bluuebunny/crossref_metadata_2025 huggingface dataset:
IJCM_174A: Lifestyle risk factors among homeless adults in Chennai- A Cross Sectional Study
Authors: Jamir Jongshina , Sudharshini S
Published: April 2024

Background:

India defines ‘homeless’ as those who do not live in Census houses, but rather stay on pavements, roadsides, railway platforms, staircases, temples, streets, in pipes, or other open spaces. According to 2018 GCC enumeration of urban homeless, there are 3764 men and 2962 women, in total 6726 adult population. As they have a relatively different lifestyle, it is essential to know about their lifestyle risk factors and their accessibility to healthcare. In order to attain our Sustainable Development goals, in particular SDG 3- it is essential to target the well being of the homeless population.

Objective:

To estimate the lifestyle risk factors among homeless population in Chennai.

Methodology:

All adults who were 18 years and above and who fit in the criteria for homeless where taken for the study and an Interviewer administered pre-designed questionnaire, under the following Socio Demographic Details, Behavioural Measurements which included tobacco use, alcohol consumption, diet, lifestyle advice and physical activity was used to ascertain the lifestyle risk factors among the homeless. Data was entered in MS excel and analyzed using SPSS-21.

Results:

Out of 341 participants, 70.7% were females,27.3% males and 2.1% transgender. 27.6% had a habit of smoking daily and among that 24.9% were using smokeless tobacco. 15% had a habit of drinking alcohol. In the past one year 57.2% had visited the hospital and 44% had visited a government facility. 27.3% did moderate work and 14.4% vigorious work. 1.5% had a habit of doing moderate exercise on a daily basis.76.8% and 54.8% had undergone screening for hypertension and diabetes mellitus respectively.

Conclusion:

Spreading awareness to the homeless population on lifestyle risk factors is essential to ensure their healthy living.
IJCM_18A: A Cross-sectional study on prevalence of pregnancy related anxiety among antenatal mothers attending Rural Primary Health Center, Kancheepuram
Authors: Priyadharshini S , Chitra
Published: April 2024

Background:

With declining rates of maternal mortality worldwide, its time to recognize the importance of addressing morbidity as well. When compared with general anxiety, pregnancy-related anxiety appears to be a stronger determinant for poor obstetric consequences. Complications include miscarriage, low birth weight, impaired cognitive and physical fetal development, and possibly death.

Objectives:

To assess the prevalence of pregnancy related anxiety with severity and the associated factors.

Methodology:

A cross-sectional on was conducted among 113 antenatal mothers attending antenatal clinic (Tuesdays)in Kundrathur Rural Primary Health Centre by consecutive sampling. Data was collected by interviewer administering a validated and structured questionnaire PRAQ R2(Pregnancy Related Anxiety Questionnaire Revised 2) and statistical analysis was done using IBM SPSS version 25.

Results:

Among 113 antenatal mothers mean age was 25.19+4.2 years, 69.9% are primi gravida, 50.4% said that current pregnancy is planned. All of the mothers having complications in current pregnancy (22.1%) had pregnancy related anxiety. The mean scores of pregnancy related anxiety domains were 7.6 out of 15 for fear of giving birth, 4.9 out of 15 for concern of own appearance, and 10.9 out of 12 for worries about bearing a handicapped child. Nearly 89.4% of mothers have pregnancy-related anxiety with most of them having low severity anxiety (44.2%). The factors associated with pregnancy related anxiety (p < 0.05) were primi gravida and those in second and third trimester.

Conclusion:

A majority of the participants are experiencing pregnancy related anxiety with most of them having low severity anxiety worrying about outcome of birth. It’s predictors included Primigravida and those in second and third trimester. Pregnancy-related anxiety should be diagnosed early during routine antenatal mothers for better maternal and fetal outcomes
IJCM_181A: Health behavioral change and Associated factors among patients diagnosed with non-communicable diseases in the Rural areas of Southern India
Authors: Kumar C. Sunil , Chandrasekhar C. , Madhu T.
Published: April 2024

Background:

Non-communicable diseases (NCDs) contributed to 71% of the global mortality and affect the ageing population with variable proportions. NCD diagnosis gives an opportunity for patients to change their health behaviors. Secondary prevention strategies like diet modification, physical activity and smoking cessation after NCD diagnosis are important and should be emphasized particularly for middle-aged and older adults.

Objectives:

1. To assess the level of health behavioral change adopted by the patients diagnosed with NCDs registered under Rural field practice area. 2. To evaluate the factors influencing the health behavioral change in NCD patients.

Methodology:

This is a Cross-sectional study design conducted at Rural Health & Training Centre, Government Medical College, Ananthapuramu, from August 2023 to October 2023. Simple random sampling was used to select 150 registered NCD cases from the RHTC data-base. We included participants who were diagnosed with either diabetes, cardiovascular disease, chronic lung disease, or cancer after recruitment. Data were collected by using pre-designed semi-structured questionnaire. Data was analyzed using IBM SPSS version 25.0. Associations were tested using chi-squares and for all comparisons p-value <0.05 was considered significant.

Results:

In total 48 (32%) NCD cases have adopted suggested behavioral change instructed by the physician. Factors such as females, graduates, Class III & above SES, diagnosed between 5 to 10 years, not having any other co-morbidities were significantly associated with good health behavioral change.

