Indian Journal of Community & Family Medicine

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/158070

Editor: Dr Sonu H Subba
ISSN: 2395-2113

Frequency: Biannually

Language: English

Open Access Peer-reviewed journal

Web site: www.aiimsbhubaneswar.edu.in/ijcfm.

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Now showing 1 - 20 of 126

Risk factors for diabetic foot ulcer among type 2 diabetes mellitus patients attending a tertiary care center – A case–control study from Central Karnataka
(Wolters Kluwer – Medknow, 2025-06) Kasturi, Eshwar S.; Vidya, G. S.; Hanji, Chandrashekar V.; Kumar, Chandan H.
Background: Diabetic foot ulcers (DFUs) are one of the most common complications in patients with uncontrolled diabetes. It is usually caused by poor blood sugar control, underlying neuropathy, peripheral vascular disease, or improper foot care. Patient education regarding foot hygiene, nail care, and proper footwear is crucial for reducing the risk of an injury, along with early screening for diabetic neuropathy and adherence to a systematic regimen of diagnosis and appropriate treatment. The study aimed to identify the association of risk factors and sociodemographic factors for the development of DFU among Type 2 diabetes mellitus (DM) patients. Material and Methods: A hospital-based case–control study was conducted in Jagadguru Jayadeva Murugarajendra Medical College Davanagere for 12 months from March 1, 2021, to February 28, 2022. Eighty-four patients with diabetic foot were cases and the 84 controls who were known cases of diabetes as of 28th February, without diabetic foot ulceration, were studied. Through personal interviews and the use of a predesigned, pretested questionnaire, data was collected on sociodemographic characteristics, the history of DM, including treatment, and associated risk factors for the development of diabetic foot. A general physical examination was performed to determine the study subjects’ state of health along with anthropometric measurements. Results: The mean age of this study population was 49.55 ± 8.4 years with male predominance. Patients with anatomical foot deformity, peripheral neuropathy, and callus were at higher risk of developing DFU. Poor glycemic control and the patients on insulin therapy were observed to be significantly associated with the development of DFUs. Diabetic foot care was well maintained among the entire study population, with no significant difference between the cases and controls. Conclusion: The most common risk factors for DFU in our study were peripheral neuropathy, foot deformities, and uncontrolled blood sugar levels.
Emerging paradigms of sexual harassment among healthcare workers in India: A cross-sectional study
(Wolters Kluwer – Medknow, 2025-06) Tilak, Rina; Kapoor, Suraj; Bajaj, Swati; Mukherjee, Gautam; Kaushik, S. K.; Yadav, A. K.; Teli, Prabhakar T.
Introduction: Sexual harassment in work settings is a burning and prevailing issue. Healthcare institutions are at risk due to organizational hierarchy and close work settings which predispose individuals to harassment. The present study was planned in healthcare institutions across India to study the emerging paradigms of sexual harassment. Material and Methods: A cross-sectional analytical study was conducted using a web-based self-administered anonymous questionnaire (pretested on 20 healthcare professionals using think-aloud technique and modified thereafter) through the snowball sampling method from August 15, 2021, to October 30, 2021. A total of 1211 individuals comprising various professional categories from healthcare institutions (medical colleges and hospitals) across India participated in the study. Results: Twenty-six per cent (317) of participants reported to have faced sexual harassment in the work settings, with 233 (45%) women and 84 (12.1%) men. Overall younger age group (26–35 years), nursing staff (39.3%), and female nursing staff (39.3%) reported more harassment (p = 0.001). Unwanted physical contact was the most common form of sexual harassment across gender (81%), followed by E-sexual harassment. Workplace emerged as the most frequent place for sexual harassment (82.2%). Empowering school children was a novel bottom-up approach suggested by the participants. Conclusion: One in every four healthcare workers in the study had faced sexual harassment. The nursing staff was the most vulnerable. Workplace was the most common harassment setting, and E-sexual harassment indicates an emerging paradigm. Focus on nursing staff, cyber protection, and enactment of gender-neutral laws are the need of the hour to prevent sexual harassment.
