bluuebunny/crossref_metadata_2025 huggingface dataset:
IJCM_138A: Small group teaching- Perceptions of Students and Faculty of a Medical College in Mangalore, India
Authors: Gupta Urbee , Shahi Anshuman , Apurva J. A. , Dayal Prashansa , Jaiswal Harsh , Kumar Nithin , Rekha T , Unnikrishnan Bhaskaran , Mithra Prasanna , Holla Ramesh
Published: April 2024

Background:

The demands on Medical Education have greatly increased in the 21st century. For this very reason, there has been an unprecedented growth in the number of medical colleges in India. The teacher’s role is to facilitate rather than to direct, to coordinate as much as to communicate. Small group teaching offers students’ opportunity to discuss and refine their understanding of complex issues, to problem solve and apply their knowledge to new situations and to reflect on their attitudes and feelings. The study aims to assess the perception of undergraduate medical students regarding small group teaching, the perception of faculty regarding Small group teaching, compare the perception of students on small group teaching, with respect to their academic performance and attendance.

Methodology:

93 faculty and 499 undergraduate MBBS students participated in the study and were given a self- administered semi-structured questionnaire. The perception of undergraduate students and teaching faculty on small group teaching was assessed using the 5-point Likert Scale. Independent t-test was applied to find difference in mean perception. Students were categorized based on their academic performance and on their attendance aggregate for the concluded semester.

Results:

In total, 404 students and 45 faculty members responded thus giving response rates of 80.9% and 48.4% respectively. The overall response rate was 75.8%

Conclusion:

The study found that both students and faculty members are favorable to the concept of SGT. They found it not only enhances the academic performance of students but also contributes to the personality development of students. Clinical correlations in all the subjects is well appreciated by students and faculty. Suggestions for improvement of SGT such as exam-oriented study, use of innovative and interactive aids can make SGT sessions more effective.
IJCM_139A: Prevalence of Hypertension among the Urban Adolescents: A Prospective Robust Survey
Authors: Revadi G , Maheshwari Mahesh , Yadav Amit Kumar , Bhaskar Smriti , Jaison Akhil , Pakhare Abhijit P
Published: April 2024

Background:

Childhood Blood pressure (BP) is a strong indicator of adult blood pressure (BP), hence, early detection and intervention is important in adolescents. Studies from China and United States have shown BP in adolescents to be variable and has indeed outlined the need to obtain three separate readings before diagnosing hypertension. There is a dearth of this documentation of blood pressure readings at different occasions in adolescents from the Indian settings.

Objective:

To determine the prevalence of elevated blood pressure and hypertension among 10-18 years school going adolescents.

Methodology:

This was a prospective longitudinal study conducted across the five urban schools of Bhopal amongst 10-18 years adolescents. Multistage cluster sampling was adopted to cover an estimated sample size of 780 over a one-year period. Those adolescents who were present during the time of survey following their parent’s consent were included. Those who were absent at two occasions during the follow up visit and those who were diagnosed with secondary hypertension were excluded. Those who satisfied the study criteria were given a self-administered WHO STEPS questionnaire initially. The height and weight were obtained followed by measurement of three auscultatory BP readings at an interval of one week apart (American Academy of paediatrics (Updated guidelines 2017) in each student. The R shiny app calculator was used for classifying hypertension in adolescents. The study was funded by AIIMS Bhopal and ethical clearance was obtained from the institute.

Results:

The overall prevalence of elevated BP/hypertension in adolescents was 1.4% (N=795). There was a positive correlation between BMI and (SBP & DBP). The generalised linear mixed model showed age, BMI and boys to have higher predisposition to elevated BP/HTN. There was a significant difference in the SBP and DBP between the 3 visits stratified by sex. Also, the change in SBP and DBP between the readings were significant by ANOVA.

Conclusion:

The prevalence of elevated BP/HTN was 1.4% with girls being protective for girls. The study cannot be generalised as it is limited to the Government schools with relatively small sample size.
IJCM_144A: Demographic Characteristics and Gender Preference Patterns among Postnatal Women at Tertiary Care Hospital in Mangalore
Authors: Gopika J , Rekha T , Unnikrishnan Bhaskaran , Mithra Prasanna , Kumar Nithin , Holla Ramesh
Published: April 2024

Background:

Gender preference among women remains a significant phenomenon that reflects the imbalance in the sex ratio. Understanding the determinants of gender preference is crucial in addressing associated challenges and promoting gender equality.

Objectives:

To study the socio-demographic profile of post-natal women, gender preference among them and the factors affecting their preference.

Methodology:

A hospital-based Cross-Sectional Study was conducted in a tertiary hospital in Mangalore among 155 multiparous postnatal women. The data were collected using a pre-tested semi-structured questionnaire and was analysed using SPSS version 17.0.

Results:

Overall, 54.83 % of the study participants belonged to the age group of 18-27 years, 57.42% were unaware of any techniques for determining a person’s sex, and the most frequently mentioned method was ultrasound. The proportion of respondents with a preference for a male child was only 20.6%. The most common reason was the male gender carrying the family name. According to 73% of respondents, having two children is ideal for a family, while having an equal number of boys and girls was the most desired combination (60%). There is a significant preference (75%) for the second child to be male if the first child was female.

