Pub Date : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1188_23
Sri Varsha SenthilKumar, Gowthamkarthic Ravichandhiran, Soumya Agadi, Abhinandan R. Wali, Prashant Dhongadi
ABSTRACT According to the 2011 census in Tamil Nadu, out of a total population of 721.47 lakhs, 7.95 lakhs were scheduled tribes (STs), which constitutes about 1.1% of ST in Tamil Nadu and 0.8% of ST compared to the total ST population in India. A brief understanding of India’s caste system and its evolution over time was required to determine caste-based discrimination. Hence, they are vulnerable and isolated due to this untouchability in the caste system. This study focuses on the quality of life (QOL) and caste discrimination among the tribal population of Chengalpattu district. Further, it provides suggestions to improve the QOL and to put an end to discrimination. It is a community-based cross-sectional study, conducted among 300 participants among the tribal population in Chengalpattu district by a systematic random sampling technique. The QOL scores were further converted into categorical variables by obtaining the mean score and dividing the group into those who got a score above the mean and those below the mean. They were labeled as good and poor QOL. More than half of them (52.7%) had poor QOL. Almost two-third of the workers had poor QOL in the social relationship (60.7%) and psychological (64%) domains, and nearly half in the physical (52.7%) and environmental (52.7%) domains. Out of 300 participants included in the analyses, 141 (47%) participants reported experiencing discrimination a few times a year/a few times a month. This study found that the tribal population in Chengalpattu district has poor social and psychological QOL compared to QOL in the environmental and physical domains. In spite of many government initiatives, a wide range of issues and problems are being faced by the tribals in India. Hence, we recommend strategies to improve the physical, social, and psychological well-being of this vulnerable population through strict legislation. The other component regarding discrimination concluded that caste but not socio-economic class is closely linked with perceived discrimination among the tribal population in Chengalpattu district and their responses to unfair treatment.
摘要 根据 2011 年泰米尔纳德邦人口普查，在 72147 万总人口中，795 万人为在册部落（ST），约占泰米尔纳德邦在册部落的 1.1%，占印度在册部落总人口的 0.8%。要确定基于种姓的歧视，需要简要了解印度的种姓制度及其随时间的演变。因此，由于种姓制度中的贱民制度，他们处于弱势和孤立的地位。本研究主要关注 Chengalpattu 地区部落人口的生活质量（QOL）和种姓歧视问题。此外，研究还提出了改善生活质量和消除歧视的建议。 这是一项以社区为基础的横断面研究，通过系统随机抽样技术在 Chengalpattu 地区的 300 名部落人口中进行。 通过获得平均分，将 QOL 分数进一步转换为分类变量，并将该群体分为得分高于平均分和低于平均分的群体。他们被标记为 QOL 好和 QOL 差。超过一半的工人（52.7%）的 QOL 较差。近三分之二的工人在社会关系（60.7%）和心理（64%）方面的 QOL 较差，近一半的工人在身体（52.7%）和环境（52.7%）方面的 QOL 较差。在纳入分析的 300 名参与者中，有 141 人（47%）表示每年或每月遭受过几次歧视。 这项研究发现，与环境和生理领域的 QOL 相比，Chengalpattu 地区部落人口的社会和心理 QOL 较差。尽管政府采取了许多措施，但印度部落仍面临着各种各样的问题。因此，我们建议通过严格的立法来改善这一弱势群体的身体、社会和心理健康。另一项关于歧视的研究得出结论，在 Chengalpattu 地区的部落人口中，种姓（而非社会经济阶层）与他们所感受到的歧视及其对不公平待遇的反应密切相关。
{"title":"Quality of life and caste discrimination among the tribal population, Chengalpattu, Tamil Nadu, India: A community-based cross-sectional study","authors":"Sri Varsha SenthilKumar, Gowthamkarthic Ravichandhiran, Soumya Agadi, Abhinandan R. Wali, Prashant Dhongadi","doi":"10.4103/jfmpc.jfmpc_1188_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1188_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 According to the 2011 census in Tamil Nadu, out of a total population of 721.47 lakhs, 7.95 lakhs were scheduled tribes (STs), which constitutes about 1.1% of ST in Tamil Nadu and 0.8% of ST compared to the total ST population in India. A brief understanding of India’s caste system and its evolution over time was required to determine caste-based discrimination. Hence, they are vulnerable and isolated due to this untouchability in the caste system. This study focuses on the quality of life (QOL) and caste discrimination among the tribal population of Chengalpattu district. Further, it provides suggestions to improve the QOL and to put an end to discrimination.