparing estimates of inequality, CI values show the substantial burden of U5MR among EAG states of India. The CC shows the lowest inequality in EAG states of India. Conclusion: The results suggested the need to receive various health strategy intercessions in agreement with the instance of ever-changing commitments of economic components to child health disparities in EAG states. Measuring the impact of determinants to wealth-related inequality in U5MR helps in lining up the interventions targeted at improving child survival.

Background: This study was undertaken because of paucity of literature regarding outcomes of inhaled formeterol/fluticasone versus formoterol/mometasone in asthmatic patients.Methods: Fifty newly (male/female) recruited cases of bronchial asthma were diagnosed on the basis of spirometry. The patients were allocated to two groups viz group A and B. Group-A received mometasone furoate/formoterol (200/10 μg OD) and Group-B received fluticasone/formoterol (200/10 μg OD) respectively. The drugs were administered through metered-dose inhaler (MDI).Results: The mean FEV1/FVC ratio recorded (64.40±9.01) before starting the treatment has significantly changed to (68.92±8.58) after starting the treatment. Mean forced expiratory volume (47.56±14.73%) noted before the use of bronchodilator also changed to mean FEV1 63.98±15.17. Mean forced expiratory volume recorded before treatment (55.02±5.01) in a group who were treated with formoterol/mometasone combination changed to (72.06±5.86) after treatment. However, the mean forced expiratory volume recorded before treatment 54.92±4.47 in a group who were treated with formoterol/fluticasone combination changed to 75.48±5.03 after the treatment. While comparing the two treatment regimens, it is evident from the results that there is no significant difference in FEV1 between the groups. However, the post bronchodilator FEV1 was significantly (p<0.001) higher among the patient group which were treated with fluticasone/formoterol combination than the group who were treated with mometasone/formoterol combination. No significant adverse effect of either of two regimens was observed thus showing that both the combinations are comparatively safe for use.Conclusions: This study reveals that both the treatment regimens showed a significant improvement in lung functions without any significant adverse event.

Background: International travel to India is on the rise and the travellers comprise a diverse group of individuals in terms of their country of origin, preferences and risk taking behaviour. Different environment coupled with all other factors makes them more vulnerable to health problems. Aims & Objectives: To find out the health problems faced by the international travellers visiting Agra City, their perception and the factors associated with them. Material & Methods: Cross – sectional study design was used and International travellers in the age group 15 to 65 years were recruited from prominent tourist places and train stations of Agra, which was sometimes during their tour and just before their departure respectively. Data collection was carried out for a period of six months i.e. from November 2015 to April 2016.Results: Out of the total 422 study subjects, 208 (48.2%) faced one or more health problems. Primary purpose of visit (religious, educational, visiting friends and relatives) and the duration of visit (more than two weeks) were found to be significantly associated with a negative health outcome. Diarrhoea (131, 63%), fever (87, 41.8%) and respiratory problems (50, 24%) were the most frequent problems and many of them had more than one problem. A majority of the participants perceived the risk of health problems to be high and more than half of the them reported having experienced culture shock (57.4%). Conclusions: There may be a need for a travel clinic at the destination. The benefit of such a new offer must be validated.

Background: Immunization coverage in India has increased over the decades and has led to decrease in child mortality. However challenges remain in terms of partial and no immunization and its causes. This study assesses the immunization status of children attending the immunization clinic and the reasons for partial or non-immunization at tertiary care government hospital of Agra district.Methods: It was a cross-sectional study and included all children between ages 9 months and 5 years during the study period. A pre-design, semi-structured, face validated and pilot tested was used after written informed consent of care givers. Data was analysed using SPSS.Results: Of the 652 children enrolled the mean age was 24.2 months. Most of the children were born in an institution (95.2%) and were from an urban area (81.9%). More than one-thirds of the children, 40.2% (n=262) were fully immunized for their age. Of the 390 partially or unimmunized the most common cause was no knowledge of vaccination‎/next dose (n=120, 30.8%) and inaccessibility/transport issues (n=120, 30.8%). On logistic regression sex of the child, mother’s education and occupation, family type were found to be significantly associated with the immunization status.Conclusions: This study indicated low full immunization and high partial immunization among attendees of immunization clinic in the institution; with lack of knowledge and transport difficulties being the primary reasons for it.

Background: The present study was conducted to recalibrate the effectiveness of Indian Diabetes Risk Scores (IDRS) and Community-Based Assessment Checklist (CBAC) by opportunistically screening for Diabetes Mellitus (DM) and Hypertension (HT) among the patients attending health centres, and to estimate the risk of fatal and non-fatal Cardio-Vascular Diseases (CVDs) using WHO/ISH chartMethods: All the people of age ≥30 years attending the health centers were screened for DM and HT. Weight, height, and waist and hip circumferences were measured and BMI and Waist Hip Ratio (WHR) were calculated. Risk categorization of all participants was done using IDRS, CBAC, and WHO/ISH risk prediction charts. Individuals diagnosed with DM or HT were started on treatment. The data was recorded using Epicollect5 and was analyzed using SPSS v.23 and MedCalc v.19.8. ROC curves were plotted for DM and HT with the IDRS, CBAC score and anthropometric parameters. Sensitivity (SN), specificity (SP), Positive Predictive Value (PPV), Negative Predictive Value (NPV), Accuracy and Youden’s index were calculated for different cut-offs of IDRS and CBAC scores.Results: A total of 942 participants were included for the screening, out of them, 6.42 % (95% CI: 4.92-8.20) were diagnosed with DM. Hypertension was detected among 25.7% (95% CI: 22.9-28.5) of the participants. A total of 447 (47.3%) participants were found with IDRS score ≥ 60, and 276 (29.3%) with CBAC score >4. As much as 26.1% were at moderate to higher risk (≥10%) of developing CVDs. Area Under the Curve (AUC) for IDRS in predicting DM was 0.64 (0.58-0.70), with 67.1% SN and 55.2% SP (Youden's Index= 0.22). While the AUC for CBAC was 0.59 (0.53-0.65). For hypertension the both the AUCs were 0.66 (0.62-0.71) and 0.63 (0.59-0.67), respectively.Conclusions: Instead of CBAC, the present study emphasizes the usefulness of IDRS as an excellent tool for screening for both DM and HT. This is the time to expose the hidden part of the NCDs iceberg by having high sensitivity of non-invasive instruments (like IDRS), so, we propose a cut-off value of 50 for the IDRS to screen for diabetes in the rural Indian population.