Conclusion:

It’s noteworthy that the preference for a male child was often tied to cultural and familial considerations, such as carrying on the family name. Interestingly, the study also highlights a prevalent preference for a second child to be male if the first child was female, signifying the persistence of gender-biased attitudes.
IJCM_146A: Development and validation of an infographic educational tool for self-management of hypertension.
Authors: Salins Prajwal , Reshmi Bhageerathy , Furtado Anusha , Sabu KM , Nair Suma , Kundapur Poornima
Published: April 2024

Background:

Hypertension is a serious condition affecting 33 % of urban & 25 % of rural Indian population. It can be controlled by the antihypertensive medications, but self-management approaches also play a very important role in lowering blood pressure. Infographics are one such material which uses visuals to educate the audience. This study assesses the understandability and actionability of the newly developed infographic aimed at self-blood pressure monitoring, medication adherence and lifestyle modifications with dietary approaches and exercise.

Objectives:

The objectives of the study were to develop an infographic tool for educating the patients with hypertension and to validate the infographic tool using PEMAT A/V.

Methodology:

“The study was divided into two phases. First phase was to develop an infographic tool. An infographic was designed using Canva and Procreate. In the second phase, the infographic was validated using the Patient Education Material Assessment Tool - Audio visual (PEMAT-A/V) by 10 participants. PEMAT is a systematic method to evaluate and compare patient education materials.

Result:

Using Canva, the infographic tool was developed, and then PEMAT-A/V was used to validate it. In terms of understandability and actionability, the mean score was 87.8% and 89.2%. The standard deviations for understandability and actionability were 0.12 and 0.14, respectively.

Conclusion:

The infographic developed in the study scored a mean percentage of more than 70 in both understandability and actionability and hence, it was concluded that it can be easily understandable by the patients.
IJCM_148A: Difference in unmet supportive care needs of patients and informal caregivers with advanced cancer, between developed and developing countries: A scoping review
Authors: Malar Madhu P , Jain Animesh , Holla Ramesh , Rao Rajath , Rao Mithun , Jose Jobinse
Published: April 2024

Background:

Cancer’s global impact is surging, burdening both developed and developing nations. Therapeutic advances extend life but heighten morbidity, highlighting unmet needs. This review aims to investigate differing unmet supportive care needs for advanced cancer patients and caregivers between developing and developed countries.

Objectives:

1. To identify and summarize the existing literature on unmet supportive care needs in patients and their informal caregivers, under groups of developed and developing countries 2. To examine the differences between the needs of the two groups

Methodology:

The review includes quantitative studies assessing the unmet supportive care needs of adult advanced cancer patients and their caregivers. Excluded are clinical-focused, pilot/protocol works, non-English content, and those not directly assessing needs. Exhaustive searches were conducted on PubMed and SCOPUS up to August 2023. Boolean search combining “advanced cancer” and “unmet supportive care needs” was executed. Results were screened on title, abstract, full text. Studies were grouped by country, and categorized as developed or developing based on HDI. Data was collected on standardized data extraction sheets.

Results:

Cancer patients and caregivers globally, irrespective of economic development, grapple with substantial unmet needs such as psychological distress, economic hardships, and limited access to comprehensive information. Developing countries, in particular, confront heightened financial difficulties, healthcare disparities between urban and rural areas, and a lack of tailored support for disease-specific requirements. Cultural nuances and regional disparities contribute to varied challenges, with a notable research gap in understanding the diverse struggles faced by individuals in developing countries.

Conclusion:

Recognizing and addressing the nuanced challenges faced by cancer patients and caregivers, particularly in developing countries, is crucial for fostering equitable and comprehensive cancer care. Bridging these gaps requires targeted interventions that account for cultural diversity, regional variations, and the unique needs of individuals navigating the complexities of cancer.
IJCM_150A: A profile of Head and Neck Cancer patients attending a tertiary cancer care centre in Southern Karnataka
Authors: Shankar Vaishna M , Shetty Ranjitha S , Salins Shirley Lewis , Mallya Sneha Deepak , Kunder Manjula Anil , Bhat Vasudev , Salins Naveen , Upadya Sudhakara P , Balaji
Published: April 2024

Background:

Overall, 57.5% of head and neck cancers (HNC) globally are from Asia. In India, HNC accounted for 30% of all cancers in males and 11 to 16% in females, of all sites of cancer. HNC in the low- and middle-income countries differ from those in the Western part of the globe in terms of age, site of disease, etiology, and molecular biology. Poverty, illiteracy, advanced stage at presentation, lack of access to affordable treatment facilities pose a major challenge in management of these cancers.

