bluuebunny/crossref_metadata_2025 huggingface dataset:
Society 5.0 For lean-driven sustainable construction: A conceptual framework
Authors: Madhushani S. J. L. , Ranadewa K. A. T. O. , Seneviratne L. D. I. P.
Published: December 2024

Nowadays, the construction industry is significantly driven by the objective of achieving sustainable development. It creates a necessity to implement lean principles within the construction industry, as lean construction greatly contributes to sustainability. Despite lean construction's potential to achieve sustainable development, numerous barriers hinder its implementation. Consequently, the concept of Society 5.0 can be utilised as a transformative framework that integrates advanced technologies with a human-centric approach to overcome these issues. The aim of this research is to investigate how lean construction can be utilised along with society 5.0 to drive sustainable development in construction. To address this objective, a comprehensive literature review was conducted, and the content was analysed to align with the research objective. The findings of this research indicated that lean construction principles can be an effective application in any part of the construction process to prioritise sustainable outcomes. Moreover, the research revealed 95 barriers for lean integrated sustainable construction, categorised under political/government barriers, economic/financial barriers, technical barriers, social barriers, and other barriers. The research highlighted the necessity to integrate lean construction and Society 5.0 to overcome the barriers and drive sustainable development in construction. These research findings are paving the way towards conducting further research on the area of Society 5.0-enabled lean construction to drive sustainable development in construction.
Validity and reliability of the Turkish version of the Maternal Health Literacy Inventory in Pregnancy scale: a methodological study
Authors: Altuntas Yeşim , Ucar Ayse Kilic
Published: December 2024

Purpose: This study aimed to translate the Maternal Health Literacy Inventory in Pregnancy (MHELIP) scale into Turkish and evaluate its validity and reliability for use in the Turkish population. Methods: The participants in this methodological study included 250 pregnant women who presented to the antenatal clinic of the Florence Nightingale Hospital in Istanbul, Turkiye. Content validity was assessed using expert approval. Confirmatory factor analysis, exploratory factor analysis, and structural equation modeling were used to assess the validity. Criterion validity was evaluated using the short-form health literacy survey tool, the Short-Form Health Literacy Questionnaire (HLS-SF12). To assess reliability, Cronbach’s alpha, item analysis, and the test-retest method were used.Results: The mean age of the participants was 32.02±4.15 years. The content validity index of the scale was .99. The scale had a four-factor structure that fit well with 48 items. “Maternal health knowledge,” “maternal health information search,” “maternal health information assessment,” and “maternal health decision making and behavior” subscales had Cronbach’s alpha values of .91, .76, .85, and .90, respectively. The MHELIP and HLS-SF12 scores were significantly correlated (r=.422, p<.001). Conclusion: The MHELIP was found to be a valid and reliable measurement tool in pregnant Turkish women.
Are the effects of stress on antenatal depression mediated by self-esteem and moderated by social support?: a cross-sectional study
Authors: Lee Eunjoo
Published: December 2024

Purpose: Social support and self-esteem play crucial roles in influencing the mental health of pregnant women. This study explored the moderating role of social support and the mediating role of self-esteem in the relationship between pregnancy-related stress and antenatal depression among pregnant women.Methods: The study included 180 pregnant women who visited the obstetrics outpatient clinic at a hospital in Changwon, Korea, between November 22 and December 30, 2022. Data were collected through structured questionnaires that assessed antenatal depression, pregnancy stress, self-esteem, and social support. The data were analyzed using descriptive statistics, Pearson correlation coefficients, and PROCESS Macro model 4. Results: The mean gestational age of the participants was 23 weeks. The mean score for pregnancy stress was 63.51±14.33, indicating a moderate level of self-esteem and social support were high, with scores of 31.06±4.83 and 41.96±7.73, respectively. Prenatal depression was notably low, averaging 6.51±4.59. It showed a significant positive correlation with pregnancy stress (r=.52, p<.001) and negative correlations with self-esteem (r=–.49, p<.001) and social support (r=–.24, p=.001). Self-esteem acted as a mediator in the relationship between pregnancy stress and antepartum depression among pregnant women, with an indirect effect of .05 and a 95% confidence interval of .02 to .08. Additionally, social support moderated the impact of pregnancy stress on antepartum depression (B=–.01, p=.036).Conclusion: The study emphasizes the need for a comprehensive approach to maternal mental health during pregnancy, which should include stress management, self-esteem enhancement, and social support interventions. Addressing these interconnected factors is crucial for promoting maternal well-being and reducing the incidence of prenatal depression.
Colposcopy Value in Young Child-bearing Women: Is New Recommendations Necessary?
Authors: Sabet Fahimeh , Aminizad Avishan , Behnamfar Fariba , Allameh Tajossadat , Shahrokh Seyedeh Ghazal , Koushan Rostami , Taravati Amirmohammad , Seresht Leila Mousavi
Published: December 2024

Background:

Cervical cancer is a common malignancy in women and HPV infection is directly linked to it and can be considerably prevented through routine screenings. Despite the belief about the persistence of HPV infection in older than 30-year-old women, high-grade lesions might be detected in younger ages; therefore, the purpose of the current study is to determine the worth of HPV infection screening in younger than 30-year-old women.

