Journal of Family Medicine and Primary Care最新文献

Introduction: Disrupted weather patterns are associated with climate change. Between 2001 and 2018, nearly 74% of disasters were water-related, including floods and cyclones. Such water-related cataclysmic events increase the risk of drowning. We aimed to map evidence on the impact of climate change on water-related physical events, associated human migration, and drowning burden in India.

Materials and methods: We searched electronic databases, government reports, and relevant websites to map evidence on water-related physical events (including but not limited to sea-level rise, glacier bursts, lake bursts, floods, rainfall, cyclones, and droughts) and consequent human migration using narrative review approach, while drowning burden through scoping review approach. We summarized the results narratively.

Results: Evidence from 48 studies and seven reports suggest that India will witness the greatest sea-level rise, significantly impacting poor coastal communities. An increase in droughts, cyclonic rainfall, storms, and floods, with increasing surface rainwater and streamflow water, due to melting glaciers is expected. Climate change-triggered migration is expected notably in northeast and south India, making farmers, drivers, street vendors, women, and youth most vulnerable. No direct evidence was identified on the impact of climate change, water-related disasters, meteorological events, or seasonal variations on drowning from India.

Conclusion: Our study highlights a significant gap in the availability of context-specific and localized data to improve disaster response and strengthen public health systems, especially for areas most vulnerable to climate change. There is an urgent need to generate new knowledge and understanding of climate change, water-related or meteorological events, and seasonal variations' impact on drowning burden as the level of risk remains unknown.

Background: The past decade has witnessed a revolution in smartphones owing to their growing importance and various applications. However, excessive usage can lead to addiction and joint pain in the wrist/thumb area. Despite these negative effects, smartphones offer medical students access to the resources they need.

Objective: To determine the association between smartphone addiction and thumb/wrist pain among undergraduate students of Jazan University.

Methods: A cross-sectional self-administrated, online survey and online convenience sample technique was used. The collected data were analyzed using SPSS Software.

Results: This survey included 337 participants, of which two-thirds were female (66.8%) and the rest male (33.2%); 32.6% of the respondents were studying in the College of Medicine. Of the 337 participants, 32% reported experiencing pain in their wrists or at the back of their neck while using a smartphone. The study found an average Smartphone Addition Scale-Short Version (SAS-SV) score of 32.5 ± 8.0 out of 50 and a total Patient-Rated Wrist Evaluation score of 48.8 ± 14.7, with a pain score of 13.3 ± 11.0 and a function score of 35.5 ± 11.7. The study also revealed a significant association between smartphone addiction and thumb/wrist pain (P value = 0.029), with females and students of the College of Applied Medical Science associated with higher SAS-SV scores, thereby indicating higher smartphone addiction.

Conclusion: Significant correlation exists between smartphone addiction and thumb/wirst pain among medical students of Jazan University.

The LGBTQ community faces specific stressors rooted in societal discrimination, bias, and marginalization, impacting mental health significantly. Persistent discrimination, exclusion, and heteronormative expectations are identified as social determinants that contribute to heightened stress levels, resulting in increased rates of anxiety, depression, and suicidality. Moreover, the COVID-19 pandemic has also severely affected the physical and mental health of a large percentage of the population, particularly impacting the health of marginalized individuals such as LGBT individuals. Studies consistently reveal alarming mental health disparities between LGBTQ individuals and their heterosexual counterparts, with elevated rates of mood disorders, substance abuse, and self-harm. Transgender individuals, in particular, face unique challenges, including high rates of gender dysphoria and discrimination-induced mental distress. The concept of intersectionality within the LGBTQ community emphasizes the compounded burden faced by individuals with multiple marginalized identities, necessitating tailored mental health strategies. The societal context, including legal and policy frameworks, plays a pivotal role in shaping the mental health and scope for LGBTQ individuals. Supportive frameworks, such as anti-discrimination laws, marriage equality, and healthcare policies, contribute to societal acceptance and individual well-being. Additionally, efforts to destigmatize LGBTQ identities, comprehensive sex education, and public awareness campaigns challenging stereotypes are crucial for fostering a more inclusive societal mindset. Establishing robust support networks within the LGBTQ community, including initiatives providing mental health resources, counseling, community spaces, and allyship programs, is vital for community resilience. These efforts not only contribute to the well-being of individuals within the LGBTQ community but also work toward creating a more inclusive society. In conclusion, addressing mental health challenges within the LGBTQ community requires a multifaceted approach involving societal understanding, legal support, destigmatization efforts, and robust community resources. By acknowledging and comprehending the unique struggles faced by the LGBTQ community, society can collectively work toward building a more compassionate, supportive, and inclusive environment for all individuals, irrespective of their sexual orientation or gender identity.

