Pub Date : 2024-07-26DOI: 10.4103/jfmpc.jfmpc_169_24
Gayatri Gogoi, Gourangie Gogoi, B. Mahanta, B. Borkakoty, Porikhit Borpujari, Tanzil S. Ahmed, Rahul Neog, Sunia Roy, Mithu Medhi
ABSTRACT COVID-19 an infectious disease caused by the SARS-CoV-2 virus, started in late 2019 and became a pandemic within a short period. To respond to the pandemic vaccines like Covishield, Covaxin, Sputnik V, Covovax, etc., were developed rapidly. However, there were raising concerns about the development of immunity as well as adverse events following vaccination. To compare anti-SARS-CoV-2 IgG antibody titres at different time-points post-vaccination between baseline seropositive and seronegative groups and to assess the adverse events following the 1st dose of Covishield vaccine among adult beneficiaries attending vaccination centre in a tertiary care hospital of Upper Assam. Prospective Cohort study was conducted from July 2021 to June 2022 among adult beneficiaries receiving the Covishield vaccine. The oral questionnaire was used incorporating socio-demographic variables, and clinical profiles including co-morbidities and adverse events following vaccination. Data analysis was done by Microsoft Excel and SPSS Out of a total of 146 study participants, IgG estimation showed 61% as seropositive and the rest as seronegative. A total of 55.40% had minor adverse events, majority of them were females (53.08%) and 88.80% belonged to 18–59 years compared to 11.11% above 60 years of age. The majority (71.60%) did not have any co-morbidities and the major AEFI was NIL among the study participants. The study group had 61% seropositive previously infected. Covishield vaccination induces an immune response and 90% seroconversion is achieved after 1st dose (booster dose). Antibody titres of the seropositive group by natural infection of SARS-CoV-2 were higher than seronegative cohort seroconverted by vaccination. The AEFI observed were minor and can be commented as safer.
{"title":"Post-vaccine immune status surveillance of Covishield vaccine and associated AEFI in previously SARS-Cov-2 infected seropositive and seronegative population in Assam","authors":"Gayatri Gogoi, Gourangie Gogoi, B. Mahanta, B. Borkakoty, Porikhit Borpujari, Tanzil S. Ahmed, Rahul Neog, Sunia Roy, Mithu Medhi","doi":"10.4103/jfmpc.jfmpc_169_24","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_169_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 COVID-19 an infectious disease caused by the SARS-CoV-2 virus, started in late 2019 and became a pandemic within a short period. To respond to the pandemic vaccines like Covishield, Covaxin, Sputnik V, Covovax, etc., were developed rapidly. However, there were raising concerns about the development of immunity as well as adverse events following vaccination.\u0000 \u0000 \u0000 \u0000 To compare anti-SARS-CoV-2 IgG antibody titres at different time-points post-vaccination between baseline seropositive and seronegative groups and to assess the adverse events following the 1st dose of Covishield vaccine among adult beneficiaries attending vaccination centre in a tertiary care hospital of Upper Assam.\u0000 \u0000 \u0000 \u0000 Prospective Cohort study was conducted from July 2021 to June 2022 among adult beneficiaries receiving the Covishield vaccine. The oral questionnaire was used incorporating socio-demographic variables, and clinical profiles including co-morbidities and adverse events following vaccination. Data analysis was done by Microsoft Excel and SPSS\u0000 \u0000 \u0000 \u0000 Out of a total of 146 study participants, IgG estimation showed 61% as seropositive and the rest as seronegative. A total of 55.40% had minor adverse events, majority of them were females (53.08%) and 88.80% belonged to 18–59 years compared to 11.11% above 60 years of age. The majority (71.60%) did not have any co-morbidities and the major AEFI was NIL among the study participants. The study group had 61% seropositive previously infected.\u0000 \u0000 \u0000 \u0000 Covishield vaccination induces an immune response and 90% seroconversion is achieved after 1st dose (booster dose). Antibody titres of the seropositive group by natural infection of SARS-CoV-2 were higher than seronegative cohort seroconverted by vaccination. The AEFI observed were minor and can be commented as safer.\u0000","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT The dynamicity and mobility of the population in a mass gathering setting pose a challenge to traditional disease surveillance methods and strain the local health services. Velankanni is one of the most sacred Christian pilgrimage places located in Nagapattinam, Tamil Nadu, India. We participated in the Velankanni festival to describe the public health preparedness, surveillance, and response activities carried out during the festival. This was a cross-sectional study. We reviewed the national and international guidelines and published literature and discussed with the key stakeholders. We developed a checklist to observe public health preparedness activities. We facilitated the staff and monitored the activities by the implementers. We established the syndromic surveillance