Materials and Methods:

This cross-sectional study has been executed on 100 under 30-year-old women who have undergone genotyping. Fourteen HPV subtypes including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 were defined as high risk and the patients were categorized in HPV 16/18 or other high-risk groups. Pap smear and colposcopy were performed for both groups and interpreted as normal, low-risk and high-risk lesions and compared between the groups.

Results:

In terms of demographic, clinical, and sexual behavioral characteristics, the present study exhibited similarity (P value > 0.05). Pap smear (P value = 0.100) and colposcopy (P value = 0.711) grading did not differ between those with HPV 16/18 versus other high-risk HPV patients. Pap smear and colposcopic findings were weekly in agreement (κ < 0.5, P value < 0.001).

Conclusion:

Early cytological plus genotyping assessment in women at early child-bearing ages seems logical, as the cervical premalignant lesions have a slow progressing nature and can be easily treated in early stages.
Elucidating the Effects of Sleep Deprivation: Exploring fMRI Imaging Biomarkers to Analyze Brain Functions Related to Insomnia
Authors: Choghazardi Yazdan , Sabzevarian Fateme , Saber Korosh , Mansoory Meysam Siyah , Khodamoradi Mehdi , Sharini Hamid
Published: December 2024

Background:

This study aimed to propose functional magnetic resonance imaging (fMRI) imaging biomarkers for the diagnosis of insomnia by examining the brain maps of young and old people during sleep deprivation (SD).

Materials and Methods:

A total of 50 healthy individuals were selected in two groups, including the young group: 17 people (20 to 30 years) and the elderly group: 23 people (65 to 75 years), who were involved in a 1-month period of SD, so that during the experiment they woke up 3 hours earlier than usual. Insomnia and sleepiness questionnaires were collected from these individuals (OpenfMRI website). Independent component analysis (ICA) processing was performed using the Generalized Intelligent Framework for Tutoring (GIFT) toolbox on old and young people’s data. Correlations between clinical variables and imaging were performed to extract insomnia biomarkers with a significance level of P = 0.05.

Results:

In the dynamic range variable, the difference in the effect of insomnia between the two groups was significant in areas such as the inferior occipital gyrus (IOG), superior temporal gyrus (STG), and posterior cingulate (PC). The fractional amplitude of low-frequency fluctuation (fALFF) variable in the anterior cingulate and precuneus areas, as well as the spatial map variable in areas such as the inferior semilunar lobule, anterior cingulate, subcallosal gyrus, and middle temporal gyrus (MTG) between the two groups, was significantly different (P = 0.05).

Conclusion:

Based on the results of this study, brain activity map in sleep-deprived people has a significant change in some brain areas and this effect is different in old and young adults.
Insulin Resistance in Type 2 Diabetes Mellitus: Pattern, Determinants, and Correlates in a Resource-Challenge Nigerian Setting
Authors: Ala Oluwabukola Ayodele , Uduagbamen Peter Kehinde , Yusuf Adebimpe Olukemi , Odeyemi Abiona Oluwadamilola , Olanrewaju Olayemi , Adedire Adejare , Adeyeye Abosede G.
Published: December 2024

Abstract

Background:

Insulin resistance (IR) is an obesity and inflammation-associated condition driving the rising global prevalence of hypertension, type 2 diabetes mellitus (T2DM), and dyslipidemia. It is a modifiable risk factor for cardiometabolic disease due to its association with sedentary lifestyle and smoking.

Aims:

To assess IR and its associations in T2DM.

Materials and Methods:

This cross-sectional study analyzed 200 T2DM patients’ data and assessed its correlates and predictors using logistic regression.

Statistical analysis used:

Statistical Package for Social Sciences 26.

Results:

The mean age of the 200 participants was 58.96 ± 8.32 years, 19 (9.5%) were smokers and 54 (27%) had diabetes for more than 10 years. The waist–hip ratio was higher in women than men, P = 0.04. The hypertensives were older and had higher IR than those without hypertension, P = 0.04 and P < 0.001, respectively. The IR was positively correlated with the atherogenic index of plasma (AIP) and atherogenic coefficient (AQ), P = 0.04 and P < 0.001, respectively. Abdominal obesity, hypertension, hypertriglyceridemia, elevated triglyceride glycemic index (TGI), and low alpha lipoprotein (HDL) were more common in women than men. The elderly had higher AIP, TGI, and lower HDL, P < 0.001, P < 0.001, and P = 0.001, respectively. IR was associated with kidney dysfunction (P = 0.02). Smoking (OR 1.93, 95% CI 1.15–2.26), hypertension (OR 5.84, 95% CI 3.17–7.28), AIP (OR 8.23, 95% CI 2.58–8.14), and AQ (OR 11.63, 95% CI 4.07–13.47) independently predicted IR.