Objective:

To identify the socio-demographic and epidemiological factors influencing the cause of Head and neck cancer

Methodology:

A cross sectional study was conducted between February 2023 till November 2023, in Manipal Comprehensive Cancer Care Centre, Kasturba Hospital, Manipal. All the newly diagnosed Head and Neck cancer (HNC) patients aged above 18 years, from December 2022 were included in the study. The participants were interviewed with the structured questionnaire. Details of the socio-demographic characteristics, various risk factors of HNC, presenting symptoms, co-morbid conditions, anthropometric details, dietary habits, level of physical activity when they were healthy, tobacco, alcohol and betel quid use were taken. Institutional Ethics Committee Approval and informed consent from the participants were taken before the initiation of the study

Results:

The study found that 84% of the head and neck cancer patients were males. 78% of the cases had education only up to or less than 10th std. The middle class and lower class (according to BG prasad scale) constituted 62% of the cases. 70% reported the site of cancer as oral cavity.

Conclusion:

The study found that consumption of tobacco, alcohol andNon-vegetarian diet are more commonly seen in HNC cases. Also, males, age group of 51-70 years, belonging to middle-class SES, are more affected.
IJCM_151A: Proportion of primary oesophageal cancer in persons with previous head and neck cancer in upper Assam
Authors: Devi Sagolsem Marycharan , Mahanta BN , Mahanta Tulika Goswami
Published: April 2024

Background:

Head and neck cancer highest amongst Indian states reported from Assam and is the leading cancer in men and third leading cancer in women. Due to advanced disease at the time of diagnosis prognosis of oesophageal cancer is poor. As mass screening for oesophageal cancer is neither feasible nor reasonable, high-risk groups should be identified and surveilled.

Objective:

To estimate the proportion of primary oesophageal cancer in persons with previous head and neck cancer in upper Assam.

Methodology:

A match case-control design with equal allocation was conducted in Assam Medical College in 2017. A total of, 232 patients with head and neck squamous cell carcinoma (HNSCC) with age and gender matched controls were evaluated with chromoendoscopy for possible second malignancy in oesophagus. Structured questioning using predesigned pretested schedule was done. Data analysis was done by using rates, ratio and proportion.

Results:

Men women ratio of the study participants was 79.3%:20.7%(184:48). According to site of primary lesion, majority having hypo-pharyngeal lesions (33%), followed by oral cavity(25%), oropharynx(18%) and nasopharynx(4%), respectively. Out of 232 patients, 64(27.59%) showed presence of varieties of oesophageal abnormalities

Conclusion:

Counselling all patients and screening of high- risk group specially those with previous head and neck cancer along with health awareness creation and timely intervention may be effective in risk reduction.
IJCM_158A: Usage and disposal of plastic waste among general population in urban slums of Field practice area, Gandhi medical college, Telangana.
Authors: Jatoth Madhavi DR , Sushmitha T. , Koteswaramma CH.
Published: April 2024

Background:

Plastics, owing to their ease of use and affordability, have taken over every aspect of our modern world. It has become an essential aspect of our everyday lives, permeating every sector from food packaging to toys and electronics, to the degree that it is unimaginable to picture a world without it. Plastic takes around 15 to 1000 years to biodegrade. The consumption of plastic by individuals and the ineffective reuse or recycling of it has detrimental effects on the ecosysystem. Overusing plastic and neglecting disposal solutions for plastic over a long time led not only India but many other nations to adopt laws to limit plastic because of its increasing environmental damage.

Objectives:

1. To determine the utilization and disposal of plastic waste among general population in urban slums. 2. To study association between sociodemographic factors and plastic usage and disposal.

Methodology:

Study Design: A cross sectional analytical study Study Population: General population residing in urban slum Sampling Technique: Simple random sampling Sample Size:216 (p= 50%, l= 7, NR=10%) Study Tools: Self-designed, semi structured, pilot-tested questionnaire will be used for the data collection which will be entered in Microsoft Excel and analysed using SPSS statistical software version 20.

Results:

Usage of plastic was seen in all the study participants and more than 96% of them were reusing the plastics more than once. Most common method was disposing plastic in municipal dust bins (60.2%) followed by open dumping (20.9%), whereas 16.4% were reusing them for other purposes. Level of education and religion has no association with proper disposal of plastic waste. Present study observed that there was a significantly high percentage (96.1%) of three generation families were following proper plastic waste disposal methods followed by nuclear and Joint families with 56.9% and 48.8% respectively. with P≤0.05.

Conclusion:

Most common method was disposing plastic in municipal dust bins followed by open dumping. Level of education and religion has no association with proper disposal of plastic waste.
IJCM_159A: Descriptive study on determinants of indoor air pollution and its perceived impact on health among residents of urban field practice area of a tertiary care hospital
Authors: Subhashrao Kulkarni Kulbhushan , Mundada Vinod D.
Published: April 2024

Background:

Indoor air pollution is the presence of unwanted substances in the indoor at concentration toxic to health. According to WHO, around 3.8 million deaths occur due to indoor air pollution every year. Very few studies have addressed indoor air pollution. Thus, this study aimed at determinants of indoor air pollution and its perceived impact on health among residents.

Objectives:

1. To study the determinants of indoor air pollution among residents of urban field practice area of a tertiary care hospital. 2. To study the perceived impact of indoor air pollution on health among residents of urban field practice area of a tertiary care hospital.

