Indian Journal of Community Medicine最新文献

Introduction: Population aging is a global phenomenon, with the number of persons over 60 steadily increasing. "Geriatric syndrome" encompasses various indicators of impaired organ function, including falls, polypharmacy, malnutrition, dementia, frailty, sleep disturbances, chronic pain, and urinary incontinence. To study the prevalence and determinants of geriatric syndrome among diabetic and nondiabetic geriatric patients in urban and rural areas of Puducherry.

Materials and methods: This community-based cross-sectional study was conducted in the field practice area of the tertiary care hospital in Puducherry. Sample size is found to be 404, and a population proportionate to the size is applied to collect the required samples from each area. Data collection involved a pre-tested interview schedule for sociodemographic characteristics and standardized, validated questionnaires for assessing geriatric syndromes among diabetic and nondiabetic individuals. The Chi-square test for categorical variables and independent t-test for numerical variables were used, with P values < 0.05 considered statistically significant.

Results: Among rural diabetics, 35.1% experienced polypharmacy, 90.7% reported mild pain, 88.7% had slight urinary incontinence, 10.3% moderate incontinence, and 1.0% severe incontinence. Additionally, 26.8% exhibited cognitive impairment, 22.7% reported falls, and 45.4% experienced depressive symptoms. Urban diabetics had a polypharmacy prevalence of 29.7%, with 85.1% reporting mild pain. For urinary incontinence, 91.9% of urban diabetics had slight symptoms, and 8.1% had moderate symptoms. Cognitive impairment was found in 24.3% of urban diabetics, 9.5% reported falls, and 29.7% experienced depressive symptoms.

Conclusion: This study provides valuable insights into the prevalence and determinants of geriatric syndromes among diabetic and nondiabetic individuals, highlighting the need for targeted clinical interventions and public health strategies that address the unique challenges of different settings.

Background: Diabetes mellitus is a serious global and Indian public health concern. The "rule of halves" (ROH) traditionally used in hypertension offers insight into diagnosis, treatment, and disease control in the community. This study aimed to explore the applicability of this concept to diabetes. The objectives included estimating the prevalence of diabetes mellitus in the study population, identifying the proportion who are aware of their disease among diabetic individuals, identifying the proportion who are on treatment among those aware of their disease, and identifying the proportion having adequate blood sugar control among those on treatment.

Materials and methods: A community-based cross-sectional study was conducted in Lakshmi Gudde, a rural area in Dakshina Kannada, Karnataka, between March and September 2023. The study employed a complete enumeration method to enroll willing individuals aged ≥ 18 years. Data were collected using a semi-structured questionnaire, and the blood sugar levels were measured using a spot HbA1c analyzer.

Results: The study, comprising 552 individuals, revealed a diabetes prevalence of 31.4%. Among those identified with diabetes, 63.5% were aware of their condition. Furthermore, of those aware, 88.7% were taking treatment, and among these treated individuals, 52.1% maintained adequate control of their blood sugar levels.

Conclusion: The ROH currently applied to hypertension can also be applied to diabetes mellitus. Further studies from diverse geographic regions across the globe are required to strengthen evidence in this regard.

Studies have shown that multiple micronutrient (MMN) supplementation may be equal or better than iron-only or iron-folic acid in the prevention and treatment of anemia in children and non-pregnant women. However, there is no updated evidence on this statement. We followed the Cochrane methodology and conducted a meta-analysis of the published literature with the application of GRADE. The searches were conducted till December 31, 2023. The primary objective was to compare the effect of MMN versus iron and/or folic acid alone on clinical and laboratory parameters of anemia in children and adults (except pregnant women). Review Manager software (version 5.3) was used for data analysis. Of 4640 citations, 12 studies were finally included. There was a significant decrease (20%) in the anemia prevalence in the 2-5 days/week MMN supplementation. A significant decrease (27%) in the prevalence of iron deficiency was noted in the daily MMN supplementation group but not in the weekly MMN supplementation group. No significant change in hemoglobin level was noted in any of the supplementation group. Regarding anthropometry parameters, a daily (not weekly) MMN supplementation led to a significant weight gain by 220 g without affecting the height gain in infants. The GRADE evidence varied from "very low to moderate certainty" for the outcome parameters. MMN supplements incorporating a high dose of iron and micronutrients when provided 2-5 days/week may lead to a significant decrease in the anemia prevalence. We need more evidence before firm conclusions can be made on MMN supplementation for prevention and/or treatment of anemia in children and adults (except pregnant women).

