Journal of Family Medicine and Primary Care最新文献

Background: In India, the Ayushman Bharat Program aims to provide comprehensive healthcare coverage to underprivileged communities, guided by the 2017 National Health Policy and aligned with Sustainable Development Goals. This study explores healthcare workers' perspectives on the implementation, impact, and challenges of Ayushman Bharat Yojana (ABY) in Kashmir, focusing on primary care services.

Methods: A mixed-methods study was conducted over ten months (October 2020 to August 2021) across ten districts in Kashmir. Fifty healthcare professionals, including 30 mid-level healthcare providers (MLHPs) and 20 medical officers, participated in semi-structured interviews and completed structured questionnaires. Data were analyzed using thematic analysis for qualitative data and descriptive statistics for quantitative data.

Results: Demographics: Among the respondents, 64% were under 30 years, and 56% were female. Positions included 40% medical officers and 60% MLHPs. Qualitative Findings: Both MLHPs and medical officers had varying levels of awareness about ABY. Key challenges included inadequate infrastructure, staffing shortages, additional duties, and long commutes. Effective communication and collaboration between MLHPs and medical officers were deemed crucial for successful implementation. Ongoing training and support were highlighted as essential needs. Quantitative Findings: Significant issues included irregular payments (66.6% MLHPs reported receiving regular incentives), staffing shortages (50% medical officers), and lack of training (35% medical officers). Common ailments managed included hypertension (33.33%) and infections (26.66%).

Conclusion: The study highlights the challenges and insights from healthcare workers regarding the ABY program in Kashmir. Addressing infrastructure deficiencies, improving communication, and providing ongoing training and financial stability are essential for enhancing the program's effectiveness. Policymakers must consider these findings to improve healthcare delivery and ensure the sustained success of the Ayushman Bharat initiative.

Introduction: Workers who work in metallurgy factories processing aluminium are at risk of exposure to various kinds of metals and chemicals.

Objective: To describe sociodemographic characteristics and to find out morbidity profile of study participants .

Methods: A cross-sectional O bservational descriptive study was conducted in two aluminium processing metallurgy factories in Howrah district of Indian state of West Bengal. The sample size for the proposed research study was 424 workers. Data were collected through a predesigned and pretested questionnaire and were subsequently analyzed by using suitable statistical package.

Results: The mean age of the workers was 45.46 years with standard deviation of 10.25 years. Maximum (28.54%) respondents had completed primary standard, and majority of respondents were from upper middle class (34.67%). 16.75% of workers reported that they suffered from communicable disease s, and 76.42% of participants reported noncommunicable diseases. 63.44% of study participants were overweight. This study showed musculoskeletal discomfort in different joints and body parts in 23.35% of participants; 2.82% of participants had ventilatory defects of lung. 3.07% of participants were suffering from hearing loss, and 5.90% of participants had refractive error of eyes.

Conclusions: Noncommunicable disease burden was higher than communicable diseases among study participants. Almost one out of four participants reported musculoskeletal discomfort in different joints and body parts.

Introduction: While various demographic factors and underlying medical conditions are associated with the development of post-COVID conditions within a month after SARS-CoV-2 infection, less is known about factors associated with post-COVID symptoms that persist for 6 months or more. The aim of this review was to determine the association between underlying conditions, other risk factors, health behaviors, and the presence of symptoms ≥6 months after COVID-19.

Methods: Studies reporting on post-COVID symptoms were searched in databases, including Medline, EMBASE, Global Health, PsycInfo, Scopus, CINAHL, Proquest, and WHO COVID-19 literature, from the beginning of the pandemic until November 2022. Studies were included if they reported on symptoms ≥6 months after COVID-19 and a relevant measure of association (adjusted or unadjusted odds or risk ratio).

Results: A total of 17 studies with 109,293 participants met the inclusion criteria; they were conducted in China (3), Italy (3), Spain (3), Russia (2), France (1), Germany (1), Sweden (1), Scotland (1), United Kingdom (1), and the United States (1). When compared to males, female participants were at an increased risk of post-COVID-19 symptoms (risk ratio (RR): 1.24; adjusted odds ratio (aOR): 3.08). Underlying conditions, including COPD/lung disease, overweight status or obesity, hypertension, cardiovascular disease, and asthma, were identified as possibly being associated with an increased risk of post-COVID symptoms.

Conclusion: Female gender and certain underlying medical conditions were associated with an increased risk of post-COVID symptoms ≥6 months after COVID-19. Further research is needed to better understand some of these associations and identify groups that are at increased risk for persistent post-COVID conditions.

Background: The imposter phenomenon (IP) involves feelings of intellectual fraudulence and phoniness in challenging new roles. IP feelings are associated with low self-esteem and anxiety in nursing students, especially during transition or early stages of nursing training. This research aims to find out the prevalence of IP and its relation with self-esteem and anxiety among nursing undergraduates.

