Journal of Family Medicine and Primary Care最新文献

Background: Physiotherapists are health professionals who enhance mobility and quality of life (QoL) through clinical reasoning and the application of evaluation and treatment strategies. Their role is crucial in promoting health, preventing injury, and maintaining function.

Aim: This paper aims to (1) share early experiences and learnings from integrating physiotherapy in rural primary health care, (2) discuss the scope and role of physiotherapists in the primary care team, (3) list the competencies of physiotherapists in rural primary care settings, and (4) advocate for a re-imagined role of physiotherapists as multi-skilled "primary care physiotherapists."

Setting and method: Using a selection of case stories from rural primary health care settings, the paper provides insights into the integration and impact of physiotherapy within these communities.

Results: The integration of physiotherapy in rural primary health care has demonstrated significant benefits in promoting comprehensive primary health care. The case stories highlight the expanded scope and essential competencies of physiotherapists as vital members of the primary care team.

Conclusion: This paper emphasizes the critical role physiotherapy plays in primary health care and calls for broader recognition and support for physiotherapists. It underscores the need for a re-imagined perspective of physiotherapists in rural settings, advocating for their role as multi-skilled primary care professionals.

Background: Cervical cancer is a leading cause of cancer mortality among women in India. Screening can help in early detection and improve outcomes. However, uptake remains low, especially in rural areas. Understanding multidimensional factors influencing screening in local contexts is essential to promote equitable access. This study examined knowledge, attitudes, practices, and sociocultural factors associated with cervical cancer screening and vaccination in rural India.

Methods: A mixed methods study was conducted among 400 women aged 18-60 years in rural Maharashtra. Quantitative data were collected on knowledge, attitudes, and screening practices by using a structured questionnaire. Qualitative data were gathered through in-depth interviews with 30 participants on perspectives influencing screening. Quantitative data were analyzed using descriptive statistics and logistic regression. Thematic analysis was done for qualitative data. The integration provided complementary insights.

Results: Quantitative results showed poor knowledge (17% had good knowledge) and positive attitudes (64%) but low screening uptake (9%). Qualitative findings revealed limited awareness, stigma around gynecological exams, gender inequities, fear, fatalism, and low prioritization of self-care as screening barriers.

Conclusion: Multifaceted strategies addressing knowledge gaps, gender roles, stigma, and access are required to improve cervical cancer screening in marginalized rural communities. Mixed methods provide comprehensive evidence for designing context-specific interventions.

Introduction: Adolescence is a crucial part of life characterised by rapid body changes that can be influenced by perceptions and misinformation regarding their body image. Body image is usually associated with self-esteem and self-worth. Therefore, it is important to address this issue at this transitional time. This study aims to understand the perception of body image and its correlation with nutritional status among first-year medical students.

Methods: A cross-sectional study was conducted among first-year medical students enrolled in the MBBS curriculum. Data related to perception of body image were collected through a self-administered, pre-tested questionnaire. Height and weight were taken by the principal investigator at the time of data collection and body mass index (BMI) was calculated according to Asian criteria for BMI. Kappa statistics were used for the agreement between self-perceived body image and BMI.

Results: A total of 234 out of the 250 students enrolled in the first year gave consent for the study. The median (interquartile range [IQR]) age of the students was 18 (17-19) years and 72% were male students. One-fourth of the students were dissatisfied with their weight (26.9%) followed by height (25%). The Kappa statistics for agreement between BMI and self-perception about body weight was 0.373 (95% confidence interval [CI], standard error (SE) of Kappa = 0.048), showing poor agreement.

Conclusion: One-fourth of the students were dissatisfied with their physical appearance. The agreement between perceived body weight and nutritional status was poor (64.53%).

This comprehensive review examines the pivotal role of health policies and guidelines in promoting, protecting, and supporting early childhood development (ECD). Recognizing the multifaceted nature of ECD, the study explores key elements commonly found in policies that span health, education, social services, and community support. The focus is on creating an integrated approach that ensures the optimal well-being and growth of children during their formative years. The review highlights the significance of maternal and child health care, emphasizing contact toward prenatal and postnatal care for pregnant women and newborns. Nutritional policies center around supporting breastfeeding and ensuring access to nutritious food, laying the foundation for a healthy start in life. Early childhood education programs and parental education initiatives are crucial components, emphasizing cognitive, social, and emotional development from the earliest stages. The review underscores the importance of a holistic perspective, urging the integration of services across sectors to provide a comprehensive framework for ECD. Research-based policies, continuous monitoring, and evaluation mechanisms ensure evidence-driven decision-making and ongoing refinement of strategies. Additionally, the role of legislation and advocacy is highlighted in protecting the rights and well-being of children and advocating for ECD at various levels. In the end, this review highlights the importance of ECD guidelines and health policies as investments that not only help individual children but also enhance societal productivity and general well-being. By prioritizing the early years, policymakers can lay a strong foundation for future health, learning, and success.