Background: The excessive use of social media among today's youth has also led to a large number of new-age problems like social media addiction, eating disorders, and body dysmorphia. Recent studies show emerging concerns linked with increased social media use and body image dissatisfaction. Although many studies have been done in other countries regarding the same, research on social media usage and body image dissatisfaction in the Indian scenario is still lagging. This study aimed to estimate the prevalence of body image dissatisfaction among female medical students who use social media and find the association between social media usage and body image dissatisfaction.

Method: A cross-sectional study was conducted among 280 girls between the ages of 19 to 24 years from different years of medical school selected by simple random sampling. Participants were explained the nature of the study during their classes and informed consent was obtained. Female students who have been using social media for at least six months were included in the study and those who suffered from any pre-existing psychiatric illnesses were excluded. Data was collected using a pretested structured questionnaire and analyzed with SPSS version 22. Bivariate and Logistic Regression analyses were done to find the association between body image dissatisfaction and related variables.

Results: Among a total of 280 participants, Instagram was the most commonly used social media app followed by WhatsApp and YouTube. The prevalence of body image dissatisfaction was 46.1% among study participants. Social media addiction was seen in 11.4% of participants. Variables that were significantly associated with body image dissatisfaction were body mass index including overweight (AOR = 7.53) and obese (AOR = 2.6) body mass indices, using more than three social media platforms (AOR = 1.86), deceptive behavior (AOR = 2.74) and social media addiction (AOR = 4.97).

Conclusion: The impact of the increasing use of social media on today's youth is evident with the high prevalence of body image dissatisfaction. The current study highlights the need for future interventions and educational strategies to promote positive body image among medical students to cater to the prevention of eating disorders and other mental health issues. Further studies must be conducted on content analysis on social media sites that threaten the body image of our youth.

The specialty of Community Medicine plays a pivotal role in training of the Indian Medical Graduate. It provides them a deep exposure to the health and healthcare in the community where most of the healthcare is needed and are equipped with skills to communicate efficiently with the patient, family, and community. Reform in medical education in the past few years through the adoption and implementation of Curriculum-Based Medical Education (CBME) has further transformed the specialty of Community Medicine. Introduction of Family Adoption Programme, where the specialty of Community Medicine plays a pivotal role, has brought to the fore opportunities and fresh challenges. We have put forth the evolution of the curriculum in Community Medicine from the Graduate Medical Education Regulation 1997 to the current CBME guidelines 2024 attempting to provide the readers, especially the faculty in Community Medicine, easy tracing of the changes in the curriculum over the past few years and serve as a ready reckoner amid the conundrum of multiple guidelines.

Background: Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections pose a significant global public health burden. However, a substantial proportion of individuals remain undiagnosed, forming a hidden reservoir that perpetuates onward transmission. This study aimed to assess the prevalence of undiagnosed HBV and HCV infections within a population presenting for diagnoses unrelated to viral hepatitis.

Methods: A cross-sectional study was conducted at a tertiary care hospital in central India. Clinical specimens from patients undergoing diagnostic workup for suspected illnesses other than HBV or HCV were analyzed for HBV and HCV serological markers.

Results: Among 1,630 specimens, a concerning prevalence of undiagnosed HBV and HCV infections was identified: 3.1% for HBV and 0.5% for HCV. Notably, a significant proportion of individuals testing positive were unaware of their infection status.

Conclusion: This study unveils a concerning reservoir of undiagnosed chronic viral hepatitis within a population not routinely screened for HBV/HCV. These findings highlight the critical need for expanding HBV and HCV screening strategies beyond traditionally high-risk populations or patients with specific clinical presentations.