Conclusion:

Around two third of the diagnosed NCD cases were not compliant to health behavioral change. Hence, health care providers need to provide behavioral change communication related to health behaviors in addition to standard medical care.
IJCM_198A: Effectiveness of a video assisted awareness program on knowledge and practices of road safety among Medical students of Kakinada, Andhra Pradesh: An Interventional Study.
Authors: Jonnakuti Sandeep Kumar , Madhavi B. Devi , Davis B. Mercy
Published: April 2024

Background:

Road safety is an issue of great concern across the world. In the last year 1,354,840 road users have died equivalent to 3712 deaths per day in the world. It is crucial to create awareness about the road safety to instill responsible behavior among citizens.

Objectives:

To assess baseline knowledge and practices of road safety among medical students. To compare the change in knowledge and practices assessed one month after a video assisted awareness program.

Methodology:

An interventional study was conducted among medical students from 1st professional year to final year, interns at Rangaraya medical college, Kakinada. Considering prevalence of 58.3% from previous study, allowable error 10%, sample size is calculated by using 4PQ/L2 as 287. Out of 1450 medical students, 287 were selected using Probability Proportionate to size sampling and 40, 50, 50, 48, 50, 49 from 2018-2023 batches using Simple Random Sampling. Students who gave written consent were included; non-drivers were excluded. Pre-tested semi-structured questionnaire was prepared and google form was shared to the study participants. A pilot study was done among 30 students. The study was approved by Institutional Ethics Committee. Data was analyzed using SPSS software Version 21. After baseline study, intervention will be done using a video assisted awareness program. Post-intervention results will be presented at the conference.

Results:

Among the participants, males and females were 46.5%, 53.5% respectively. Majority of them (77.7%) drive a two-wheeler. 70.3% have poor knowledge regarding airbag deployment during a crash, poor knowledge about vehicle maintenance (70.7%). About 77.7% do not use helmet, 44.9% do not use seat belt, 45.3% had distracted driving.

Conclusion:

The knowledge of participants was found to be fair and the practices were found to be poor.
IJCM_210A: Assessment of Outdoor Patients Waiting Time and Consultation Time in a Tertiary Care Hospital of Kolkata
Authors: Datta Mousumi
Published: April 2024

Background:

Waiting and consultation times affect patient satisfaction and the managerial capacity of the health system. Whereas waiting time is mainly attributed to organizational processes, consultation time is characterized by health demands, concerns, and protocols followed by service providers, which vary between individuals. Therefore, periodic evaluation of the entire process is necessary to achieve continuing health service improvement.

Objectives:

1. To measure the waiting time and consultation time for each participant 2. To find out the variation of waiting and consultation time according to the departments visited.

Methodology:

A descriptive, cross-sectional study was carried out at a tertiary care medical college hospital in Kolkata, between May-June 2023. A systematic sampling design was followed. Data collection was conducted for two weeks for the entire OPD duration (9 AM-3 PM). Waiting Time was defined as the time taken from registration to chamber entry. Consultation Time was defined for the study as the time taken from chamber entry to exit. Timing record was maintained by giving a time-indicated note to the patient at the time of registration. Exit interviews were conducted after completing consultations.

Results:

Total number of participants was 432, with 74.8% female and mean age of 28.7 years. There were 22% participants who had 10 or more years of schooling and 80.1% resided in rural areas. Mean waiting time was 98.6 minutes (SD 45.4) and the consultation time was 6.5 (SD 13.7) minutes. Waiting time was maximum for general medicine OPD (mean-122 min) and minimum for pediatric medicine OPD (mean 43 min), while consultation time was maximum for surgery OPD (mean 6.8 min).

Conclusion:

The study shows an imbalance between waiting time and consultation time. Walk-in patients for minor illnesses and unnecessary referrals should be reduced to prevent overcrowding of tertiary institutes and compromising quality of care.
IJCM_226A: Bridging the Gap: Model Immunization Centers in Urban Bihar - A Study on Factors Shaping Community Acceptance and Utilization for Improved Immunization Coverage
Authors: Rauny Rahul , Sinha N.K. , Dhalaria Pritu , Agrawal Ayushi , Verma Anupam , Singh Ajeet , JSI Syed Hassan
Published: April 2024

Background:

Despite significant strides in immunization coverage, Full Immunization coverage in urban areas of India lags behind rural regions, with Urban India recording 75.5% compared to 76.8% in rural areas. Additionally, the prevalence of zero-dose children is higher in Urban India (7.5%) compared to rural counterparts (6.3%). Urbanization introduces a complex dynamic marked by poverty, migration, and growing disparities in health access, social services, and economic resources that necessitate innovative strategies to address immunization inequities in urban settings. In this direction, the Government of Bihar in 2017 introduced the concept of Model Immunization Centers (MICs) to provide high-quality immunization services to urban poor and marginalized to improve coverage and build trust, confidence and motivation for public immunization services.

Objectives:

The primary objective of the study was to assess and identify the factors that shape the community’s acceptance and utilization of immunization services at MICs in Patna and Siwan.

Methodology:

A mixed-methods approach was employed, combining quantitative data analysis of immunization records and demographic information with qualitative assessments of community perceptions through in-depth interviews and focus group discussions. The study site i.e., Patna and Siwan Districts of Bihar was purposively selected.