\u0000 \u0000 \u0000 \u0000 It is a community-based cross-sectional study, conducted among 300 participants among the tribal population in Chengalpattu district by a systematic random sampling technique.\u0000 \u0000 \u0000 \u0000 The QOL scores were further converted into categorical variables by obtaining the mean score and dividing the group into those who got a score above the mean and those below the mean. They were labeled as good and poor QOL. More than half of them (52.7%) had poor QOL. Almost two-third of the workers had poor QOL in the social relationship (60.7%) and psychological (64%) domains, and nearly half in the physical (52.7%) and environmental (52.7%) domains. Out of 300 participants included in the analyses, 141 (47%) participants reported experiencing discrimination a few times a year/a few times a month.\u0000 \u0000 \u0000 \u0000 This study found that the tribal population in Chengalpattu district has poor social and psychological QOL compared to QOL in the environmental and physical domains. In spite of many government initiatives, a wide range of issues and problems are being faced by the tribals in India. Hence, we recommend strategies to improve the physical, social, and psychological well-being of this vulnerable population through strict legislation. The other component regarding discrimination concluded that caste but not socio-economic class is closely linked with perceived discrimination among the tribal population in Chengalpattu district and their responses to unfair treatment.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140761785","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 : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1524_23
Alisha Handa, A. Gaidhane, Sonali G. Choudhari
{"title":"Nurturing child growth and development through maternal agency","authors":"Alisha Handa, A. Gaidhane, Sonali G. Choudhari","doi":"10.4103/jfmpc.jfmpc_1524_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1524_23","url":null,"abstract":"","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783591","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 : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1259_23
Rakhi Kusumesh, Vivek K. Singh, Shivani Sinha, M. S. Ali, Sarita K. Mishra, A. Ambasta, Ved Prakash, Pravek Sinha, B. Sinha, R. N. Priyadarshi
ABSTRACT To analyze the potential predisposing factors and clinical presentation of mucormycosis in patients with COVID-19. Medical records of 141 patients with COVID-19-associated mucormycosis (CAM) treated at a tertiary care center in Bihar were reviewed. The predisposing factors, clinical features, and imaging findings of mucormycosis were analyzed. The median age was 48 years (IQR, 43-60). A total of 58 patients developed concurrent CAM and 83 post-CAM. The median interval between COVID-19 and onset of CAM symptoms was 15 days (IQR, 9–16). A total of 80 patients received at-home treatment for COVID-19, and 73 had mild-to-moderate disease. While 61 patients received in-hospital treatment, 57 had severe disease. At presentation, 131 patients had hyperglycemia: 64 type 2 diabetes mellitus (DM) and 67 new-onset DM. The history of glucocorticoid use for COVID-19 was present in 125 patients; 47% were administered at home without monitoring plasma glucose. The common presenting features were toothache, periocular or facial pain, and edema. Rhino-orbital mucormycosis was the most common. Imaging revealed rhinosinusitis in all patients, including pansinusitis (68%), pterygopalatine fossa involvement (21%), cavernous sinus thrombosis (38%), brain abscess (8%), and infarct (4%). All patients received intravenous liposomal amphotericin B, and surgical debridement was performed in 113. COVID-19 patients with hyperglycemia are at risk of developing CAM, irrespective of the severity. Timely recognition of symptoms and prompt initiation of therapy by primary healthcare physicians are imperative for enhancing outcomes. Additionally, glucocorticoid overuse should be avoided, and close monitoring for hyperglycemia development is warranted.