Assessment of food habits and intensity of physical activity among private school-going adolescents of Bhubaneswar city: A cross-sectional study
(Wolters Kluwer – Medknow, 2025-06) Mishra, Spandan; Mishra, Alpana; Behera, Basanta Kumar
Background: A major global risk factor for mortality, inadequate physical activity is increasing in many low- and middle-income nations, including India. This is contributing to the burden of noncommunicable diseases and negatively impacting global health overall. The objectives of the study are to assess the food habits and intensity of physical activity among school-going adolescents aged 12–15 years in Bhubaneswar. Material and Methods: The cross-sectional study was done among school-going adolescents aged 12– 15 years in the private schools of Bhubaneswar City, Odisha. Two hundred participants were selected from two schools from two different zones of Bhubaneswar. The selected participants were administered with a Madras Physical Activity Questionnaire along with nutrition-related questions from 2006 India and Central Board of Secondary Education Global School-based Student Health Survey Questionnaire. Results: Out of 200 participants, 119 were male (64%) and 81 were female (36%), with a mean age of 14.05 years participated in the study with a mean body mass index (BMI) of male and female participants was 23.00 kg/m2 and 21.85 kg/m2, respectively. Similarly, the mean BMI of early and late adolescent age groups was 21.77 kg/m2 and 22.71 kg/m2, respectively. Sixty-three (70.8%) participants of mid adolescents performed inadequate physical activities under the school curriculum in comparison to early adolescents with a P value statistically significant (0.001). Out of 200 participants, 117 (58.5%) had inappropriate dietary habits of eating vegetables and fruit on a daily basis. Ninety (45%) participants were consuming drinking carbonated soft drinks such as Pepsi, Coca Cola, Sprite, and Coke for more than twice a week. Sixty-six (33%) participants skipped their breakfast for more than twice a week. The present study involves school-going adolescents to assess their physical activity and the dietary patterns followed by them. The dietary pattern was also enquired through a validated questionnaire for the previous week, giving an overview of 7 days dietary cycle. Most of the students belong to higher socioeconomic strata and reading in private (self-funded) schools. Conclusion: The dietary behavior, specifically consumption of fruits and vegetables and fast foods, was significantly associated with mid-adolescence and male gender. Health education and creating opportunities for physical education among students will improve the physical activity pattern. Further qualitative study may be conducted to explore the barriers and factors for this physical activity and dietary pattern among school-going adolescents.
A community-based study to estimate the burden and determinants of risk of developing obstructive sleep apnea among adults in an area of North India
(Wolters Kluwer – Medknow, 2025-06) Sangwan, Garima; Sharma, Nitika; Garg, Rajesh; Dureja, Sangeeta
Introduction: Obstructive sleep apnea (OSA) is an often underestimated sleep disorder that poses significant health risks among adults worldwide. This community-based cross-sectional study was undertaken to estimate the burden of risk of developing OSA in the population and study the factors making people susceptible to developing OSA. Material and Methods: The community-based cross-sectional study was conducted in the field practice areas of the Department of Community Medicine, Kalpana Chawla Government Medical College, Karnal, among 310 adults using Berlin Questionnaire that assesses an individual’s risk of developing OSA based on questions related to symptoms, anthropometry, and hypertension. Data were analyzed using univariate and multivariate regression analyses at a significance level of p-value <0.005. Results: The study included a total of 310 participants, with a mean age of 47.5 years (SD ± 13.6) and a range from 21 to 82 years. Among 310 participants, 21% were at high risk of developing OSA. Overall, in multivariate analysis, history of chronic disease (adjusted odds ratio = 14.29, 95% confidence interval: 5.26–16.67, p < 0.001) age, and body mass index (BMI), emerged as significant predictors of the risk of OSA in the target population. Conclusion: Among the participants, 21% were at high risk for OSA, with chronic disease history, age, and BMI emerging as significant predictors in multivariate analysis. Understanding the factors making people susceptible to develop OSA would give an opportunity to educate the people about its prevention and would contribute in formulating a preventive and screening strategy for OSA, which is currently not in place.