Results:

The study found that the effectiveness of MICs was significantly influenced by family, community, and social norms. Additionally, MICs played a pivotal role in enhancing people’s trust, confidence, and motivation through the provision of a favourable environment, hygiene maintenance, the availability of free vaccines, reduced waiting times, and courteous staff behaviour. These factors have collectively led to improved immunization coverage, increased footfall, and improved rates of full immunization.

Conclusion:

The success of MIC in gaining people’s trust and confidence has been a driving force behind the increase in footfall coverage at session sites and high Full Immunization Coverage in Patna and Siwan
IJCM_230A: Obstacles Faced by Medical Undergraduates Wearing Spectacles In A Medical College In Mangalore
Authors: Garg Yug , Abraham Roche Varghese , Samhitha D , Sneha J , Holla Ramesh , Motappa Rohith , Unnikrishnan Bhaskaran , Rekha T , Mithra Prasanna , Kumar Nithin , Rao Mithun
Published: April 2024

Background:

Spectacle compliance is vital among the young population to combat visual impairment arising from untreated refractive errors. Encouraging spectacle use is crucial, despite the challenges they present, such as fogging, scratches, and discomfort when prescribed wrong

Objectives:

1. To study the obstacles faced by medical undergraduates while using spectacles. 2. To find out the various factors associated with the obstacles faced by undergraduates while wearing spectacles.

Methodology:

The study protocol was submitted for the approval from the Institutional Ethics Committee (IEC) of Kasturba Medical College, Mangalore. After obtaining the approval from ethics committee, permission was obtained from the Dean of Kasturba Medical College, Mangalore and data collection was done after receiving informed consent from the participants. A semi- structured questionnaire was distributed to the participants

Results:

72.7% faced obstacle of dependency on spectacles and 71.5% faced difficulty of adjusting spectacles with gloved hands. Â· Out of 60(34.9%) study participants who ride two-wheeler, 21(35%) participants faced difficulties while riding due to spectacle use and wearing helmet(42.8%), glaring(19.1%) and fogging(14.2%) were the major difficulties faced. Â· Among 54(32%) study participants who drive 4-wheeler, 9(16.6%) participants faced difficulties while driving due to spectacle use and the major difficulties encountered were glaring(55.5%) and restricted field of vision(22.2%). Â· A statistically significant association with P value of 0.001 was established between duration of spectacle usage and dependency on spectacles

Conclusion:

Based on our study, we have found that most of the participants have been using spectacles for 1-10 years mainly for correction of refractive errors like myopia and thus use spectacles throughout the day.
IJCM_231A: Barriers and Facilitators for Integrating Screening and Brief Intervention for Quitting Substance Use in Primary Care Settings
Authors: Kulkarni Muralidhar M , Viswanathan Anusha , Akhila D , Bantwal Priyanka , Praharaj Samir Kumar
Published: April 2024

Background:

Substance Use disorders (SUD) are commonly encountered in general medical practice which include people of all ages and socioeconomic groups. In these circumstances, Screening and Brief Intervention (SBI) can be a useful tool for managing the disease burden in primary care setting. There is a need to investigate the hurdles and enablers that act as a catalyst for integrating Screening and Brief Intervention in primary health care practice

Objectives:

To explore the barriers and facilitators for implementing screening and brief intervention (SBI) for SUD at primary health care settings

Methodology:

A written informed consent was obtained from the subjects after briefing about the topic and interview was initiated with the help of an interview guide. The interview was recorded using an audio recorder. The discussion was written in the vernacular language and translated verbatim. Inductive thematic coding was applied to analyse the data

Results:

A total of 10 participants were interviewed which included four Medical Officers (MO), two Auxiliary Nurse Midwives (ANMS), one each Medical Social Worker (MSW), Tobacco Cessation Cell Consultant, Counsellor and substance user. Some challenges to integrating screening services included lack of manpower, hesitance to reveal substance use by women and identifying trained health care providers to seek assistance for quitting. Facilitators of Screening and brief intervention delivered at Primary Care level includes a favourable attitude of the health care provider, awareness among doctors about harmful effects of substance use and patients’ good rapport with field workers

Conclusion:

This study’s results point towards a multi-pronged approach like involvement and capacity building of different health care providers like Accredited Social Health Activist (ASHA), ANMs and MO along with encouraging community participation for integrating Screening and Brief Intervention in this setting.
IJCM_245A: Beyond the Basics: Insights into Pharmacovigilance Literacy among Postgraduate Medical students: A Mixed-Methods study from central India.
Authors: Wath Darshan Ashok , Rathod Pragati , Wadhwa Sarita , Narlawar Uday
Published: April 2024

Background:

Pharmacovigilance ensures medical intervention safety by detecting, assessing, understanding, and preventing adverse drug effects or related issues. As the guardians of patient well-being, healthcare professionals, particularly postgraduate medical students, are integral contributors to the pharmacovigilance landscape. Understanding their knowledge, attitudes, and practices in this domain is essential for fostering a culture of drug safety and continuous improvement in healthcare delivery. The present study aspires to identify potential gaps in awareness, uncover barriers to active participation in pharmacovigilance activities, and, ultimately, offer insights that can inform targeted educational interventions.

