Indian Journal of Community Medicine最新文献

Background: LaQshya program was launched to increase institutional deliveries, provide quality labor room and operation theatre services and improve the satisfaction of the beneficiaries. The objective of this study was to assess postnatal women's satisfaction with childbirth services at secondary healthcare facilities from the patients' and healthcare providers' perspectives.

Materials and methods: Mixed-method study was conducted across five healthcare facilities where both modes of delivery, normal vaginal and cesarean section, were available, in District Dehradun, Uttarakhand. One hundred and ninety-one women were interviewed using a Hindi-validated scale (SMMS), and 25 IDIs were conducted among healthcare providers, to understand their perspectives on factors influencing satisfaction and dissatisfaction of postnatal women with childbirth services.

Result: All post-natal women (n = 191) were more satisfied with childbirth services. Mean satisfaction score was slightly higher for cesarean delivery (155.1 ± 10.8, n = 31) than normal vaginal delivery (154.1±9.9, n = 160), but not statistically significant. Overall experience was similar across all facilities. Lowest scores reported for factors: Food and sanitation services and respect for privacy. Healthcare providers' perspectives for high satisfaction among women were good behavior of healthcare workers, comfort provided, quality of services, prompt action, and immediate meeting with the baby, whereas for dissatisfaction was inadequate infrastructure, lack of privacy, quality services, manpower shortage, hygiene and sanitation, and inadequate material resources.

Conclusion: The study reported a high level of satisfaction among postnatal women for childbirth services at secondary healthcare facilities, as in most cases, it was the only option for institutional delivery for them. However, healthcare professionals reported several areas of improvement in the services.

Background and objective: Knowledge regarding noise pollution has been increasing recently, but awareness in the context of hospital settings is necessary among the hospital staff to make noise reduction in hospitals a priority in India. The objective of this study is to determine the awareness regarding hospital noise and its effects among staff working in a tertiary care hospital in North India.

Materials and methods: A cross-sectional study was conducted among staff members working in any capacity in a 1600-bedded tertiary care hospital in New Delhi, India. A predesigned, pretested, semistructured questionnaire was used to collect information on knowledge and perception among the staff regarding hospital noise in their workplace and its effects. Data were analyzed in SPSS 21 IBM SPSS Statistics for Windows Version 21.0 [Computer software]. IBM Corp.

Results: Of 450 study participants, 319 (70.9%) agreed that noise affects human health and 235 (52.2%) were knowledgeable regarding any hospital noise legislation. The most frequently perceived health effect of hospital noise was annoyance (311, 69.3%), followed by hearing impairment (285, 63.5%). Workplaces were deemed to be noisy by only 219 (48.7%) respondents. Of the sources of noise identified, 29% were totally avoidable and 23% were partially avoidable. Education, socioeconomic status, and area of work were significantly associated with knowledge and perceptions regarding hospital noise.

Conclusions: Knowledge regarding hospital noise and its effects was lacking among 25-50% of the staff working in the hospital. More than half of the identified hospital noise sources were either completely or partially avoidable through staff sensitization, strategic procedural changes to mitigate noise, and strict implementation of patient and visitor rules.

Background: Health is a fundamental right of every individual. As lifestyle diseases are becoming more common these days, need for health care services increases. Globally, medical inflation has been on the rise. Even in a country with a robust healthcare system, the unexpected costs of medical emergencies can pose a significant financial burden. Hence, there is a need for health insurance schemes as it provides financial security to the family. Unfortunately, many people remain unaware of the benefits of health insurance, leaving them vulnerable to financial distress during times of medical crisis.

Materials and methods: This cross-sectional study was conducted at the Urban Health Training Centre. Adult patients (age ≥25 years) attending the OPD were included. A semistructured questionnaire assessed sociodemographic factors, health insurance awareness, type, coverage, and reasons for nonenrollment. Descriptive statistics and Chi-square tests analyzed associations between sociodemographic factors and health insurance awareness/enrollment. Binary logistic regression identified predictors of awareness and enrollment.

Results: Above 70% were aware of health insurance. Colleagues were a primary source of information. Lack of awareness was the main barrier to enrollment. Higher education, male gender, and joint family living were associated with greater awareness. Enrollment rates were significantly higher in government employees (P = 0.004), individuals with higher education (P = 0.001), and living in joint families (P = 0.04).