Methodology:

A community-based cross-sectional study conducted among 105 households of urban field practice area of a tertiary care hospital during August 2023 to October 2023. Data collection was done using predesigned pre tested interview schedule which consists of sociodemographic characteristics, sources of indoor air pollution, checklist of contributory factors of air pollutants and related symptoms/diseases.

Results:

About 45.7% households had second hand smoke in house. Smoke from the neighbourhood troubled 38% respondents. 33.3% households had IAP owing to vehicular exhausts. 75.2% houses were having absence of cross ventilation and 68.5% houses were poorly ventilated. Also, 60.9% houses reported overcrowding. About 53.3% complained of having at least one symptom of IAP.

Conclusion:

Majority of the households were exposed to IAP due to second hand smoke, neighborhood smoke while absence of cross ventilation accented it. Efforts to address IAP should be made to protect residents from adverse health effects.
IJCM_160A: Occupational Burnout among Medical residents in tertiary health care centre in Mangalore: A cross sectional study
Authors: Jain Aayushi , Patel Sakshi , Jain Kanisha , Gaur Drishti , Rajasingh Stafin Stephen , Shekhar Dishi , Saha Partho , Unnikrishnan Bhaskaran , Rekha T , Rathi Priya , Mithra Prasanna , Kumar Nithin , Holla Ramesh
Published: April 2024

Background:

Burnout in medical profession can reduce the work output and affect the clinical decision making.

Objectives:

To estimate the proportion of medical residents experiencing burnout.

Methodology:

In this cross-sectional study, 172 medical residents working in the hospitals affiliated with Kasturba Medical College, Mangalore were assessed for presence of burnout. Permission was obtained from the Institutional Ethics Committee before the commencement of the study. Copenhagen Burnout Inventory scale was used to determine the presence of burnout syndrome among the participants.

Results:

The mean age of the participants was 27.6 years and a high proportion (n=93, 53.8%) of the participants were males. Forty-eight percent (n=83) of the participants in our study had burnout. A high proportion (n=35, 42.2%) of the participants with burnout were from first year of residency. Burnout was observed in the majority of unmarried males. Burnout was also seen to be highest in younger residents, and those who lacked adequate sleep.

Conclusion:

The proportion of occupational burnout among medical residents in our study was found to be very high. Early identification of the presence of burnout in the healthcare profession and initiating steps to reduce it can help them to provide uncompromised quality care to the patients.
IJCM_164A: Association between Sleep Quality and Short-Term memory among medical students in mangalore
Authors: Mithra Prasanna , Keerthana Lakshmi T , Agarwal Avinika , Pohekar Shalvi , Parhi Anjalika , Shetty Varsha , Singh Shuvam
Published: April 2024

Background:

Sleep plays a crucial role in maintaining cognitive functions, including memory, which is essential for academic performance. However, there is limited research exploring the relationship between sleep quality and short-term memory among medical students.

Methodology:

Fourth-semester MBBS students from Kasturba Medical College, Mangalore, were selected using non- random convenience sampling. A total of 195 students participated, completing a standardized sleep quality assessment (Pittsburgh Sleep Quality Index) and a semi-structured self-administered questionnaire-based short-term memory test. Data were analyzed using SPSS version 16, with correlation tested using Karl Pearson’s Coefficient of Correlation Test.

Results:

The majority (56.4%) of participants exhibited good sleep quality, with 69.1% of these achieving high scores in short-term memory assessment tasks. A negative correlation (r = -0.450, p < 0.001) was found between sleep quality and short-term memory scores. Students with good sleep quality were more likely to have higher short-term memory scores compared to those with poor sleep quality.

Conclusion:

The study suggests that good sleep quality is associated with better short-term memory performance among medical students. These findings underscore the importance of promoting good sleep habits to enhance cognitive function and academic performance in medical education.
IJCM_172A: Risk Scoring of Type 2 Diabetes Mellitus and Coverage of Screening Services through Primary Health Care System among Adults in a Block of Murshidabad District, West Bengal
Authors: Sarder Tarek Anower , Akbar Fasihul , Ghosh Ritu , Mandal Sukanta , Das Dilip Kumar
Published: April 2024

Background:

Type 2 diabetes is a major public health challenge. Indian Diabetes Risk Score (IDRS), a simple and cost-effective tool consisting of two modifiable (waist circumference, physical activity) and two non-modifiable risk factors (age, parental history) for diabetes, can be easily applied in mass screening programmes. Opportunistic screening for diabetes among individuals aged = 30 years is being done under the programme for Prevention and Control of Non-communicable Diseases.

Objective:

To assess the risk of type 2 diabetes mellitus using IDRS, coverage of screening services for diabetes through the primary health care delivery system and to identify their correlates.

Methodology: :

A descriptive, cross-sectional study was conducted in a block of Murshidabad district, West Bengal during September to November 2023 among permanent residents aged = 30 years on a calculated sample of 300 selected through multi-stage sampling. Required data were collected by interviewing the study subjects using pre-designed, pre-tested schedule including IDRS, reviewing medical records and measuring waist circumference. Analysis was done using SPSS-20.