Developing strategies for tackling depression, anxiety and stress – A rising problem among the nursing students in a metropolitan city
(Wolters Kluwer – Medknow, 2025-06) Sadawarte, Deepika; Patekar, Ashwini; Sadawarte, Mandar
Background: Mental health issues such as depression, anxiety, and stress have been of increasing concern in almost all students, nursing students being exceptions to this, as they have added responsibility to serve duties in outpatient departments and wards. This study was done to estimate the prevalence of depression, anxiety, and stress among the nursing students of a tertiary care hospital and develop strategies to tackle them. Material and Methods: A longitudinal study was conducted among the nursing students of a tertiary care hospital who attended their annual checkups in the general outpatient department of the institute. Two hundred and eighty-two nursing students of the institute were enrolled in the study in whom depression, anxiety, and stress were assessed using the DASS-21 validated scale. Strategies to tackle the mental issues were planned and implemented. Results: The prevalence of severe depression and anxiety found among nursing students was 1.3% and 17.2%, respectively, whereas 21.5% had severe stress. The prevalence of depression was found to be higher in 2nd-year nursing students, whereas anxiety was found more among 1st-year students. The strategies that were implemented helped in reducing the stress and anxiety among these students. The most liked strategy is “Mann-ki-Saheli.” Conclusion: The study focusses on the mental health of the students and having appropriate coping measures is required. Personal counseling and involving peers were the major strategies to tackle the mental health issues among nursing students.
Effect of counseling on knowledge and attitudes for family planning among postpartum women delivering at a tertiary care hospital in Central Gujarat: An interventional study
(Wolters Kluwer – Medknow, 2025-06) Patel, Sangita; Malkhede, Swapnil; Sheth, Priyash; Shah, Maitri; Chugh, Latika Tarun
Introduction: Unmet needs reduced from 13% to 9% among married women according to the NFHS 5 data. Misconceptions can result in unsafe abortions, unwanted pregnancies, and higher maternal and infant mortality risks. Hence, the present study was conducted to evaluate the difference in knowledge and attitude of family planning methods before and after counseling. Material and Methods: A nonrandomized trial was conducted among 206 postpartum women who delivered at the Department of Obstetrics and Gynecology in SSG hospital, Vadodara, for 2 years. One hundred and three participants in each group, i.e. control group and intervention group were interviewed. Intervention group counseling was done followed by a 10-min Hindi video, and informational leaflets about family planning methods were provided. One-week washout period was kept; afterward, control group counseling was given by standard counselor. Follow-up assessments after six months were conducted through home visits or telephone interviews. Data were collected, entered in Excel Spreadsheets, and analyzed using MedCalc. Results: The intervention group showed a significant improvement in knowledge postintervention, with a mean knowledge score of 17.53 ± 4.59 compared to the baseline mean of 11.84 ± SD 5.45 (p < 0.0001). However, there was no significant difference in baseline knowledge between the intervention and control groups. Postintervention, the intervention group had significantly higher knowledge scores (17.53 ± 4.59) compared to the control group (11.41 ± 5.27) (p < 0.0001). Conclusion: In this study, it was observed that improvement in knowledge and attitude was noticed in women in both intervention and control groups, but the improvement was significantly higher in the intervention group compared to the control group.
Assessment of cold chain and logistics management practices in the Universal Immunization Programme: A mixed method study in the West district of Tripura
(Wolters Kluwer – Medknow, 2025-06) Guha, Ishita; Guha, Puspita; Pal, Mrinmoy; Biswas, Ranjan
Background: Effective implementation of the Universal Immunization Program is related to vaccine safety, effective cold chain management and knowledge and skills of the cold chain handlers. The study was done to assess the Cold chain practices and logistics management under Universal Immunization Program in the West district of Tripura. Material and Methods: The study is a mixed method study (Quantitative and Qualitative). In Quantitative method Cross-sectional and in Quantitative method In-depth interviews was conducted among Cold chain handlers till data saturation over 3 month period in 28 nos of cold chain points of West Tripura district. Results: 82.1% of the CCPs were having dedicated cold chain rooms. Only 28.4% of CCPs had dedicated power backup. Temperature monitoring of cold chain equipment, vaccine storage and management, and recordkeeping was found satisfactory. However, supportive supervision was lacking. All CCHs had satisfactory knowledge about cold chain management systems. Conclusion: Overall result is satisfactory; further improvement can be done by good supportive supervision as a key measure in the improvement of cold chain system.
