bluuebunny/crossref_metadata_2025_split huggingface dataset:
IJCM_200A: Symptom Burden Profile of individuals facing chronic life-limiting illnesses and barriers to effective management of symptoms in palliative care- Grounded theory qualitative study.
Authors: Sushma M N 
Published: April 2024

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Conclusion:
Increasing burden of chronic diseases in elderly, high private healthcare utilization and suboptimal health insurance coverage leads to an increase in out-of-pocket expenditure on healthcare. Measures should be adopted for strengthening of health services and expanding insurance coverage among elderly, which in turn will reduce burden of out-of-pocket health expenditure.
IJCM_239A: Health seeking behaviour and its determinants among adult population: a comparative study between urban and rural area of western Uttar Pradesh
Authors: Sulthana Banisha , Gautam Neelam S , Bano Tanveer 
Published: April 2024

Background:
Health seeking behaviour is remedial action undertaken by individuals for their health problem or illness. It may vary in rural and urban areas and with different sociodemographic variables. To provide adequate health care services to the community, it is essential to know about their health seeking behaviour and its determinants.

Objectives:
1. To describe health seeking behaviour and determine various factors influencing it among adult population in rural and urban areas of Meerut. 2. To assess their awareness on health insurance policies.

Methodology:
A community based cross-sectional study among adult population was conducted in rural and urban areas of Meerut, Uttar Pradesh from 1st July to 30th September, 2023. Estimated sample size was 200 each from rural and urban areas. Study participants were selected by multistage sampling method. Data collection was done by a pre-tested and semi-structured questionnaire.

Results:
Among 400 study participants, 91% in urban and 60% in rural areas showed positive health seeking behaviour. In both areas, most of them preferred public health facilities. Major factor affecting health seeking behaviour in rural area was convenience of approach, while that in urban area was low cost of treatment. Majority rural population was unaware of health insurance policies, while almost half of urban population were aware of it.

Conclusion:
Positive health seeking behaviour and awareness on health insurance policies are seen more in urban area than rural. Awareness programmes on positive health seeking behaviour and health insurance are essential, especially in rural areas.
IJCM_241A: Perception of the effectiveness of small group teaching and didactic classes among Health Science students
Authors: Darshan B B , Tolambiya Kshitiz , Siwach Prateek , Akshaya K M , Krishnan Rahul 
Published: April 2024

Background:
The global trend towards the teaching and learning process is becoming more dynamic and interactive compared to traditional didactic lectures. Medical schools are changing their teaching strategies to ensure that students are prepared for lifelong.

Objectives:
To determine the perception of the effectiveness of small group teaching and didactic classes among health science students.

Methodology:
This was a cross-sectional study conducted among 300 undergraduates of Kasturba Medical College, Mangalore, and undergraduates of Manipal College of Dental Sciences, Mangalore. Data was entered and analyzed using SPSS version 29.0. The results were expressed in the form of tables and graphs.

Results:
Among the BDS students most of them were in the Second year (53.3%) and Third year (28.3%). Around 17% of students preferred SGT as it was an interactive session, 17% preferred it as it helps the application of knowledge and 23% of students chose SGT as it provides them an opportunity to present, and as their confidence 28% favored SGT as it enhances thinking ability 15% selected SGT as was a mode self-learning.

Conclusion:
Most of the undergraduates supported SGT over DIDACTICS. SGTs were found to be the method that provides an opportunity to clear doubts. Under the type of SGTs, many students preferred problem-based learning type, followed by seminars and flip classes.
IJCM_244A: Awareness on breast cancer and its screening methods among the women in urban field practice area, Government Medical College, Siddipet, Telangana.
Authors: Kanmani K , Gayathry D. , Snehika A , Sreenivas G. 
Published: April 2024

Background:
Breast cancer is the most common female cancer worldwide including India, where advanced stages at diagnosis, and rising incidence and mortality rates, make it essential to understand cancer literacy in women. An understanding of the awareness and predictors of breast examination is an important first step that may guide the design of interventions aimed at raising awareness across the general population.

Objective:
This study aimed to evaluate the level of awareness related to breast cancer risk factors, signs, symptoms, and methods of screening among women residing in the study area.

Methodology:
A cross-sectional study was conducted during October 2023 - November 2023 among women residing in the urban field practice study area in Siddipet. A semi-structured questionnaire consisting of socio-demographic characteristics, questions related to awareness of breast cancer, and various screening methods was administered to 225 women in the study area.

Results:
The study showed an overall knowledge level of 35.00% regarding breast cancer. Participants had average knowledge about risk factors, signs, and symptoms, whereas their awareness on various screening methods was weak.

Conclusion:
The current study concluded that public awareness of breast cancer remains relatively low, and still needs several public awareness initiatives using mass media, such as television, Internet, and social media. Indian breast cancer patients present with advanced disease stage and have numerous poor prognostic factors, hence knowledge regarding the prevalence of risk factors was necessary. Many women, once aware, state that they would be interested in taking preventative therapy when they feel the timing is more appropriate for them. Dedicated breast health clinics, providing information about preventative therapy, and risk-reducing lifestyle changes could empower women to make personalized choices. These could be cost-effective when comparing costs of a specialist consultation with the costs of potential breast cancer therapy and psychological harm caused by breast cancer.
IJCM_255A: Knowledge, attitude, and practice of No-Scalpel Vasectomy among married men attending a rural health facility in Kundrathur, Chennai
Authors: Karunya M , Kumar Thirumalai PR 
Published: April 2024

Background:
Male sterilisation, i.e., Vasectomy is one of the safest and most effective contraceptive methods as it has very low complication and failure rates. According to the NFHS-5 data, the male sterilisation rates in India and Tamil Nadu are about 0.3% and 0.1% respectively. Though there is sufficient knowledge on the effectiveness of No-scalpel vasectomy, there is lack of acceptance of male sterilisation as a permanent method of contraception

Objective:
To assess the knowledge, attitude and practice of No-scalpel Vasectomy among married men of Kundrathur, Chennai

Methodology:
A cross-sectional study was conducted among 116 married men between 22 to 60 years of age, attending the Upgraded Primary Health Centre, Kundrathur by consecutive sampling. A pretested semi-structured questionnaire was used to assess their knowledge and practice. Attitude was measured using 4-point Likerts scale. Data was analysed using SPSS software version 21

Results:
Among the 112 participants who consented to participate in the study, 82 i.e., 73.2% of them were aware of vasectomy and the most common source of information was Mass media (51.2%). 74.2% agreed that contraception was not the sole responsibility of a wife, yet 48.2% of them disagreed that men should undergo vasectomy. The most perceived barrier for non-acceptance of vasectomy was Lack of awareness (33%), followed by Impotency following vasectomy (13.4%) and â€œInability to do heavy work following vasectomy (12.5%). None of the participants (0%) underwent vasectomy, whereas 57.1% were willing to undergo, and 61.6% were willing to recommend the same to others.

Conclusion:
There seems to be a huge gap between the knowledge, attitude and practice of No-Scalpel Vasectomy among the study population. Thus, intense behavioural change communication should be advocated to increase the awareness and decrease the misconceptions regarding Vasectomy.