Conclusion:

IR contributes majorly to the rising global prevalence of hypertension, T2DM, and dyslipidemia. Its association with sedentary lifestyles and smoking makes it a modifiable risk factor for cardiometabolic and renal disease. All efforts are needed to curtail its rising trend.
Evaluation of Lipid Profile in Patients with Non-diabetic Chronic Kidney Disease
Authors: Das Dwijen , Hossale Basavachetan , Purayil Saran Kaatil
Published: December 2024

Abstract

Background

Chronic kidney disease (CKD) is a global health concern associated with dyslipidemia, which contributes significantly to disease progression and cardiovascular risk. Understanding lipid profile alterations in non-diabetic CKD patients is crucial for improving management strategies.

Objectives

This study aimed to analyze lipid profiles in non-diabetic CKD patients and explore the association between lipid abnormalities and CKD severity.

Materials and Methods

A cross-sectional study involving 80 non-diabetic CKD patients was conducted at Tezpur Medical College and Hospital. Fasting lipid profiles, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured. GFR was estimated using the CKD Epidemiology Collaboration (CKD-EPI) equation. Correlations between lipid parameters and CKD stages were assessed statistically.

Results and Discussion

Dyslipidemia was observed in 65% of participants and was more prevalent in advanced CKD stages. A significant decline in HDL-C levels was observed with disease progression (P = 0.029). TG levels increased with advancing CKD but were not statistically significant (P = 0.343). No significant variation was noted in TC or LDL-C levels across stages. Significant correlations included a positive relationship between GFR and HDL-C (P < 0.05) and a negative relationship between TG and HDL-C (P < 0.01). These findings suggest that lipid abnormalities in CKD are influenced by insulin resistance, oxidative stress, and uremic toxins, contributing to cardiovascular risk.

Conclusion

This study underscores the high prevalence of dyslipidemia in non-diabetic CKD patients, with HDL-C serving as a potential marker of disease severity. Regular lipid monitoring and tailored interventions are essential to manage cardiovascular risk effectively.
Lower urinary tract symptoms and dysfunction as a result of functional constipation: a cross-sectional study
Authors: Mahfouz Aml , Wali Yasser , Metwally Rasha H , Fouad Ahmed H , Khalil Ahmed F
Published: December 2024

Background

Lower urinary tract symptoms (LUTS) and dysfunction can be a significant complication of functional constipation (FC), especially in children. The relationship arises due to the close anatomical and functional connections between the bladder, bowel, and pelvic floor muscles.

Aim

The study aimed to investigate the presence of LUTS and the lower urinary tract dysfunction (LUTD). among children with FC.

Patients and methods

A cross-sectional descriptive study was carried out on children aged 4–10 years at the pediatric gastroenterology clinic of Alexandria University Children’s Hospital with an established diagnosis of FC according to Rome IV criteria. Age-adapted Agachan score was used to quantify the severity of FC. The Arabic version of the dysfunctional voiding symptom score (DVSS) was used to investigate the presence of LUTD.

Results

The study was conducted on 105 children (54 boys, 51 girls), 50.5% of the patients had positive DVSS scores; 62.3% were girls and 37.7% were boys with statistically significant positive DVSS in girls. Most patients had moderate to severe scores by using the age-adapted Agachan score. Multivariate logistic regression analysis was used to determine the independent predictors of bladder bowel dysfunction in patients with chronic FC. The independent predictors were dysuria, decreased voiding frequency, urgency, daytime incontinence, and female sex. History of bright red blood in the stools and the presence of anal fissures during the perianal examination were more common with bladder and bowel dysfunction patients than FC alone (P=0.011 and 0.027, respectively). The prognostic performance of age-adapted Agachan score to predict the positivity of DVSS score was found statistically significant.

Conclusion

Both LUTS and LUTD were correlated positively with FC, a crucial finding that necessitates the awareness of this finding.
Toxic and trace elements in scalp hair samples of Egyptian children with multiple sclerosis: a case–control study
Authors: Abdulhai Eman A. , Abdelrazik Eman
Published: December 2024

Background

Heavy metals and trace elements are considered as environmental pollutants that pose serious risks to public health as they are nonbiodegradable and remain in the ecosystem. It has been documented that they are neurotoxic, and their levels in hair samples can be used as a biomarker of exposure, indicating their levels in soft tissues. Multiple sclerosis (MS) is considered one of the most common chronic neurodegenerative diseases. Its pathogenesis is complex and multifactorial, and there is interaction between genetic and environmental factors.

Aim

The aim of this study is to compare the levels of some heavy metals and trace elements in hair samples of children with MS with those of healthy controls to investigate their possible association with the onset of MS.

Patients and methods

A total of 30 children with MS and 30 healthy children were investigated. Using inductively coupled plasma atomic emission spectrometry, we analyzed 21 elements in hair samples from MS patients and a healthy control group.

Results

Zn, Cr, Ba, Mg, Mn, Se, Sr, and V were significantly higher in hair samples from children with MS. While Hg, B, and As were only detected in cases, there was no significant difference in the level of Al, Ag, Ca, Cd, Cu, Fe, Ni, Pb, P, and Na between cases and controls.