Deaf-and-dumb and visually impaired adolescent girls’ experience related to menstrual hygiene in Odisha, India: A phenomenological study
(Wolters Kluwer – Medknow, 2025-06) Arunachalam, Serma Subathra; Samantaray, Kajal; Tigga, Rashmita; Shetty, Asha P.; Singh, Aravind Kumar; Sahoo, Krushna Chandra
Introduction: Menstrual health and hygiene are essential to women’s overall health. The menstrual health needs of the blind, deaf, and dumb put them at risk for negative health effects. Material and Methods: A total of 33 in-depth interviews (IDIs) were conducted among visually impaired and deaf-and-dumb adolescent girls in Bhubaneswar, Odisha, India. The IDIs were recorded using audio, and field notes were taken. The Consolidated Criteria for the Reporting of Qualitative Research guideline was used for reporting. Results: Most of the adolescent girls possessed knowledge of menstrual hygiene from their family members and were able to manage their menstrual hygiene on their own. None of the participants believes that their disability hinders their ability to practice menstrual hygiene. In addition, they are guided in school by their female caretaker and a friend. Conclusion: We can help to improve the health, dignity, and empowerment of with disability around the world, allowing them to reach their full potential.
Navigating challenges and bridging gaps: Evaluating the 95-95-95 targets of UNAIDS in Northeast India’s seven sister states
(Wolters Kluwer – Medknow, 2025-06) Arya, Arushi; Raj, T. P. Sherin; Tiwari, Vijay Kumar
Introduction: The UNAIDS 95-95-95 targets are part of a global strategy to end the AIDS epidemic by 2030. These targets aim for 95% of PLHIV to know their status, 95% of diagnosed individuals to receive antiretroviral therapy (ART), and 95% of those on treatment to have suppressed viral loads. The study aims to project the achievement for the year 2025 based on available data from 2018 to 2021 to ascertain the progress made toward the UNAIDS 95-95-95 targets in the seven northeastern sister states of India. Material and Methods: The methodology adopted for this article is a combination of secondary data sources and literature reviews. The main source of information is the National AIDS Control Organization Annual Sankalak Report 2022. Results: Tripura is expected to achieve the target of 95-95-95 in the near future, and the other states have varying degrees of gaps to bridge. With the current pace of achievements, states of Manipur and Meghalaya will be achieving the target in the year 2060 and 2059, respectively. Arunachal Pradesh, Assam, and Nagaland also have substantial gaps, expected to achieve target in the year 2042, 2034, and 2042, respectively. Conclusion: The main causes of high prevalence of HIV/AIDs may be higher percentage of injectable drug use, less ART coverage, and less comprehensive knowledge. Factors contributing to the gaps may include inadequate infrastructure, socioeconomic challenges, policy implementation gaps, and resource allocation disparities. The data highlight the higher prevalence of HIV/AIDS among injecting drug user in the northeastern states compared to female sex workers and men who have sex with men and are far behind the targets except Tripura. Therefore, efforts should be made to address these challenges, focusing on enhancing education, health care, infrastructure development, and socioeconomic opportunities.
Qualitative assessment of faculty’s perspectives regarding effective implementation of competency-based medical education
(Wolters Kluwer – Medknow, 2025-06) Nagar, Noopur S.; Nagar, Shashwat S.
Introduction: It has been just over four years since the implementation of competency-based medical education (CBME) and it is opined that medical education has undergone a paradigm shift. With the inception of CBME, the focus has shifted from a traditional trainer-based approach to a newer learner-based approach. The role of medical teachers has also shifted from being a traditional teacher to being a facilitator for the implementation of the program. The trainer’s perspectives and qualitative assessment of the implementation of the new program are less explored. The study was planned to carry out a qualitative assessment of faculty members’ perspectives regarding the new competency-based medical curriculum with respect to their perceived challenges and many reservations about its effective implementation in the future. Material and Methods: A qualitative study was conducted, which included in-depth interviews of medical faculty members. The faculty members selected were from all three categories, i.e. pre, para, and clinical subjects. Data were collected after preparing a guide for in-depth interviews and obtaining consent from them. A rapporteur was appointed to make a note of the verbatim and themes were generated on the basis of the responses provided. Content analysis was carried out from the responses of the faculty members. Results: A total of nine themes were generated on the basis of content analysis. Most faculty members believed that CBME was more structured and had clear objectives and better documentation. However, they felt it was more resource-intensive and needed better planning and resources for better implementation. Faculty members perceived the strengths of the new curriculum along with its challenges in implementation and felt that in order to make it a success, there is a need for better planning and capacity building. Conclusion: Even though CBME is in its early stages, the curriculum structure appears promising to most faculty members. Qualitative assessments of similar types in different institutes across the country can help in evaluating and successfully implementing CBME in the future.