in the designated locations of the event and used tracker software to capture the data. Emergency medical teams were formed with trained health personnel to respond to medical emergencies. The team monitored all the public health activities. There are 59 primary care public health facilities and nine ambulatory Mobile Medical Units, with 160 medical officers available at the site. Of the 16,169 persons who attended the medical camps, 9863 (61%) were males and 8408 (52%) were aged 15–44. Acute diarrheal disease was the most frequent of the reported syndromes, followed by injuries, acute febrile illness, and animal bites. There was no outbreak of any disease either identified or reported. Our findings suggest that risk assessments should be used, and establishing an Incident Command Center is vital for executing command and control mechanisms during mass gatherings.
{"title":"Public health preparedness, syndromic surveillance, and response during the largest religious gathering at the Catholic pilgrimage center of Velankanni in South India: 2016","authors":"M. Ponnaiah, Viduthalai Virumbi, Upasana Sharma, Sendhilkumar Muthappan, Ganeshkumar Parasuraman, Premkumar Balasubramanian, Vijayalakshmi Venkatachalam, Kolandaswamy Karumanagoundar","doi":"10.4103/jfmpc.jfmpc_1815_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1815_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 The dynamicity and mobility of the population in a mass gathering setting pose a challenge to traditional disease surveillance methods and strain the local health services. Velankanni is one of the most sacred Christian pilgrimage places located in Nagapattinam, Tamil Nadu, India. We participated in the Velankanni festival to describe the public health preparedness, surveillance, and response activities carried out during the festival.\u0000 \u0000 \u0000 \u0000 This was a cross-sectional study. We reviewed the national and international guidelines and published literature and discussed with the key stakeholders. We developed a checklist to observe public health preparedness activities. We facilitated the staff and monitored the activities by the implementers. We established the syndromic surveillance in the designated locations of the event and used tracker software to capture the data. Emergency medical teams were formed with trained health personnel to respond to medical emergencies.\u0000 \u0000 \u0000 \u0000 The team monitored all the public health activities. There are 59 primary care public health facilities and nine ambulatory Mobile Medical Units, with 160 medical officers available at the site. Of the 16,169 persons who attended the medical camps, 9863 (61%) were males and 8408 (52%) were aged 15–44. Acute diarrheal disease was the most frequent of the reported syndromes, followed by injuries, acute febrile illness, and animal bites.\u0000 \u0000 \u0000 \u0000 There was no outbreak of any disease either identified or reported. Our findings suggest that risk assessments should be used, and establishing an Incident Command Center is vital for executing command and control mechanisms during mass gatherings.\u0000","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.4103/jfmpc.jfmpc_129_24
A. Nishanthi, Rajalakshmi Mahendran, K. Ganapathy, M. Shanthi
ABSTRACT Rational drug prescribing skills of interns remain bleak despite clinical pharmacology training during their second year, warranting the need for further training. This study was designed to evaluate the effectiveness of a short-structured learner-centric training program using the World Health Organization (WHO) guide to good prescribing in improving interns’ knowledge of rational drug use and their rational drug prescribing skills. This quasi-experimental study was implemented at a tertiary care teaching hospital in South India. We conducted a short-structured learner-centric training program on rational drug prescribing for interns in September 2022, using the WHO guide to good prescribing. The medical interns who consented to participate were included in the study. A pre-test was administered at the start of the training, followed by a post-test and feedback questions at the end of the program. Statistical tests used for quantitative data were the Wilcoxon signed-ranks test and McNemar’s Chi-square test. Qualitative data were analyzed using manual content analysis. Of the 77 interns who attended the training program, 73 provided consent and completed both the pre-test and the post-test. Their mean age was 22 years, with a slight preponderance of female participants (53.4%). Overall, there was a statistically significant increase in the median (interquartile range) total scores from 52 (44.6 – 60) to 84 (70 – 88) after the training (P = 0.001), out of a maximum score of 93. Also, a significantly greater number of them wrote legible prescriptions (grade 4/excellent – 44 in pre-test vs 52 in post-test; P = 0.001) after the training. The short-structured learner-centric training program based on the WHO guide to good prescribing significantly improved the knowledge of rational drug use and rational drug prescribing skills among medical interns.