Conclusion

Zn, Cr, Ba, Mg, Mn, Se, Sr, and V were significantly higher in hair samples from children with MS. There was no significant difference in levels of Al, Ag, Ca, Cd, Cu, Fe, Ni, Pb, P, and Na between cases and controls.
Study of the incidence of intraventricular hemorrhage in preterm babies in Damanhour medical national institute’s neonatal intensive care unit
Authors: El-touny Eman M. , Hassan Mohamed F. , Khamis Gamila S. , Ayad Ashraf M. , El Bedawy Neveen M.
Published: December 2024

Purpose

To study the incidence of intraventricular hemorrhage (IVH) and its predictors among premature neonates admitted to Neonatal Intensive Care Unit (NICU) and also to look for the mortality rate due to IVH.

Patients and methods

This retrospective cohort study was conducted on 80 preterm babies with a gestational age (GA) of less than or equal to 36 weeks. They were divided after obtaining cranial ultrasound imaging into study group (16 preterm babies with IVH) and a control group (64 preterm babies without IVH), both groups were then compared in terms of maternal history such as age, Gravida Para Scoring, preterm siblings, incidence of preeclampsia/eclampsia, type of delivery.

Preterm data and IVH predictors such as GA, sex, birth weight (BW), Down Score, use of mechanical ventilation (MV), apnea, pneumothorax, thrombocytopenia, jaundice, hypoxia, early onset sepsis, hypotension, seizures, jaundice, Patent Ductus Arteriosus, metabolic diseases, blood diseases were compared. Mortality rates were also compared between the two groups.

Results

The incidence of IVH among total neonates was 20%, significant differences were observed between the two groups regarding to GA and BW, mechanical ventilation, apnea, hypotension/shock, seizures. The mortality rate was 56.3% in the IVH group and 20.3% in the control group. Moreover, when multivariate logistic regression analysis for the variables affecting IVH was performed; only seizures showed significant outcomes.

Conclusion

Prematurity and low BW are significant risk factors for IVH. Seizures were strongly linked to the incidence of IVH. Prevention of preterm birth, prenatal and postnatal care are mandatory to prevent IVH and its complications.
Fibrosis-4 and Ultrasonography Assessment of Metabolic Dysfunction-associated Steatotic Liver Disease: A Cross-sectional, Observational Study
Authors: Eva Israt Zerin , Qureshi Nazmul Kabir , Ferdous Chandina , Afrooz Farhana , Jahan Dilruba Nusrat , Samad M. A.
Published: December 2024

ABSTRACT

Introduction:

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease, has now emerged as endemic. Fibrosis-4 (FIB-4) can grade the risk of evolving liver fibrosis utilizing inexpensive easily available parameters, and ultrasonography (USG) is the attainable initial imaging modality to detect the presence of MASLD. This study aimed to determine the prevalence and grades of MASLD along with fibrosis risk stratifications according to the FIB-4 index among the urban diabetic population of Bangladesh.

Methods:

This cross-sectional observational study was performed at National Healthcare Network Uttara, Dhaka, Bangladesh, from November 2022 to October 2023 with ethical clearance among nonpregnant adults having type 2 diabetes mellitus, aged 18 years to ≤74 years. The presence of MASLD with grading was ascertained by USG of the hepatobiliary system, and the fibrosis risk score was calculated according to the FIB-4 index.

Results:

Overall, 167 subjects were studied (male-to-female ratio of 1:1.7). USG revealed that 94.6% had fatty changes in the liver, among them 37.7% had Grade 1, 48.5% had Grade 2, and 8.4% had Grade 3 fatty changes. Risk stratification by the FIB-4 index revealed that 65.3% had low risk, 31.7% indeterminate risk, and 3.0% high risk for hepatic fibrosis. Most subjects in the indeterminate and high-risk group had HbA1c% ≥7 than the low-risk group for fibrosis. The study found that 41.9% of patients were overweight, 47.3% were obese, and central abdominal obesity was seen in 85.6% of patients.

Conclusion:

This study revealed a considerable prevalence of MASLD, with varying degrees of liver fibrosis among the diabetic population. Case-finding strategies using USG and noninvasive tests (such as FIB-4) should be applied to rule out or in advanced fibrosis.
Safe Implementation of Robotic Surgery for Gynecologic Diseases at a Tertiary Center: Retrospective Analysis of 149 Cases and Review of the Literature
Authors: Yoshimura Takuma , Nishio Hiroshi , Sakai Kensuke , Nogami Yuya , Hayashi Shigenori , Yamagami Wataru
Published: December 2024

Objectives:

The initial learning curve is a barrier to introducing robotic surgery. Evidence regarding appropriate simulation programs that allow for a smooth introduction of gynecological robotic surgery remains limited.

Materials and Methods:

We retrospectively analyzed 149 patients who underwent robotic surgery for gynecologic diseases. Before their first procedure, the surgeons completed a robotic surgery training program. Assistant surgeons also completed simulation programs, including setup procedures and manipulation of the robotic arm.