Objectives:

To assess the knowledge levels of postgraduate medical students regarding pharmacovigilance, to examine their attitudes towards reporting adverse drug reactions, and explore the practical application of pharmacovigilance principles in their clinical practice. Additionally, the study aimed to identify potential barriers and facilitators influencing their engagement with pharmacovigilance activities.

Methodology:

This research adopted a mixed-method approach, combining quantitative and qualitative techniques to provide a comprehensive understanding of the subject matter. In Qualitative phase the focused group discussion has been undertaken followed by developing the questionnaire which after validation was used for quantitative data collection. The study population comprised postgraduate medical students from the tertiary care institute of central India. Data analysis involved thematic analysis for qualitative data and statistical techniques for quantitative data.

Results:

It was observed that the knowledge of the participants regarding ADR reporting and pharmacovigilance was poor.

Conclusion:

Various barriers regarding ADR reporting were identified, and appropriate interventions were suggested by the participants.
IJCM_258A: Perceptions regarding mid-day meal programme among parents of government school children in rural field practice area of a government medical college a cross sectional study.
Authors: Gowd P. Kavya Sree , Sowmya l. , Sujatha P. , Madhavi B. Devi
Published: April 2024

Background:

Mid - Day Meal Scheme (MDMS) renamed as PM POSHAN in 2021 is aiding 11.80 crore children studying in 11.20 lakhs schools across the country making it the largest school feeding programme in the world. This study was intended to know the opinion of parents of children going to government schools regarding mid - day meal.

Objectives:

1. To study the perceptions of parents regarding Mid -Day Meal Scheme. 2. To identify the barriers for non-consumption of Mid - day meals.

Methodology:

Study Design Cross - sectional study Sampling Systematic Random Sampling Study setting “Rural Field Practice Area of a Government medical college. Study Period November - December 2023 Inclusion criteria Parents and Guardians who gave written informed consent. Exclusion criteria Parents who could not respond due to mental problems. Ethical Prior ethical approval was taken from Institutional Ethics Committee. Data collection and analysis data collection was done using pre-designed semi structured questionnaire and analyzed using Excel and SPSS software.

Results:

Mean age of the respondents (parent) was 33Â±7SD. Majority (72.9%) of the respondents were mothers. 59.4% of parents perceived that quality of MDM was good. It was found that overall satisfaction among parents regarding MDM was 65%. More than two thirds (67.5%) of parents felt that MDM has improved their childs school performance.

Conclusion:

Most of the parents were satisfied about the quality of mid - day meal and few parents agreed that MDM has encouraged parents to send their children to school. Most of the parents agreed that MDM is beneficial and should be continued
IJCM_26A: Validation of Rashtriya Bal Swasthya Karyakram (RBSK) screening tool in Screening of Developmental Delay (DD) among under 3-year children in Bengaluru.
Authors: Santhosh Gokul , Deepthi R , Ashwini L
Published: April 2024

Background:

Most DD tools available are designed in western countries which are lengthy, time consuming and need expertise to administer. RBSK has a simple tool to screen children aged 0-6 for developmental delays and disabilities. However, the psychometric properties are not published in public domain to understand its validity

Objective:

To study psychometric properties of RBSK screening tool for Screening of Developmental Delay among under 3 year children in Bengaluru.

Methodology:

A cross-sectional study was conducted among 262 children were screened in area covering five PHCs in Bengaluru. The children, categorized into eight strata based on age and underwent evaluation for developmental delay using both by the RBSK screening tool and the Ages and Stages questionnaire (ASQ) which is considered as gold standard. sensitivity, specificity, positive and negative predictive value along with kappa statistics was calculated readings of both the study tools.

Results:

The study encompassed a near-equal proportion of male (145,55.3%) and female (117,44.7%) children. Notably, the RBSK screening tool detected developmental delays in 13% of cases, slightly higher than the 10.7% identified by the ASQ tool. The RBSK tool exhibited a sensitivity of 97.01%, specificity of 96.43%, positive predictive value of 99.56% and negative predictive value of 79.41%. The calculated Kappa value of 0.854 signifies substantial agreement with the gold standard ASQ tool, reaffirming the RBSK tool’s validity in identifying developmental delays. Good psychometric properties was observed across gross motor, fine motor, communication, psychosocial and problem solving domains.

Conclusion:

This study demonstrates good psychometric properties of the RBSK screening tool in terms of sensitivity, specificity, and positive predictive value. Its user-friendly administration enables screening a larger population, effectively identifying more children with developmental delays, thereby facilitating early interventions crucial for their well-being
IJCM_260A: Utilization of dbt(direct benefit transfer) under Nikshay poshan yojana by tuberculosis patients attending to tuberculosis unit in a government general hospital.
Authors: Tajunothu Siva Prasad , Garapati Sridevi , Peethala Sujatha , Madhavi Devi B
Published: April 2024

Background:

Nikshay Poshan Yojana was launched by MoH&FW, a centrally sponsored scheme under National Health Mission (NHM)on April 2018. Under the programme financial incentive of Rs.500/- per month is given for each notified TB patient, whether treated in public or private sector notified on the Nikshay platform. This study aims to understand the utilization of NPY.