{"title":"Evaluation of a short-structured learner-centric training program on rational drug prescribing for medical interns: A quasi-experimental study","authors":"A. Nishanthi, Rajalakshmi Mahendran, K. Ganapathy, M. Shanthi","doi":"10.4103/jfmpc.jfmpc_129_24","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_129_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Rational drug prescribing skills of interns remain bleak despite clinical pharmacology training during their second year, warranting the need for further training. This study was designed to evaluate the effectiveness of a short-structured learner-centric training program using the World Health Organization (WHO) guide to good prescribing in improving interns’ knowledge of rational drug use and their rational drug prescribing skills.\u0000 \u0000 \u0000 \u0000 This quasi-experimental study was implemented at a tertiary care teaching hospital in South India. We conducted a short-structured learner-centric training program on rational drug prescribing for interns in September 2022, using the WHO guide to good prescribing. The medical interns who consented to participate were included in the study. A pre-test was administered at the start of the training, followed by a post-test and feedback questions at the end of the program. Statistical tests used for quantitative data were the Wilcoxon signed-ranks test and McNemar’s Chi-square test. Qualitative data were analyzed using manual content analysis.\u0000 \u0000 \u0000 \u0000 Of the 77 interns who attended the training program, 73 provided consent and completed both the pre-test and the post-test. Their mean age was 22 years, with a slight preponderance of female participants (53.4%). Overall, there was a statistically significant increase in the median (interquartile range) total scores from 52 (44.6 – 60) to 84 (70 – 88) after the training (P = 0.001), out of a maximum score of 93. Also, a significantly greater number of them wrote legible prescriptions (grade 4/excellent – 44 in pre-test vs 52 in post-test; P = 0.001) after the training.\u0000 \u0000 \u0000 \u0000 The short-structured learner-centric training program based on the WHO guide to good prescribing significantly improved the knowledge of rational drug use and rational drug prescribing skills among medical interns.\u0000","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.4103/jfmpc.jfmpc_1845_23
J. Sorout, S. Kacker, N. Saboo, Munesh Kumar
ABSTRACT A group of related risk factors known as central obesity, elevated blood pressure, impaired fasting glucose, elevated triglycerides (TGs), and low levels of high-density lipoprotein (HDL) are collectively referred to as metabolic syndrome (MetS). A low quality of life (QoL) in terms of health is linked to MetS. This study sought to determine how lifestyle modifications affected the health-related quality of life (HRQoL) of primary care patients with MetS. In this study, we randomized 300 subjects diagnosed with MetS as per the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, into control, yoga, and yoga + diet groups according to their intervention which was given for 6 months. Socio-demographic, anthropometric, and physiological and biochemical parameters were collected at baseline, 3 months, and 6 months. The 36-Item Short Form Health Survey (SF-36) was also used to assess HRQoL. The results of this study indicate that yoga + diet and yoga intervention led to significant decrease in metabolic risk factors, such as waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), TGs, and increase in HDL at 3 months and 6 months from baseline. SF-36 score also showed increment (from 0 score to 100) at 3 months and 6 months, which indicates improvement in HRQoL. Dietary changes and yoga are useful strategies for reducing the risk of MetS, which improves QoL in relation to health. Incorporating yoga practices and advocating a balanced diet within primary care systems can significantly benefit individuals with or at risk of MetS.
