Journal of Family Medicine and Primary Care最新文献

Background: Functional gastrointestinal disorders (FGIDs) affect the quality of life of individuals. There is a lack of comprehensive community-based data on FGIDs in Kerala. Therefore, the current study was conducted to describe the prevalence and patterns of FGIDs among adults aged 18-69 years in Ernakulam district, Kerala.

Methods: A multistage cluster sampling method was used to conduct a house-to-house survey among 342 participants from urban and rural areas of a Taluk in Ernakulam district. The Rome IV Diagnostic Questionnaire (R4DQ) for adults was translated into Malayalam and administered via the Open Data Kit platform. Data analysis was performed using IBM SPSS Statistics V28.

Results: The average age of participants was 48 ± 13 years, and 68.7% were females. The prevalence of FGIDs was 66.4% (95% CI: 61.2%-71.2%). Belching disorder (22.5%), functional abdominal bloating/distension (20.8%) and functional constipation (18.1%) were the most prevalent individual conditions. A decreasing trend for FGIDs was observed with increasing level of education (83.7%, 66.9%, 59.3%, P value = 0.006). Participants with a history of haemorrhoids or fistula (81.0% vs 63.1%, P = 0.007) and those with hypertension (78.5% vs 62.7%, P = 0.009) showed higher prevalence compared to their counterparts.

Conclusion: The prevalence of FGIDs in the study population was high, and FGIDs were associated with various individual characteristics. Strengthening the existing healthcare system to manage FGIDs, along with educational programmes aimed at improving the knowledge and management of FGIDs among the general population, is warranted to enhance the timely management of common FGIDs and to help avoid the onset of severe complications.

Background and aim: Osteoporosis has been reported among many postmenopausal women (PMW). Studies also evaluated the link between osteoporosis and periodontitis. However, to date, the relationship between these two conditions remains unclear. Therefore, we systematically reviewed the current literature to answer the PECO question "Is there a relationship between low bone mineral density (BMD) and periodontitis in terms of clinical attachment loss among PMW?"

Methodology: Two authors independently searched the major databases using various MesH terms and keywords to identify and screen studies that fulfilled the eligibility criteria. Critical appraisal tools were used to measure the methodological quality of included studies. GRADE evaluation and meta-analysis were also performed.

Results: Seventeen studies (3689 participants) were finally included in the review. The majority of the included studies (n = 14) showed an association between low BMD/osteoporosis and periodontitis among PMW. The risk of bias was measured as moderate among the cross-sectional studies and low in case-control studies. Meta-analysis revealed high heterogeneity among the studies (I ² = 91%). Increased clinical attachment loss in osteoporosis was observed compared to the control group (pooled standard mean difference = 0.75 (0.22-1.28) with P < 0.001). Sensitivity analysis was also done by eliminating the studies with a high risk of bias. The GRADE quality of evidence was low among the studies indicating more clinical research to support the findings.

Conclusion: This systematic review and meta-analysis found a relationship between low BMD/osteoporosis and periodontitis. However, more longitudinal studies with larger sample sizes are required to support the findings of this review.

Pranayama, yogic breathing techniques, are considered a form of meditation. In classical yoga, the breath is associated with prana; thus, pranayama is a means to control the inner force, the prana shakti or life energy. Pranayama is more than regular breathing and if practiced in structured and methodical manner can reduce the body's physical symptoms of stress and anxiety. It has more recently gained popularity in the western world because of the many health benefits that come from a pranayama practice. Anxiety disorders are among the most common mental health conditions, affecting millions worldwide. Anxiety is an emotional state in which one perceives worry, danger, apprehension, and nervousness and has negative effects on all aspects such as social, personal, and academic performance. It is closely linked with autonomic nervous system dysregulation, often reflected in decreased heart rate variability (HRV), a biomarker of vagal tone and emotional and psychological resilience. HRV reflects the balance between sympathetic and parasympathetic nervous activities. Nonpharmacological approaches such as yogic breathing techniques have shown promising approaches in reducing anxiety symptoms. The modulation of HRV through slow breathing, often characterized by a prolonged expiratory phase, enhances vagal tone, restores sympathovagal balance, and promotes homeostasis. Research indicates that yoga interventions positively impact individuals with mental health disorders, improving positive symptoms and quality of life and reducing milder symptoms. This review explores the therapeutic potential of slow pranayama in reducing anxiety symptoms and managing anxiety disorders. It examines current evidence, limitations, and future research directions for integrating yoga-based practices into mental health care.

Background: Epidemiological data on mental health challenges faced by health care providers (HCPs) involved in coronavirus disease 2019 (COVID-19) patient care are still limited. Aims and Objectives: To find out the prevalence and correlates of common mental disorders (CMDs) amongst HCPs involved in the care of COVID-19 patients in the city of Nagpur and to explore the mental health challenges faced by them while dealing with the pandemic.

