bluuebunny/crossref_metadata_2025 huggingface dataset:
IJCM_193A: To study prevalence of hypertension among medical nursing staff at Maharashtra: A cross sectional study
Authors: Gopalrao Chopade Manda , Gattani P.L , Maidapawad S
Published: April 2024

Background:

Hypertension, a leading public health concern worldwide, is a significant risk factor for cardiovascular diseases, which are the top cause of global mortality. In India, hypertension contributes substantially to noncommunicable disease burden. Healthcare professionals, particularly nurses, are expected to have lower prevalence due to their medical background. However, factors like high-stress work environments and demanding work conditions may increase their susceptibility to hypertension. This study aims to explore the prevalence of hypertension among nursing staff at Maharashtra, considering their unique occupational challenges.

Objectives:

To study prevalence of hypertension among Medical Nursing staff

Methodology:

This cross-sectional study was conducted at Government Medical College at Maharashtra, targeting the entire cohort of medical nursing staff over a period of three months. The study employed total enumeration sampling, including all medical nursing staff at the college. Data collection involved face-to-face interviews using a pretested and pre- validated questionnaire.

Results:

Prevalence of hypertension among nursing staff was 100 (21.96%). Most participants with HTN are in the 31-40 age range (55.6%), which is also the largest group without HTN (52.4%). Vegetarians are more likely to have HTN (60.2% vs. 43.8% in non-HTN), while the mixed diet group is more prevalent in the non-HTN group (56.2% vs. 39.8% in HTN) which have significant association(p=0.0078)

Conclusion:

The study highlights the prevalence of hypertension and its associated risk factors among nursing staff at Medical College at Maharashtra. The findings underscore the need for targeted health interventions and stress management strategies within this group, considering their critical role in healthcare delivery and their exposure to high-stress occupational environments.
IJCM_196A: Exploring the transition from medical students to interns: A leap into clinical practice
Authors: Jain Animesh , Bansal Shivam , Bhuyan Satya Sundar , Babu Achsah Sara , Simna TT , Ranjan Pushpa
Published: April 2024

Background:

The transition from medical student to independent doctor is a crucial phase, marked by a year-long clinical internship in India. Despite this, challenges arise, and stress is common among interns. This study aims to assess the preparedness of interns graduating under the present MBBS curriculum in India and understand the challenges they face during their internship.

Methodologyology:

This cross-sectional analytical study was conducted in teaching hospitals affiliated with Kasturba Medical College, Mangalore. Interns working in various departments of these hospitals were included in the study. Universal sampling was employed, approaching all available interns during the 14-day study duration. The sampling strategy was non-random, based on convenient sampling.

Results:

Out of 150 interns, 77 scored well in various aspects of clinical skills. However, discrepancies were observed in specific areas. While 84% demonstrated good history-taking skills, only 55% could effectively discuss medications with patients. Interns displayed lower competence in understanding drug interactions, with only 37 out of 150 scoring well. Communication and teamwork were strong points, with 82 interns effectively working in a multi-disciplinary team. On the contrary, clinical procedures and diagnostic skills showed dismal performance, especially in emergency situations and practical procedures.

Conclusion:

Interns exhibit strength in communication and teamwork but face challenges in diagnostic skills and clinical procedures. The findings emphasize the need for targeted interventions in specific areas, ensuring a well-rounded preparation for junior doctors. Addressing these challenges will contribute to a smoother transition from medical students to competent healthcare professionals.
IJCM_2A: Perceptions of and challenges faced by college students in receiving sexual health education during their school days- An exploratory study
Authors: Sekhar Monica Albert , Edward Shanthi
Published: April 2024

Background:

Sexuality health education stands as an essential cornerstone in shaping the physical, emotional, and social well-being of young adults, and nowhere is this need more evident than in India. As a country known for its diverse culture, traditions, and a burgeoning youth population, addressing the unique challenges and opportunities pertaining to sexual health education is of paramount importance. Currently, there is no existing curriculum or syllabus for sexual health education in schools or colleges.

Methodology:

Qualitative data was obtained by conducting in depth interviews. Around 10-20 In depth interviews were conducted. Participants were college going students who gave consent and were open to talk about the topic. Interview was conducted using an interview guide and the process was audio recorded. Data was analysed manually using grounded theory.

Results:

The themes generated were previous exposure to sexual health education, Sources of information, topics under sexual health education. Challenges faced by young adults were explored under the following themes- difficulties faced during school/ college, past experiences, cultural taboos etc. Many young adults advocated the need for sexual health education. Surprisingly a few handfuls of students thought it was not necessary to teach sexual health education at all. However, all of them were not satisfied with the education they received on sexual health in the past.