{"title":"Yoga and nutritional therapies for promoting health-related quality of life in persons with metabolic syndrome—An interventional observational study","authors":"J. Sorout, S. Kacker, N. Saboo, Munesh Kumar","doi":"10.4103/jfmpc.jfmpc_1845_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1845_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 A group of related risk factors known as central obesity, elevated blood pressure, impaired fasting glucose, elevated triglycerides (TGs), and low levels of high-density lipoprotein (HDL) are collectively referred to as metabolic syndrome (MetS). A low quality of life (QoL) in terms of health is linked to MetS. This study sought to determine how lifestyle modifications affected the health-related quality of life (HRQoL) of primary care patients with MetS.\u0000 \u0000 \u0000 \u0000 In this study, we randomized 300 subjects diagnosed with MetS as per the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, into control, yoga, and yoga + diet groups according to their intervention which was given for 6 months. Socio-demographic, anthropometric, and physiological and biochemical parameters were collected at baseline, 3 months, and 6 months. The 36-Item Short Form Health Survey (SF-36) was also used to assess HRQoL.\u0000 \u0000 \u0000 \u0000 The results of this study indicate that yoga + diet and yoga intervention led to significant decrease in metabolic risk factors, such as waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), TGs, and increase in HDL at 3 months and 6 months from baseline. SF-36 score also showed increment (from 0 score to 100) at 3 months and 6 months, which indicates improvement in HRQoL.\u0000 \u0000 \u0000 \u0000 Dietary changes and yoga are useful strategies for reducing the risk of MetS, which improves QoL in relation to health. Incorporating yoga practices and advocating a balanced diet within primary care systems can significantly benefit individuals with or at risk of MetS.\u0000","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.4103/jfmpc.jfmpc_1742_23
Felix O. Sanni, Elizabeth A. Sanni, Collins Onyeagwaibe, Tukwasi Ahamuefula
ABSTRACT Female genital mutilation (FGM) is widely acknowledged globally as a violation of the fundamental human rights of girls and women. FGM is still widely practiced in Nigeria but at diminishing rates. Primary care physicians must educate and campaign to end this hazardous practice in Nigeria, especially in high-incidence areas. This study fills the knowledge gap by identifying FGM determinants to help policymakers reduce it. The study employed a retrospective cross-sectional design using data from the United Nations International Children’s Emergency Fund for 2011, 2016–2017, and 2021. The sampling involved multistage cluster sampling. Data analysis utilized IBM-SPSS, presenting FGM prevalence across years and exploring associations with various factors. This study analyzed 63,365 Nigerian women across a decade (2011, 2016–2017, and 2021). FGM awareness fluctuated (35.1% in 2016–2017, 33.0% in 2011, and 31.9% in 2021), while FGM prevalence increased from 46.6% (2011) to 69.5% (2021). Education correlated with lower FGM prevalence. Geographic disparities were observed, with the Southwest having the highest (70.1%) and the Northeast having the lowest (34.5%) prevalence. Religion influenced FGM rates, with Christians (54.2%) and those with other/no religion (58.0%) showing higher rates than Muslims (52.6%). Urban women had a slightly lower prevalence (52.6%) than rural women (54.2%), and wealth quintiles displayed variations. Variability was also evident among states, ranging from 2.0% to 86.3%. Daughters’ circumcision was influenced by maternal circumcision status, education, region, religion, and wealth quintile. Common FGM procedures involved removing genital flesh (63.7%) and nicking without removal (55.1%), often performed by nurses/midwives (63.7%). The study emphasized the urgent need for continuous awareness campaigns and education to combat FGM among Nigerian women. Education emerged as a critical factor in reducing FGM, highlighting the importance of investing in girls’ education.
