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 89

Medical officer's perspectives and professional challenges in handling poisoning cases in rural India
(Wolters Kluwer-Medknow Publications, 2022-06) Mahadik, Kakasaheb; Raut, Asawari; Chowdhury, Monidipa; Asad, Ali Haider; More, Shubham
Introduction: Poisoning is a significant public health problem in developing countries, more so in rural areas. Very little is known about the treatment available for poisoning cases in the context of rural health care provision in India. This study explores the perceptions of the primary health care medical officers regarding the management of poisoning cases. Material and Methods: A semistructured, self-designed survey form was used to interview the medical officers in Pune district. The interview focused on understanding rural hospital settings in terms of infrastructure, available facilities, and medical officers' perception of professional challenges in the management of poisoning cases. Results: Underreporting of poisoning cases in these primary health centers (PHCs) and transferring to higher hospitals without basic first aid provided was noted through interviews. Conclusion: Medical officers in rural PHCs lack the necessary training and knowledge required for the management of poisonings which is further worsened by lack of resources. There is a need to focus on poison management in continuous medical education. Training programs and education for medical officers are needs of the hour.
COVID-19 pandemic: Probing the dynamics in the North Himalayan state
(Wolters Kluwer-Medknow Publications, 2022-06) Sharma, Priya; Rattan, Saurabh; Katoch, Vikram; Gupta, Gurdarshan; Narain, Jai P
Introduction: Coronavirus disease or COVID-19 emerged in December 2019 in China and thereafter spread to all regions of the world including India. In the Himalayan state of Himachal Pradesh, India, the first case was identified in the month of March 2020. As the most populous district of the state of Himachal Pradesh, Kangra not only identified the first case in the state but also thereafter suffered disproportionately due to the virus causing severe health and economic disruption. The study was carried out to better understand the pattern and trends of COVID-19 pandemic in the district since its emergence, covering the first and the second wave to use the data to prepare the future course of action. Materials and Methods: A robust database comprising real-time data in a line list format was created. The observations covered all confirmed COVID-19 cases in the district from March 20, 2020, to June 30, 2021, in terms of disease progression and distribution in time, place, and person, and the possible risk factors for severe disease. Results: During the study period, 45,871 cases and 1030 deaths were reported in Kangra district, with a case fatality rate of 2.2%. Of the 12 districts of the state, Kangra reported the highest number of cases (22.6%) and deaths (29.7%). Ninety percent of all cases occurred during the second wave. While the first wave peaked in December 2020 with 2596 cases, the highest number of cases occurred in May 2021 when as many as 25,625 cases were reported. The test positivity rate of 15.2% during the second wave which was many times higher than that seen during the previous year. The case fatality rates during the first and second waves were 2.2% and 2.1%, respectively. Conclusions: The study highlights an explosive surge in COVID-19 cases during the second wave, indicating the highly infectious nature of the virus. While absolute number of deaths was several times greater during the second wave, the case fatality rates did not differ greatly between the two waves.
Study on occupational ventilatory defects among workers employed in cement factories of Darjeeling district, West Bengal, India
(Wolters Kluwer-Medknow Publications, 2022-06) Sarkar, Payel; Biswas, Daliya; Gazi, Eashin; Ishore, Kaushik
Introduction: Cement factory workers are at a high risk of exposure to crystalline silica-laden cement dusts and at a higher risk of developing chronic obstructive pulmonary disease (COPD), like chronic bronchitis, emphysema and restrictive lung disease like silicosis. This study was done to measure the extent of occupational ventilatory defect among workers employed inside cement factories. Material and Methods: A cross sectional study was conducted among cement factory workers using questionnaire on respiratory symptoms 1986 and spirometry was done after seeking permission from the concerned authority and Institutional Ethics Committee. Logistic regression analysis was done to test for statistical significance. Results: Ventilatory defect was present among one fourth of the factory workers. Obstructive type of lung disease was much higher (94.6%) than restrictive lung disease (5.4%). Almost half of the study subjects had presented with different types of respiratory symptoms. Breathlessness on exertion was commonest symptom, followed by cough day and night. Ventilatory defects were noted to be much higher (86.5%) among the workers working in the cement factories for more than 10 years and increasing trend was observed with increment in their age and years of working at the factory. Ventilatory defect were significantly high among smokers (29.5%), subjects who started smoking in early age (35.9%) and there is increasing trend of defects with a greater number of cigarettes intake. Conclusion: Periodically awareness generation and mandatory use of personal protective equipment should be practiced among workers in cement factories.