Results:

The mean (± standard deviation) operative, setup, and console times were 170 ± 54 min, 22 ± 8 min, and 126 ± 51 min, respectively. No patient required blood transfusion or conversion to laparoscopy or laparotomy. Patients undergoing surgery by the same surgeon were divided into three groups (first-third, middle-third, and last-third of patients undergoing surgery) to assess chronological changes. No statistically significant differences were found between the operative and console times among these groups. The setup times for the middle and last third of patients were 20 ± 7 min and 18 ± 7 min, respectively, which were statistically significantly shorter than those for the first third of patients. No significant differences in the operative and console times done by five physicians who completed programs were observed between the first 75 and the latter 74 procedures; however, the setup times of the latter 74 procedures were significantly shorter than those of the first 74 procedures (25 ± 9 min vs. 19 ± 6 min; P < 0.001).

Conclusion:

The setup time was influenced by clinical experience. An appropriate simulation program allowed a safe implementation of robotic surgery.
The Impact of Oxidized Regenerated Cellulose Application during Cystectomy and Drainage in Endometrioma Patients: A Retrospective Cohort Study
Authors: Marwali Luky Satria , Setiawan Marcel Ezra , Emeraldi Malvin , Asadi Agus Surur , Putera Aditya Rangga , Puspitasari Rany Ayu
Published: December 2024

Objectives:

This study aims to determine the impact of oxidized regenerated cellulose (ORC) during cystectomy and drainage on recurrence and ovarian reserve.

Materials and Methods:

Women aged 18–45 years with endometrioma (pathologically confirmed) who underwent conservative laparoscopy surgery (cystectomy and drainage) using ORC at Fatmawati General Hospital Jakarta, Indonesia, were included in this study. All surgeries were done by complete excision of all endometriosis lesions (especially for excision of deep infiltrating endometriosis and adenomyosis resection). All patients were followed up for 1 year, and the recurrence rate and postoperative anti-Mullerian Hormone (AMH) were evaluated.

Results:

Twenty patients were included in the cystectomy group and 19 in the drainage group. The researchers found the result was not significant (P = 0.622) in recurrence rate. AMH was decreased from 3.0 ± 1.8 to 2.1 ± 1.5 in cystectomy with ORC group. Conversely, AMH decreased from 1.4 ± 1.25 to 1.1 ± 0.9 in the drainage with ORC group. The reduction of AMH level was more significant in the cystectomy group (P = 0.002) than in the drainage group (P = 0.124).

Conclusion:

Cystectomy with ORC significantly reduces ovarian reserve. Drainage followed by insertion of ORC to the cyst cavity can be an option to maintain ovarian reserve with a risk of recurrence that is not significantly different from cystectomy.
The Necessity to Improve the Functioning of Research Cell to Enhance the Research Environment in Indian Medical Colleges
Authors: Giri Purushottam A. , Joshi Krupal
Published: December 2024

Medical research in Indian medical colleges is essential for advancing healthcare and fostering innovation but faces significant challenges such as inadequate infrastructure, limited funding, and insufficient researcher support. Establishing dedicated Research Cells (RCs) offers a viable solution by providing structured support, streamlining administrative processes, and fostering a culture of research excellence. RCs play a pivotal role in managing grants, facilitating ethics approvals, and offering capacity-building programs to enhance research skills and output. Recommendations for effective RC implementation include securing adequate funding, integrating RCs into institutional frameworks, and aligning their objectives with institutional goals. Promoting indigenous indexing agencies and supporting Indian medical journals are critical for improving the visibility and global impact of Indian research. Additionally, incentivizing quality research and ensuring adherence to ethical guidelines are vital for sustaining a robust research ecosystem. This article underscores the transformative potential of Research Cells in addressing systemic issues and enhancing the research environment in Indian medical colleges.
IAPSM’s Position Paper on Typhoid Vaccines for Adult Immunization in India
Authors: Goel Kapil , Verma Madhur , Sharma Nikita , Parida Swayam Pragyan , Bhardwaj Anu , Nadda Anuradha , Sharma Sahil , Sen Arunima , John Jacob , Bansal Adarsh , Gupta Madhu
Published: December 2024

Typhoid is a major public health concern in India, particularly among those dwelling in urban slums with poor sanitation. The disease caused by Salmonella enterica serovar Typhi spread majorly through contaminated food and water. The economic burden of the disease is catastrophic and affects both families and the government making a strong case for including typhoid vaccines in the national immunization schedule. The World Health Organization has prequalified several vaccines and has recommended their use in endemic areas. While there is robust evidence for vaccination of children from India and other LMICs, the case for adult vaccination remains less clear. The Indian Association of Preventive and Social Medicine acknowledges the necessity to adopt a widespread typhoid immunization program, along with other preventive strategies, especially in the vulnerable pockets. IAPSM recommends focusing on newer-generation Typhoid Conjugate Vaccines (TCVs), which provide long-lasting and superior immunological benefits, and are effective across all ages including adults. IAPSM suggests routine use of Typbar-TCV™ for adults up to 45 years old in India. The organization also highlights the necessity for post-marketing surveillance of these vaccines, to monitor the long-term safety and effectiveness of various vaccines in different communities. IAPSM encourages members to take front-line efforts in their community health service areas, and finally appeals for the development of vaccines to cover a more extensive range of Salmonella infections so that control over typhoid can be strengthened.
Family Adoption Program: An NMC-mandated Initiative
Authors: Shah Hemangini Kishore , Virk Amrit Kaur , Dongre Amol , Datta Shib Shekhar , Gupta Subodh S.
Published: December 2024

