Indian Journal of Community Medicine最新文献

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: 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.

Children with developmental disabilities require medical care, rehabilitation therapies, and social welfare support. While district early intervention centers offer some services, the private sector remains unorganized. The study aimed to qualitatively assess caregivers' needs, identify gaps in referral linkages, and suggest health systems interventions to assure smooth transition from medical to rehabilitation services. In-depth interviews of 28 caregivers of children with cerebral palsy, intellectual disability and autism spectrum disorder were conducted. Interviews were analyzed from the perspective of health systems interventions, using content analysis. Study revealed three themes. The first theme related to inadequate information at diagnosis including insufficient information about complications among high-risk babies, and inadequate guidance when delayed milestones were observed. The second theme related to interaction with the doctor, highlighting perceived lack of knowledge among doctors about developmental disabilities, ineffective communication, and limited knowledge about rehabilitation services. The third theme was regarding challenges with rehabilitation such as caregivers' inadequate knowledge about therapies benefits and need for coordination between doctors and therapists. Findings indicate the need for strengthening knowledge about early childhood development, the benefits of early intervention, and strengthening referral pathways to assure coordination between available services and continuity of care.

Background: The global burden of malnutrition affects millions of children. Stunting, known as the chronic form of malnutrition, attacks the overall growth and development of the child. A child who is stunted is most likely to suffer from irreversible physical and mental damage. The study aims at formative research to identify and document various determinants of stunting in rural India.

Methods: The study was conducted in Kherol village of Sabarkantha district. Through an ethnographic approach, eight children (four stunted and four non-stunted) under the age of 2 years were enrolled in the study. For identifying the determinants of stunting, the children were observed for three consecutive days (approx. 12 hours a day) by researchers after obtaining consent from the parents. The observations were then analyzed based on the broad themes that emerged from the study.

Results: The observations were classified in to themes and analysis was conducted. The themes identified for analysis were feeding practices, food hygiene, animal exposure and sanitation and hygiene. Consumption of packet and junk food was found to be more among, stunted children. Families of children from non-stunted group maintained a better personal hygiene. Frequency of breastfeeding was found more among children of non-stunted group. Practice of handwashing after animal exposure was found poor among members of children who were stunted.

Conclusion: Improper feeding and poor hygiene and sanitation practices have a potential to jeopardize the nutritional status of young children and can be the mainspring for children to suffer from malnutrition and its lifelong consequences.

Background: Worldwide, there is a growing concern of Internet Gaming Disorder (IGD). IGD is an emerging problem in India, the top ranked country in gaming app downloads and the second largest Internet-using country in the world. Especially post pandemic, young adults spend longer hours on Internet and online gaming. This study was done to estimate the prevalence of IGD and to find out the association of IGD with sociodemographic and Internet gaming pattern characteristics.

Materials and methods: This cross-sectional study investigated the prevalence and predictors of IGD among 353 young adults aged 18-25 years in Tamil Nadu using an online self-reported questionnaire. Internet Gaming Disorder Questionnaire-Short Form (IGDQ-SF) assessing all nine DSM-5 criteria for IGD was used. Data were analyzed using the SPSS version 21. Categorical data are presented as frequency and proportions. Bivariate analysis and multiple logistic regression were done to identify the predictor variables of IGD. P value < 0.05 is considered statistically significant.

Results: Out of 353 young adult participants, 3.4% had IGD. Multiple logistic regression analysis revealed that age of starting gaming, money spent on Internet, buying and playing online games, amount of time spent online on weekends, and type of game played were strongly associated with IGD (P < 0.05).

Conclusion: Understanding the prevalence of IGD and its causes and associated factors remains limited, underscoring the need for additional research and the implementation of preventive measures.