Risk perceptions of heat-related illnesses, assessing vulnerability, and adaptive capacity of brickkiln workers in a rural Puducherry: A cross-sectional study
(Wolters Kluwer – Medknow, 2025-06) Ramakrishnan, Iswarya; Senthil, Rajini; Pravinraj, S.; Dhasaram, Premnath; Venkatesan, Monisha; Manjubairavi, T.; Ravi, Sheeba
Introduction: One of the physical risks that may lead to health issues at work is heat; brickkiln workers are often exposed to conditions that increase their risk of developing heat-related illnesses (HRIs). Three of the most crucial ways to avoid these kinds of disorders are knowledge, attitudes, and practices (KAPs). Material and Methods: In 2023, a cross-sectional study was carried out between March and June. A total of 280 brickkiln workers were recruited from five rural commune areas of Puducherry, using multistage random sampling method. The data were collected on demographic characteristics, risk perception, and spontaneous adaptation behaviors through KAP scores using structured questionnaires. Chi-square tests and correlation matrix were employed to analyze the data. Results: 11.4% of participants experienced HRIs, while 68.2% never had HRI. The mean values for knowledge (K-score), attitudes (A-score), and practices (P-score) were 13.5 (standard deviation [SD] ± 4.01), 4.21 (SD ± 2.17), and 4.23 (SD ± 1.99). KAP scores showed significant variations according to educational attainment (P < 0.001) and economic level (P < 0.001). In addition, KAP scores were higher (P < 0.05) for individuals with work experience than those without it. Eventually, higher educational achievements, higher income status, and longer years of work experience were associated with KAPs of participants. Conclusion: This study showed a relationship between participants’ education, income, and year of work experience with their KAP level about heat waves. To raise awareness, health education initiatives and providing improved learning material, should be taken.
Exploring menstrual hygiene products’ usage and health problems associated with menstruation in India: A nationwide survey
(Wolters Kluwer – Medknow, 2025-06) Thumati, Goutham; Samala, Priyanka; Sarkar, Amrita; Saurabh, Suman; Gehlawat, Mamta
Introduction: Health issues related to menstruation are often neglected and there lies a complete absence of health-seeking behavior. This study aimed to explore the usage of different Menstrual Hygiene Products (MHP), and menstrual problems among Indian menstruators. Material and Methods: A mixed method study was conducted over a period of two months using an online pretested semistructured questionnaire with sections on sociodemographic profile, MHP usage, and menstrual problems. A Google Form link was disseminated through various social media platforms. Data were extracted into Excel spreadsheets and analyzed using EpiData analysis. Results: 787 participants took part in this survey. The mean age of participants was 25.5 (±6.9) years. Sanitary pads (91.7%) were the most common MHP used irrespective of the sociodemographic profile of the menstruators; followed by menstrual cups (13.8%), cloth (5.8%), cloth pads (4.4%), period panties (3.9%) and tampons (2.8%). Median Out-of-Pocket Expenditure (OOPE) on MHP was Indian National Rupee (INR) 106.5 (Inter-quartile range 80–250) per month. 78% of participants faced at least one menstrual problem (mood swings most common) and 17% faced Coronavirus disease pandemic-related menstrual problems. Conclusion: To combat the growing problem of disposable MHP waste, period poverty, and poor menstrual health-seeking behavior; Government and nongovernmental organizations need to work together and create awareness about hygienic usage of sustainable MHP.
Linking infant and young child feeding practices to Z-scores: Unraveling the impact on childhood stunting and wasting
(Wolters Kluwer – Medknow, 2024-06) Gosalia, Vibha Vinodkumar; Jasani, Krishna Mahendrabhai; Misra, Late Shobha V.