Results:

Among 300 participants, 40.7% had high risk; 54% and 5.3% had moderate and low risk of diabetes respectively according to IDRS. In multivariable analysis, age =35 years (AOR 18.10, 95% CI 5.07-64.66), female gender (AOR 2.36, 95% CI 1.40-4.00) and being in joint family (AOR 3.53, 95% CI 1.77-7.04) were significant correlates for high-risk category according to IDRS. Only 67% were screened for diabetes within last six months, of which 89% were through primary health care delivery system. Screening status varied significantly by age group (OR 3.81, 95% CI 1.98-7.35) and IDRS risk categories (OR 1.72, 95% CI 1.06-2.80).

Conclusion:

Alarmingly substantial proportion of people in the area are at high/moderate risk of diabetes coupled with low opportunistic screening coverage, which highlights the need for intensive behaviour change communication and stronger service delivery.
IJCM_175A: Attitude towards the proposed changes by Medical Council of India (MCI) in MBBS curriculum and mandatory rural posting among medical undergraduate students
Authors: Nikhilesh R. , Aggarwal Shagun , Gupta Anubhav , Vardhan Arohi , Lonkar Aishwarya , Kumar Nithin , Rekha T , Unnikrishnan Bhaskaran , Mithra Prasanna , Holla Ramesh
Published: April 2024

Background:

The Medical Council of India (MCI) has proposed significant changes to the MBBS curriculum, including mandatory rural postings for undergraduate medical students, to address healthcare disparities. Understanding student attitudes towards these reforms is crucial for successful implementation.

Methodology:

A cross-sectional study was conducted among 215 undergraduate students at Kasturba Medical College, Mangalore. Participants completed a semi-structured questionnaire assessing demographics, awareness of reforms, and attitudes towards curriculum changes and rural postings. Data were analyzed using SPSS v17.0, with perceptions measured on a 5-point Likert scale.

Results:

Student attitudes towards the proposed reforms were diverse. While some welcomed early clinical exposure and incentives for rural postings, others expressed concerns about implementation challenges and career implications. Family background, incentives, and perceptions of rural practice significantly influenced attitudes.

Conclusion:

The study underscores the complexity of student perspectives on MCI’s reforms. Targeted interventions and dialogue are essential to address concerns and enhance acceptance, facilitating successful implementation.
IJCM_180A: Risk factors for hemorrhoids among patients attending selected tertiary care hospitals in Mangalore: A matched case control study
Authors: Jain Animesh , Suresh Karthika , Santhosh Vishnu , Karjol Sachin , Achar Nikita , Kejriwal Ayushi
Published: April 2024

Background:

Hemorrhoids is a common anorectal condition affecting a vast majority of population all around the world. The establishment of a definite association of hemorrhoids with bowel habits and other factors like BMI is less explored.

Objectives:

To find out the association of hemorrhoids especially with bowel habits and to establish the association of BMI with respect to the onset of hemorrhoids.

Methodology:

This case control study was conducted among 90 cases and controls from the hospitals affiliated to Kasturba Medical college, Mangalore. Data were analyzed using SPSS version 29. Uni-variate analysis was done, and the odds ratio and confidence levels were tested and determined using binary logistic regression.

Results:

Majority of the controls were normal with respect to BMI categorization (36.8%) whereas 34.9% of the cases were obese (p=0.095)

.

The number of people who consumed mixed diet was greater in the cases (72.3%) than in the controls (64.4%). 61.5% of patients complained of blood in stools compared to 2.2% of controls, there were 10.5% of cases with pus in stools and none in controls (p=0.249). Use of laxatives was seen in 27.7% of cases and only 2.1% of controls (p=0.001). A total score of >=15 was indicative of constipation. 12.8% showed constipation compared to none in the controls. (p=0.026).

Conclusion:

Association of constipation with hemorrhoids was statistically significant. The occurrence of hemorrhoids was not associated with the body mass index of the individual and the occurrence of diarrhea was not significant with respect to hemorrhoids.
IJCM_19A: Aspirin delays the onset of hypertensive disorders of pregnancy among nulliparous pregnant women: a secondary analysis of the ASPIRIN Trial
Authors: Kavi Avinash , Hoffman Matthew K. , Somannavar  , Metgud Mrityunjay C. , Goudar Shivaprasad S. , Moore Janet , Nielsen Eleanor , Goco Norman , Derman Richard J
Published: April 2024

Background:

Hypertensive disorders of pregnancy (HDP) remain a primary contributor for maternal and perinatal death and results in long-term health risks for both the mother and child. Heterogeneous studies have evaluated the possible benefit of low dose aspirin (50 to 150 mg per day) in pregnancy to minimize the risk of HDP.

Objective:

To assess the impact of low-dose Aspirin (LDA) starting in early pregnancy on delaying preterm hypertensive disorders of pregnancy.

Methodology:

This was a non-prespecified secondary analysis of a randomized masked trial of Low-dose Aspirin (LDA). Nulliparous singleton pregnancies between 6 weeks and 0 days and 13 weeks 6 days in 6 low- middle income countries (Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, Zambia) enrolled in the ASPIRIN Trial were included. The incidence of HDP at delivery at three gestational age periods (< 37 weeks) between women who were randomized to Aspirin or Placebo. Women were included if they were randomized and had an outcome at or beyond 20 weeks (Modified Intent to Treat).