{"title":"A retrospective analysis of the trends in the prevalence of female genital mutilation and associated factors among women of reproductive age in Nigeria 2011–2021","authors":"Felix O. Sanni, Elizabeth A. Sanni, Collins Onyeagwaibe, Tukwasi Ahamuefula","doi":"10.4103/jfmpc.jfmpc_1742_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1742_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Female genital mutilation (FGM) is widely acknowledged globally as a violation of the fundamental human rights of girls and women. FGM is still widely practiced in Nigeria but at diminishing rates. Primary care physicians must educate and campaign to end this hazardous practice in Nigeria, especially in high-incidence areas. This study fills the knowledge gap by identifying FGM determinants to help policymakers reduce it.\u0000 \u0000 \u0000 \u0000 The study employed a retrospective cross-sectional design using data from the United Nations International Children’s Emergency Fund for 2011, 2016–2017, and 2021. The sampling involved multistage cluster sampling. Data analysis utilized IBM-SPSS, presenting FGM prevalence across years and exploring associations with various factors.\u0000 \u0000 \u0000 \u0000 This study analyzed 63,365 Nigerian women across a decade (2011, 2016–2017, and 2021). FGM awareness fluctuated (35.1% in 2016–2017, 33.0% in 2011, and 31.9% in 2021), while FGM prevalence increased from 46.6% (2011) to 69.5% (2021). Education correlated with lower FGM prevalence. Geographic disparities were observed, with the Southwest having the highest (70.1%) and the Northeast having the lowest (34.5%) prevalence. Religion influenced FGM rates, with Christians (54.2%) and those with other/no religion (58.0%) showing higher rates than Muslims (52.6%). Urban women had a slightly lower prevalence (52.6%) than rural women (54.2%), and wealth quintiles displayed variations. Variability was also evident among states, ranging from 2.0% to 86.3%. Daughters’ circumcision was influenced by maternal circumcision status, education, region, religion, and wealth quintile. Common FGM procedures involved removing genital flesh (63.7%) and nicking without removal (55.1%), often performed by nurses/midwives (63.7%).\u0000 \u0000 \u0000 \u0000 The study emphasized the urgent need for continuous awareness campaigns and education to combat FGM among Nigerian women. Education emerged as a critical factor in reducing FGM, highlighting the importance of investing in girls’ education.\u0000","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.4103/jfmpc.jfmpc_292_24
S. Meena, M. Badkur, M. Lodha, M. S. Rodha, Ramkaran Chaudhary, Naveen Sharma, Prakash C. Kala, Ravi Gaur, Sumit Bishnoi
ABSTRACT Diabetic foot is a common complication of diabetes mellitus, affecting approximately 15–20% of individuals with diabetes. It is a comorbid condition that significantly impacts the routine life of patients. This study aimed to assess multidisciplinary management strategies and their impact on the outcomes of patients with diabetic foot. A prospective observational study was conducted on 56 patients with diabetic foot. Outcome measures included the type of surgery, frequency of surgery, morbidity, mortality, patient satisfaction, return to work, and the number of patients using prostheses The majority of the patients (87%) received surgical treatment. The most common type of surgery performed was debridement (55%), followed by minor amputations (toes amputation/forefoot amputation) (28%) and major amputations (below-knee (B/K) or above-knee (A/K)) (15%). More than 70% of patients had multiple surgeries. The mortality rate was low (7%), and 71% of surviving patients were satisfied with their treatment. Sixty-seven percent of patients had an early return to work. The number of patients using prostheses was also high (73% of major amputation cases). Multidisciplinary management is the most effective approach for diabetic foot patients. These patients may experience less morbidity and an early return to work. A specialized care clinic for diabetic foot patients is essential to prevent treatment failure, loss of follow-up records, permanent limb loss, and economic burdens on society.