Knowledge, attitudes and utilization of food labels among undergraduate medical students in a medical college in Chennai – A cross sectional survey
(Wolters Kluwer-Medknow Publications, 2022-06) Annamalai, Sinthiya; Gopichandran, Vijayaprasad
Introduction: Food labeling is an important method of providing food-related information on the package of food products, to facilitate people’s choice of safe and appropriate foods. Medical students are potential agents of change in food label utilization behavior in the community. The objectives of this study were to evaluate the knowledge, attitudes, and utilization of food labels among undergraduate medical students in a medical college in Chennai. Material & Methods: We conducted a cross-sectional survey of 200 students studying in the 1st to 3rd year in a medical college through an online Google Forms survey, self-administered by the students after online informed consent was obtained. We gathered information on their knowledge, attitudes, and utilization of food labels. Results: Of 400 students approached, 200 responded to the online survey. They had good knowledge about food labels. Female students had 3.4 (1.59 to 7.25) times better knowledge compared to men. The students had a positive attitude toward food labels, and a majority thought that the food labels are useful. Utilization of food labels to understand the nutritive content (55%), additives (57%), and manufacturer details (47%) was poor. Utilization of food labels was 2.7 times more (1.142–6.587) among those who did regular exercise, and it was 0.2 (0.09 to 0.9) times less among those who were on a strict diet. Conclusion: Medical students had a sound knowledge and good attitude toward food labels, but their food label utilization patterns were still poor. There is a need to incorporate food labeling in the undergraduate medical curriculum and inculcate better food label utilization behavior.
Bi-directional screening for COVID-19, tuberculosis and diabetes in flu, DOTS and NCD clinics in a rural hospital in Northern India
(Wolters Kluwer-Medknow Publications, 2023-06) Rajan, Shruthi; Kathirvel, Soundappan; Rehman, Tanveer
Introduction: To assess the status of bi-directional screening for COVID-19, tuberculosis and diabetes among people attending Non-communicable Disease (NCD), Directly Observed Treatment Short-course (DOTS), and flu clinics of a secondary care hospital in rural northern India. Material and Methods: A cross?sectional, analytical study was conducted among the eligible (aged ?18 years) population who attended the study clinics in a rural sub-district hospital. In the flu clinic, consecutive patients were assessed for screening for TB (symptom-based) and diabetes (random blood sugar) and status of referral to DOTS and NCD clinics. Similarly, the screening for diabetes and COVID-19, Reverse Transcription-Polymerase Chain Reaction (RT-PCR) in the DOTS clinic, and TB and COVID-19 in the NCD clinic were assessed. The independent association of factors with COVID-19 positivity were assessed by calculating the adjusted prevalence ratios (aPR) at 95% confidence interval (CI). Results: Of the 405 people assessed, 279 (68.9%), 102 (25.2%), and 24 (5.9%) were from flu, NCD, and DOTS clinics, respectively. 26 (25.5%) and 22 (91.7%) of NCD and DOTS clinic patients underwent RT-PCR for COVID-19. TB screening in NCD and flu clinics was done among 4 (3.9%) and 7 (12.5%), respectively. A total of 23 (9.0%) were found positive for COVID-19, and no factors other than the presence of COVID-19 symptoms (aPR: 2.89; 95% CI: 1.33–6.29) had any independent association with COVID-19 positive status. Conclusion: The low screening for TB in NCD and flu clinics indicates the need to strengthen the implementation the TB-DM and TB-COVID-19 bidirectional screening. Similarly, the low screening or testing for COVID-19 in the NCD clinic can be improved by the implementation of systematic screening strategies like TB-DM bidirectional screening.