Results:

Amongst the 11,976 pregnancies, LDA did not significantly lower HDP at delivery.

Conclusion:

In low-risk nulliparous singleton pregnancies, early administration of LDA resulted in lower rates of preterm HDP and delivery before 34 and 37 weeks. LDA works in part by delaying HDP.
IJCM_195A: Prevalence of Drug Adherence Among Hypertensive Patients attending Primary Health Centre - A Cross sectional Study
Authors: Arunachalam Divya Priya , Maheswari Uma , Damodaran
Published: April 2024

Background:

There is an increase in prevalence of hypertension 31.5% in urban and 26.2% in rural dwellers of Tamil Nadu (ICMR-INDIAB study). Adherence to hypertension medication is very important for improving the quality of life and preventing complications. In this study we aim to estimate the drug adherence among hypertensive patients using Morisky Medication Adherence Scale.

Objectives:

To estimate the prevalence of drug adherence and its influencing factors among hypertensive patients in Rural Health Training Centre areas of Madras Medical College.

Methodology:

180 Hypertensive patients attending Non-Communicable Disease clinic from two rural health centres 90 patients from each Padiyanallur PHC and Medavakkam PHC were recruited for the study. In this study we have used The Morisky Scale MMAS-4 to address medication adherence.

Results:

Study results showed that 32.62% of hypertensive patients had high adherence to antihypertensive medications,53.48% patients had medium adherence whereas 13.9% patients had low adherence. Adherence to drug is higher among females (36.9%) than males (29.1%). Patients with low to medium adherence to antihypertensive drugs are having more than 10% risk of developing cardiovascular disease (OR – 3.6, 95% CI – 1.86 to 6.75) than their counterpart. Patients with good knowledge (42%) had high adherence than people with poor knowledge (24.2%)

Conclusion:

The study reported only 32.62% were found to be adherent to antihypertensive medications. To ensure high level of control among hypertensive sustained and focussed interventions should be implemented at all levels of health care.
IJCM_200A: Symptom Burden Profile of individuals facing chronic life-limiting illnesses and barriers to effective management of symptoms in palliative care- Grounded theory qualitative study.
Authors: Sushma M N
Published: April 2024

Background:

Managing symptoms such as pain, breathlessness, and fatigue poses significant challenges in patients with advanced diseases. While palliative care has proven to enhance symptom control, there is a lack of exploration into the factors that contribute to successful symptom management in this specific context. This study was conducted to gain insight into the elements that support effective symptom management in palliative care within home settings and to explore the barriers that are encountered in this process.

Objectives:

To enumerate symptom burden profile of Patients facing chronic life limiting illness registered in Home based Palliative care program implemented by SVYM in Bengaluru and Hassan cities .

Methodology:

This is a Gounded theory study using qualitative semi- structured interviews. conducted between August 2023 to December 2023. Study participants are the primary caregivers of Patients with chronic life limiting illness in need of palliative care in Hassan and Bengaluru. 50 participants were interviewed through convenience sampling for the purpose of the study. Edmonton's Symptom assessment scale (ESAS) was used to assess the symptom burden of patient during the registration and 3 weeks post intervention.

Conclusion:

Effective symptom management relies on collaborative decision-making between patients and healthcare professionals, along with the coordinated efforts of a multidisciplinary team. Taking steps to address psychological distress and assessing the comprehension and expectations of patients and their families would enhance the overall effectiveness of symptom management in palliative care.
IJCM_202A: Catastrophic health expenditure (CHE) due to diabetes mellitus among urban slum population of Agra city- An Observational study
Authors: Prathyusha Lingareddy , Agrawal Renu , Singh Geetu , Kumar Sarvesh
Published: April 2024

Background:

People with diabetes need extensive self-management support, medications, regular screening for and treatment of possible complications and comorbidities, all of which can increase out-of-pocket (OOP) costs in patients and their families. There is a very strong correlation between the level of OOPs and an indicator that is used to monitor how well a health system is performing in terms of financial protection namely, incidence of catastrophic health expenditure.

Objectives:

1. To assess the catastrophic health expenditure on treatment of diabetes mellitus and its complications in the study population. 2. To find out the association of CHE with sociodemographic profile, diabetic profile, and treatment compliance among the study population.

Methodology:

After applying the inclusion criteria 360 known diabetics were included from the four randomly selected slum areas of Agra city. A cross- sectional study through face-to-face interview using predesigned, pretested, and semi-structured questionnaire was conducted from September 2020 to March 2022. Data was entered on MS excel and appropriate statistical analysis was done.

Results:

Males and females were 59% and 41% respectively. Nearly 66% participants were of age group 35-60 years, 28% were illiterates, 54% were unemployed & 44% belong to upper lower socioeconomic class. Almost 96% were having type 2 diabetes, 74% were on oral hypoglycaemic agents and 70% were compliant to treatment. Monthly median direct out-of-pocket expenses were INR 1500 and indirect expenses were INR 505. Type of diabetes, and treatment regimen were the factors found to be associated with Catastrophic health expenditure.