Introduction: Poor infant feeding practices predispose children to nutritional disorders which may persist into early childhood with life-long consequences. We aimed to find out prevalence of malnutrition among children aged less than six years and to assess infant and young children feeding practices and their impact on malnutrition. Methods: An analytic cross-sectional study was conducted between March 2021 and May 2022 among children up to six years of age registered in the Anganwadi centers of Rajkot district. Using the formula n = Z2pq/e2, a sample size of 504 was estimated, including 10% nonresponders. Samples were drawn using a multistage simple random sampling method. The z scores related to the anthropometric measurements were estimated using the World Health Organization Anthro 2011 software. We reported prevalence of different types of malnutrition and infant and young child feeding practices. A logistic regression was used to identify significant factors for stunting and wasting (P < 0.05). Results: The mean age of the children was 32.43 months (SD 18.7 months). The prevalence of stunting and wasting was found 36.7% and 30.5%, respectively. The prevalence of prelacteal feeding practices was 72.8%. Less than one-fourth (21.4%) of children were exclusively breastfed and 77.9% of the children received complementary feeding at appropriate age. The binary logistic regression model showed that stunted growth was strongly associated with exclusive breastfeeding and complementary foods’ introduction at the appropriate age. Conclusion: As compared to national, state, and district averages, the prevalence of wasting was remarkably higher among children included in the study. In addition, the study underscores the disturbingly high prevalence of prelacteal feeding practices, which can have a detrimental effect on the health of newborns.
Occupational injuries and health-seeking behavior of informal sector waste collection workers in Nellore, India
(Wolters Kluwer – Medknow, 2024-06) Chinthapatla, Sai Divya; Tiwari, Rajnarayan Ramshankar
Introduction: Waste collection workers are exposed to occupational injuries at every step in the process of waste collection and disposal, from the point of collection at homes, during transportation, and at the sites of recycling or disposal. This study was undertaken to assess the prevalence of injuries among municipal waste collection workers and their health-seeking behavior for the injuries. Methods: This cross-sectional study included 422 workers from randomly selected 20 wards in four zones of Nellore. The information regarding sociodemographic, occupational, and injury characteristics were collected using a pre-tested questionnaire by conducting a face-to-face interview with each of the study participants. Results: Two hundred and four (48.3%) workers suffered from injury in the past 12 months. A shorter duration of the job, a lack of safety training, and a lack of awareness about the risk of injury on the job were significantly associated with the occurrence of injuries. The health-seeking behavior was found to be poor, with only 40.7% of those who suffered injury and 30.6% of overall workers preferring to approach any health-care facility for the treatment of wounds. Conclusion: The informal sector waste collection workers are at risk of injuries while pursuing their occupation. The health seeking behavior was found to be poor among them.
Building healthy foundations: Screening for 4 D’s (defects at birth, diseases, deficiencies, and development delays) among under-five children under the Rashtriya Bal Swasthya Karyakram program in Bengaluru, South India
(Wolters Kluwer – Medknow, 2024-06) Deepthi, R.; Siraja, Ameenah Anwar Hussain; Santhosh, Gokul; Vinaya, M.
Introduction: The 1st 2000 days of a child’s life from conception to five years of age are the most crucial days for early childhood development. The Rashtriya Bal Swasthya Karyakram (RBSK) is an ongoing screening screening program aims to screen the children not only in these crucial years but until they are 18 years of age and routinely refers them to higher centers for further management. Our study aimed to determine the 4 Ds – defects, deficiency, disease, and disability for children under five years of age, screened under RBSK. Methods: A cross-sectional study was conducted in one rural and two urban Primary Health Centers (PHCs) under the field practice area of government medical college in Bengaluru, South India. All the children registered under the anganawadi centers of the selected PHCs were included. Anthropometric measurements including weight, height, and mid upper-arm circumference were collected. Data was also collected from RBSK reports. Results: Among the 760 children screened, 41.6% deficiencies, 2.6% childhood diseases, and 0.3% disabilities and zero (0) defects were detected. Conclusion: The reporting of deficiencies was substantial (41.6%) under the RBSK program. But, the reporting of developmental delay and defects was not regular and was very low. To enhance its effectiveness, strategies include improving infrastructure and resources, strengthening screening and early detection through trained health-care workers, and standardized tools. Capacity building and training for health-care professionals are essential, as is community engagement through awareness campaigns and collaboration with local organizations.