Young infant nurturing practices among mothers of rural areas in Agra district, Uttar Pradesh: A community-based cross-sectional study
(Wolters Kluwer-Medknow Publications, 2023-06) Yadav, Smita; Misra, Sunil Kumar; Nagergoje, Manisha Madhukar; Aqeel, Khan Iqbal
Introduction: Healthy initiation of life is essential in establishing the foundations of a healthy nation. Traditional care practices at home and in the community inevitably affect maternal and young infant health. The objective is to study young infant nurturing practices and factors influencing these practices in rural Agra. Material and Methods: This is a community-based cross-sectional study that was conducted in rural Agra, using a multi-stage random sampling method. A total of 240 mothers were interviewed using a structured questionnaire. Results: The study results showed that 65.0% of the mothers were following either satisfactory (58.3%) or good (6.7%) nurturing practices. Of the three components of nurturing, the majority (61.6%) of mothers had satisfactory (46.6%) or good (15%) breastfeeding practices, most (86.6%) were giving satisfactory (56.6%) or good (30%) thermal care and only 53.33% were following satisfactory (42.2%) or good (10.8%) hygiene practice. The practice regarding newborn care was found to have a significant association with the place of birth, type of delivery and educational status of the mothers and fathers. Conclusion: This study outcome shows the need for a better awareness and educational outreach program coupled with an effective health-care delivery system to improve young infant nurturing practices in achieving better health.
New cost-effective human leukocyte antigen testing algorithm for screening of human leukocyte antigen-matched related donor in thalassemia major patient pretransplant workup: A single-center study from resource-constrained settings
(Wolters Kluwer-Medknow Publications, 2023-06) Singh, Parvind; Tiwari, Aseem Kumar; Mishra, Vikash Chandra; Chandra, Dinesh; Bhardwaj, Amit K; Dey, Nikki; Raina, Vimarsh
Introduction: India has a huge disease burden of thalassemia major with an estimated 40 million carriers and over a million thalassemia major patients. Very few patients are optimally treated, and the standard of care “hematopoietic stem cell transplant” (HSCT) is out of reach for most patients and their families. The cost of HSCT is significant, and a substantial proportion of it goes to human leukocyte antigen (HLA) testing of family members (HLA screening) in hope of getting a matched related donor (MRD) for HSCT. The aim of this study was to establish that a new proposed testing algorithm of HLA typing would be more cost-effective as compared to the conventional HLA screening within MRD families for possible HSCT. Material and Methods: Buccal swab samples of 177 thalassemia patients and their prospective family donors (232) were collected. Using a new HLA testing algorithm, samples were tested for HLA typing in a sequential manner (first HLA-B, then HLA-A, and finally HLA-DR) using the sequence-specific oligonucleotide probe method on the Luminex platform. Results: The new sequential HLA-A, HLA-B, and HLA-DRB1 testing algorithm showed a 49.1% reduction in cost compared to the conventional HLA testing algorithm. Furthermore, 40 patients (22.59%) were found to have HLA-MRD within the family among other samples that were tested. Conclusion: The new HLA testing algorithm proposed in the present study for identifying MRD for HSCT resulted in a substantial reduction in the cost of HSCT workup.