Conclusion:

A significant proportion of 39.4% of the study participants were found to have catastrophic health expenditure.
IJCM_203A: Referral Audit of the Public Healthcare system in Bhopal district of Madhya Pradesh
Authors: Yadav Sushma
Published: April 2024

Background:

Referral of patients from doctor to doctor has been identified as high-risk area as patient valuable information can be lost or not quantified properly during the transit. Improving the quality of the referral process and its documentation is important to facilitate timely access to specialty care.

Objective:

To conduct referral audit of the public health care system in Bhopal district of Madhya Pradesh.

Methodology:

Audit (document review) or the secondary data pertaining to the out referrals entered in the referral registers was captured after due permission from the administrators/ in- charges of the health facilities using the format for data extraction for referral given by the WHO Referral Register Standards. Quota sample of 50 referred patient entries was taken from the primary and secondary health facilities (1 district hospital, 1 CHC, 2 PHCs) based on patient load and level of care provided in the hospital was taken from OPDs, IPDs and Emergencies wherever out referral registers were maintained.

Results:

There was a physical presence of out referral register or records in all the health facilities. Details like reason for referral was mentioned in most of the facilities whereas back referral was not mentioned in most of the facilities.

Conclusion:

Maintenance of the patient health records in the out- referral registers were not up to the required standards stated by the WHO. There is a need for the uniform implementation of state referral policy to ensure quality control of referral mechanisms and maintain continuum of care for better patient outcomes.
IJCM_207A: Deaf blindness in India: Prevention and Long-Term Challenges
Authors: Shetye Anuradha
Published: April 2024

Background:

Deaf-blindness is a disability encompassing varying degrees of hearing impairment and low vision together. Congenital deafblindness is when its onset under 2 years age.

Objectives:

In India, there are no organized data for deafblindness and estimates indicate there could be more than 500,000 deafblind people. Voluntary organizations provide unwavering support to deafblind children and adults alike.

Methodology:

(i) early identification (ii) prompt referral for community rehabilitation (iii) early assessment and intervention by identification of high- risk children (iv) individualized education to monitor progress (v) continued review and planning for further education and employment in adulthood.

Results:

Primary prevention by (i) immunization against Rubella to prevent Congenital Rubella syndrome; (ii) education of all women of childbearing age about healthy habits and avoiding alcohol and drug use; and (iii) accessible antenatal health care for all pregnant women.

Conclusion:

Strategists and politicians need joint up thinking with perseverance and a strong will to tackle this condition with long term sustained input. They are urged to consider deafblindness as a distinct category in the national census and survey counts.
IJCM_214A: Digital interventions for childhood malnutrition in a tribal area of Andhra Pradesh: Understanding the problem through a health system perspective
Authors: Roy Adrija
Published: April 2024

Background:

Childhood malnutrition is a major public health concern in the tribal areas of Andhra Pradesh, India, particularly in the region of ITDA Rampachodavaram. The integration and effectiveness of digital health interventions in these underserved regions are vital for addressing this endemic issue. However, the unique challenges posed by the remote and resource- limited settings of tribal areas make the implementation of such interventions particularly complex. Moreover, the varying complexity of the digital health ecosystem in these areas adds another layer of concern to deploying digital health solutions.

Objectives:

1. To explore digital health interventions related to childhood malnutrition in the Integrated Tribal Development Agency (ITDA) of Rampachodavaram. 2. To understand the dynamics of the local health system and the digital health ecosystem in the implementation of these interventions. 3. To examine the role of street-level bureaucrats in implementing digital interventions and identify the barriers and facilitators affecting this process

Methodology:

The research was conducted in ITDA Rampachodavaram, involving interviews with health system officials and Focus Group Discussions (FGDs) with frontline health workers. The Health System Dynamics (HSD) framework and Lipskyâ€™s theory on street-level bureaucrats were utilized, and enriched with insights into the digital health ecosystem.

Results:

The study reveals significant systemic, contextual, and human factors influencing the implementation of digital health interventions. Challenges include the complex role of street-level bureaucrats and systemic barriers like inadequate training, technological limitations, and disparities in digital access and literacy.

Conclusion:

This study highlights the potential of digital health interventions in improving childhood malnutrition outcomes in tribal areas. It stresses the importance of adaptive, inclusive strategies and advocates for digital health equity. Empowering frontline health workers and tailoring interventions to the specific health system dynamics and digital ecosystem of tribal regions are key for effective implementation.
IJCM_217A: Literacy for health: Bridging the gap between female literacy and health seeking behaviour
Authors: Kumari Shivangi , Mehnaz Saira , Abedi Ali Jafar , Ansar M. Athar , Ahmad Sameena
Published: April 2024

Background:

The private sector has maintained its dominance in the healthcare industry despite numerous government measures to improve public services. Public sector is still not a choice for treatment, various reasons being large distance from residence, poor quality of care, shortage of drugs, poor attitude of health care provider. Enumeration of the factors that defines pattern of the utilization of health services become utmost important. Hence, this study is being conducted to understand the factors behind the utilization of government health services.