Materials and methods: This study, conducted among HCPs (doctors, nurses, lab technicians and pharmacists) of Nagpur's public health care facilities involved in COVID-19 care, employed a concurrent parallel mixed-method design. A cross-sectional analytical study assessed CMD prevalence and correlates among HCPs using a self-administered questionnaire. Regression analyses were conducted, with statistical significance set at P < 0.05. Analysis was done in STATA 16. An exploratory study using in-depth interviews explored mental health challenges and coping mechanisms among the HCPs. Thematic analysis with deductive coding was done. Atlas.Ti 22 was used for data analysis.

Results: A total of 308 HCPs participated. The overall prevalence of CMD was 55.2% (95% CI: 49-61%). Univariate analysis revealed age, sex, workplace, work hours, sleep duration as factors significantly associated with CMD. The mental health challenges faced by HCPs during the pandemic were improper administrative measures, physical challenges and lack of support from the patients and the public.

Conclusion: Over half of the HCPs experienced a CMD. Challenges included administrative issues, personal concerns and negative interactions with patients or the public. Targeted interventions are crucial to mitigate the mental health burden on HCPs during such outbreaks.

Background: Patients with allergic rhinitis (AR) usually present with symptoms such as frequent sneezing, nasal obstruction, a runny nose, and nasal itching. Allergic eye symptoms, such as itchy eyes, epiphora, and redness, might coexist with nasal symptoms, potentially worsening the severity of the condition and impairing quality of life.

Objectives: This study aimed to assess the frequency and severity of allergic nasal and ocular symptoms in individuals diagnosed with AR.

Methods: This cross-sectional study was conducted from April 2024 to March 2025. The study population included 438 adults diagnosed with AR, who exhibited at least two allergic symptoms. The participants were recruited through an ENT clinic and completed a self-administered questionnaire. Symptom severity was measured using a 4-point Likert scale. Spearman's rank correlation coefficient was used to assess the relationship between the summed severity of nasal symptoms with that of ocular symptoms.

Results: Of the 438 participants, 86.1% reported at least one allergic ocular symptom. Frequent sneezing (83.3%) and nasal obstruction (80.1%) were the most prevalent nasal symptoms, whereas itchy eyes (76.5%) were the most common ocular symptom. A significant moderate correlation was found between the summed severities of nasal and ocular symptoms (rho = 0.436, P < 0.001).

Conclusion: This study highlights the significant co-occurrence and association between nasal and ocular symptoms in patients with AR. These findings underscore the importance of considering both nasal and ocular symptoms in the clinical management of AR to improve patient outcomes and quality of life.

Background: Subacute thyroiditis (SAT) is a self-limited inflammatory thyroid disease that follows or co-exists with a viral infection. COVID-19 has numerous multisystemic effects, including thyroid disorders. Possible mechanisms involved in COVID-19 infection-associated thyroid dysfunction include: apoptosis, inflammatory reaction and damage to follicular cells, direct effect of the virus, or interaction with thyroid angiotensin converting enzyme 2 (ACE2) receptors, respectively.

Methodology and results: In the period November 2021-February 2022, 12 patients with SAT associated with COVID-19 were evaluated in our department (11 women, one man); mean age 50 ± 13.1 years. The mean time between COVID-19 infection and the onset of subacute thyroiditis was 23 ± 10.2 days. The most common symptoms presented by affected patients were: fever, pain in the thyroid, and complaints associated with thyrotoxicosis. All patients presented severe inflammatory syndrome, but the clinical and biochemical picture of thyrotoxicosis was more severe compared to other viral subacute thyroiditis. In 60% of cases, 2D ultrasonography was suggestive for subacute thyroiditis, but the parameters of Share-Wave Elastography (SWE) confirmed the diagnosis in 100% of cases (mean thyroid stiffness 234.2 ± 34.5 kPa). Under steroid therapy, during follow-up, thyroid stiffness gradually decreased at 4 weeks (130.38 ± 15.4 kPa), respectively, at 8 weeks (64.7 ± 5.3 kPa). The clinical outcome was favorable in all cases. Two patients developed hypothyroidism and were treated accordingly. SAT is characterized by a significantly increased stiffness of the thyroid.

Discussion: The results of this study documented a significant difference in thyroid tissue stiffness between. SAT at baseline and values recorded at the follow-up visit. It should be noted that changes in the elastic properties of the thyroid parenchyma were associated with gradual normalization of biochemical parameters. The early diagnosis of SAT associated with COVID-19 is crucial, as prompt treatment with glucocorticoids leads to complete resolution of the disease.

Conclusion: SWE sonoelastography is useful in the positive diagnosis of subacute thyroiditis.

Purpose/background: With the rising global prevalence of type 2 diabetes mellitus (T2DM), effective treatment strategies are essential. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, key in T2DM management, offer benefits beyond glycemic control. This study aimed to assess global research trends, hotspots, and future directions of SGLT2 inhibitor studies in T2DM through bibliometric analysis.