Socioclinical risk factors for cervical dysplasia and presence of human papillomavirus among women attending a tertiary care teaching hospital of Central Odisha
(Wolters Kluwer – Medknow, 2024-06) Ashe, Swetaleena; Nanda, Saumya; Rattan, Roma; Behera, Tapas Ranjan
Introduction: Carcinoma cervix being the second-most common gynecological malignancy in India contributes nearly 14% of all cancers in females. Cervical dysplasia and presence of human papillomavirus (HPV) DNA are the two most important factors for developing cervical cancer. Hence, our study aims to be a flag bearer to raise the awareness for cervical screening with the main objective (i) to estimate the magnitude and distribution of cervical dysplasia among the women of 21–65 years and (ii) to find association between different socio-clinical risk factors and cervical dysplasia and HPV infection among the study subjects. Methods: It was a cross-sectional study carried out in a tertiary care hospital of Central Odisha, with a sample size of 176. Purposive sampling was done. Predesigned pretested questionnaire along with Pap smear and endocervical smear sample for HPV determination were used for data collection. Results: Nearly 62% of women suffered from cervical dysplasia. Women aged ?35 years were found to have nearly thrice the risk of having cervical dysplasia. Nearly 20% of women tested positive for HPV DNA and these women were found to be 11 times more prone for developing cervical dysplasia compared to women tested negative for HPV DNA. Conclusion: Women with repeated genital infection with HPV and aged more than 35 years were more susceptible to cervical dysplasia. Those with early age at menarche, itching per vaginum, postcoital bleeding, and postmenopausal bleeding, etc., had a significant risk for developing cervical dysplasia. Hence, such symptomatic women should be made aware to undergo screening for cervical cancer at the earliest.
Vaccination equity: Exploring immunization coverage for selected vaccines in urban Bengaluru’s elderly community
(Wolters Kluwer – Medknow, 2024-06) Sangeetha, M. D.; Deepthi, R.; Menon, P. K. Sreenath; Veeresappa, D K
Introduction: Globally, the proportion of elderly individuals is steadily increasing, posing significant challenges for health-care systems. Vaccination plays a crucial role in preventing vaccine-preventable diseases and associated morbidity and mortality in the elderly. In India, there is no national immunization schedule dedicated to the elderly group. This study aimed to explore the vaccination coverage for selected vaccines, namely pneumococcal conjugate vaccine, Influenza, and coronavirus disease 2019 (COVID-19), among the elderly residing in urban Bengaluru. Methods: A cross-sectional study was conducted between January and March 2023. Data were collected from 132 elderly participants living in three wards of Rajajinagar, Bengaluru. A structured questionnaire was used to collect sociodemographic data, health conditions, and vaccination status. The data were analyzed using EPI data 3.1 Software, and the Chi-square test and Fisher’s exact test were used to assess the association of demographic variables with vaccine intake. Results: The results showed that vaccination uptake for influenza and pneumococcal vaccines was nil, while for COVID-19 vaccines, 4.5% of participants had not taken any dose, 6.8% had taken the first dose, 57.6% had taken the second dose, and 31.1% had taken the booster dose. Sociodemographic analysis revealed significant associations between vaccine uptake and variables such as age, socioeconomic status (below the poverty line card holder), and body mass index. Conclusion: The low uptake of vaccines in the elderly population highlights the need for specialized strategies and initiatives to increase vaccination coverage. The study recommends suitable measures to improve vaccination coverage among elderly, creating awareness among healthcare professionals and the general population, and enhancing vaccine accessibility and availability to promote healthy aging in India.
Remission of type 2 diabetes mellitus through intensive lifestyle modification in ambulatory setting
(Wolters Kluwer – Medknow, 2024-12) Antony, Annu; Behera, Priyamadhaba; Patro, Binod Kumar; Taywade, Manish
Type 2 diabetes mellitus (T2DM) is a widespread chronic condition often influenced by a complex interplay of factors. We present a remarkable case of a 54-year-old man diagnosed with T2DM in February 2016, whose journey sheds light on the potential for T2DM remission through lifestyle modifications. Remarkably, at the time of diagnosis, he displayed elevated glycated hemoglobin (HbA1c) levels at 11.6% alongside extreme work-related stress, as evidenced by a Depression Anxiety Stress Scale (DASS) score of 27. Following a structured treatment plan, including pharmacological therapy and lifestyle changes, the patient demonstrated good glycemic control over 2 years. However, what makes this case truly exceptional is his decision to discontinue all medications against medical advice in October 2018. In this period, he continued to focus on lifestyle adjustments, including exercise, diet, and addressing the root cause of his stress. Crucially, the patient’s commitment to stress management and lifestyle modifications had a profound impact on his health. Through meticulous cross-verified testing at the All India Institute of Medical Science, Bhubaneswar, this case reveals substantial improvements in HbA1c levels, from 11.6% to 5.3% and a significant reduction in stress levels (DASS score from 27 to 12). Corresponding reductions were also observed in fasting blood sugar and postprandial blood sugar levels. Furthermore, microalbuminuria, a complication associated with diabetes, exhibited signs of reversal. These findings suggest that T2DM and its associated complications can be effectively managed and even reversed in certain cases through lifestyle modifications, underscoring the intricate link between mental well-being and physiological outcomes.