Awareness, perceptions, and attitude towards Coronavirus disease 2019 vaccine among pregnant women in India: A cross-sectional study
(Wolters Kluwer-Medknow Publications, 2023-06) Pushkar, Kumar; Sahu, Rajesh; Kapoor, Suraj; Kaushik, S. K.; Teli, Prabhakar; Bobdey, Saurabh; Yadav, Arun Kumar
Introduction: The present study was conducted to explore the awareness and perception of the coronavirus disease 2019 (COVID-19) vaccine among pregnant women. Material and Methods: A descriptive cross-sectional study was conducted from September 01, 2021, to September 28, 2021, among 301 pregnant women aged 18–35 years at antenatal care outpatient department in a tertiary care hospital of Western Maharashtra. Results: On assessing the knowledge and awareness score, the mean score (± standard deviation) was 7.83 ± 1.2 out of 16. A total of 176 (58.5%) had good scores(?8). There was no statistically significant association between knowledge and awareness scores and the level of education, type of residence, and age or with weeks of gestation. Although the overall awareness of study participants was satisfactory, 177 (58.8%) felt that COVID-19 vaccines should be avoided during the first trimester. Interestingly, 45 (15.3%) felt that vaccines should not be given during menstruation. There were misconceptions about perceived contraindication, with 81(26.9%), 50(16.6%) and 43(14.4%) responding that diabetes, hypertension and heart disease are contradicts respectively. Interestingly, a total of 52 (17.3%) responded as likely when enquired whether the present vaccine can cause infertility. Similarly, about 62% of study participants felt that the vaccine might alter the DNA. Conclusion: The present study revealed good overall knowledge and awareness about the COVID-19 vaccine among pregnant with certain misconceptions. The findings suggest that immediate health education programs, risk communication, and correct information should be disseminated by respective health authorities.
Eating behaviours and perception about body shape among adolescent girls of Panjab University, Chandigarh
(Wolters Kluwer-Medknow Publications, 2023-06) Kaur, Harleen; Sharma, Manoj, Kumar; Goel, Naveen, Krishan; Rohilla, Ravi; Bishnoi, Mamta; Kaur, Ravneet
Introduction: Indians are experiencing nutritional and lifestyle transitions due to globalization and westernization. The study aimed to find out the current eating patterns and body shape concerns and various factors that influence eating behaviors and body shape concerns of late-adolescent girls. Material and Methods: A cross-sectional study was conducted among 230 undergraduate adolescent girl university students from 12 departments in the age group of 17–19 years. Eating attitude and body shape concerns of adolescents were determined by using the standard eating attitude test-26 (EAT-26) and body shape questionnaire (BSQ-34). Results: The duration of the study was 6 months and participants were selected by simple random sampling. The mean age of the study subjects was 18.52 (±0.63) years. The majority of subjects had an urban background (85%). Less than half had an exercise routine (44%) which was followed daily. As per body mass index (BMI) distribution, 19.57% were underweight, 11.3% were overweight and only 2.17% were obese. An unfavorable eating attitude was found in 18% of subjects whereas 38.2% had mild to the marked concern of body shape. There was a significant positive correlation between BSQ with BMI (r = 0.387, P ? 0.01) and BSQ-34 with EAT-26 (r = 0.367, P ? 0.01). Conclusion: Current study shows that late adolescent urban females are susceptible to eating disorders and are body image conscious. Institutional mechanisms should be brought in place to address the need of improving their eating habits and modification of lifestyle.
Perception on effect of AYUSH treatment among patients with selected NCDs at life style diseases clinics from six states of India: Lessons learnt and way forward
(Wolters Kluwer-Medknow Publications, 2023-06) TP, Sherin Raj; Tiwari, Vijay Kumar; Gandotra, Ramesh
Introduction: The AYUSH system of medicine is effective in the case management of non-communicable diseases (NCDs). The Ministry of Health and Family Welfare launched a pilot program in 2016 integrating AYUSH with the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke for community-based screening and management of NCDs. This study was done to assess the effectiveness of AYUSH treatment with Yoga practices in project districts in terms of the adoption of a healthy lifestyle besides relief from NCDs. Material and Methods: The study was conducted in six districts from six states, namely Bhilwara (Rajasthan), Surendranagar (Gujarat), Gaya (Bihar), Darjeeling (West Bengal), Krishna (Andhra Pradesh), and Lakhimpur-Kheri (Uttar Pradesh) with a total sample of 56 lifestyle disease Clinics and 1790 beneficiaries. Results: The results show that 75% of patients were currently doing yoga and 60%–80% of patients experienced various benefits of yoga. These benefits were relief from pain (82%), improvement in appetite (72%), reduction in weakness (72%), and sickness (71%). The study also found that after taking AYUSH treatment, overall 73% of patients reduced dosage of allopathic medicines, 52% had reduced side effects of allopathic medicines, 24% stopped allopathic medicine, and 50% got faster recovery. Conclusion: Low cost and fewer side effects are considered merits of AYUSH medicine that drive its acceptance in the community and could be prioritized under preventive care. The dual form of medicine is the new form emerging option to the existing modern medicine.