Methods: English-language publications on SGLT2 inhibitors in T2DM (2014-2024) were retrieved from the Web of Science Core Collection. Bibliometric techniques were applied to analyze publication output, geographic distributions, institutional contributions, and citation patterns. Visualization and network analyses were conducted using VOSviewer (v1.6.19) and CiteSpace (v6.3.1.0).

Results: A total of 4,146 publications were identified. The USA led in research output (1,152 publications), followed by Japan (857) and China (792). Annual publications grew steadily. Keyword and citation analyses revealed a shift in research focus from glycemic control to cardiovascular and renal protection. The most cited paper, Dapagliflozin and Cardiovascular Outcomes (3,842 citations), emphasized the cardiovascular benefits of SGLT2 inhibitors, reflecting the evolving "prevention-treatment integration" approach in diabetes care.

Conclusions: This analysis provides a comprehensive overview of global SGLT2 inhibitor research in T2DM. The findings highlight the transition from metabolic control to cardiorenal protection, guiding future research and clinical practice.

Background: This study explores the psychological and physiological dimensions of religious pilgrimage participation among attendees of Mahakumbh 2025, focusing on individuals seeking care at a psychiatry outpatient department.

Methodology: We examined the relationships between demographic factors (age, gender), frequency of pilgrimage participation, body mass index (BMI), cognitive functioning (as measured by MOCA), and depressive symptoms (HAM-D).

Results: The findings reveal a significant inverse relationship between pilgrimage frequency and depression scores, suggesting that regular participation in spiritual practices may offer emotional resilience. Gender differences emerged, with female participants showing higher levels of depressive symptoms. Cognitive performance was primarily influenced by age, with older participants displaying lower MOCA scores, independent of pilgrimage frequency. Additional insights indicate that individuals reporting a higher sense of spiritual upliftment and daily spiritual engagement also exhibited lower levels of anxiety and depression. While some participants showed elevated physiological stress markers, such as high blood pressure and altered heart rate variability (HRV), these were counterbalanced by psychological benefits.

Conclusion: This study contributes to a growing body of evidence that spiritual engagement during mass religious gatherings may foster mental well-being, despite the physical demands such events impose. These findings underscore the need for integrated health services at large-scale religious events and highlight the complex interplay of spirituality, personality, and demographic variables in shaping mental health outcomes.

Introduction: Type 1 diabetes mellitus (T1DM) management encompasses multiple, complex daily tasks that strain blood glucose monitoring and the logistics requirements for therapy, burdening the health-related quality of life (HRQoL).

Objective: This study aimed to measure and compare the QoL in an adult with T1DM with a pump user vs. multiple daily injections (MDI).

Methods: This case-control study was conducted in a diabetes center in Riyadh, Saudi Arabia. A total of 200 adults with T1DM were managed in a 1:2 (cases/controls) ratio. The cases referred to adults using the pump for >6 months, while controls included patients using more than two daily insulin injections. Data were collected using the self-administered diabetes quality of life (DQOL) questionnaire. Continuous and categorical variables were presented as mean ± standard deviation (SD) and percentages and underwent the t-test and the Chi-square test, respectively.

Results: Patients using insulin pump therapy reported notably higher satisfaction levels with diabetes management (mean score of 4.62 ± 0.60 vs. 4.15 ± 0.99, P value = <0.001), general health perception (4.29 ± 0.63 vs. 3.87 ± 0.74, P value = 0.001), time required for blood glucose monitoring (4.05 ± 0.95 vs. 3.67 ± 1.23, P value = 0.035), and knowledge about their condition (4.59 ± 0.55 vs. 4.18 ± 0.93, P value = 0.001).

Conclusions: The overall DQOL score indicated a slightly greater health-related quality of life for the insulin pump group, but the difference was not statistically significant.

Background: India is home to one-third of global oral cancers. There is a substantial unmet need for oral health services in India but there is a workforce shortage. Recently, the Community Health Officer (CHO) is assigned the responsibility of screening, symptomatic management, and appropriate referral of patients with oral problems.

Objectives: This study aimed to assess the reliability of nurses' oral health assessment and describe the oral health status of housekeeping staff of a tertiary health centre in Bhopal.

Materials and methods: A cross-sectional survey was held among 308 housekeeping staff, selected through simple random sampling, at a tertiary care hospital in Bhopal in March 2023. Five nursing interns were trained in oral health assessment. With due attention to ethical considerations, data were collected using the Oral Health Assessment Tool (OHAT).

Results: The intra-class coefficient (nursing interns and the dentist) of the OHAT was 0.865 (P < 0.001). Dental pain (32.1%) was the primary complaint, and 71.4% had no history of substance use. About 91.2% of the participants rinsed their mouths after meals, 56.5% brushed their teeth at least once daily, and 72.1% never visited a dentist. The findings revealed that none of the participants had "good oral health" status. The unhealthy oral status was in oral cleanliness (42.5%) and gum and tissue (29.5%).

Conclusion: The involvement of trained nurses in oral health screening can reduce the oral disease burden in India. Use of CHO training modules on oral care should be made mandatory reference material for undergraduate nursing programme in India.