Objectives:

1. To know the purpose of utilizing the NPY by the TB patients. 2. To assess the gaps for delay in credit the amount.

Methodology:

It’s a cross-sectional study done among patients who were registered at DTC-TB unit of Government Medical College Kakinada through telephonic interview. Sample size was estimated to be 64 taking prevalence of NPY as 80% with absolute error of 10%. Data was collected by using questionnaire in November 2023 and analyzed by SPSS 21.0. Prior permission from Institutional Ethics committee was obtained.

Results:

Mean age of participants was 41.4+12.4yrs. Males contributing 85.4% and females 14.6%. Nearly half (48%) has taken 2months of treatment, 97.9%were under category I treatment and all were enrolled under NPY. Awareness on NPY was 79.2% and 95.8% reported irregularity in getting NPY. Out of those who received NPY, only 42.1% utilized it for nutrition.

Conclusion:

DBT enrolment was good. Availability of DBT to the patients was very minimal.
IJCM_264A: An assessment of Dialysis services in the state of Chhattisgarh
Authors: Nanda Sarthak , Verma Nirmal , Jain Kamlesh
Published: April 2024

Background:

In India, about 3.4 crore people need dialysis, with 2.2 million new cases of renal diseases every year. With approximately 4950 dialysis centres, the demand is less than half met. Every Dialysis has an additional expenditure tag of about Rs.2000, it results in expenditure of Rs.3-4 Lakhs annually for the patient. The Dialysis Program under Public Private Partnership was formally announced in the Union Budget 2016-17 by the Honourable Finance Minister.

Objective:

To assess the dialysis centres working under the National Dialysis Programme. To look at the resources and equipment’s of various centres to look at the patient load of various centres

Methodology:

The teams from Pt. J.N.M Medical college went to 8 centres of various centres giving dialysis services. This covered 75% of the centres of the state. Centre staff as well as patients were interviewed. The interview was conducted using a predesigned, validated, semi-structured questionnaire.

Results:

The staff working in the centres is well trained and they are managing the workload well. The technicians are doing well in terms of giving services and most of the centres have multiple machines. Raipur is the most advanced one.

Conclusion:

These dialysis centres are doing a good job in managing workload however, the centres should have a dedicated Medical officer for the centre. Although, workload is well managed because of Medical Officers working in DH and trained staff of the centre, the medical officers of District Hospital can be trained for reduction of employment stress
IJCM_265A: Cellular Consequences of Fruit Juice Metallurgy: A Closer Look at Heavy Metal Influence
Authors: Mukhi Senna , Srikantiah Rukmini Mysore , Parashiva Guruprasad Kanive , Regupathi Iyyaswami
Published: April 2024

Background:

The leaching of heavy metals from packaging materials into packed juices can have several adverse effects on the quality and safety of the products and potentially pose health risks to consumers.

Objective:

The research aimed to investigate the cytotoxic effects of heavy metals specifically vanadium, cadmium, arsenic, and mercury, which are commonly found in packaging materials of marketable fruit juices which are leached into juices itself (orange and mixed fruit juices stored in cans, leak- proof bags, and tetraPaks).

Methodology:

The study utilized cell lines, namely HepG2 (human liver cancer) and HeK293 (human kidney), to assess the impact of these heavy metals on cellular viability, DNA damage, mitochondrial function, and cell cycle progression. Flow cytometry was used to analyse cell cycle alterations.

Results:

The MTT assay showcased dose-dependent decrease in cell viability with increasing concentrations of heavy metals. Annexin V Assay determined V, Hg and As had necrotic death pattern while Cd had apoptotic death pattern for both the cell lines in presence of heavy metal digests. Cells treated with heavy metals, and the resulting DNA damage observed to be high after quantified using comet tail length, olive tail movement, and tail moment measurements. Mitochondrial function assays in the presence of heavy metals revealed that increased mitochondrial membrane potential, mitochondrial mass, and reactive oxygen species production. ROS generation assessed to understand the impact of heavy metals on cellular health and oxidative stress.

Conclusion:

This study shed light on the potential cytotoxic effects of heavy metals found in fruit juices. These findings contribute to our understanding of the potential risks associated with heavy metal exposure from consumer products and emphasize the importance of regulatory measures to ensure food safety and human health.
IJCM_276A: Determinants of Delayed Sputum Conversion among Tuberculosis Patients in Malappuram District: A Case Control Study
Authors: Rajeev Krishnaraj , Sebastian NM
Published: April 2024

Background:

Treatment of drug-sensitive TB consists of an intensive phase of 2 months followed by a continuation phase of 4 months. After completion of intensive phase of therapy, sputum AFB smear microscopy is repeated and presence of smear conversion is suggested as a significant early predictor of treatment effectiveness. Delay in sputum conversion will lead to prolongation of the period of time that patients remain contagious.

Objectives:

To study the determinants of delayed sputum conversion among Tuberculosis patients in Malappuram district

Methodology:

A Case control study was conducted among tuberculosis patients residing in Malappuram district of Kerala and registered under NTEP in District Tuberculosis Centre (DTC), Manjeri, Malappuram. After satisfying inclusion and exclusion criteria, 90 tuberculosis patients who failed to achieve sputum smear negativity after completion of 2 months of intensive phase multi drug therapy were taken as cases. Another 90 tuberculosis patients those who achieved sputum smear negativity after completion of 2 months of intensive phase therapy were selected as control group. Data was collected by interview method.