{"title":"Risk factors and clinical presentation of rhino-orbital mucormycosis: Lesson learnt during Covid pandemic","authors":"Rakhi Kusumesh, Vivek K. Singh, Shivani Sinha, M. S. Ali, Sarita K. Mishra, A. Ambasta, Ved Prakash, Pravek Sinha, B. Sinha, R. N. Priyadarshi","doi":"10.4103/jfmpc.jfmpc_1259_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1259_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 To analyze the potential predisposing factors and clinical presentation of mucormycosis in patients with COVID-19.\u0000 \u0000 \u0000 \u0000 Medical records of 141 patients with COVID-19-associated mucormycosis (CAM) treated at a tertiary care center in Bihar were reviewed. The predisposing factors, clinical features, and imaging findings of mucormycosis were analyzed.\u0000 \u0000 \u0000 \u0000 The median age was 48 years (IQR, 43-60). A total of 58 patients developed concurrent CAM and 83 post-CAM. The median interval between COVID-19 and onset of CAM symptoms was 15 days (IQR, 9–16). A total of 80 patients received at-home treatment for COVID-19, and 73 had mild-to-moderate disease. While 61 patients received in-hospital treatment, 57 had severe disease. At presentation, 131 patients had hyperglycemia: 64 type 2 diabetes mellitus (DM) and 67 new-onset DM. The history of glucocorticoid use for COVID-19 was present in 125 patients; 47% were administered at home without monitoring plasma glucose. The common presenting features were toothache, periocular or facial pain, and edema. Rhino-orbital mucormycosis was the most common. Imaging revealed rhinosinusitis in all patients, including pansinusitis (68%), pterygopalatine fossa involvement (21%), cavernous sinus thrombosis (38%), brain abscess (8%), and infarct (4%). All patients received intravenous liposomal amphotericin B, and surgical debridement was performed in 113.\u0000 \u0000 \u0000 \u0000 COVID-19 patients with hyperglycemia are at risk of developing CAM, irrespective of the severity. Timely recognition of symptoms and prompt initiation of therapy by primary healthcare physicians are imperative for enhancing outcomes. Additionally, glucocorticoid overuse should be avoided, and close monitoring for hyperglycemia development is warranted.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792202","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 : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_534_23
V. K. Sobhith, M. D. Solomon
ABSTRACT The human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic remains a major healthcare problem for the humanity. It is important to understand the level of stress among people living with HIV/AIDS (PLHA), which may have an influence on their living. The main aim of the study is to assess the perceived stress and the factors influencing. Descriptive study. The details of a total of 750 PLHAs registered in the district were collected, and the researcher selected 210 samples using the simple random sampling method. The researcher used the standardised Perceived Stress Scale developed by Sheldon Cohen in 1983. The data analysis was done using descriptive statistics and tests. While analysing the perceived stress of the respondents, more than half 61% of the respondents have reported a moderate level of perceived stress. The study also depicts that perceived stress is being influenced by gender, marital status, occupation, number of dependents, and monthly income of PLHA. PLHAs in the selected geographic area experience a significant level of perceived stress, which indicates the need for programmes to address it.
{"title":"Perceived stress and its influencing factors among persons living with HIV/AIDS (PLHA) in Kannur district, Kerala, India","authors":"V. K. Sobhith, M. D. Solomon","doi":"10.4103/jfmpc.jfmpc_534_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_534_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 The human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic remains a major healthcare problem for the humanity. It is important to understand the level of stress among people living with HIV/AIDS (PLHA), which may have an influence on their living.\u0000 \u0000 \u0000 \u0000 The main aim of the study is to assess the perceived stress and the factors influencing.\u0000 \u0000 \u0000 \u0000 Descriptive study. The details of a total of 750 PLHAs registered in the district were collected, and the researcher selected 210 samples using the simple random sampling method.\u0000 \u0000 \u0000 \u0000 The researcher used the standardised Perceived Stress Scale developed by Sheldon Cohen in 1983.\u0000 \u0000 \u0000 \u0000 The data analysis was done using descriptive statistics and tests.