Material and methods: A cross-sectional survey randomly selected nursing students from the six established nursing institutions in Uttarakhand state. Three hundred eight (n = 308) participants completed the survey questionnaires, which included a structured socio-demographic sheet, the Clance Imposter Phenomenon Scale (CIPS), the Generalized Anxiety Scale-7 (GAS-7), and the Rosenberg Self-esteem Scale (RSES). Appropriate descriptive and inferential statistics were used to generate the results.

Results: The mean age of the students was 20.93 (SD = 1.09) years. The mean CIPS score was 58.57 (SD = 10.69). Frequent to intense feelings of impostorism were reported by 43.4%, and 51.3% reported at least moderate IP feelings. Further, second-year students than third year, on average, significantly reported higher scores on imposter phenomenon (P < 0.001), anxiety (P = 0.006), and lower scores on self-esteem (P = 0.018). As predicted, CIPS scores correlated positively with GAS-7 (r = -.340, P < 0.01) and negatively with RSES (r = -.307, P < 0.01). A multiple regression model predicting the imposter phenomenon with self-esteem demonstrated a negative main effect of self-esteem (P < 0.001) and significant two-way interaction.

Conclusions: A higher proportion of the students reported feelings of imposter phenomenon. Low self-esteem was reported as a strong predictor of IP. Institutional strategies such as mentorship, supervised education, and early screening of psychological issues could be preventive and promotive strategies. Future research is recommended to identify the cause of poor IP in students.

Introduction: The ST population, residing in isolated, underdeveloped areas, faces significant health disparities compared to non-tribal communities. In particular, the lack of mental health infrastructure in these regions exacerbates their health challenges. Tribal communities possess distinct cultural beliefs surrounding health and illness, yet scant information exists regarding their physical and mental well-being. In addition, limited access to mental health services prevails, and many tribal individuals opt for traditional healing methods.

Methodology: This study is part of the "Tele-mentoring for Rural Health Organizers of Chhattisgarh (TORENT)" project, which aims to equip rural health organizers and community health officers (CHOs) with training to screen, identify, counsel, refer, and follow up with community members facing mental health issues.

Results: Covering 27 districts in Chhattisgarh, this study enlisted trained CHOs to employ the MERIT tool for mental health screenings. Among the tribal population, the study unveiled elevated rates of tobacco and alcohol use, anxiety, depression, hallucinations, and substance use disorders. Challenges in seeking professional help were widespread, driven by transportation difficulties and limited awareness. Field visits (77%) played a pivotal role in identifying cases, alongside self-referrals and referrals by Mitanin or ASHA workers. Notably, a significant proportion had a family history of alcohol use, with a preference for a locally brewed liquor called Mahua.

Discussion: This study provides vital insights into the mental health status of Chhattisgarh's tribal populations. It underscores their socioeconomic challenges, high prevalence of substance use disorders, and barriers to accessing mental health services. The study highlights the importance of delivering mental health care within tribal communities, emphasizing the engagement of locally available primary care health workers. Furthermore, it advocates for an integrated approach that acknowledges the role of faith healers in tribal communities' mental health care.

Introduction: Menstrual cups are a sustainable alternative to traditional menstrual products, yet their usage remains low in many regions. In India, only 0.3% of women use menstrual cups, representing a lack of knowledge and a negative attitude towards the use of menstrual cups. This study aimed to promote menstrual cup usage and develop the right attitude among women (18-45 years old) in selected colleges in Patna.

Material and methods: One group pre-test-post-test quasi-experimental study was conducted in selected colleges in Patna with a nonrandomized convenient sampling technique employed to select 100 participants. The intervention consisted of a 30-minute video session on menstrual cup usage, and a structured questionnaire administered pre- and post-intervention to assess knowledge and attitudes.

Results: Post-intervention analysis showed a significant increase in knowledge and positive attitudes towards menstrual cup usage. The video-assisted teaching program was found effective in enhancing knowledge regarding menstrual cup usage, as evidenced by the mean knowledge score, which improved from 7.25 + 1.89 to 8.40 + 1.43, as well as the attitude mean score, which improved from 32.14 + 8.50 to 33.91 + 7.88.

Conclusion: The video-assisted teaching program effectively enhanced knowledge and positively influenced attitudes toward menstrual cup usage among women in the targeted age group. This suggests that similar educational interventions could be beneficial in promoting sustainable menstrual hygiene practices. Many participants suggested that if it is added through government schemes, it will be more valuable in promoting the adoption of menstrual cups among women.