Conclusion: The study revealed a significant gap between health insurance awareness and coverage. Government-sponsored schemes without premiums and employer mandates were the main reasons for enrollment (36.5%). Lack of awareness, perceived good health, and affordability concerns were the primary barriers to enrollment.

Background: Nomophobia, the fear of being without mobile phone contact, is recognized as a behavioral addiction characterized by anxiety when individuals are unable to access their smartphones or mobile networks. This phenomenon is increasingly observed among medical students, whose academic and personal reliance on smartphones is significant. The present study aims to determine the prevalence of nomophobia and identify the factors predicting its occurrence among undergraduate medical students at a University in Belagavi, South India.

Materials and methods: A cross-sectional study was conducted over 1 year among 416 undergraduate medical students using a universal sampling technique. After obtaining informed consent, data were collected using a predesigned structured questionnaire covering sociodemographic details and smartphone usage patterns. Nomophobia was assessed using the Nomophobia Questionnaire (NMP-Q). Data were analyzed using IBM SPSS v23.0, and P values <0.05 considered statistically significant.

Results: The median (interquartile range) age of participants was 21 (2) years, and the overall prevalence of nomophobia was 97.4%. Significant associations were observed between nomophobia and age group, frequency of smartphone checks, and the number of applications installed. Among the four dimensions of nomophobia, the highest mean score was observed for not able to communicate (4.16 ± 1.54), followed by not able to access information, losing connectedness, and giving up convenience.

Conclusion: The prevalence of nomophobia among medical students is alarmingly high and consistent with other studies. These findings highlight the urgent need for awareness, targeted interventions, and support systems to mitigate smartphone-related anxiety and its potential impact on student wellbeing and academic performance.

Background: Fever is a common symptom of many infectious diseases, and acute febrile illness has been a common occurrence in the low- and middle-income countries like India and imposes heavy burden on the healthcare system, especially at the primary healthcare level. We aimed to study the clinical profile, seasonal pattern, and geolocation of the patients with fever reporting to a primary health center (PHC).

Materials and methods: This hospital- and community-based longitudinal study was conducted in the Union Territory of Puducherry, and the data was collected from 2634 fever patients of all ages reporting to the fever clinic in a PHC. Structured questionnaire was used to collect the relevant data. Mean, median, and mode were used to analyze the data, and Quantum Geographic Information System software was used to geolocate the febrile patients reporting from the service area of PHC Kalapet.

Results: Majority of the participants (34.5%) belonged to the age group of 20-44 years, and 53% of males were affected with febrile illness. Respiratory symptoms were the most common symptoms associated with fever when they reported to PHC Kalapet. In addition, most of the study participants were diagnosed as a probable case of acute respiratory illness (ARI; 58.7%). More number of cases were reported from the months of November to January in the rainy and post-rainy seasons. Clustering of febrile cases was seen in areas like Periyakalapet and Pillaichavady.

Conclusion: Fever continues to be a major public health problem in India, where a few cases go undiagnosed due to limited diagnostic facilities in PHCs. ARI cases were the highest among the fever cases reporting to a PHC, and most of the fever cases were managed at the primary care level.

Background: The association between night eating and quality of life has been well documented and seemingly has had an impact on both sleep quality and health-related quality of life (HRQoL). However, recent evidence about this relationship among university students is limited, and research on eating disorders (ED) is sporadic. The aims of this study are to investigate the prevalence of eating disorders and to explore the associations between these outcomes with body mass index (BMI), insomnia, and HRQoL among Delhi University students.

Material and methods: A questionnaire on night eating questionnaire (NEQ) (night eating) along with subscale on morning anorexia, delayed morning meal, evening hyperphagia, sleep disturbance and the Form-36 health quality survey was administered to a convenience sample of 524 students (284 females and 240 males, mean age: 19.66 ± 2.26 years), attending one of the largest Indian universities. Data were collected during May to July 2022.

Results: Prevalence of night eating syndrome (NES) in the population was found to be 33%, of which 48% were females. People suffering from morning anorexia and night awakening have much lower mental health composite scores (MCS) and physical health composite scores (PCS). Furthermore, the presence of evening hyperphagia was found to be a significant predictor of PCS scores. A total of 49% of the participants showed poor sleep quality, whereas only 13% reported insomnia symptoms.