Introduction: Severe hypertension in pregnancy deserves prompt recognition and urgent effective reduction in order to reduce the risk of complications such as eclampsia and HELLP syndrome and to achieve desirable neonatal outcomes. There is a need for effective and safe parenteral antihypertensive treatment.

Subjects and methods: We studied the effectiveness and safety of intravenous labetalol use in severe hypertension in pregnancy and post-partum period in a teaching hospital in Chhattisgarh in 101 women. IV labetalol was given as bolus doses till the blood pressures were controlled. Neonatal outcomes were recorded, and adverse effects such as hypotension, hypoglycemia, and neonatal asphyxia were documented.

Results: Intravenous labetalol given as a single bolus of 20 mg was efficacious in controlling blood pressures in 93 out of 101 (93%) women, and the rest were controlled with 1 or 2 additional doses in 1-3 hours. No neonatal deaths happened beyond the 13 intrauterine fetal deaths at presentation. No women developed any episodes of hypotension, tachycardia of more than 100, or nausea or vomiting on labetalol.

Conclusion: Intravenous labetalol, even as a single bolus dose, is highly efficacious and is free of any major adverse effects.

Introduction: Neurological disorders are the leading causes of death and disability globally. In low-middle-income countries such as India, there is a wide treatment gap for neurological disorders. To address this gap, an initiative known as the Karnataka Brain Health Initiative (KaBHI) was developed in collaboration with the public health system of the state of Karnataka in India.

Method: A structured hybrid training program was conducted for 120 medical doctors working in the Primary Health Centers (PHCs) in the public health system in three districts of Karnataka. Pre- and post-training evaluation was conducted to assess physicians' knowledge and skills for evaluating patients with common neurological conditions.

Results: Of 120 PHC doctors, 111 (92%) scored below the passing score of 50 points out of 100 before the training program. After the training, all trainees scored above this cut-off. The study found a significant improvement in knowledge and skills after the training (before training: 40.48 ± 7.92, after training: 66.28 ± 8.98 (P < 0.001) mean difference = 25.81), and was comparable among the PHC doctors in all three districts.

Conclusions: Our study shows the feasibility of training primary care doctors in the public health system to manage selected common neurological disorders. The training program can potentially help to reduce the treatment gap for neurological disorders in India.

Background: The metabolic syndrome (MetS), according to the Adult Treatment Panel III of the National Cholesterol Education Programme, is a collection of metabolic abnormalities that includes one, two, or all three of the following traits: obesity in the abdomen, dyslipidemia, hypertension, fasting blood sugar, or insulin resistance. This study's aim was to assess the relationship between fasting serum leptin and MetS in elderly adults with T2DM in the Northern Indian population.

Material and methods: The following information was collected from all the participants: (1) anthropometric data, (2) biochemical data, and (3) a lifestyle questionnaire on sociodemographic data, dietary practices, smoking, and alcohol intake to identify their risk factors for diabetes mellitus, CVD, and hypertension.

Results: A total of 36 older participants (56.30%) had a history of hypertension, while 29 elderly participants (44.61%) had diabetes mellitus. A total of 32 elderly participants (49.2%) had MetS, and this group had higher serum leptin (P 0.003), body weight (P = 0.019), BMI (P 0.001), waist circumference (P 0.001), CRP (P = 0.021), insulin (P = 0.001), and HOMA-IR (P = 0.003) values as well as higher percentages of females (P = 0.001), and those with type 2 diabetes mellitus (P = 0.002) and hypertension (P = 0.039) than those in the non-MetS group.