Conclusion:

This study sheds a spotlight on the lack of sexual health education and its repercussions on young adults today. Difficulties faced by young college going students can be used to design an age appropriate culturally sensitive sexual health curriculum for school going adolescents.
IJCM_201A: Understanding psychological stress in working women: A cross-sectional study in Mangalore
Authors: Rekha T , Rai Aakash , Roy Rose Ann , Marya Manya , Sharma Aparajita , Unnikrishnan Bhaskaran , Mithra Prasanna , Kumar Nithin , Holla Ramesh
Published: April 2024

Background:

Stress is defined by American Psychological Association is “Any uncomfortable emotional experience accompanied by predictable biochemical, physiological and behavioral changes.” It is a feeling of being overwhelmed, worried or run-down. Stress affects people of all ages, gender and circumstances and can lead to both physical and psychological health issues. Social contexts and family structures are particularly impacted by stress in women. This study aims to assess the levels of stress and associated factors of stress among working women in Mangalore.

Methodology:

This cross-sectional study was conducted among 298 working women, who were managerial staff/Clerical staff recruited from 2 Banks, 2 shopping malls, health care workers from 2 hospitals and doctors/ clerical staff from Medical College, Mangalore. Data was collected using a semi- structured questionnaire including sociodemographic characteristics and perceived stress scale and analyzed using SPSS version 24. Results were expressed in mean (standard deviation) and proportion. For comparison across the groups chi-square test was used. A ‘p’ value of less than 0.05 was considered statistically significant.

Results:

Out of 298 women surveyed, 3.4% were found to be highly stressed, 83.9% were moderately stressed. Significant stress determinants were found to be associated with age, education, occupation, years of work experience and marital status- where the association is statistically significant. Working women prefer to go for leisure activities like outing with friends and family to reduce stress while other activities like smoking and alcohol consumption were least popular among the study participants.

Conclusion:

The study emphasizes the critical elements—age, education, employment, job experience, and years since marriage—that significantly influence women’s stress levels. Furthermore, it highlights that for working women, entertainment is the main way to decompress, and employers need to take note of this to help staff members maintain a healthy work-life balance.
IJCM_204A: A qualitative research to identify the barriers and facilitating factors in the utilization of healthcare services by a Particularly Vulnerable Tribal Group (PVTG) in Udupi District
Authors: Biju S , Shetty Ranjitha S , Unnikrishnan Bhaskaran , Gouspure Shrikanth
Published: April 2024

Background:

Udupi district hosts two major Particularly Vulnerable Tribal Groups (PVTG) namely Malaikudiya and Koraga. Koraga tribes are declining in number and deprived of availability of healthcare services and accessibility to healthcare facilities. There are a lot of barriers such as lack of awareness and social stigma amalgamate the existing conditions of Koraga tribes in Udupi district. Research studies pertaining to this problem has been seldom done.

Objective:

We aim to explore the barriers and facilitating factors in accessing healthcare services by a Particularly Vulnerable Tribal Group (PVTG) in Udupi district.

Methodology:

We conducted qualitative research through 8 in-depth interviews with AMOs from PHC and CHC, ITDP staff and NGO workers, and 3 focus group discussions with community health nurses, ASHA workers, and Koraga community leaders from Udupi district. We explored the major facilitators and barriers that influence the utilization of health care services by the PVTG.

Results:

On the beneficiaries’ point of view, lack of awareness, distance to health facilities, poor public transportation, perceived negative behavior of hospital staff, lack of infrastructure, unwelcoming neighbourhood approaches, and economic instability were the main barriers to utilizing healthcare facilities. On the stakeholders (providers) point of view, availability of healthcare facilities, government policies and schemes and NGO activities are the facilitating factors.

Conclusion:

Our study highlights the barriers to utilizing health facilities; these are not always driven by factors linked to the PVTG members’ socio- economic status but also depend significantly on the quality of the health services and other contextual factors. Although the government has made efforts to improve the rural healthcare system through national-level programs, our qualitative study shows that there are a number of barriers which lessens the effectiveness of the programs to enhance the utilization of healthcare facilities by the PVTG in the study area.
IJCM_205A: A qualitative study to assess factors affecting the uptake of measles vaccine in a metropolitan city
Authors: Chandanshive Pradnya , Hadaye Rujuta
Published: April 2024

Background:

Measles is a communicable and potentially fatal, but vaccine- preventable disease. India has set a target of 95% vaccination coverage for Measles-Rubella elimination by the end of 2023 with the help of Intensified Mission Indradhanush (IMI 5.0). The National Immunization Schedule of India recommends two doses of Measles-Rubella (MR) vaccine at 9 months and 16-24 months. The immunization coverage dropped across the globe during the COVID-19 pandemic during the year 2020-2021. Consequently, there was a recent surge in measles cases in some Indian states. The state of Maharashtra reported over 3000 cases; and its capital city Mumbai reported with over 400 cases in December 2022. Various factors such as fear of side effects, lack of information and ignorance have been found to influence vaccine uptake.

Objective:

To determine the factors associated with the uptake of measles vaccine in the community.

Methodology:

The study data collection was conducted during November- December 2023, in the M-east municipal ward of Mumbai, using Qualitative research methods until data saturation, i.e., In-depth Interviews and Focus- Group Discussions. 1. On a one-to-one basis, In-depth Interviews (IDI) were conducted among health authorities and healthcare workers involved in the immunization program, from the Public Health Department of Mumbai. 2. Focus-Group Discussions were conducted with a homogenous group of participants comprising mothers of under-five children, and healthcare workers.