The National Medical Commission (NMC) of India has introduced the Family Adoption Program (FAP) as a key initiative within the Competency-Based Medical Education (CBME) framework. FAP is designed to reshape medical education by deeply embedding students within communities, providing a platform for experiential learning that enhances their understanding of healthcare challenges beyond the clinical setting. Under the program, medical students adopt families in rural or underserved areas and work with them over an extended period, addressing health needs and fostering a holistic, socially responsive approach to care. This engagement allows students to understand the multifaceted determinants of health—such as social, economic, cultural, and environmental factors—that influence well-being and disease. Through direct interaction with families, students develop a community-centred approach to healthcare delivery, fostering continuity of care and empowering communities in managing their own health. This paper explores how FAP integrates community engagement into medical education, driving both student learning and community health outcomes. It outlines the theoretical underpinnings and practical implementation strategies of FAP, offering a roadmap for medical colleges to successfully integrate this initiative into their curricula. The paper highlights best practices and innovative approaches from institutions, emphasizing the need for institutional ownership, interdisciplinary collaboration, and partnerships with local communities to ensure long-term success. Additionally, it provides insights for scaling FAP nationally, positioning it as a transformative step towards cultivating compassionate, community-oriented healthcare professionals. By fostering deeper connections between medical students and communities, FAP has the potential to improve health equity and transform health care across India.
Role of Gender Equity and Disability Inclusion to Help Achieve the Larger Cause of Health for All and Attain SDG 2030 by India
Authors: Kar Sonali , Bashar Abu , Gnanasekaran Sridevi , Jayasree A K , Indu Pillaveetil Sathyadas , Srivastava Kajal
Published: December 2024

Gender equality had been targeted under Millennium Development Goals 2015 as Goal 3, whose primary focus was women’s education. It was further reinforced under the ambit of Sustainable Development Goal 5 as again gender equality and women empowerment, whose timeline is by 2030. The review article essays the journey of this very pertinent theme, from abeyance to gaining prominence, and the associated societal variations. Gender equity now is the finer version, which is accepted and received well too, and this inclusiveness has urged us to add disability inclusion into our context of discussion. These issues are always challenges that crop up in the path of development and evolution. Hence, it is very essential that deliberations are conducted to get an insight into the deviations at the regional as well as rural areas in terms of addressing these issues. With appreciable improvement in health-related targets, these issues are coming to the fore, as barriers to sustainable improvements. Hence, developing strategies for gender equity and disability inclusion are likely to play vital roles in the overall goal of Health For All (HFA).
Operationalization of One Health Approach in India: Still Miles to Go?
Authors: Saxena Deepak , Yasobant Sandul , Kalpana Pachillu , Sayed Zahiruddin Quazi , Bhardwaj Pankaj
Published: December 2024

One health (OH) has been a buzzword in the political and academic fraternity during the last couple of years in India and globally. While OH is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems, it recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and interdependent. OH approach mobilizes multiple sectors, disciplines, and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems while addressing the collective need for clean water, energy, and air, safe and nutritious food, taking action on climate change, and contributing to sustainable development. Here, a comprehensive roadmap for operationalizing the One Health approach in India is proposed as the way forward.
Urban Health Resilience: Strategies for Strengthening Public Health Systems in Response to Urbanization Challenges
Authors: Mathur Medha , Wani Varun J. , Basu Rivu , Manihar Priya , Ansari Mohammad Waseem Faraz , Mathur Navgeet , Vyas Shaili , Nayak Smrutiranjan , Verma Anjana , Singh Surendra
Published: December 2024

The social structure of India is rapidly evolving, towards modernization. The urban population of India is projected to approach 60 crores by 2036. Urban health resilience stands for building the capacity of urban systems to withstand and adapt to health-related stresses like natural disasters, man-made disasters, and pandemics like COVID-19 and the capability to recover from them by well-equipped hospitals, efficient emergency response mechanisms, and a network of well-trained and motivated healthcare professionals. Also, the involvement of communities is central to building urban health resilience. Strong policy frameworks are required for establishing a resilient urban health ecosystem. Addressing social determinants, such as income inequality, education, and housing, is also a basis of building urban health resilience. Some examples have been instrumental in designing a resilient urban health system like Singapore’s Smart Nation Initiative, Copenhagen, Denmark’s Model for Sustainable Urban Living internationally, Ahmedabad’s Heat Action Plan and Kochi’s Waterfront Development for Climate Resilience are excellent examples from our country. The suggested strategy for an urban resilient system is a Rapid, Extensive, Sturdy, Ingenious, Lucid approach with an International collaboration for an Enthusiastic, Non-latent, Continuous Early warning system (RESILIENCE).
Need for a Strong FOPL in India-position Statement
Authors: Sharma Nandita , Bahurupi Yogesh , Garg Suneela , Kapil Umesh , Bhardwaj Pankaj , Bera Om Prakash , Singh Mahendra , Aggarwal Pradeep
Published: December 2024