Introduction: Carbamylated haemoglobin is the result of reaction of isocyanate with N-terminal valine residues of the α and β chains of haemoglobin. Carbamylated haemoglobin concentration is dependent on the degree and duration of uraemia and thus may potentially serve as a marker to differentiate acute kidney injury (AKI) and chronic kidney disease (CKD).

Methods: A hospital-based prospective clinical comparative study was conducted in an urban tertiary medical care centre. Carbamylated haemoglobin was estimated in a total of 60 patients, 30 each of chronic kidney disease and acute kidney injury. The comparison of the carbamylated haemoglobin levels among the CKD and AKI groups was done using Mann-Whitney test. The mean value of carbamylated haemoglobin among the CKD group was 240.71 ± 75.64 μgVH/g, whereas among the AKI group, it was 67.15 ± 17.05 μgVH/g. These values are statistically significant with P < 0.001.

Results: Carbamylated haemoglobin values were elevated in relation to renal dysfunction, and it significantly correlated with chronicity of kidney disease. Mean CarHb among the CKD group was significantly high in comparison to the AKI group with statistical significance, with a P value of <0.001.

Conclusion: It was significantly attributed in this study that carbamylated haemoglobin >100 μgVH/g is diagnostic of CKD and a value <100 μgVH/g is diagnostic of AKI. Thus, in this study, it can be concluded that carbamylated haemoglobin is a useful marker to differentiate AKI from CKD.

Purpose: The COVID-19 pandemic was caused by severe acute respiratory syndrome coronavirus-2 (SARS-COV2). The impact of the pandemic is becoming more apparent now on various tissues and body organs. Limited knowledge is present about the characteristics, duration, and long-term sequelae of ocular problems post-COVID-19 infection. The purpose of the present study was to evaluate and analyze the ocular problems occurring in healthcare workers after COVID-19 infection.

Material and method: This was a cross-sectional survey study conducted in the Department of Ophthalmology, Patna Medical College and Hospital, Patna. The participants were healthcare workers who were exposed to COVID-19 infection ≥6 months back. A questionnaire was prepared. Responses were evaluated and analyzed. Patient consent and institutional committee permission were taken as per norms.

Result: A total of 210 healthcare workers who were infected with COVID-19 >6 months back responded with complete answers. The maximum number of respondents was between the ages of 31 and 60 (73.3%). The pre-covid ocular problems were present in 25% of the participants, especially in those having chronic diseases (such as diabetes, hypertension, or both). Post-ocular problems were faced by 60% of the participants, which was significant (P < 0.01). Dry eye, itching, and foreign body sensations were present in 60% of those facing ocular problems (P < 0.01). Ocular surface manifestations were more common.

Conclusion: A knowledge, understanding, and awareness about ocular problems and their long-term sequelae in post-COVID-19-infected patients will help in early diagnosis and better management of such patients.

Introduction: Road traffic injuries are the eighth leading cause of death in India. The Law Commission of India report says that 50% of the victims who died of preventable injuries could have been saved had they received the medical care on time. To protect the people who help road accident victims, Good Samaritan Law was enacted.

Objectives: To assess awareness and knowledge about Good Samaritan Law among the general literate population and to assess the impact of awareness session on awareness score.

Methods: In this cross-sectional study, adult participants of either gender, literate enough to read and comprehend the material provided, were included in the study through either an electronic or written informed consent process. The participants were asked to complete a questionnaire, watch/read the awareness video/material provided, and then complete the post-awareness session questionnaire. The participants were divided into the aware and unaware groups for further assessment of pre-awareness scores. The pre- and post-awareness session scores were compared in the participants using paired-t-test.

Results: In this study, 379 participants gave consent for participation; however, only 288 participants attempted the post-awareness questionnaire. The mean pre-awareness session score was significantly higher in the aware group (8.5) as compared to the unaware group (5.6). The pre-awareness scores were significantly high in doctors as compared to medical students in the aware group and as compared to medical students, graduates, teachers, and general public in the unaware group. Post-awareness session scores (9.2 ± 2.8) were observed to be significantly higher (p < 0.001) than pre-awareness session scores (6.4 ± 3.4).