Results:

The most common barriers in measles vaccination that emerged was fear of side effects and overworked healthcare workers, while the motivating factors were good rapport between the community and healthcare workers and communicating health-related information. One of the core themes that emerged was the need for strengthening routine immunization services.

Conclusion:

Tremendous efforts are taken by the public health systems and healthcare workers in the community for ensuring good quality healthcare, including routine immunization. However, establishing a good rapport and building trust among the community members is the need of the hour for ensuring a robust immunization coverage uniformly across the nation.
IJCM_206A: Building a demographic, developmental and environmental surveillance site in an urban slum and resettlement colony in Delhi, India: processes, engagement, and challenges – a SWOT analysis
Authors: Basu Saurav , Sharma Nandini , Rao Shivani , Singh M M , Malik Shikha Taneja
Published: April 2024

Background:

Demographic, developmental and environmental surveillance sites (DDESS) enable accurate and prospective health-related data collection amongst socioeconomically disadvantaged populations that facilitate health planning and interventions.

Objectives:

We explored the community-engagement strategies, enablers, and barriers in building a DDESS site in an urban slum and resettlement colony-based field practice area of a government medical college in Delhi.

Methodology:

We conducted qualitative research through SWOT analysis that identified both internal (strength and weaknesses), and external (opportunities and threats) factors in building the DDESSS. Informal interviews with multiple stakeholders including researchers, field investigators, project staff, local medical officers, resident doctors, community health workers, local residents, and leaders were conducted.

Results:

The themes related to SWOT analysis were identified as: (1). Internal factors – Strengths (a). Pre-existing linkage with the community especially provision of comprehensive primary care services (b). Establishment of community-advisory boards (c). Community needs assessment (2): Internal factors - Weaknesses (a). Perceived lack of individual benefit in residents (b). Dissatisfaction with functioning of existing health services (c). Inadequate digital literacy among senior staff hindering generation and adoption of health data to meet population healthcare needs (c) Concerns over privacy in questions related to socioeconomic status and mapping of the area. (3). External factors – Opportunities (a). Employment of field workers belonging to the community to demonstrate trust and build confidence (b). Outreach health services including noncommunicable screening camps, and child vaccination. (4). External factors - Threats (a). Inefficient functioning of health system such as out-of-stock drugs, delayed vaccination, unavailability of diagnostic services in existing primary health facilities. (b). ensuring availability of adequate human and financial resources beyond the project period. (c) dominance of CABs by influential individuals or groups.

Conclusion:

Garnering community support and active community engagement enable the process of establishment of medical college based DDESS sites.
IJCM_208A: Challenges in the uptake of testing for Tuberculosis Infection among household contacts of Index Tuberculosis patients: An operational analysis
Authors: Samudyatha UC , Kamath Prasanna BT
Published: April 2024

Background:

Gaps in Tuberculosis Preventive Treatment (TPT) cascade among household contacts (HHCs) of Tuberculosis patients are often attributed to the knowledge gaps among the HHCs.

Objectives:

To examine the factors affecting the uptake of IGRA testing among HHCs of drug-susceptible, pulmonary TB patients registered between January and May 2023 in Kolar district, Karnataka using Health Belief model and qualitative interviews.

Methodology:

Between April and June 2023, 196 HHCs of 70 registered TB patients were included in the mixed methods study. Using a four-point Likert scale questionnaire, adult HHCs were interviewed regarding their knowledge of TB disease, perceived susceptibility and severity of TB Infection, benefits, and barriers in testing for TB Infection (IGRA) and cues for action. Mann Whitney U test was used to compare the scores of those who were tested and those who were not. Further, reasons for not undergoing IGRA testing were also assessed qualitatively.

Results:

Among 196 HHC, 45 were children under 5 years. IGRA testing had been done in 47% (71/151) of eligible HHCs. Among adult HHC, self- perceived and Index case-attributed susceptibility score was significantly associated with testing; while perceived severity scores, knowledge and perceived benefit scores were not. Major themes in barriers to testing were misinterpretation of ‘TB Infection’, selective testing of HHCs, delayed contact tracing, lack of logistics and lack of planning and coordination. TPT was given to 84% (38/45) under five HHCs. Major cue for TPT provision was availability of TPT, followed by caregiver’s perceived susceptibility.

Conclusion:

Perceived susceptibility of HHC to TB infection is often misinformed. Group counselling of HHCs, provision of IGRA at doorstep and a well-established referral system will improve the uptake of IGRA.
IJCM_211A: Evaluation of Maternal Death Surveillance In Relation To Eclampsia In Jabalpur Division Of Madhya Pradesh
Authors: Toppo Neelam Anupama , Thakur Aditya , Soni Deepali , Dubey Priyanka
Published: April 2024

Background:

The GOI is striving towards bringing down the MMR.