Due to lifestyle changes, urbanization, and the rise of ultra-processed foods (UPF), India is undergoing a rapid nutritional transformation. These dietary shifts have significantly contributed to the rise in non-communicable diseases (NCDs), which now account for a substantial portion of mortality and disease burden in the country. A strong Front-of-Pack Labeling (FOPL) system is recommended in this position statement as a powerful public health tool to address this issue. Through the provision of easily comprehensible nutritional data, FOPL encourages food producers to create healthier goods while empowering customers to make educated dietary decisions. Current labeling practices in India, such as the Indian Nutritional Rating (INR), fall short due to complexity and voluntary implementation. This paper evaluates international best practices, including warning labels and color-coded systems, highlighting their effectiveness in reducing the consumption of high-risk foods. We argue for straightforward, uniform, and globally evidence-based approach to mandatory FOPL implementation. Policymakers, industry stakeholders, and public health advocates must collaborate to develop an FOPL system that addresses India’s unique dietary landscape. Such an initiative is crucial to reducing the NCD burden and fostering healthier eating habits nationwide.
IAPSM Position Paper on Vertical Transmission of HIV from Mother to Child
Authors: Debnath Dhrubajyoti J. , Rai Sanjay K. , Kamble Suchit , Gawade Nilesh , Thakare Meenal M , Giri Purushottam , Javadekar Shubhada Suresh
Published: December 2024

Human immunodeficiency virus (HIV) can be transmitted through vertical route from the mother to her child during the period of pregnancy, process of childbirth, or through the breastfeeding. This is still a worldwide health issue, especially in environments with low resources. Without intervention, the transmission rate ranges from 15 to 45%, influenced by breastfeeding practices. Effective interventions, including antiretroviral therapy (ART), can reduce the transmission likelihood to about 2% with breastfeeding and 1% without breastfeeding. A further expansion of access to prevention of mother-to-child transmission of HIV (PMTCT) services was made possible by the year 2011 through the Global Plan toward the Elimination of New HIV Infections among Children and Keeping their Mothers Alive. By 2022, there were 130,000 new HIV infections in children under five, down from 310,000 in 2010. Nevertheless, the Joint United Nations Programme on HIV/AIDS (UNAIDS) Global Strategy to End AIDS’s 2025 targets cannot be met with the current level of progress. To prevent new infections in children, pregnant and breastfeeding women with HIV must receive faster medical attention. This position paper discusses the primary prevention of HIV and the healthcare system’s role in providing comprehensive care to HIV-positive women and their families. The continuum of care includes antenatal, intrapartum, post-delivery, and pediatric services, addressing the unique needs of each woman and her family. Individual-level interventions highlight the importance of partner selection, consistent condom use, avoiding needle sharing, and reducing risky sexual behaviors. Overcoming barriers to medication adherence, such as stigma and discrimination, is crucial for effective prevention and treatment. Community-level interventions are equally important in reducing stigma and discrimination and fostering healthcare-seeking behavior. The paper emphasizes a multi-faceted approach, involving healthcare systems, individuals, and communities, to accomplish the objective of an HIV-free generation by stopping HIV from spreading through the vertical route. Collaboration across these levels is essential to realizing this vision and ensuring optimal health outcomes for HIV-infected individuals, their children, and families.
Digital Health Revolution in India: Transforming Health and Medicine
Authors: Rana Rishabh Kumar , Kapoor Neelesh , Kumar Dewesh , Verma Madhur , Taneja Gunjan
Published: December 2024

Digital innovation and its integration in various parts of lifestyle are inevitable as humans have started to evolve over time. Its integration in our health and various systems is irrefutable. In this position paper, we explore the various aspects of this important component of technology, discuss its evolution over time, discuss the various existing modalities, highlight the regulatory frameworks in India, and elaborate on the different ways it can be integrated in our country’s future health plans. We believe digital health is here to stay and play important role in shaping our lives in terms of our accessibility and other interactions related to health.
AI Horizons in Indian Healthcare: A Vision for Transformation and Equity
Authors: Kapoor Neelesh , Sanjana S N , Davalagi Shubha B. , Balu P S , Sethia Soumitra
Published: December 2024

