Background: Nipah virus infection is an emerging infectious disease of south-east Asia region, which has gained public health importance. Nipah virus is classified internationally as a biosecurity level (BSL) 4 agent. Objective was to assess knowledge, practice and attitude regarding Nipah virus infection. Methods: A cross sectional study was done in urban and rural health training centers among adult population, data was collected using pre-designed and pre-tested proforma. Data was entered in Microsoft excel, frequencies and percentages were calculated. Results: In present study majority of study participants belonged to less than 25 years. Nuclear families were common in both urban (76%) and rural (44%) areas. 41% and 35% of urban and rural study participants belonged to class II status respectively. In present study it was found that both urban and rural study participants had heard about Nipah virus infection in recent few months. 73% of urban study participants considered themselves at risk of Nipah virus infection when compared to 36% of rural participants. Rural study participants did not have clarity of spread, signs and symptoms. 11% and 6% of urban and rural study participants had heard health education talks about Nipah virus infection respectively and most common source was social media. Conclusions: The present study finding is suggestive of good knowledge regarding Nipah virus infection among urban population when compared to rural setting. Continuous health education has to be imparted at all levels of health care so as to make community aware about spread, clinical presentation and prevention aspects of Nipah virus infection.

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Background: Adolescence is phase of maturations where an individual experiences drastic changes in growth and development. Age group 10-19 years is defined as adolescent age by World health organization. In developing countries, this is the period when many children drop-out of school and miss out on education. Among adolescent girls’ menstruation is a major life changing event. We conducted this study among rural adolescent girls to know their knowledge, attitude and practices towards menstruation. We also educated all girls on physiology and hygienic practices during menstruation.Methods: A cross-sectional study was conducted among adolescent girls attending our out-patient clinic in the rural area. All girls were interviewed to assess their knowledge and practices towards menstruation. Informed consent was taken from all girls before stating the study. Data presented in form of frequency, percentages. Chi-square test was applied to analyze for association.Results: 87% were students, 88% adolescent girls belonged to Below Poverty Line (BPL) families. 98% adolescent girls had attained menarche before 15 years of age, 27% adolescent girls had dysmenorrhea presenting as pain in abdomen region. Sanitary pad was being used by only 64% adolescent girls, of whom, 59.4% change sanitary pad twice daily, 75% dispose it by burning. Overall, 36% adolescent girls used cloth, of whom, 41.7% changed cloth twice a day, 69.4% adolescent girls wash and burn the cloth. Among adolescent girls still studying in school 71.2% used sanitary pads which was statistically significant.Conclusions: Education is essential to empower girls to take informed decisions. On receiving adequate information on menstruation, girls were willing to adapt healthy hygienic practices. Hence, health education activities should be started at all schools so as to inculcate good practices early in life.

Background The role of yoga in paroxysmal atrial fibrillation (AF) is known. But its role in permanent AF has not been studied. Purpose The objectives of our study are to evaluate the effects of yoga on symptoms, heart rate, quality of life, hospitalisations, medication adherence and echocardiographic parameters in permanent AF. Methods We conducted a single centre, randomised, participant blinded, parallel group, sham-controlled study between October 2019 and September 2020. We included patients aged 18–65 years with permanent AF due to any cause. Patients in New York Heart Association (NYHA) class≥3, modified European Heart Rhythm Association (mEHRA) class ≥3 and left ventricular ejection fraction (LVEF)<30% were excluded. Total of 84 patients underwent randomisation into two groups of 42 each. None of the participants had prior knowledge or contraindications to yoga. Subjects in yoga arm underwent supervised and self-performed yoga sessions consisting of various asanas, pranayamas and dhyana, while those in the sham arm underwent supervised and self-performed joint exercises, each session lasting for 60 minutes/day for 6 days a week along with guideline directed medical therapy in both arms. The primary endpoints were improvement in NYHA class, mEHRA class, heart rate at rest and after 6 minute walk test, 6 minute walk distance, quality of life, medication adherence, hospitalisations, LVEF and left atrial volume index at 3 months. The secondary endpoints included the same parameters assessed at 1month. Quality of life was assessed by the short form (SF)-36 questionnaire which has eight domains. Scores for each domain range from 0 to 100, with a higher score defining a more favourable health state. All analyses were based on intention to treat principle. Results The groups were well-matched at baseline. The mean age of study participants was 50.62±12.97 years, 56% were women and the most common risk factor was rheumatic heart disease found in 47.6% of the cases. Four patients in the yoga group and 3 in the sham group were lost to follow up. There was significant improvement in various parameters in the yoga arm at 1 and 3 months. (Figures 1 and 2). Hospitalisation at 3 months was lower in the yoga arm (0.73±0.81) versus sham arm (1.13±0.93); p=0.044. Out of 38 patients in the yoga arm, 6 patients had improvement in the medication adherence compared to 9 patients (out of 39) in the sham arm at 3 months, p=0.419, OR (95% CI) = 0.62 (0.19–1.96). Higher the compliance to yoga, defined by the number of sessions per week, more was the improvement in various parameters. No harms were noted. Conclusion Among patients of permanent AF already on medical therapy, yoga significantly improves symptoms, heart rate, functional capacity, quality of life and hospitalisations when compared to a sham procedure. Larger, multicentre, double blinded studies are required to generalise the results, though participant blinding cannot be 100% assured. FUNDunding Acknowledgement Type of funding sources: None.