Results:

Patients with lower socio-economic status (OR = 3.59, 95% CI 1.92- 6.73), low BMI or underweight (OR = 1.98, 95% CI 1.1 - 3.6), multiple symptoms (OR= 5.50, 95% CI 1.98 - 15.28), increased duration of symptoms (OR=4.54, 95% 2.24-9.19), co-morbid condition of diabetes mellitus (OR = 2.25, 95% CI 1.24 - 4.09) are at statistically significant risk of delay in sputum smear conversion after intensive phase of anti-tubercular therapy.

Conclusion:

Patients with lower socio-economic status, low BMI or underweight, multiple symptoms, increased duration of symptoms, co-morbid condition of diabetes mellitus are at statistically significant risk of delay in sputum smear conversion after intensive phase of anti-tubercular therapy. Treating physicians and public health experts should give special attention to TB patients with these risk factors.
IJCM_278A: Forecasting of Dengue Cases and Deaths in India: An application of Auto Regressive Integrated Moving Average Model
Authors: Tripathy Sashikanta , Mishra Amit Kumar , Ruikar Manisha
Published: April 2024

Background:

Dengue is a mosquito borne viral disease caused by Dengue virus (DENV). Nearly about half of global population is at risk now with an estimated 100-400 million infections occurring every year. South East Asia (SEA) countries are at more risk for having Dengue infections due to its temperate climate. In India also, the cases are rising every year due to change in environmental and climatic conditions.

Objectives:

1. To assess the trend of Dengue in India, 2. To forecast Dengue cases and deaths in India

Methodology:

For this time series analysis study, data on Dengue were collected from National Health Profile 2005-2022 and NVBCDCP; and a secondary data analysis was done. Gretl software was used to develop the model and to forecast Dengue cases and deaths. Data were checked for stationarity and appropriate ARIMA (Auto Regressive Integrated Moving Average) model for the available data was developed. Using the developed model, the cases and deaths are forecasted for next 3 years (2023-2025).

Results:

The available data showed an increasing trend of Dengue cases and deaths in India. The three years forecasted data for Dengue cases & deaths also shows an increasing trend. The predicted Dengue cases for 2025 are 278513 (95% CI; 208898-348128) and the Dengue deaths for 2025 are 308 (95% CI; 166-450).

Conclusion:

From the time series analysis of the data, it is clear that the public health burden of Dengue is on an increasing trend. Hence, it is recommended that the policy makers & health workers need to focus more on planning & implementing effective preventive interventions to reduce the public health burden of Dengue cases & deaths.
IJCM_28A: Prevalence of anemia and its association with Knowledge, Attitude, Practice and Health seeking behaviour regarding anemia among women in the age group of 15 - 59 years : a community based cross-sectional study in a rural area in Ernakulam District.
Authors: Nikhila L.N , Abraham Ruth , Sajithamony
Published: April 2024

Background:

29.9% of reproductive-age women globally and 57% in India suffer from anemia making it a public health concern.

Objectives:

1. To determine the prevalence of anemia among women aged 15-59 years in a rural area in Ernakulam District. 2. To assess the knowledge, attitude, practice and health seeking behaviour related to anemia among women in the study setting. 3. To find the association between anemia and the knowledge, attitudes, practices and health-seeking behavior (HSB) of women in the study setting.

Methodology:

A community based cross-sectional study was conducted over 3 months in Chengamanad panchayat among 208 women aged 15-59 years using cluster sampling. Study tool was an expert-validated semi-structured questionnaire in local language and participants were interviewed after taking informed consent. Hemoglobin levels were measured by Junior Public Health Nurses using a Digital Hemoglobinometer. Statistical analysis was done using SPSS software and p < 0.05 was considered as statistically significant.

Results:

In the study among 208 participants (mean age: 41.52 ± 12.11 years), anemia prevalence was 43.8% (37.1%, 50.5%) (Mild: 20.2%, Moderate: 19.7%, Severe: 3.8%), with a mean hemoglobin level of 11.98 ± 1.82 gm/dl. Among the 91 women with anemia, 72.5% (66.4%, 78.6%) lacked adequate knowledge, though 89% had a positive attitude. Only 59.3% (52.6%, 65.9%) practiced effective anemia prevention strategies, and 50.5% exhibited insufficient HSB. Anemia was found to be significantly associated with religion (?2 = 10.66) and education (?2 = 8.09). Significant association was found between knowledge and attitude (?2 = 5.88), practice (?2 = 3.60) and HSB (?2 = 19.24).

Conclusion:

A high anemia prevalence (43.8%) was idenitifed and was significantly associated with religion and education. Emphasizing behaviour change communication is crucial for effective intervention.
IJCM_288A: Factors responsible for death among HIV infected patients registered in ART Centre Jabalpur, Madhya Pradesh.
Authors: Klein Carefirmly , Toppo Neelam Anupama , Jabalpur Aditya Thakur- NSCB Medical College , Pradesh Madhya
Published: April 2024

Background:

Factors responsible for death in HIV infected population are necessary to devise disease specific preventive interventions at both state and national level HIV programs. This study examines the factors responsible for death among HIV-infected individuals registered in Anti-Retro-viral Therapy (ART) center Jabalpur, Madhya Pradesh.