{"title":"Impact of multidisciplinary management via special clinic for the outcome of diabetic foot disease: A prospective observational study","authors":"S. Meena, M. Badkur, M. Lodha, M. S. Rodha, Ramkaran Chaudhary, Naveen Sharma, Prakash C. Kala, Ravi Gaur, Sumit Bishnoi","doi":"10.4103/jfmpc.jfmpc_292_24","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_292_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Diabetic foot is a common complication of diabetes mellitus, affecting approximately 15–20% of individuals with diabetes. It is a comorbid condition that significantly impacts the routine life of patients. This study aimed to assess multidisciplinary management strategies and their impact on the outcomes of patients with diabetic foot.\u0000 \u0000 \u0000 \u0000 A prospective observational study was conducted on 56 patients with diabetic foot. Outcome measures included the type of surgery, frequency of surgery, morbidity, mortality, patient satisfaction, return to work, and the number of patients using prostheses\u0000 \u0000 \u0000 \u0000 The majority of the patients (87%) received surgical treatment. The most common type of surgery performed was debridement (55%), followed by minor amputations (toes amputation/forefoot amputation) (28%) and major amputations (below-knee (B/K) or above-knee (A/K)) (15%). More than 70% of patients had multiple surgeries. The mortality rate was low (7%), and 71% of surviving patients were satisfied with their treatment. Sixty-seven percent of patients had an early return to work. The number of patients using prostheses was also high (73% of major amputation cases).\u0000 \u0000 \u0000 \u0000 Multidisciplinary management is the most effective approach for diabetic foot patients. These patients may experience less morbidity and an early return to work. A specialized care clinic for diabetic foot patients is essential to prevent treatment failure, loss of follow-up records, permanent limb loss, and economic burdens on society.\u0000","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.4103/jfmpc.jfmpc_413_24
Saniya Khosla, Rahul Chauhan, Ayush Aggarwal, Nupur B. Patel
ABSTRACT Dengue infection can take on many different forms, ranging from no symptoms to a mild fever, all the way to a severe condition known as dengue shock syndrome. Although the typical symptoms of dengue are well known, the virus can also cause rare neurological complications. Dengue encephalitis is a severe form of neuroinvasive dengue that can be fatal as the virus directly affects the central nervous system. This case series provides a comprehensive overview of dengue, its clinical spectrum, and the potential for severe neurological complications such as dengue encephalitis. It highlights the importance of considering dengue as a possible diagnosis in patients with encephalitis, particularly during a dengue epidemic.
{"title":"Dengue encephalitis – An unusual case series","authors":"Saniya Khosla, Rahul Chauhan, Ayush Aggarwal, Nupur B. Patel","doi":"10.4103/jfmpc.jfmpc_413_24","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_413_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 Dengue infection can take on many different forms, ranging from no symptoms to a mild fever, all the way to a severe condition known as dengue shock syndrome. Although the typical symptoms of dengue are well known, the virus can also cause rare neurological complications. Dengue encephalitis is a severe form of neuroinvasive dengue that can be fatal as the virus directly affects the central nervous system. This case series provides a comprehensive overview of dengue, its clinical spectrum, and the potential for severe neurological complications such as dengue encephalitis. It highlights the importance of considering dengue as a possible diagnosis in patients with encephalitis, particularly during a dengue epidemic.","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Uncontrolled glycemic parameters in type 2 diabetes mellitus (T2DM) are a major concern. The present study aimed to evaluate the effectiveness of continuous glucose monitoring (CGM) on glycemic control in type 2 diabetics on insulin therapy. This prospective observational