Objectives:

i)To find the prevalence of Reproductive Tract Infections, among married women of reproductive age group, seeking treatment among rural and peri-urban areas of Aligarh. ii) To find the determinants of utilization of reproductive health services among married women in Aligarh.

Methods:

This cross-sectional study was conducted between 2020-2021 Data was collected through a pretested, semi-structured questionnaire through simple random sampling from 500 married women of reproductive age group, in the field areas registered under Department of Community Medicine, JNMCH A.M.U. Data was analysed using IBM SPSS 20.0. Proportion, frequencies, chi square were used to interpret the data.

Results:

Among total females interviewed 201 (40.2%) were found to have symptoms of Reproductive Tract Infections, out of them 165, (74.1%) sought treatment. Among 165 females who started treatment, 62.4 % of females seeking treatment were literate.69% females who delayed treatment were illiterate. Self-motivation for treatment was seen among 60.2 % of literate females. Area of residence, social class and female’s role in decision making also determined the treatment seeking behaviour.

Conclusion:

In our study female literacy has been found as major factor influencing the health seeking behaviour. Factors like place of residence, socio economic status, female role in decision making were significant. There is no denying the significant health benefits of supporting women’s education. Education has a crucial role in family planning, from the earliest stages to caring for one’s own health and newborn children.
IJCM_23A: Long-Term Maternal and Childhood Outcomes Among Women with Post-Partum Depression in Rural and Urban Areas of Khordha, Odisha.
Authors: Roy Payel , Subba Sonu Hangma , Singh Arvind Kumar , Behera Binod Kumar , Behera Priyamadhaba , Mohanty Pankaj Kumar , Parmar Arpit
Published: April 2024

Background:

The prevalence of Postpartum Depression in India varies from 6.8-21.5%. About 5% women reported persistent PPD symptoms even three years after childbirth. PPD increases the suicide risk among mothers. It not only affects the psychological health but also physical health & quality of life of mother. Maternal PPD affects the mother child bonding and also the child growth & development.

Objective:

To assess the long-term effects of post-partum depression on the mothers and the children at 1 year-5 years.

Methodology:

We have done a Cohort study with 290 mother-child dyads in both rural and urban area of Khordha, Odisha. Mothers were screened using EPDS for PPD at 6wk to 6 months after delivery. The outcome for mothers and children were assessed at one year to five years after delivery. Chronic depression was assessed with EPDS, confirmed by psychiatric evaluation and suicidality of the mother with SBQ-R; child anthropometric outcomes with WHO growth charts and development with Bayley Scale of Infant and Toddler Neurodevelopment.

Results:

Among the 62 mothers screened positive for post-partum depression, 18 (29%) were found to have Chronic depression and a significant association was found between post-partum and chronic depression (OR=11.25, CI- 4.60- 27.69, p-value <0.001].

Conclusion:

Maternal post-partum depression had significant impact on the maternal and child child-health in the long term.
IJCM_236A: Out-of-pocket expenditure on healthcare among geriatric population in central Kerala
Authors: Roy Merin Mariam , Vincent Jose
Published: April 2024

Background:

India is facing dual challenges caused by a rapid increase in burden of non-communicable diseases, marking epidemiological transition and an unprecedented expansion of geriatric population. The elderly faces a higher burden of disease due to a decline in their physical and immune systems, resulting in greater need and utilization of healthcare. The expanding geriatric population is inadequately supported by appropriate healthcare services which is essential for healthy ageing. Out-of-pocket expenditure on health carries significant adverse impacts. In order to lessen the financial burden of out-of-pocket medical expenses, the healthcare needs of the elderly ought to be addressed.

Objectives:

To assess the healthcare utilization pattern and out-of-pocket expenditure on healthcare among geriatric population in central Kerala.

Methodology:

A community based cross-sectional study was conducted among 150 elderly individuals, systematically sampled from 5 randomly selected wards of Adat Gram Panchayat in Thrissur district, Kerala. Data on sociodemographic characteristics, healthcare utilization and healthcare expenditure were collected using a pretested, semi-structured questionnaire by one-to-one interview. Appropriate statistical tests were used for analysis.

Results:

Mean age of respondents was calculated to be 72.64 Â± 7.42. Majority (63.3%) preferred to utilize private health facility. 88.7% followed modern system of medicine. 43.3% had availed health insurance. Most commonly reported morbidities among elderly were Diabetes, hypertension and dyslipidaemia. The median direct medical cost was ?3000 (?560, ?4200) while the median direct non-medical cost was ?300 (?200, ?500). The total median out-of-pocket expenditure on healthcare among elderly was ?3550.

Conclusion:

Increasing burden of chronic diseases in elderly, high private healthcare utilization and suboptimal health insurance coverage leads to an increase in out-of-pocket expenditure on healthcare. Measures should be adopted for strengthening of health services and expanding insurance coverage among elderly, which in turn will reduce burden of out-of-pocket health expenditure.