Objectives:

1. To understand the trends of HIV deaths in last 6 years in Jabalpur District. 2. To understands the factors responsible for deaths among registered HIV positive patients in ART Centre of Jabalpur District.

Methodology:

A retrospective chart review of factors responsible for death was undertaken among HIV-infected patients who were treated between January 2016 and December 2021 at ART Center Jabalpur.

Results:

Among total of 83 sample cases registered from January 2016 to December 2021, 86.7% of those who died were males. Mean duration of survival after initiation of treatment is 17 months. 49.4% of the cases falls under the age group of 31-45 years. 75.9% of the cases contracted the virus through sexual mode of transmission. 56.6% of the cases had opportunistic infections. Tuberculosis is (32.5%) is the leading opportunistic infections and 28.9% of cases had CD4 count in the range of 50-199 cells/mm.

Conclusion:

Tuberculosis has remained the leading factor responsible for deaths among the HIV patients on ART. Deaths were significantly associated with patient’s CD4 count at the time of diagnosis and the presence of opportunistic infections during treatment.
IJCM_292A: Chikungunya Outbreak Investigation at Village Bolasa, Petlawat, Jhabua, Madhya Pradesh, India, September 2023
Authors: Mahadik Mrunal Madhukar , Jain Abhishek , Dzeyie Kevisetuo Anthony
Published: April 2024

Background:

Chikungunya, a resurging vector-borne disease caused by chikungunya virus, remains a global health challenge. In 2023, globally 4.4 lakhs suspected cases and 365 fatalities were estimated; India accounting for 21% of the global burden. On 5 September 2023, suspected outbreak of chikungunya was reported at Bolasa village, Jhabua, Madhya Pradesh by local newspaper.

Objective:

We investigated to confirm the outbreak, describe the epidemiology and provide evidence-based recommendations.

Methodology:

We compared past three years Integrated Disease Surveillance System (IDSP) data to confirm the outbreak. We defined a suspect case as fever with arthralgia in a resident of Bolasa village, during 20 August-30 October 2023, searched cases by reviewing patients register from health-care-facilities and house-to-house in Bolasa village. Cases were interviewed using semi- structured questionnaire prepared by modifying WHO chikungunya toolbox and data analyzed using Microsoft-Excel. We conducted environmental survey at domestic and peri-domestic areas and serum samples collected for laboratory confirmation.

Results:

No chikungunya case was reported in the last three years. We identified 117 suspected cases (56% females) with median age of 40 years (range 27-52 years). Other than fever and arthralgia, the other symptoms included bodyache (78%) and headache (67%). Overall attack rate (AR) was 8%; highest AR in Tadvifaliya of 18% followed by Harijan and Patidar faliya with 12% each. Among the cases, 76% stored water in containers without cover, mosquito larvae were found in the containers in the house or nearby place of 60% cases. Of the 20 serum samples tested, nine were positive for chikungunya IgM-antibody.

Conclusion:

We detected a confirmed chikungunya outbreak in a rural setting with vector breeding sites identified in a community. Outbreak investigation led to vector control by eliminating breeding sites and community sensitization on water storage practices. We recommended early case reporting, periodic entomological surveys and source reduction.
IJCM_304A: A Study on Stigma-Discrimination and Sense of Grip on Disease Experienced by the PLHIV Visiting ART Centre of a Tertiary Care Hospital of Kolkata
Authors: Roy Shuvajit , Bandyopadhyay Lina , Sahu Monalisha , Modak Dolanchamp , Paul Bobby
Published: April 2024

Background:

People Living with HIV face not just a health challenge but also the burden of stigma-discrimination. The impact isn’t just physical; it takes a toll on their mental health. Many internalize this stigma, feeling shame about their condition. It Is crucial to address these issues not only for those directly affected but also to build a society that is compassionate and understanding, supporting individuals with HIV/AIDS rather than marginalizing them.

Objective:

To determine the level of stigma-discrimination faced by PLHIV visiting the ART center of a tertiary care hospital of Kolkata including the factors associated with it. The second objective is to explore their sense of grip on the disease among them.

Methodology:

This descriptive method study was conducted in November 2023 among 120 PLHIV (Selected by systematic random sampling) visiting the ART center of the School of Tropical Medicine, Kolkata after getting permission from IEC & NACO. Qualitative data was collected via IDI & KII. Quantitative data were analyzed using MS Excel, SPSS v. 16, employing descriptive and inferential statistics. Manual thematic analysis applied for qualitative data.

Results:

Among 120 participants 45.8% of the participants faced more stigma & discrimination in comparison to others. There was a statistically significant difference in the level of stigma & discrimination based on their age group (p-value 0.033), type of family (p-value 0.014), Addiction status (p-value 0.037), co-morbidities (p-value 0.011), viral load (p-value 0.033). On exploring sense of grip on disease majority of the participants were shown to have a compliant profile.