Objective:

To describe the Maternal Death Surveillance and Response (MDSR) Programme and to assess the maternal deaths due to Eclampsia and factors associated with it in Jabalpur Division of M.P.

Methodology:

A descriptive Cross-sectional study was conducted in four purposively selected districts of Jabalpur Divisions from April 2021 to March 2022. In debth Interview was conducted with all stakeholders and verbal autopsy for 68 maternal deaths. Triangulation of data from district, verbal autopsies and in-depth interviews of stakeholders (health care providers) was done to identify the factors responsible for maternal deaths due to eclempsia at various levels.

Results:

There was only maternal death review being done but no surveillance and response system was found. 57.35% deceased women received >4 Antenatal checkups and 25% 3 ANC checkups. 54.38%, 52.63% and 36.84% antenatal deceased women had Anaemia, Edema and High Blood Pressure respectively. Which were diagnosed at First or Second trimester of pregnancy but were not corrected timely or treated effectively. Most of the deaths occurred in postnatal period, women had early marriage and early pregnancy and 55.88% belonged to ST category.

Conclusion:

Families faith on Quacks, Faith healer and Jhad Funk, Poor compliance against medical advice, various delays and multiple refferals found as contributors in maternal deaths. Most of the women died during or after third trimester and 84% had symptoms during first and second semester and those symptoms were treatable. Timely, correct and quality treatment could have been save those deceased women and their precious children.
IJCM_213A: Feasibility and acceptability of different rapid methods for estimation of potentially missed mortality events during COVID-19 pandemic time in West Bengal
Authors: Saha Indranil , Kundu Ramendra Nath , Ghosh Anuska , Chetri Birshikha , Sangwan Ramesh Kumar , Saha Asim , Chakrabarti Amit , Sharma Arun Kumar
Published: April 2024

Background:

During the surge of COVID-19 pandemic, the mechanism of reporting and documentation of deaths was inadequate. It is crucial to establish the mechanism for measuring the actual events of COVID-19 and associated mortalities as well during this pandemic situation. This is the first instance of application of different rapid methods for death estimation during the pandemic situation. If found to be valid, these methods may be useful for other countries with limited resources and less developed death registration system.

Objective:

To find out the feasibility, acceptability of different rapid method for estimating the cause of deaths among the general population & healthcare workers and also to estimate the number of deaths among allopathic doctors.

Methodology:

The study was conducted from September 2022 to October 2023. Target population being adult deceased person between 1st April 2020 to 30th November 2022 among general population, health care worker and allopathic doctor. For the general population, the study was conducted in one urban municipal area and two sub-centres of Habra Block I under North 24 Parganas district with WHO Verbal Autopsy (VA) tool for adult. Complete enumeration with snowballing, compartmental and capture-recapture method was adopted for general population, health care worker and allopathic doctor respectively.

Results:

Overall, 300 VA could be performed (121 urban & 179 rural) among general population. There were challenges related to both feasibility & acceptability in terms of data access, permission and cooperation. Research team employed a combination of persistence, local collaboration, and strategic decision-making to successfully collect data. Acceptability was more in rural area. Total number of deceased doctors was estimated to be 246 from two different lists.

Conclusion:

Rapid methods may be employed as a part of response systems during pandemic or any future disasters if adequate governmental support and assistance is obtained along with aid from the local people.
IJCM_216A: Task force study for evaluation of community level acceptability, scalability and linkage within health system of ICMR pre-validated Labike/ Technologies for screening & diagnosis in rural & urban population–An implementation research
Authors: Gour Devendra
Published: April 2024

Background:

The concept of ABDM- Ayushman Bharat Digital Health Mission and Ayushman Bharat- Pradhan Mantri Jan Arogya Yojna are in root for overall aims of the research and importance of this research proposal. There is a need to study the acceptability & scalability of ICMR pre-validated technologies -Mobile Lab technology & digital technologies, skilled manpower needed for health data updating from individuals given individual health ids.

Objectives:

To do situational analysis of availability of medical diagnostic, testing facilities in under privileged/ remote areas.

Methodology:

Study Design – Implementation research, Sample - 1000 households (5000 population) have been equally enrolled from rural and urban areas which are further equally divided into two groups of control and intervention. Base Line Data has been collected on following information- socio-demographic characteristics, blood pressure measurement, health needs, health seeking behavior of community, availability and utilization of existing health care facilities and blood investigations. Study tools: Questionnaire for baseline survey – After informed consent, interview of the family head was done using set of quantitative and open-end qualitative questionnaires.

Results:

77.9% and 69.3% belong to Upper Lower class in urban and rural areas. 21% and 15.6 % blood pressure measurements were deranged in urban and rural areas, 11.8 % and 10% population in urban and rural areas showed their willingness for lab investigations at door step through LABIKE. Blood glucose measurements of 5.4 % and 10.6% population in urban and rural areas were deranged. Haemoglobin values of 11.8 % and 17% population in urban and rural areas were low than 10 g/dl. 7 % and 12.7 % population in urban and rural areas utilized existing health care facilities.