study was done in the Outpatient Department of General Medicine from January 1, 2021 till December 31, 2021 on patients with confirmed T2DM and on insulin therapy. Patients underwent detailed history and physical examination. The CGM device was inserted to record blood glucose levels throughout the day and night for monitoring. Parameters like glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), post-paradial blood sugar (PPBS), and lipid profile parameters [cholesterol, triglyceride (TG), and low-density lipoprotein (LDL)] were compared at baseline and after a follow-up of 3 months. P-value < 0.05 was used to indicate significant difference. Of 107 patients screened, 100 were included in the study and seven were excluded. The mean age of the patients was 60.6 ± 11.1 years. Fifty-six (56%) of the patients were males, and 44 (44%) were females. The mean body mass index (BMI) was 22.9 ± 2.4 kg/m2. Compared to baseline values, after 3 months of CGM, there was significantly decreased HbA1c (9.41 ± 0.83 vs 9.87 ± 1.16 g%, P < 0.001), FBS (194.640 ± 22.4587 vs 205.10 ± 35.7758 mg/dl, P = 0.002), PPBS (271.160 ± 29.1235 vs 299.180 ± 42.3798, P < 0.001), cholesterol (184.470 ± 28.5192 vs 198.430 ± 38.8367 mg/dl, P < 0.001), LDL (102.410 ± 22.8973 vs 112.040 ± 30.8859, P < 0.001), and TG (140.890 ± 18.0979 vs 146.730 ± 20.8665 mg/dl, P < 0.001). There was a significant improvement in the glycemic parameters and lipid profile parameters with the adoption of CGM. Overall, CGM is a novel method for practical use for management of patients with T2DM.
{"title":"The association of continuous glucose monitoring with glycemic parameters in patients with uncontrolled type 2 diabetes: A prospective observational study","authors":"Abhishek Chaubey, Deepika Chaubey, Abhishek Dwivedi, Saurabh Dwivedi, Tanu Mishra","doi":"10.4103/jfmpc.jfmpc_1950_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1950_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Uncontrolled glycemic parameters in type 2 diabetes mellitus (T2DM) are a major concern. The present study aimed to evaluate the effectiveness of continuous glucose monitoring (CGM) on glycemic control in type 2 diabetics on insulin therapy.\u0000 \u0000 \u0000 \u0000 This prospective observational study was done in the Outpatient Department of General Medicine from January 1, 2021 till December 31, 2021 on patients with confirmed T2DM and on insulin therapy. Patients underwent detailed history and physical examination. The CGM device was inserted to record blood glucose levels throughout the day and night for monitoring. Parameters like glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), post-paradial blood sugar (PPBS), and lipid profile parameters [cholesterol, triglyceride (TG), and low-density lipoprotein (LDL)] were compared at baseline and after a follow-up of 3 months. P-value < 0.05 was used to indicate significant difference.\u0000 \u0000 \u0000 \u0000 Of 107 patients screened, 100 were included in the study and seven were excluded. The mean age of the patients was 60.6 ± 11.1 years. Fifty-six (56%) of the patients were males, and 44 (44%) were females. The mean body mass index (BMI) was 22.9 ± 2.4 kg/m2. Compared to baseline values, after 3 months of CGM, there was significantly decreased HbA1c (9.41 ± 0.83 vs 9.87 ± 1.16 g%, P < 0.001), FBS (194.640 ± 22.4587 vs 205.10 ± 35.7758 mg/dl, P = 0.002), PPBS (271.160 ± 29.1235 vs 299.180 ± 42.3798, P < 0.001), cholesterol (184.470 ± 28.5192 vs 198.430 ± 38.8367 mg/dl, P < 0.001), LDL (102.410 ± 22.8973 vs 112.040 ± 30.8859, P < 0.001), and TG (140.890 ± 18.0979 vs 146.730 ± 20.8665 mg/dl, P < 0.001).\u0000 \u0000 \u0000 \u0000 There was a significant improvement in the glycemic parameters and lipid profile parameters with the adoption of CGM. Overall, CGM is a novel method for practical use for management of patients with T2DM.\u0000","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.4103/jfmpc.jfmpc_1803_23
Taniyaa Cruz Ferdina, Deepanchakravarthi Vellingiri, N. S. Raja, Gracy Paulin Dharmalingam