Conclusion:

The levels of stigma- discrimination were associated with their behavioral & disease characteristics. Thus, raising awareness is essential to combat stigma and enhance sense of grip on the disease.
IJCM_308A: A descriptive study on Nipah outbreak at Kozhikode
Authors: Salam Ahana , Jayakrishnan T , Divya CV , Lakshmananan Anjali
Published: April 2024

Background:

Out of 6 outbreaks happened in India 4 were from Kerala. Similar to the previous outbreak in Kerala, the one in 2023 also started with the one case and subsequent clustering of cases in family contacts and likely nosocomial transmission in hospitals. It shows the rest of the country are exposed to the high risk of another outbreak making preparedness vital.

Objective:

To understand the process of controlling the outbreak

Methodology:

The following data was collected from District Medical Office, Media, Press release collected. On 10th September information about death of a person and development of similar symptoms in family was reported. The death audit was done. The close contacts of primary case were also traced. The 2nd death of a person was investigated and taken as index case. All the primary and secondary contacts of both cases were traced, line listed, quarantined and followed for any onset of symptoms. Fever surveillance and fever clinics were started and outbreak was declared. Mapping of areas done and containment zones and lockdown was declared till October 1st. Later 2 more health care workers turned positive. Multi-disciplinary teams were mobilized. Nipah cell was opened and 19 core committees were formed. Contacts were categorised in to high and low risk. To disseminate the details media point was arranged.

Results:

The contact between primary and index case established. Two family members of the deceased were also turned positive within in 1 week. Field visit was done to recognise the source. Fever survey was started and fever cases were detected. Government hospitals were prepared to meet the emergency by arranging wards according to the severity of disease.

Conclusion:

In response to the recurrent NiV outbreaks, it is paramount that proactive measures be taken to mitigate future risks. Enhanced Surveillance is of utmost importance.
IJCM_315A: Pesticide exposure and Diabetes Mellitus - A Community based Analytical Cross-sectionalstudy among agricultural workers in Madurai east community block, Tamil Nadu
Authors: Thendralan V , Priya S.
Published: April 2024

Background:

World Health Organization (WHO) states that diabetes mellitus (DM) is the ninth leading cause of death in 2019¹. The study by Velmurugan et.al² in 2021 in rural Tamil Nadu shows a high prevalence of DM among agricultural workers (15.0%) compared to non-farming communities (8.7%). Pesticides, a source of Endocrine Disrupting Chemicals (EDCs) play a major etiological role in Diabetes Mellitus among them. Hence the need for present study.

Objectives:

1. To estimate the prevalence of diabetes mellitus among agricultural workers in Madurai East Block 2. To find the association between pesticide exposure and other variables with DM.

Methodology:

A community-based cross-sectional study was conducted among 150 agricultural workers in Madurai East using multistage cluster sampling during august to November 2023.Sample size was calculated using Velmurugan et.al studyÂ². After obtaining informed consent, study population was interviewed using semi-structured validated (containing details about sociodemographics, pesticide exposure questionnaire, diabetic status) followed by anthropometric measurements in the previous day evening and advised 8 hrs fasting that night. Next day morning by 6 am, second visit was made to check fasting capillary blood glucose (CBG) using Accu-Chek glucometer. Data was analyzed using SPSS software version 21.0.

Results:

The mean age of the study population was 50.63 ± 13.36 years. Females constituted 66% (n=99). The mean years of agricultural work was 26.55 ± 13 years. The overall prevalence of DM among study population was 29.3%. The prevalence was slightly higher in pesticide applicators (33.33%) than agricultural workers (29.1%). Except for age, the chi-square test showed no significant association between pesticide exposure, gender, family history of DM, with DM.

Conclusion:

Higher Diabetic prevalence among agricultural workers demands further research to prove the hypothesis of pesticide exposure and development of diabetes.
IJCM_318A: Risk Factors for Anaemia among Type 2 Diabetes Mellitus Patients in Mangalore- A Case Control Study.
Authors: Rekha T , Ramakrishnan Mahima Advaitha , Archa KR , Dahiya Navneet , Chopdar Ankita , Sharma Vagish , Unnikrishnan Bhaskaran , Mithra Prasanna , Holla Ramesh
Published: April 2024

Background:

Anaemia, a common haematological abnormality, currently stands at a prevalence rate of 24.8% worldwide and 39.86% in India, affecting 1.62 billion individuals overall. Studies have shown that patients with Diabetes are twice as likely to be prone to anaemia.

Objective:

To study the risk factors for anaemia among patients with type 2 Diabetes Mellitus.

Methodology:

This is a record-based case-control study of 50 cases (diabetic with anaemia) and 100 controls (diabetic without anaemia) in Government Wenlock Hospital, Mangalore. Patients with haemoglobin concentration below the normal level (as defined by WHO as <13 g/dl for men and <12 g/dl for women) were considered anaemic. Data was entered and analyzed using the statistical software SPSS Version 17.0. Univariate analyses and a Chi-Square test were conducted to identify risk factors.

Results:

The median age of cases as well as controls was 60 years. The duration of diabetes was 8 years in cases and 7 years in controls. Among 50 cases, there were 39 (78%) males and 11(22%) females and among 100 controls, 68(68%) males and 32(32%) females. On univariate analysis, it was found that the low serum urea, creatinine, albumin, total protein and calcium levels were significantly associated with the presence of anaemia (P <0.05).

Conclusion:

The above parameters implicate impairment in renal function and hence we can conclude that impaired renal function is a risk factor for developing anaemia in type 2 Diabetes Mellitus patients.