Conclusion:

There is need to generate robust grass root level network by integrating community and health service providers.
IJCM_219A: A “One Health” Model for Prevention and Control of Anthrax in Koraput, Odisha, India
Authors: Biswal Sangram , Sahoo P , Satpathy S , Tripathy GK , Papanna M , Sahoo N , Hossain S
Published: April 2024

Background:

Anthrax, a neglected zoonotic disease caused by Bacillus anthracis, poses a significant threat in Odisha, India, particularly in the tribal district of Koraput, which has reported numerous human cases and deaths but lacks consistent robust surveillance.

Objectives:

This study aimed to pilot a “One Health” surveillance model in Koraput, involving community health workers, para-veterinarians, and block- level teams in outbreak investigations.

Methodology:

As part of the “One Health Approach to Anthrax Control in India (OHAI)” project Odisha University of Agriculture and Technology (OUAT), in collaboration with the Departments of Animal Husbandry and Health and Family Welfare, Government of Odisha, initiated prospective laboratory-based anthrax surveillance in three blocks of Koraput. Confirmed cases in animals were identified via microscopic, culture, or PCR testing for Bacillus anthracis. Community awareness programs and rapport-building exercises were conducted with human and veterinary officials at the block and district levels following the detection of outbreaks.

Results:

Between March and June 2023, five anthrax outbreaks were detected in Koraput, with four involving both cutaneous human and animal deaths and one in animals only. Livestock losses included cattle (27), goats (2), and buffalo (1). Of the 38 samples collected (blood, bone, tissue, and soil), 11 (35%) tested positive for anthrax by RT-PCR. OUAT rapidly communicated results (<24 hours) to the state health department, leading to joint investigations and control measures, including livestock vaccination, safe carcass disposal, and medical outreach camps for screening and prophylaxis. In total, five district/block level meetings and two state-level consultations were held, culminating in a zoonotic roadmap draft, which included an anthrax prevention and control action plan.

Conclusion:

The study’s adoption of the One Health framework facilitated a rapid response to anthrax outbreaks in Koraput, effectively managing both human and animal cases. This model presents a viable approach for controlling anthrax in endemic areas of India.
IJCM_22A: Impact of Pranayama and Dhyana intervention on metabolic syndrome among women: community based repeated measures design
Authors: Rao Chythra R , Bidnurmath Ashwini S , Shetty Avinash , Kamath Asha
Published: April 2024

Background:

Prevalence of metabolic syndrome among adults in India, is reported to be around 20%-25%, with significantly higher proportion among women than men. Yoga interventions has been promoted as an important non- pharmacological tool to address the growing burden of non-communicable diseases.

Objectives:

To assess the effectiveness of a pranayama and intervention (yoga) intervention on various components of metabolic syndrome among 30 to 60-year-old women with hypertension.

Methodology:

A community based repeated measures design was undertaken 156 among hypertensive women (79 intervention, 77 controls) residing in coastal part of southern India. Anthropometric measurements, blood pressure, fasting blood glucose (FBS) and lipids were measured. Six-month pranayama and dhyana intervention were administered to the intervention arm, whereas routine treatment was continued for the control arm. Follow-up was done to ensure practice of interventions while investigations were done at baseline and 6th month.

Results:

Majority of the women in the intervention and control arm were aged 45-60 years. In the intervention arm, using the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria, most [57(72.2%)] of the women had elevated blood pressure. Nearly half of them [38(48.1%)] had abdominal obesity, elevated FBS was seen among 39(49.4%) and 50.6% had low HDL. Hypertriglyceridemia was seen in less than a third [23(29.1%)] women. In the control arm, most [52(70.3%)] of the women had elevated blood pressure, 27(36.5%)] had abdominal obesity, half of them had elevated FBS [39(52.7%)] and low HDL [36(48.6%)]. Hypertriglyceridemia was seen in 21(28.4%) women. No significant change was noted at the end of 6th month follow-up in body mass index (BMI) (p=0.533), systolic(p=0.051) and diastolic blood pressure (p=0.485).

Conclusion:

There was no significant difference in the 6th month prevalence of components of metabolic syndrome compared to baseline, in both arms of the study.
IJCM_220A: Proportion of self-medication among elderly in a tertiary hospital in southern Kerala - a cross sectional study
Authors: Varughese Steffi Ann
Published: April 2024

Background:

The use of drugs, herbs, or home remedies on one’s own initiative, or on the advice of another person, without consulting a doctor. Over-the-counter availability of medicines, promotion of drugs, lack of proper awareness regarding the drug and its side effects, unheeded drug policies are all leading causes of antimicrobial resistance in today’s world.

Objectives:

To determine the proportion and determinants of self-medication among elderly individuals above 50 years of age visiting the district hospital in South Kerala

Methodology:

A hospital based cross sectional study was conducted in the inpatients above 50 years of age from the Medicine, Surgery, Pulmonology, Cardiology departments of the district hospital, Kollam. Minimum sample size was calculated to be 156 and convenience sampling was done. A semi-structured questionnaire was formulated, and data was collected in interview mode over the months of June-July 2022. Data was tabulated using MS-Excel and statistical analysis was done using SPSS software version 21. Descriptive statistics were expressed as frequencies and percentages. Chi square test was used to test any differences between proportions.