Conclusion: In older persons with T2DM, our study discovered a favorable correlation between serum leptin and MetS. It can act as a standalone indicator of MetS, offering a way to spot populations at risk for associated consequences and enabling early intervention.

Background: Family planning (FP) services are pivotal in assessing a country's healthcare efficacy. Despite India's strides in FP promotion, disparities persist in its utilization rates. This study analyzes Karnataka's FP trends by using National Family Health Survey (NFHS) rounds 4 and 5, comparing its indicators with national averages.

Methods: A retrospective record review-based descriptive study design was employed. Data from NFHS-4 (2015-16) and NFHS-5 (2019-21) were analyzed using MS Excel 365. Key variables included age at marriage, total fertility rate (TFR), and various contraceptive methods.

Results: Karnataka exhibited a stable rate of early marriages for women and a decline among men aged 25-29 years. TFR in Karnataka slightly decreased, with increased contraceptive usage and significant growth in modern contraceptive methods. However, male sterilization rates remained low. There was an improvement in health workers' engagement with female non-users and in providing information on contraceptive side effects.

Conclusion: While Karnataka has progressed in FP, challenges such as early marriages persist. Enhancing integration, leveraging technology, and empowering women are essential for comprehensive FP services in India.

Background: To end the COVID-19 pandemic, we need to reach herd immunity. A successful pediatric COVID-19 immunization program is the only way to achieve this goal. The objective of this study was to determine the views of parents in Saudi Arabia on the COVID-19 vaccine in children.

Materials and methods: This cross-sectional study took place within the Family Medicine Pediatric clinics at the King Faisal Specialist Hospital and Research Center (KFSH and RC). All parents of patients of Family Medicine Pediatric Clinics at KFSH and RC, Riyadh, were invited to participate in this study between January 2022 and June 2022. A culturally sensitive and specially designed questionnaire was administered using an interview-based model.

Results: Safety concerns were the primary reason for vaccine hesitancy among parents, with 29.7% of parents expressing concerns about side effects and 25.1% not knowing where to get reliable information about vaccines. Negative information and lack of perceived need were also important factors, with 17.1% and 18.3% of parents citing these reasons, respectively. Poor knowledge about vaccines was a significant predictor of parental vaccine hesitancy. Mothers had more concerns about the efficacy and safety of vaccines than fathers.

Conclusion: Our study demonstrated a negative attitude toward the pediatric COVID-19 vaccine among parents in Saudi Arabia. A higher level of awareness about the vaccine was significantly associated with planning on having the vaccine. There is a need for effective awareness programs for better pediatric COVID-19 vaccine-related education to increase the acceptance of the vaccine among parents in Saudi Arabia.

Introduction: Cancer is one of the major public health concerns leading to high trends of mortality and morbidity in India. Health-related quality of life (HRQoL) is an indicator of the sense of well-being applicable, which includes all the domains of physical, social, emotional, and functional well-being. The inferences can strengthen the palliative care needs of patients. This study was conducted to assess the HRQoL of patients on anticancer therapy and to measure the perceived palliative care needs amongst diagnosed patients on cancer therapy.

Methodology: Mixed method approach was used to assess the objectives of the study. FACT-G questionnaire was used to assess the HRQoL of patients among a sample size of 290 participants for quantitative analysis and 9 for in-depth interviews. Data were generated and analyzed in SPSS version 23. Spearman correlation coefficient was used to test the association between the well-being score and demographic factors.

Results: The mean age of the study population was 52.46 ± 13.83 years with 65% females. The mean FACT-G score was 61.1 ± 17.1 with mean domain values of 14.97 (physical well-being), 16.55 (social well-being), 16.21 (emotional well-being) and 13.35 (functional well-being). FACT-G score was significantly associated with education level, type of cancer and type of anticancer therapy. Qualitative themes described pertaining to delayed diagnosis, financial distress, side effects, social isolation (factors worsening QoL) and support, and attitude (factors improving QoL).

Conclusion: HRQOL scores were found low in all types of cancer and early referral for palliative care might have a positive effect on the quality of life of cancer patients. Cancer is the leading cause of morbidity and mortality with its profound social and economic consequences leading to impoverishment and societal inequity.