Borrowing, loss of income and related sociodemographic factors in post-traumatic stress disorder in COVID-19 patients: A cross-sectional study from a government hospital in Mumbai, India
(Wolters Kluwer – Medknow, 2024-12) Bhondve, Amit; Tilak, Shruti Vijay; Sudarson, Nived G.; More, Shermeen Rajesh; Saraf, Prashant Harish; Singh, Shreyansh Dinesh; Lele, Eeshwari Vinay; Shah, Ritu Mohit; Shah, Kavya Amitabh; Mehra, Diya Padam
Introduction: Socioeconomic and related demographic characteristics may contribute to psychological distress following hospitalization with COVID-19. Financial strain experienced during the hospital stay may be associated with a heightened risk for posttraumatic stress disorder (PTSD). Material and Methods: The present study aimed to assess the prevalence and socioeconomic correlates of PTSD among patients previously hospitalized with COVID-19 in a government hospital in Mumbai, India, through a cross-sectional, questionnaire-based study design. Patients were contacted through telephonic interviews 3 months following discharge. The questionnaire included demographic and socioeconomic details in relation with COVID-19 hospitalization and the PTSD Checklist for DSM-5 (PCL-5). Results: Only (6.7%) patients received a provisional diagnosis of PTSD, while 12/89 (13.5%) were classified as having subthreshold PTSD. 10/89 (11.2%) scored ?31 on the PCL 5 and had probable PTSD. 10/89 (11.2%) scored ?31 on the PCL?5. On bivariate analyses, being unmarried or divorced or separated (P = 0. 037), having children who were minors (P = 0. 002), traveling from outside the state for hospitalization (P < 0.001), borrowing (P = 0.002), or loss of income (P = 0.028) due to hospitalization were significantly associated with subthreshold PTSD. On multivariable analysis, borrowing (adjusted odds ratio [AOR] 9.45, 95% CI 1.08–82.72) and traveling from outside the state (AOR 35.75, 95% CI 1.46–875.45, P = 0.028) retained significance for subthreshold PTSD. Conclusion: Socioeconomic factors may contribute to PTSD burden in previously hospitalized COVID-19 patients. This points to a need for mental health screening and economic relief measures in financially vulnerable patients.
Exploring hematopoietic stem cell awareness and engagement among healthcare professionals: A cross-sectional survey
(Wolters Kluwer – Medknow, 2024-12) Mishra, Vikash Chandra; Chandra, Dinesh; Raina, Anoushka; Raina, Vimarsh
Introduction: Hematopoietic stem cell transplantation (HSCT) is a crucial treatment for various blood disorders. However, the scarcity of matched related donors has led to the establishment of stem cell donor databases, commonly known as stem cell registries. These registries aim to streamline the identification of unrelated volunteer stem cell donors for matched unrelated donor HSCT. This study specifically aims to assess the level of knowledge and engagement among healthcare professionals in Delhi National Capital Region (NCR) regarding hematopoietic stem cell (HSC) donation. Material and Methods: The cross-sectional observational study involved 240 healthcare professionals was conducted in the Delhi. Results: The study findings indicate that the level of awareness about HSC and transplants among healthcare professionals was 44.25 and 40%, respectively, revealing a substantial knowledge gap in this field. Surprisingly, none of the participants reported prior experience with stem cell donation. However, a noteworthy 70.4% expressed a willingness to be part of the stem cell registry. Conclusion: The study emphasizes the urgent need for comprehensive education and awareness initiatives, especially targeting healthcare professionals, to bridge the knowledge gap and boost volunteer stem cell donor registrations for the benefit of patients requiring HSCT. The results serve as a foundation for fostering a more informed and engaged community in the field of HSCs, underscoring the importance of proactive measures to enhance knowledge and participation.

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