Results:

Among 156 participants more than half of the study participants (52.6%) with a history of self-medication described as more often (51.2%). 50% with history reported symptoms like gastritis, followed by diarrhoea, anxiety and sleep disturbances. The most commonly self-medicated drugs were Paracetamol (85.4%) followed by cetirizine (14.6%), cough syrups (12.2%) and antibiotics (9.7%) like Azithromycin and Amoxiclav

Conclusion:

Self-medication practices come with a lot of potential risks, like incorrect self-diagnosis, severe adverse reactions, delay in seeking medical care, incorrect choice of therapy and administration of drugs, drug interactions, masking of severe disease, dependence and abuse.
IJCM_222A: Assessment of Implementation of Health and Wellness Centers in Kashmir Valley. A Descriptive Study
Authors: Shahroz  , Khan Muhammad Salim , Ayub Taha , Haq Inam ul , Pandit Mohammad Iqbal , Qurieshi Mariya , Kawoosa Misbah Feroz , Sabah Iram , Lone Abdul Aziz , Sumji Ishtiyaq Ahmad
Published: April 2024

Background:

Health and wellness canters component were launched under the ambit of Ayushman Bharat Yojana. In Kashmir, there was scarce data regarding health and wellness centers implementation therefore this study was undertaken to identify the gaps in implementation of the program at grassroot levels.

Objective:

to assess and compare the existing staff, services, lab services and infrastructure at health and wellness centers across ten districts of Kashmir valley.

Methodology:

a descriptive cross-sectional study was done to evaluate the implementation of health and wellness centers in ten districts of Kashmir valley. study population: staff at health and wellness centers study setting: selected health and wellness centers in 10 districts of Kashmir valley sampling: convenient sampling and random sampling 10 % of upgraded health and wellness center in each district at the beginning and 12 months of study. study timeline: 15months data collection 12 months interpretation 3 months study tools: preformed checklist, semi open questionnaires interviews

Results:

the results of the study indicated that there was still a gap in implementation of program as per guidelines. there were deficiencies in terms of yoga and wellness, proper space for health and wellness centers and staff was not trained properly about the program.

Conclusion:

this study was done in Kashmir valley to asess the implementation of health and wellness center component of Ayushman Bharat yojana. the study highlighted important deficiencies during the implementation of the program as per guidelines.
IJCM_224A: Routine Immunization coverage in less than 2 years residing in the filed practice area of a Medical college, Dharwad, Karnataka
Authors: Priya Prachi , Dixit Umesh
Published: April 2024

Background:

Immunization is the process whereby a person is offered protection from or is made resistant to an infectious disease, typically by the administration of a vaccine. Immunization is most successful and cost-effective public health interventions which averts about 3 million deaths annually. According to (NFHS) 4, children in the age group of 12 to 23 months who were fully immunized with BCG, measles, and 3 doses each of polio and DPT was 62.0% at the national level and 62.6% for Karnataka.

Objective:

The present study is an attempt to know the factors influencing the coverage of immunization in children between 12 -23 months who are residing in the field practice areas of the department of Community Medicine of SDMCMSH, Dharwad

Methodology:

A community based cross-sectional study was conducted among 91 rural children and 134 urban children between age group 12-23 months under field practice area of SDMCMSH, Dharwad

Results:

Out of 225 children studied, 134 from urban setting 74.6% were fully immunized. 91 from rural setting 89% were fully immunized. While un complete immunization coverage in urban and rural is 25.4% and 11% respectively Furthermore it was observed that factors like number of ANC visits the mother had, gender of the child, distance of the immunization center from the home, and educational level of the parents did not significantly influence the immunization status.

Conclusion:

We conclude from our study that the complete immunization coverage is 74.6% in the urban setting and in rural setting complete immunization coverage is 89%.
IJCM_225A: Assessment of factors influencing measles vaccine uptake in a metropolitan city: A cross-sectional study
Authors: Rujuta  , Chandanshive Pradnya
Published: April 2024

Background:

Globally, measles deaths were estimated to be over 1,28,000 in the year 2021, despite the easy availability of safe and effective vaccines to prevent the infection. Routine childhood immunization coverage rates dropped during the COVID-19 pandemic and India has been one of the worst affected countries. The most recent measles outbreak was reported last year in Mumbai, Maharashtra.

Objectives:

1. To estimate the level of uptake of measles vaccine in children aged 12 months to 5 years 2. To determine the factors associated with the uptake of measles vaccine.

Methodology:

This cross-sectional study was conducted over 2 months in a municipal ward of Mumbai during Oct-Nov 2023 in mothers with children aged 12 to 60 months, living in the area for at least past 6 months. Five out of fifteen clusters of Municipal Health Post areas were selected randomly & from each, 82 eligible households were chosen randomly for door-to-door interviews with the participants.