Gender of the baby and its impact on the health-related quality of life of postpartum women
(Wolters Kluwer-Medknow Publications, 2022-06) Singh, Pallika; Rasania, SK
Introduction: Health-related quality of life (HRQoL) is a multidimensional concept and is relatively neglected in both research and practice. Gender equality is a crucial measure of human rights for millions of women and girls around the world. Most postpartum researches have focused on physical complications. This study was conducted to analyze the impact of gender of the baby on the HRQoL of postpartum women at 6 weeks. Material and Methods: The study was conducted in a resettlement colony, Kalyanpuri, located in Delhi, India, with a sample size of 330 postpartum women. The data were collected in the 6th week of postpartum period using the Medical Outcomes Study Short Form 36 Health Survey for HRQoL. Results: The findings showed that the birth of a male baby led to a significantly (P < 0.05) better mean HRQoL score than the birth of a female baby. The mean scores of general health, vitality, social functioning, and mental health domains were significantly less in the case of a female newborn child. Conclusion: The male dominance in the Indian society which leads to financial supremacy and coercion for continuation of family lineage was an important predictor of lower HRQoL of the women in the postpartum period. This demonstrates the need for risk factor for gender equity to and achieve universal health coverage.
Prevalence and correlates of social networking addiction and its association with adult ADHD and stress among students of a medical college
(Wolters Kluwer-Medknow Publications, 2023-06) Singh, Abhishek Bahadur; Mishra, Ambrish Kumar; Vijay, Mano; Karanth, Varsha; Mittal, Kailash
Introduction: Repeated use of social network is said to cause addiction. Attention deficit hyperactivity disorder (ADHD) is disorder found in childhood. Studies have shown that such children continue to have the symptoms of ADHD as adults. The aim of this study was to find the prevalence of social networking addiction and Internet addiction and their relationship with ADHD. Also, to assess the relationship between perceived stress and sociodemographic factors with social networking and internet addiction. Material and Methods: A cross-sectional study was conducted among 150 undergraduate and postgraduate students of BMCRI after ethical clearance. Medical students who gave consent were included through stratified random sampling. Those who were taking treatment for psychiatric illness were excluded. Scales like the Young Internet addiction test (IAT); Bergen’s Facebook Reporting Scale, ADHD Self-Reporting Scale, and Wender Utah Brief Rating Scale for ADHD, and Cohen Perceived Stress Scale (PSS) for perceived stress have been used. Results: The mean age was found to be 21.56 ± 3 years. 62.6% were males and 37.33% of were females. The prevalence of Internet addiction was found to be 23.3% (n = 35), with 2% (n = 3) were having severe addiction, 6.6% (n = 10) were having moderate Internet and 14.6% (n = 22) having mild internet addiction according to modified Young’s criteria (2011). The prevalence of social networking addiction as per the Bergen Facebook Addiction Scale (BFAS) score was 4.66% and adult ADHD was 15%. There was a strong positive correlation (0.76) between Internet Addiction and Facebook addiction scores and between BFAS score and IAT score. A moderate positive correlation (0.46 and 0.47) between Internet addiction and Facebook addiction with perceived stress and ADHD and IAT score with PSS score and ASRS score, weak positive correlation with PSS score and ASRS score was observed. Conclusion: A significant proportion of medical students develop Internet addiction and minority develops social network addiction. Furthermore, perceived stress and ADHD scores are positively correlated with internet and social networking addiction.