\u0000 \u0000 \u0000 \u0000 While analysing the perceived stress of the respondents, more than half 61% of the respondents have reported a moderate level of perceived stress. The study also depicts that perceived stress is being influenced by gender, marital status, occupation, number of dependents, and monthly income of PLHA.\u0000 \u0000 \u0000 \u0000 PLHAs in the selected geographic area experience a significant level of perceived stress, which indicates the need for programmes to address it.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783605","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 SARS-COV virus operates as a significant risk factor for invasive fungal aspergillosis and mucormycosis. Successful management of this fulminant infection requires early recognition of the disease and aggressive medical or surgical interventions to prevent the high morbidity and mortality associated with the disease process. 1. To isolate and identify different species of fungi among acute rhinosinusitis patients. 2. To assess the association of risk factors causing fungal rhinosinusitis. 3. To assess the changing trend in fungal rhinosinusitis during the COVID era. This is a retrospective observational study conducted from May 2020 to October 2022, attending the ENT department and relevant data were collected from the medical records department of ABVIMS and Dr RML Hospital, New Delhi, a Tertiary Care Referral Centre in India. The major risk factors studied were age, gender, COVID-19 infection and underlying diseases (such as diabetes mellitus, ischaemic heart disease, hypertension, malignancies, chronic kidney DISEASES, etc.); details of corticosteroid use of all patients were recorded in the datasheet. The pandemic data was divided into three distinct time periods/waves/eras, i.e., first, second, and third waves, each of which included ten months, to examine the changing trend in fungal rhinosinusitis in the pandemic era of COVID-19. A total of 412 patients out of which 236 patients were clinically diagnosed with fungal sinusitis based on revised EORTC criteria. The most common site involved was the orbit with paranasal sinus and eye 86/236 (36.4%), followed by involvement of nasal and paranasal sinus alone 68/236 (28.8%). The most prevalent age range affected was 40 to 50 years. The most commonly associated comorbidity was diabetes mellitus (DM) in 176 (74.5%), followed by head and neck malignancies in 22 (9.32%) patients. Thirty-eight (50.6%) Rhizopus species and 18 (24%) Aspergillus flavus were the most common isolated fungal species on culture, followed by Mucor spp. 14 (18.6%) and Aspergillus fumigatus 5 (6.6%) in the period. In the second wave of COVID, there was a surge in Zygomycetes cases 36 (45%) and after the second wave, the Aspergillus cases increased by 14 (19%) during Jan-Oct 2022. With the continuing coronavirus pandemic, there is an unprecedented and discernible rise in the prevalence of acute invasive fungal sinusitis certainly a spike in cases of Aspergillus infection was observed, probably due to unprecedented usage of Amphotericin B for the treatment of mucormycosis during the third wave This underlines the importance of the need to tailor our treatment protocol as per the etiological agents hence the right antifungal drugs combined with urgent surgical procedures on a case-to-case basis may certainly increase the chances of survival.
{"title":"The changing trend of fungal infection in invasive rhinosinusitis in the COVID era","authors":"Parul Garg, Vikash Ranjan, Avnisha, Sneha Hembrom, Sachin Goel, Shalini Malhotra","doi":"10.4103/jfmpc.jfmpc_871_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_871_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 SARS-COV virus operates as a significant risk factor for invasive fungal aspergillosis and mucormycosis. Successful management of this fulminant infection requires early recognition of the disease and aggressive medical or surgical interventions to prevent the high morbidity and mortality associated with the disease process.\u0000 \u0000 \u0000 \u0000 1. To isolate and identify different species of fungi among acute rhinosinusitis patients. 2. To assess the association of risk factors causing fungal rhinosinusitis. 3. To assess the changing trend in fungal rhinosinusitis during the COVID era.