Results:

Among the sample of 428 children, measles vaccine coverage was 96.7%, but only 263 (61.45%) children were vaccinated in timely manner. The facilitator for mothers in vaccine uptake was receiving information from healthcare workers during and after pregnancy (77.57%). The barriers were lack of information about vaccination schedule (18.69%), and child being unwell during vaccination (10.74%).

Conclusion:

Huge efforts have been taken by the Public Health Department for achieving this level of vaccine coverage, however, measles elimination is still a challenge due to delayed vaccination.
IJCM_227A: Perception and attitude towards Generic drug prescription among Medical Undergraduates of Mangalore
Authors: Chauhan Nupur , Mithra Prasanna , Unnikrishnan Bhaskaran , Rekha T , Kumar Nithin , Rajpurohit Trisha , Chakerverty Vrenda , Krishna Mahathi , Rao Mithun
Published: April 2024

Background:

The assessment of future doctor’s perceptions and understanding about generic medicines may help in recognizing possible barriers to greater generic medicine usage. This study was done to explore and evaluate the perceptions and attitudes towards prescribing generic drugs among medical undergraduates of Mangalore and the factors associated with it.

Methodology:

This cross-sectional study was conducted among Undergraduate Medical students of KMC, Mangalore. The data was collected using a semi-structured questionnaire and analysed using Statistical Package for Social Sciences (SPSS) version 25. Results were expressed in tables and figures. The chi-square test was used for comparison across the groups, and p-value < 0.05 was considered statistically significant.

Results:

The study was conducted among 282 students, with a mean age of 21 years. More than half of the participants,51.4%(n=145) were VI semester students. A higher proportion of them,72% were aware that generic medicine contains the same active substance(s) as the brand medicine, and 75.2% were aware that generic drug manufacturers need to conduct bioequivalence studies to show equivalence between the generic medicine and the branded medicine. Overall,64.9% agreed that generics are safe and 80.9% students think that there should be a training program to increase the awareness regarding generic drugs among doctors and patients.

Conclusion:

Although a good percentage of students had adequate knowledge about generic medicines; there was a significant proportion that expressed concerns about the same. These beliefs could represent a major hurdle to larger generic use and could lead to increased health-care expenses.
IJCM_228A: Awareness & possession of health insurance scheme and its impact on health care utilization amongst people seeking services in tertiary care hospitals of coastal Karnataka: A cross-sectional study
Authors: Surendran Jithin , Rekha T , Ommen Sara J , Aggarwal Muskaan , Akshita  , Johari Aali , Mohan Shruti , Jetly Bhuvi , Talukdar Shibam , Unnikrishnan Bhaskaran , Mithra Prasanna , Kumar Nithin , Holla Ramesh
Published: April 2024

Background:

Healthcare is a fundamental human right, and various insurance schemes in India strive to make healthcare inexpensive and accessible to everyone. The government’s Ayushman Bharat and PMJAY programmes aim to guarantee universal health coverage and financial risk protection for households within the country. According to the NITI Ayog, more than 40 crore people lack health insurance coverage in the country. This lack of awareness limits access to healthcare services, especially for the marginalized population. The focus of this study is to assess the impact of availing health insurance on healthcare utilization.

Objective:

To assess the level of awareness and proportion of patients who are availing health insurance scheme and its impact on healthcare utilisation.

Methodology:

This cross-sectional study was carried out at teaching hospitals affiliated with Kasturba Medical College, Mangalore. The sample size was estimated to be 118, which included the adult patients admitted to the wards of respective hospitals who gave informed consent. The study participants received an internally verified questionnaire with four sections in Kannada and English.

Results:

Out of 118 participants, 89% are literate, and two-thirds are holders of BPL card. 84% of study participants are aware of a certain health insurance scheme, among which 90% being aware of the services offered and 82% considering it may be a worthwhile investment. 60% of total respondents possessed any kind of insurance scheme, with three quarters of them utilizing government schemes. Among the insurance holders, 82% receive full reimbursement for their medical condition and 58.5% agree that owning health insurance enables them greater access to health-care services. Paying medical expenses out of pocket drives uninsured people to reconsider obtaining an insurance.

Conclusion:

Public awareness and financial assistance programs should be tailored with culturally competent communication and simplified enrolment processes to enhance the coverage of health insurance services.
IJCM_232A: Identification of Kinematic Motifs in Crouch Gait of Children with Cerebral Palsy
Authors: Krishnan Shyam K , Unnikrishnan Bhaskaran , Joshua Abraham M , Krishnan C.M.C , Figardo Sheron , Poojary Manish C , Kumar Abhishek
Published: April 2024

Background:

Crouch Gait is a fairly common pathological gait adaptation seen in children with Cerebral Palsy, characterized by inadequacy of plantar flexion, knee extension and hip extension in the stance phase of gait. From a kinetic perspective crouch gait severely impairs the ability to generate thrusting forces through the extensor muscles of stance extremity which is necessary for forward progression. Broader goal of this study was to develop and test a wearable robotic exoskeletal device for children with crouch gait, where a knee actuator provides extensor thrust. Artificial Intelligence (AI) models which control the torque output of the knee actuator, needed to be trained to activate, control, or organize the output.