Factors associated with delayed diagnosis among sub-Saharan African women
(Wolters Kluwer-Medknow Publications, 2023-06) Balhi, Salma
Breast cancer incidence in sub-Saharan Africa is among the lowest in the world; however, mortality is as high as in high-incidence countries because of poor survival rates. Most breast cancer patients in sub-Saharan Africa are diagnosed at advanced stages after prolonged symptomatic periods. Understanding the reasons why women in sub-Saharan Africa seek care after the onset of symptoms is essential to promoting early diagnosis and ultimately improve their cancer survival.
Health-related quality of life among people living with HIV/AIDS on highly active antiretroviral treatment: A questionnaire-based study
(Wolters Kluwer-Medknow Publications, 2023-06) Mahajan, Vikram K.; Vashist, Sanket; Mehta, Karaninder Singh; Chauhan, Pushpinder Singh; Singh, Ravinder; Manvi, Sujaya; Sharma, Anuj
Introduction: The knowledge of the effect of sociodemographic and disease-related factors on health-related quality of life (HRQoL) among people living with HIV/AIDS (PLWHA) is important for planning comprehensive health-care services for them. Material and Methods: Two hundred PLWHA on antiretroviral therapy (ART) volunteered to complete a self-reported World Health Organization’s Quality of Life?HIV brief questionnaire (WHOQoL-HIV-BREF) that examines six domains each with four items (physical, psychological, level of independence, social, environmental, and spiritual) with 25 facets and additional 5 facets specific to PLWHA (symptoms of HIV, social inclusion, forgiveness, worries about the future, and death and dying). Results: Only 135 questionnaires from 73 (53.3%) men and 63 (46.7%) women (male: female – 1.14:1) aged 20–82 years(mean ± standard deviation: 42.9 ± 10.5 years) were found complete. Eighty-five (63%) individuals were aged 41–60 years, 78 (57.8%) individuals were matriculates, graduates, or postgraduates, 76 (56.3%) respondents were married, and 38 (28.1%) were widows/widowers. Staying-alone workers comprised 43 (31.8%) individuals. Overall health and HRQoL were rated satisfactory (n = 85.2%) and good/very good (n = 74.8%) by a significantly greater number of individuals (P = 0.001). Pearson’s Chi-squared test showed no statistically significant (P > ?) associations between good HRQoL and variables such as age >40 years, gender, education, marital status, duration of disease, disclosure of serostatus to family, ART for >3 years, and CD4 >200 cells/mL. Conclusion: Regular ART can result in adequate control of immunosuppression and no comorbidities in a majority of PLWHA, family and social acceptance, and financial security can result in overall good HRQoL in all six domains within the WHOQoL-HIV-BREF. The study is limited by its cross-sectional study design and small sample size.
Antihypertensive medication non-adherence and its associated factors among adult patients with uncontrolled hypertension in a primary care setting
(Wolters Kluwer-Medknow Publications, 2023-06) Michael, Godpower Chinedu; Tanimu, Salihu Tanko
Introduction: Medication nonadherence is a significant challenge in the management of patients with hypertension. This study aimed to assess antihypertensive medication nonadherence and its associated factors in a cohort of patients with uncontrolled hypertension. Material and Methods: A cross-sectional study was conducted among 225 adult patients with uncontrolled hypertension systematically selected from attendees of the general outpatient clinic of an academic tertiary hospital in Kano, Nigeria. A structured questionnaire was used to collect data on their sociodemographic, clinical, and follow-up appointment characteristics. An 8-item medication adherence scale was used to assess medication adherence. Results: There were 155 (68.9%) females. The participants’ median age (interquartile range [IQR]) was 55 (45–63) years. Their median adherence score (IQR) was 4 (1–6) of 8, while 87.1% were non-adherent to antihypertensive medication. The duration of treatment (p = 0.009), current blood pressure (p = 0.006), and adherence to follow-up clinic appointments(p = 0.0004) were significantly associated with their median medication nonadherence scores. Conclusion: The prevalence of medication non-adherence in this population is high; however, patients who have been treated for more than 5 years, those with high blood pressure readings (Stage 2 hypertension), and those who were adherent to follow-up appointments had worse medication adherence scores than the other counterparts. These findings justify the need to extensively explore (especially those with long duration of treatment and Stage 2 blood pressure readings) and address the reasons for non-adherence to antihypertensive medication (which should include the identified associated factors), given that medication adherence is crucial in controlling hypertension and its consequences.