Background: Scabies may cause community outbreaks without early diagnosis and appropriate treatment. Oral ivermectin offsets some of the challenges associated with topical 5% permethrin application for treating scabies. We aimed to evaluate the efficacy of two doses of oral ivermectin (200 µg/kg) on day one and day seven compared to 5% (weight/volume [w/v]) once whole-body application of permethrin lotion in treating scabies.

Materials and methods: We recruited 100 participants with mild or moderate scabies and randomized them into ivermectin and permethrin arms using computer-generated sequences. Participants and their contacts in the ivermectin arm received two doses of ivermectin (200 µg/kg) on day one and day seven. Participants and their contacts in the permethrin arm received treatment with 5% (w/v) permethrin application over the whole body. The participants were followed up after 4-6 weeks of the intervention to determine the cure rate.

Results: We got a similar cure rate among the scabies patients who received either ivermectin (90.70%) or permethrin (93.33%). The cure rate was 100% after one dose of whole-body application of permethrin or two appropriate doses of ivermectin among mild to moderate cases of scabies. The cost was lower in the ivermectin arm than in the permethrin arm.

Conclusion: The cure rates of scabies with one local application of 5% permethrin lotion and two doses of oral ivermectin tablets are similar. Ivermectin has an added advantage that the cost is lower and its usage is convenient.

Childhood obesity is a notable public health concern in India and other developing nations. There are many published articles on the prevalence of obesity among school children in various states of India. Estimating obesity prevalence at state and national levels will help understand its distribution and guide effective prevention strategies. To estimate the pooled prevalence of obesity among school-going children in India using a systematic review and spatial analysis. This systematic review and meta-analysis include cross-sectional studies from 1995 to 2023, reporting the prevalence of obesity among school-going children in India. Two authors independently screened and extracted data from PubMed, Scopus, and the Web of Science. Study quality was assessed using the Newcastle-Ottawa Scale, and the random effect model was used as there was high heterogeneity (I² >50%). Spatial analysis and cumulative meta-analysis were performed using R and STATA software. A total of 125 articles were selected based on the inclusion and exclusion criteria. The overall pooled prevalence of obesity was found to be 6.97% (95% CI: 5.97, 7.97). Among the different regions of India, the highest pooled prevalence was found in the Northern region, that is, 8.58% (95% CI: 5.47, 11.69), and the lowest in the Central region, that is, 5.63% (95% CI: 3.95, 7.31). The cumulative analysis indicated a rising trend in the prevalence of obesity among school-going children over the years. This meta-analysis offers vital insights into its scope and geographical distribution, helping to develop effective strategies to prevent its persistence into adulthood. Trial registration: The PROSPERO registration number is CRD42023431574.

Background: Insomnia is defined as a condition involving insufficient or poor-quality sleep, marked by one or more symptoms such as difficulty initiating or maintaining sleep, early morning awakening, or non-restorative sleep. Sleep plays a critical role in supporting mental functions and, consequently, overall performance. Inadequate sleep reduces general alertness, impairs attention, and slows cognitive processing.

Methods: A cross-sectional study was conducted among students enrolled at Indira Gandhi National Open University (IGNOU) in 2023. The Insomnia Severity Index (ISI) scale was employed to assess the prevalence of insomnia within this group. Data were collected via an online Google Form from November 2023 to June 2024.

Results: A total of 17,172 students responded to the study. The prevalence of insomnia was 42.9% (95% CI: 42.2%-43.6%). The prevalence of subthreshold insomnia, clinical insomnia of moderate severity, and clinical insomnia of severe severity were 30.6% (95% CI: 29.9%-31.3%), 10.2% (95% CI: 9.7%-10.6%), and 2.1% (95% CI: 1.9%-2.3%), respectively. More than half of the students, 57.1% (95% CI: 56.4%-57.8%), did not have insomnia. The prevalence of insomnia among female students was 44.8%, compared with 40.6% among male students, and the difference was statistically significant (P < 0.001). A significant difference (P < 0.001) was also found in the prevalence of insomnia between students living in rural areas (37.1%) and those living in urban areas (46.5%).

Conclusion: Approximately two out of every five students at IGNOU experience insomnia.