Objectives:

Rhythmical/repetitive patterns, like the phases of normal gait, needed to be identified in crouch gait, which could be used to train AI models

Methodology:

A total of 30 children with cerebral palsy were screened of which 7 children aged between 7 and 14 years, who presented with classical crouch gait were recruited. Kinesiological data was collected through accelerometric and goniometric placed bilaterally on thigh, leg, and knee, as well as pressure sensors embedded on to bilateral insoles at the fore-foot and hind foot, while the children walked over a 5 meter course. All sensor data was relayed through an Arduino micro-controller unit for analog to digital conversion and stored on a laptop computer. All Accelerometer and goniometric data was plotted against time on MS Excel to identify specific patterns or motifs.

Results:

Key kinematic motifs could be identified in crouch gait, which bestowed semblance of rhythmicity, and cyclical pattern, which was difficult to identify under normal observation.

Conclusion:

Accelerometric, as well as goniometric data suggest the presence of inherent kinematic patterns in the same. These could be used for training AI models for robotic exoskeletal devices.
IJCM_234A: Malaria Surveillance System Assessment in Jashpur district, Chhattisgarh State, India, January - March 2023
Authors: Girhay Prashant , Kokare Vikas , Dzeyie Kevisetuo Anthony
Published: April 2024

Background:

Globally in 2021, 247 million malaria cases were reported from 84 malaria endemic countries. India is committed to eliminate malaria by year 2030. India reported >160,000 malaria cases in 2021 and 2022; 65% cases from four states-West Bengal, Chhattisgarh, Orrisa and Jharkhand.

Objectives:

We assessed malaria surveillance system in Jashpur district to describe epidemiology of reported malaria cases, for its strengths and weaknesses and to provide evidence-based recommendations.

Methodology:

We analyzed surveillance data for the year 2022. We assessed timeliness and completeness attributes of the system using US CDC guidelines for evaluating the surveillance system of the five randomly selected reporting units (RUs) for January-March 2023. We reviewed surveillance data reporting portal, hospital records and interviewed key informants. We analyzed data using MS Excel and calculated frequencies and proportion

Results:

Jashpur reported 269 cases in 2022; 51% female, 58% among tribal community, 89% above 15 years and 90% were of plasmodium falciparum. The maximum number of cases were reported during July to November with peak in the month of August. The annual parasite index (API) per 1000 population was 0.3 for the district, however two blocks had API of >0.5. All the five RUs submitted monthly reports timely. Of the ten reporting formats reviewed, 48% critical blank fields were not filled.

Conclusion:

Malaria surveillance system in Jashpur detected cases largely among tribal community, identified high burden blocks with good timeliness but require improvement in complete information. We recommended district to focus preventive public health measures in high burden blocks and orient the laboratory technicians for complete data entry in line list of cases.
IJCM_237A: Assessment of out-of-pocket expenditure amongst admitted patients in a tertiary care centre of Maharashtra: a cross-sectional study.
Authors: Ghoshal Titas , Gattani P. L. , Maidapwad S. L.
Published: April 2024

Background:

In India, financing health-care majorly constitutes out-of-pocket expenditure. Health expenditure in India accounts for

Objectives:

1. To assess the total out-of-pocket expenditure of patients due to current illness. 2. To assess out-of-pocket health expenditures in a single episode of illness in families of different socio-economic strata. 3. To study association between various specialities and direct out-of-pocket health expenditure incurred after admission. 4. To find the percentage of patients getting benefit of state government health insurance (MJPJAY).

Methodology:

A cross-sectional study was conducted by interviewing 233 patients (or care-takers) admitted in a tertiary-care centre, using a pre-designed semi-structured questionnaire in local language. Expenditures before and after admission (=3 days) due to current illness was documented. Enrolment for MJPJAY benefit was recorded. The data was compiled in MS-excel and analysed using SPSS.

Results:

The median out-of-pocket expenditure for the current illness was Rs.2935 (IQR: Rs.1375 to Rs.8508.75). The median out-of-pocket expenditure in the IVth and Vth social classes according to Modified B.G. Prasad classification, is Rs.3715(IQR: Rs1925 to Rs.9060) and Rs.5210(IQR: Rs.2917 to Rs.8350) respectively. 12.43% (excluding obstetric) patients were enrolled for benefit of MJPJAY at the time of study.

Conclusion:

The out-of-pocket expenditure is found to be high among the patients studied, especially, among those choosing to visit private health facilities pre-admission. Post-admission, as the direct expenditure was more than indirect in most cases, the underlying causes may be unavailability of drugs and investigations required for management. MJPJAY benefits are received post diagnosis, therefore pre-diagnostic investigations contribute to high out-of-pocket expenses. Further studies are required to evaluate the preference towards private health facility.