Evaluation of usage of immunity boosters among the citizens of Pune district during the COVID-19 pandemic
(Wolters Kluwer-Medknow Publications, 2023-06) Sajith, Manjusha; Danole, Ritika Rajendra; Shaji, Jilu Treasa; Kuruvila, Ansee
Introduction: Post the coronavirus disease (COVID-19 pandemic), there was a spike in demand for immunity boosters, leading to the irrational use of supplements. To assess the usage of immunity boosters among the citizens of Pune City and correlate the side effects associated with supplements. Material and Methods: A cross-sectional study was conducted from September 2020 to May 2021 in Pune. Data, such as demographic, supplement intake (allopathic, homeopathic, and ayurvedic/home remedies), duration, frequency of supplements, and side effects associated with supplements, were collected through a personal interview and e-form circulation. The correlation of the immunity boosters with the side effects was done using Karl Pearson’s Correlation test in SPSS software version 22.0. Results: Out of 1006, the ayurvedic supplements/home remedies were preferred by 906 (98%) allopathic supplements by 599 (65%) and homeopathic supplements by 256 (28%) participants. The commonly reported side effects were acidity (37%), headache (29.6%), nausea (9%), loss of appetite (8.8%), diarrhea (7%), stomach ache (6%), cough (5.6%), and constipation (4.1%). These side effects had a weak positive linear proportionality with ayurvedic supplements such as amla (r = 0.162), Giloy Vati (r = 0.139), turmeric (r = 0.108), and Kadha (r = 0.102); also, Eupatorium perfoliatum, Vitamin C, and Vitamin D showed a linear proportionality with loss of appetite (r = 0.15), headache (r = 0.12), and cough (r = 0.12), respectively. A higher incidence of side effects such as nausea (r = 0.267), diarrhea (r = 0.243), headache (r = 0.164), and acidity (r = 0.113) was observed when supplements were taken for 6 months. Conclusion: Most participants were on immunity boosters during the COVID-19 pandemic. The study concluded that using immunity boosters in excess or for more than 6 months causes side effects, the most recurrent ones being acidity, headache, nausea, and lack of appetite.
What brings people to government urban primary care facilities? A community-based study from Delhi, India
(Wolters Kluwer-Medknow Publications, 2022-06) Virmani, Nitish; Mittal, Ishaan; Lahariya, Chandrakant
Introduction: Mohalla or Community Clinics of Delhi, India, provides free primary care services to the general population, with special focus on the underserved and marginalized. This study was conducted to analyze the perception and experience of target beneficiaries and to understand and document the determinants of people visiting these clinics. Material and Methods: A community-based study was conducted from October 2019 to April 2020. A semi-structured questionnaire was used for data collection. Correlation and comparative analysis were used. Thirty-seven Mohalla Clinics and their catchment areas were visited. A total of 391 respondents (including 35 health staff and 356 community members) were included. Results: Proximity of clinics, waiting times, age, perceived quality of treatment, and cleanliness at facilities were the factors that influenced the usage of clinics. Lack of first-aid facilities and long waiting time (at a few facilities) were identified challenges. There is a need for wider publicity and awareness about the clinics and regular analysis of data to determine an appropriate mid-course action to further increase utilization. Conclusion: Community Clinics of Delhi, India, have brought people back to government primary healthcare (PHC) facilities. The popularity of these clinics has encouraged a number of Indian states to set up similar facilities. The factors behind their success need to be studied in detail to derive lessons for making urban PHC accessible in other low- and middle-income countries.