Conclusion: In this study, it was observed that the percentage of participants who were aware of the law was less. It demonstrated the impact of awareness session on increasing GSL awareness score in participants. These findings indicate the need of awareness programs to transform bystanders into good samaritans.

Background: Antibiotic resistance has become quite a challenge in the treatment of bacterial infections in the world. Therefore, the present study was conducted with the aim of investigating the pattern of antibiotic resistance among microorganisms isolated from the culture medium prepared from hospitalized patients.

Methods: The type of study was cross-sectional descriptive. The antibiotic resistance pattern of positive samples collected from patients who got hospitalized in Shahid Faghihi hospital of Shiraz University of Medical Sciences between 2020 and 2021 using the disc diffusion method according to CLSI standards was measured. Then the data were entered into SPSS version 22 software and analyzed with appropriate statistical tests.

Results: Of all positive samples, 69.7% were Gram-negative and the rest were Gram-positive. The most frequent Gram-negative bacteria were Acinetobacter baumannii (31.4%), Escherichia coli (25.3), and Klebsiella pneumonia (21.2%), and the most frequent Gram-positive bacteria were Staphylococcus aureus (79%), Coagulase-negative staphylococci (15.4%), and Enterococcus (3.6%). The resistance rate of Acinetobacter baumannii, Klebsiella pneumonia, and Pseudomonas aeroginosa against ciprofloxacin was 91.4%, 74.3%, and 52.3%; the resistance rate against gentamicin was 90.5%, 54.3%, and 43.9%; the resistance rate against Piperacillin-Tazobactam was 85.6%, 65%, and 43.1%; the resistance rate against imipenem was 97.1%, 57.9%, and 65.4%; and the resistance rate against colostin was 1.9%, 0%, and 3.4%, respectively. The resistance rate of Staphylococcus aureus against cefoxotin and vancomycin was 42.7% and 2.8%, respectively.

Conclusion: Finally, we concluded from this study that microorganisms isolated from patients have developed resistance to many commonly used antibiotics.

Background: Characterizing risk factors for drug-resistant tuberculosis (TB) is critical to guide targeted interventions in high-burden settings like India. We aimed to identify socioeconomic, lifestyle, and clinical factors associated with drug-sensitive and drug-resistant TB acquisition.

Materials and methods: A comparative cross-sectional study recruited 350 bacteriologically confirmed TB patients registered under the National Tuberculosis Elimination Program (NTEP) in Gujarat, India, and 300 matched participants without active/past TB. Multinomial logistic regression analyzed risk factors for 200 drug-sensitive and 150 drug-resistant TB cases compared to participants without active or past TB.

Results: Key factors independently associated with higher adjusted odds ratios (aOR) of both TB types included low socioeconomic status (SES) (drug-sensitive TB: aOR 1.7, 95% CI 1.2-2.5; drug-resistant TB: aOR 2.2, 95% CI 1.3-3.7), crowding (>5 persons/room) (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 1.9, 95% CI 1.2-2.9), undernutrition (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 2.0, 95% CI 1.2-3.2), smoking (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.3; drug-resistant TB: aOR 1.7, 95% CI 1.1-2.7), and indoor air pollution (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.2; drug-resistant TB: aOR 1.8, 95% CI 1.2-2.8).

Conclusion: Marked social determinants and clinical risks drive heightened susceptibility for both TB types in India, while prior inadequate treatment and nosocomial exposures selectively enable additional drug resistance. Holistic prevention policies jointly targeting transmission, vulnerability, and curative factors are imperative.

Background: Despite many measures taken by the government, still the problem of Vitamin A deficiency and anaemia exists among children. This study focuses on coverage of iron and folic acid and Vitamin A supplementation among children aged between 9 months and 5 years and to find out the barriers in administrating these supplements to children.

Methods: An explanatory sequential mixed methodology was conducted in the field practice area of Thirubuvanai primary health centre. In the quantitative survey, a cross-sectional cluster sampling survey was conducted to find the coverage of IFA and Vitamin A supplementation among children (n = 215), followed by a qualitative interview (n = 14) to find out the barriers in administrating these supplements to children was conducted among the mothers.

Results: Our study found that Vitamin A supplementation coverage was taken only by 42% of the children in the last 6 months preceding the survey. IFA supplementation was taken by 31.2% of the children in the last 7 days preceding the survey. Lack of awareness, myths and misbeliefs, fear of adverse effects and lack of family support were found as barriers in administering the supplement to the children.

Conclusion: The study findings have highlighted the need for community health education to improve the coverage of supplement administration.