ABSTRACT The coronavirus disease 2019 (COVID-19) pandemic has affected the healthcare delivery system in both developed and developing countries. Many antenatal women skipped their regular antenatal check-ups due to fear of viral contamination and lack of transport facilities. Integrated Child Development Services (ICDS), which plays a major role in antenatal care, also suffered a great deal during the pandemic. 1. To assess knowledge and utilization of ICDS services by antenatal women during the COVID-19 pandemic. 2. To determine factors influencing the knowledge and utilization of ICDS services by antenatal women. 3. To determine the barriers to utilization of ICDS services during the pandemic. This study was conducted as a descriptive study in a tertiary care center. Antenatal women whose pregnancy period coincided with the second wave of the COVID-19 pandemic were interviewed using a structured questionnaire. The sample size was calculated as 198. Data were entered in Microsoft Excel and analyzed using Statistical Package for Social Sciences (SPSS). Around 61% of the study population had adequate knowledge about ICDS services. The proportion of antenatal women utilizing ICDS services reduced from 87.8% to 69.6% during the pandemic. Only a few of the mothers were followed up by the Anganwadi workers during the pandemic. The main barriers to not utilizing ICDS services were fear of the spread of the pathogen and lack of awareness about the availability of services during the pandemic. There has been a reduction in the utilization of ICDS services by antenatal women during the COVID-19 pandemic. Measures should be taken by the government to ensure undisrupted care for antenatal women during such hard times.
{"title":"Knowledge and utilization of Integrated Child Development Services among antenatal women during COVID-19 pandemic","authors":"Taniyaa Cruz Ferdina, Deepanchakravarthi Vellingiri, N. S. Raja, Gracy Paulin Dharmalingam","doi":"10.4103/jfmpc.jfmpc_1803_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1803_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 The coronavirus disease 2019 (COVID-19) pandemic has affected the healthcare delivery system in both developed and developing countries. Many antenatal women skipped their regular antenatal check-ups due to fear of viral contamination and lack of transport facilities. Integrated Child Development Services (ICDS), which plays a major role in antenatal care, also suffered a great deal during the pandemic.\u0000 \u0000 \u0000 \u0000 1. To assess knowledge and utilization of ICDS services by antenatal women during the COVID-19 pandemic. 2. To determine factors influencing the knowledge and utilization of ICDS services by antenatal women. 3. To determine the barriers to utilization of ICDS services during the pandemic.\u0000 \u0000 \u0000 \u0000 This study was conducted as a descriptive study in a tertiary care center. Antenatal women whose pregnancy period coincided with the second wave of the COVID-19 pandemic were interviewed using a structured questionnaire. The sample size was calculated as 198. Data were entered in Microsoft Excel and analyzed using Statistical Package for Social Sciences (SPSS).\u0000 \u0000 \u0000 \u0000 Around 61% of the study population had adequate knowledge about ICDS services. The proportion of antenatal women utilizing ICDS services reduced from 87.8% to 69.6% during the pandemic. Only a few of the mothers were followed up by the Anganwadi workers during the pandemic. The main barriers to not utilizing ICDS services were fear of the spread of the pathogen and lack of awareness about the availability of services during the pandemic.\u0000 \u0000 \u0000 \u0000 There has been a reduction in the utilization of ICDS services by antenatal women during the COVID-19 pandemic. Measures should be taken by the government to ensure undisrupted care for antenatal women during such hard times.\u0000","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.4103/jfmpc.jfmpc_333_24
Shivashankar Kengadaran, Divvi Anusha
{"title":"Vaginal tobacco – A hidden addiction in the African continent","authors":"Shivashankar Kengadaran, Divvi Anusha","doi":"10.4103/jfmpc.jfmpc_333_24","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_333_24","url":null,"abstract":"","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}