Evaluation of palliative care training program for medical interns in a tertiary care teaching hospital, South India
(Wolters Kluwer-Medknow Publications, 2022-06) Elayaperumal, Suguna; Venugopal, Vinayagamoorthy; Adinarayanan, S; Dongre, Amol R
Introduction: The Department of Community Medicine has been training medical interns for providing hospital-based palliative care (HBPC) and community-based palliative care (CBPC) services with an interprofessional team. This study was done to evaluate the training program on palliative care developed for medical interns. Material and Methods: It was a retro-pre type of program evaluation done among 172 interns between January 2016 and December 2017. One day program was conducted for the interns by faculty trained in palliative care, followed by placement in HBPC and CBPC program. At the end of training, self-perceived improvement in knowledge was collected on a five-point Likert scale. Certificates were issued on completion. Data were entered and analyzed using Epi Info (version 7.2.2.6) software. Wilcoxon signed-rank test was applied between pre- and post-scores. Manual content analysis was done for open-ended questions. Results: The mean age of the participants was 22.5 ± 0.8 years, with 76 (44.2%) males and 96 (55.8%) females. There was statistically significant improvement in perceived knowledge scores after attending the training. Areas of learning, values learned, and uses of learning in future career and suggestions for improving the training program were the categories obtained. Conclusion: The training program improved the self-perceived knowledge on palliative care among medical interns. The exposure to HBPC and CBPC program had a positive effect on their attitude and perceived skills for caring of chronically ill patients. Such programs can be initiated by other palliative care providing institutions for training medical interns.
Health equity in dialysis care: Time for action
(Wolters Kluwer-Medknow Publications, 2023-06) Ramasamy, Senthilkumar; Agrawal, Sanjana; Rathore, Vinay; Galhotra, Abhiruchi
The development of chronic kidney disease and its progression to End Stage Renal Disease requiring renal replacement therapy remains a significant source of reduced quality of life and premature mortality. The global dialysis population and treatment gap is growing, especially in low- and middle- income countries. In India, 70% of those starting dialysis, die or discontinue treatment in the initial period due to the high cost of treatment and lack of access to dialysis therapy. Achieving health equity requires ensuring access to the resources that needs to be healthy, and addressing social determinants of health involves needs factors that influence the health outcomes. Universal Health Coverage requires an alternate model to address the substantial Out-Of-Pocket-Expenditure borne by these patients for traveling and medications.
Knowledge, awareness, and risk prevention among hepatitis patients attending a tertiary care hospital in Delhi
(Wolters Kluwer-Medknow Publications, 2022-12) Tiwari, VK; Balsundaram, P; Raj, T. P. Sherin
Introduction: People living with chronic viral hepatitis in India often lack awareness on risk factors and prevention. Moreover, due to fear of stigma and discrimination, they often delay appropriate and timely treatment, resulting in chronic treatment and impoverishment. The objective of this study is to assess knowledge, awareness, and prevention regarding risk factors among viral hepatitis-infected patients attending a super-specialty hospital in Delhi. Material and Methods: Data were collected from 389 patients using systematically random sampling using a pretested, structured interview schedule from patients attending Institute of Liver and Biliary Sciences, New Delhi. Results: Findings revealed that 90.7% of the respondents believed that hepatitis B virus/hepatitis C virus (HBV/HCV) can be transmitted through sexual contact with a person who is infected, 94.3% said that it can be transmitted by transfusion of infected blood, 90% reported that it can be spread from infected mother to child during child birth, 93.8% responded that it can be transmitted if a person uses a razor, pierced ear ring, needle, or syringe used by an infected person, 83% believed that HBV/HCV can cause cancer in 90% of the respondents in long run, and more than 35% believed that HBV/HCV is curable. Results also show that 7.2% of the respondents have been vaccinated for HBV infection in the past, 20.8% of the respondents have screened their families for hepatitis B infections, and 77.9% of the respondents have received antiviral medications. Conclusion: HBV/HCV-infected patients had less knowledge about various facts regarding disease and continue to experience emotional disturbances, stigma, and discrimination.

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