Conclusion: NES is found to be more common among girls in the Indian context. The presence of morning anorexia and night awakening was also observed to have a significant impact on both the physical and mental component scores of the quality of life index, which confirms the relevance of sleep and disciplined eating habits as major contributors to students' well-being and thereby attainment of a better quality of life.

Physical inactivity is a significant public health concern among medical students. This study analyzes physical activity patterns and influencing factors among medical students in Kashmir, India. A cross-sectional study was conducted among medical students (n = 241) from first to third-year MBBS program in Kashmir, J and K, India. Convenience sampling was employed considering the descriptive nature of the study. Physical activity was measured using the three-day physical activity recall questionnaire. Among the study participants (N = 241), 144 (59.8%) were female, with a mean age of 20.3 ± 1.4 years. Only 14 (5.8%) participants met recommended physical activity levels. Males (n = 97) had higher average daily Metabolic Equivalent of Task scores (55.8 ± 7.2) compared to females (n = 144, 54.7 ± 4.9). The study highlights alarmingly low physical activity levels among medical students in Kashmir. Interventions targeting gender-specific approaches and increased institutional support may be effective in promoting physical activity in this population.

"Precision Public Health (PPH)" envisions personalized medicine and timely healthcare interventions for communities sharing common characteristics. PPH represents transition of precision medicine technologies assisted by "artificial intelligence" and "omics"- genomics, proteomics, and transcriptomes- to public health. The Human Genomic Variation Project linked with pathogens genomic sequencing has uncovered connections and diversity at molecular level elucidating aspects of susceptibility, immunity and resistance. This knowledge integrated with PPH has created the next-generation tool, public health genomic knowledge base (PHGKB) having potential to enhance awareness, generalizability and effectiveness of targeted resource allocations. Artificial Intelligence for public health further encompasses electronic health records- Ayushman Bharat Health Account (ABHA)- innovative initiative to digitalise health data from diverse populations, locations and timepoints converting real-world electronic data to real-world intelligence network. Comprehensive inputs from this network can guide computer programs- better known as algorithms and machine learning- for prediction, behaviour analysis and resource optimization. Simultaneously, challenges of gathering data from underprivileged groups, remote areas and paramedical staff with limited access to newest technology tools can produce "algorithmic bias" creating prejudices in policy decisions and disruptions in resource allocations to already disadvantaged populations. Time has arrived to decide, expand and limit, the role of precision and prediction tools to public health, considering both positive and negative disruptive effects. People should have the opportunity to make public health choices based on the best science and facts, with the least amount of risk and cost, and with the most health in their communities.

The present study aims to critically analyze the effects of yogic interventions on dyslipidemia compared with distinct control conditions. We systematically searched the relevant randomized controlled trials published from January 2001 to January 2025 in electronic databases such as PubMed, Scopus, Web of Science, and the Cochrane Library. Additionally, we conducted a manual search in a peer-reviewed journal. We used a random-effects model based on the inverse variance method to calculate weighted mean differences. We also assessed the risk of bias, heterogeneity, sensitivity analysis, and reporting bias. A total of 58 records were included in this systematic review, and 53 were considered for meta-analysis. In the group analysis, yoga was compared to control (no intervention), walking/aerobic exercise, and dietary restriction groups, respectively. As a result of the overall comparison between groups, people practicing yoga showed lower levels of total cholesterol (MD: -10.99, 95% CI: -15.19 to -6.78, I2 = 97%, P < 0.001), triglycerides (MD: -17.17, 95% CI: -22.00 to -12.34, I2 = 93%, P < 0.001), low-density lipoprotein (MD: -10.71, 95% CI: -13.75 to -7.68, I2 = 96%, P < 0.001), very low-density lipoprotein (MD: -278, 95% CI: -5.33 to 0.15, I2 = 99%, P = 0.06) and higher high-density lipoprotein cholesterol (MD: 2.44, 95% CI: 1.69 to 3.19, l2 = 93%, P < 0.001). These findings suggest that yoga as an intervention has a greater impact on controlling lipid profiles. Medical professionals should recommend yoga as a complementary and alternative therapy for their patients under safe guidance, for better and integrated healthcare.