Artificial intelligence (AI) is poised to revolutionize healthcare delivery in India, offering solutions to address the nation’s unique healthcare challenges. This position paper, presented by the Indian Association of Preventive and Social Medicine, examines the integration of AI in Indian healthcare, exploring its applications across diagnostic imaging, patient care, medical research, rehabilitation, and administrative processes. Notable implementations include AI-driven disease detection systems, telemedicine platforms, and public health surveillance tools, with successful applications in tuberculosis screening, breast cancer detection, and ophthalmological care. While these advancements show promise, significant challenges persist, related to data privacy concerns and interoperability issues, including the need for robust ethical frameworks. The paper highlights key stakeholder collaborations, including government initiatives and international partnerships, which are driving innovation in this space. Based on this analysis, we propose policy recommendations emphasizing research investment, professional training, and regulatory frameworks to ensure responsible AI adoption. Our vision advocates for an approach that balances technological advancement with accessibility and equity in healthcare delivery.
Countering Tobacco Industry Interference: A Policy Brief on Strengthening the WHO FCTC Article 5.3 Adoption in India
Authors: Goel Sonu , Rajkhowa Priyobrat , Kapoor Shivam , Pandey Ashish K. , Singh Rana J
Published: December 2024

Tobacco use in India contributes to over 1.35 million deaths annually, posing a major public health challenge. Tobacco industry interference (TII) is a significant barrier to effective tobacco control, especially in low- and middle-income countries (LMICs), such as India. This interference undermines public health efforts by manipulating policy implementation and enforcement. The adoption of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) Article 5.3 in India has made progress, with 23 states implementing the guidelines. However, enforcement gaps and persistent tobacco industry (TI) tactics continue to weaken tobacco control measures. Nefarious strategies, such as lobbying and misinformation, further complicate the effective execution of these policies. To effectively reduce tobacco use in India, stronger and enforceable policies are needed at both national and state levels. Strengthened legal frameworks, increased public awareness, and robust monitoring systems are critical to protect public health policies from TII. These steps are essential to safeguard public health and enhance the impact of tobacco control initiatives.
Integration of Palliative Care into Primary Care: A Collaborative Effort Between the Indian Association of Palliative Care and the Indian Association of Preventive and Social Medicine
Authors: Atreya Shrikant , Butola Savita , Bhatnagar Sushma , Kumar Dinesh , Muckaden Maryann , Kuraikose Jyothsana , Jeba Jenifer , Gupta Mayank , Palat Gayatri , Sanghai Pankaj , Mathews Lulu , Kumar Gaurav , Joad Anjum , Giri Purushottam , Kadri Amiruddin
Published: December 2024

India staggers at the 59th position (out of 81 countries globally) in the quality of death and dying index. A chronic life-threatening illness is often complicated by marginalized living, out-of-pocket health expenditure, illiteracy, and poor social support, and pushes the population further into the vicious spiral of suffering. The Indian Association of Palliative Care and the Indian Association of Preventive and Social Medicine joined hands in April 2023 to address the gap in the demand and availability of palliative care and proposed to empower Community Medicine physicians to provide primary palliative care. They put forth recommendations for education, service, and research developments in primary palliative care. In April 2023, the Indian Association of Palliative Care and the Indian Association of Preventive and Social Medicine joined hands to disseminate palliative care services to the community. Subsequently, a task force comprising faculties from Palliative Medicine and Community Medicine was formed. The position paper on primary palliative care jointly published by the Indian Association of Palliative Care and the Association of Family Physicians of India provided the framework for this position paper. The paper focused on education, service development, and research. The task force recommended the following: 1. Empower faculties and residents of the Department of Community Medicine, undergraduate students from medical and allied specialties posted to the department to provide primary palliative care. 2. Integrate palliative care into outpatient clinics (general OPDs in the hospital), community health centers, and home care as a part of the family adoption program. 3. Improve access to essential medications, including opioids, in urban and rural areas 4. Follow the recommendations of the National Health Policy 2017 to develop blended training programs for faculties and students. 5. Engage the community to identify patients with chronic life-threatening illnesses and allocate resources to support patients at home. 6. Collaborate to develop a protocol for regular audits and research for service improvisation.
Internal and Surgical Ablations of Ventricular Arrhythmia and Bundle Branch Reentry Ventricular Tachycardia
Authors: Chen Hongwu , Chen Minglong
Published: December 2024

Catheter ablation is a crucial therapeutic approach for managing ventricular arrhythmias (VAs), offered improved outcomes over the last few decades. The strategy’s efficacy and safety have seen consistent enhancements, benefiting patients both with and without structural heart disease. Combining endocardial and epicardial ablation has proven valuable, particularly in nonischemic cardiomyopathy, myocardial infarction, arrhythmogenic right ventricular cardiomyopathy, and certain epicardially originating focal VAs. However, despite these advancements, some VAs remain refractory, leading to life-threatening electrical storms and increased mortality rates. Surgical epicardial ablation has emerged as a promising alternative for managing such challenging cases. Bundle branch reentrant ventricular tachycardia (VT), a specific form of sustained monomorphic VT, involves a reentry circuit comprising the distal His-Purkinje system, left and right bundle branches, and the proximal ventricular septum. This review underscores the significance of comprehending the underlying substrate in VAs necessitating internal and surgical ablation, particularly in the context of bundle branch reentrant VT. The discussion encompasses mapping strategies, clinical prognosis, and the identification of optimal ablation techniques. Through this comprehensive examination, clinicians can better navigate the complexities of VA management, ultimately improving patient outcomes.