Introduction: Antimicrobial resistance is a public health concern with global ramifications. Antibiotic misuse and overuse, are rampant in our country but more alarming is the data on the use of antibiotics primarily because of lack of access is another threat. A majority of the data on drug sales and consumption in India comes from the private sector and is typically gathered from private commercial organization. Because data on antibiotic usage in India is rarely reported, the study's objectives were to estimate antibiotic consumption in ICU patients and also to assess antibiotic usage trends using the WHO AWaRE classification.

Materials and methods: A prospective observational study was carried out in the ICU department for six months after obtaining institutional ethics committee approval (P14/2021/14). In-patient records and details on antibiotic prescriptions were collected from the day of admission until they were discharged from the intensive care unit. Data on antibiotic consumption were retrieved from the hospital pharmacy. Descriptive statistics such as frequency, percentages, and means were used to summarize the data. Microsoft Excel 2016 was used for all statistical analyses.

Results: The results of the study showed that female patients (54%), made up a significant majority of those receiving antimicrobial treatment. The age group between 40-49 years (21.68%) was the most common for those receiving antimicrobial treatment. Surgical prophylaxis (37.34%) emerged as the most common indication. Among the different antimicrobials studied, ceftriaxone 1 gm (108.5 DDD) emerged as the most prescribed antimicrobial. The access group of antibiotics accounted for 55% of the total usage.

Conclusion: Appropriate use of antibiotics is important to minimize the risk of adverse events and antimicrobial resistance.

Aim: This study aims to evaluate the impact of the National Tobacco Control Program initiative on the attitudes toward tobacco use and tobacco dependency among transgender individuals in Puducherry.

Materials and methods: A Quasi-experimental design was used to examine the effectiveness of the intervention. The study involved 52 transgender individuals from the SCOHD organization in Puducherry. The intervention included two awareness sessions, the Distribution of IEC materials during each session, and recreational activities for the participants. Changes in attitude toward tobacco use were measured using the Intention to Quit Tobacco questionnaire, while tobacco dependency among participants was assessed using the Fagerstrom Nicotine Dependency Scale (FNDS). Measurements were taken at baseline and third month to track the evolution of attitudes and dependency.

Results: The program resulted in significant shifts in attitude and nicotine dependency among transgender individuals. This program indicated a positive trend, with an increase in individuals progressing to the contemplation and preparation stages, suggesting a growing willingness to reduce or quit tobacco use. The Fagerstrom Nicotine Dependency Scale showed a decrease in nicotine dependency over three months.

Conclusion: The NTCP awareness sessions and follow-ups had a noticeable impact on altering attitudes toward tobacco use and reducing nicotine dependency among transgender individuals in Puducherry.

Peutz-Jeghar syndrome (PJS) is an inherited condition that puts people at an increased risk for developing hamarotmatous polyps in the digestive tract as well as cancers of the breast, colon, rectum, pancreas, stomach, testicles, ovaries, lung and cervix. With typical presentation, majority cases of PJS can be diagnosed in childhood. PJS is inherited by mutation in the STK II gene, also known as LKB1 gene. We describe the case of a 14-year-old male who presented to us with recurrent abdominal pain, vomiting and weight loss associated with growth failure. Classic melanin spots were present on lips and buccal mucosa. Diagnosis of PJS was established via clinical history, examination, CT scan, and endoscopy revealing the need for laparotomy for bowel obstruction secondary to chronic intermittent intussusception, enterotomy for small polyps. Polyp histopathology was consistent with hamartomatous polyps of PJS.

Background: Anaemia is a major public health concern in developing countries, with cases increasing rapidly among women, young girls, and children under age 5.

Aims: This study aimed to estimate the prevalence of anaemia and to identify the age and gender distribution of anaemia among those attending IPD/OPD of a teaching hospital located in the tribal block.

Methodology: The study was conducted at a multispecialty tertiary care hospital in tribal predominant area, Jharkhand, India. A retrospective, chart-based study design was adopted to achieve the objectives. All inpatient case records available from the Department of Laboratory Medicine and the electronic hospital information system of the institute were reviewed between January 1, 2021, and January 31, 2024.

Result: A total of 15004 reports were screened for detecting anaemia, of them 7095 (47.3%) were males and 7909 (52.7%) were females. The overall prevalence of any grade of anaemia was found in 6579 (43.8%; 95% CI: 43.1-44.6). Univariate logistic regression analysis to predict status of anaemia among study participants showed the odds of being anaemic was 1.5 times (95% CI: 1.2-2.1) higher among those with age >60 years compared to those who were in the age group of 1-4 years. Females had 2.3 times (95% CI: 2.2-2.5) higher odds of having anaemia than males.

Conclusion: This study shows that half of the patients attending hospital are anaemic and the burden increases as the age increases and highest among elderly >60 years. The results of our secondary data analysis should contribute to better screening and identifying the cases among people attending the hospital and also could aid planning services at the primary care level.