\u0000 \u0000 \u0000 \u0000 This is a retrospective observational study conducted from May 2020 to October 2022, attending the ENT department and relevant data were collected from the medical records department of ABVIMS and Dr RML Hospital, New Delhi, a Tertiary Care Referral Centre in India. The major risk factors studied were age, gender, COVID-19 infection and underlying diseases (such as diabetes mellitus, ischaemic heart disease, hypertension, malignancies, chronic kidney DISEASES, etc.); details of corticosteroid use of all patients were recorded in the datasheet. The pandemic data was divided into three distinct time periods/waves/eras, i.e., first, second, and third waves, each of which included ten months, to examine the changing trend in fungal rhinosinusitis in the pandemic era of COVID-19.\u0000 \u0000 \u0000 \u0000 A total of 412 patients out of which 236 patients were clinically diagnosed with fungal sinusitis based on revised EORTC criteria. The most common site involved was the orbit with paranasal sinus and eye 86/236 (36.4%), followed by involvement of nasal and paranasal sinus alone 68/236 (28.8%). The most prevalent age range affected was 40 to 50 years. The most commonly associated comorbidity was diabetes mellitus (DM) in 176 (74.5%), followed by head and neck malignancies in 22 (9.32%) patients. Thirty-eight (50.6%) Rhizopus species and 18 (24%) Aspergillus flavus were the most common isolated fungal species on culture, followed by Mucor spp. 14 (18.6%) and Aspergillus fumigatus 5 (6.6%) in the period. In the second wave of COVID, there was a surge in Zygomycetes cases 36 (45%) and after the second wave, the Aspergillus cases increased by 14 (19%) during Jan-Oct 2022.\u0000 \u0000 \u0000 \u0000 With the continuing coronavirus pandemic, there is an unprecedented and discernible rise in the prevalence of acute invasive fungal sinusitis certainly a spike in cases of Aspergillus infection was observed, probably due to unprecedented usage of Amphotericin B for the treatment of mucormycosis during the third wave This underlines the importance of the need to tailor our treatment protocol as per the etiological agents hence the right antifungal drugs combined with urgent surgical procedures on a case-to-case basis may certainly increase the chances of survival.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140766287","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 : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1374_23
Jovita Leon, Sonali Sarkar, Debdatta Basu, Nivedita Nanda, N. M. Joseph
ABSTRACT Tuberculosis (TB) disrupts iron balance through systemic inflammation. Pulmonary tuberculosis (PTB) is linked to diverse anaemia types, necessitating intricate haematological and biochemical assessments for diagnosis. This study aims to describe the prevalence of anaemia of chronic disease (ACD), iron deficiency anaemia (IDA) among PTB patients and factors associated with these types of anaemia. A cross-sectional analysis was conducted from community-based cohort study involving sputum-positive PTB patients from 2018 to 2020 in urban Puducherry. Participants were enrolled from 10 primary health centres within 2 weeks of initiating anti-tubercular treatment (ATT). Blood samples were collected for assessing haematological and biochemical parameters. The sTfR/log ferritin ratio was used to distinguish between ACD and IDA. Data were captured using Epicollect5 and analysed using STATA V14. Of the 176 PTB patients included, 63.07% (111/176) had anaemia, with ACD being the predominant type (84.6%, 94/111). The C-reactive protein (CRP) levels were higher among the anaemic group [40.77 (16.66-58.51) mg/dl vs 24.65 (14.23-47.26) mg/dl] and higher among the ACD as compared to IDA [46.9 (22.3-61.2) vs 20.8 (13.0-39.1) mg/dl]. Undernourished [adjusted prevalence ratio (APR) =3.43; confidence interval (CI): 1.21-9.69] and patients having low risk of dependence on tobacco [APR = 1.52; CI: 1.10-2.11] had higher risk of ACD. Female patients had higher risk of IDA [APR = 4.95, P < 0.01]. The largest proportion of the PTB participants with anaemia had ACD. Acute-phase reactant and inflammatory marker are increased among newly diagnosed new sputum smear-positive (NSP) PTB participants at the start of ATT. Addressing inflammation is needed for combating anaemia in PTB patients.
摘要 结核病（TB）通过全身炎症破坏铁平衡。肺结核（PTB）与多种贫血类型有关，因此需要进行复杂的血液学和生化评估以进行诊断。本研究旨在描述肺结核患者中慢性病贫血（ACD）和缺铁性贫血（IDA）的发病率以及与这些类型贫血相关的因素。 该研究对 2018 年至 2020 年期间普杜切里市痰液阳性 PTB 患者的社区队列研究进行了横断面分析。参与者是在开始接受抗结核治疗（ATT）后两周内从 10 个初级保健中心招募的。采集的血样用于评估血液学和生化参数。sTfR/log 铁蛋白比值用于区分 ACD 和 IDA。数据使用 Epicollect5 采集，并使用 STATA V14 进行分析。 在纳入的 176 名 PTB 患者中，63.07%（111/176）患有贫血，其中以 ACD 型贫血为主（84.6%，94/111）。贫血组的 C 反应蛋白（CRP）水平较高 [40.77 (16.66-58.51) mg/dl vs 24.65 (14.23-47.26) mg/dl]，ACD 组的 C 反应蛋白水平高于 IDA 组 [46.9 (22.3-61.2) vs 20.8 (13.0-39.1) mg/dl]。营养不良[调整患病率比（APR）=3.43；置信区间（CI）：1.21-9.69]和烟草依赖风险低的患者[APR=1.52；CI：1.10-2.11]患 ACD 的风险更高。女性患者的 IDA 风险较高 [APR = 4.95，P < 0.01]。 在患有贫血症的 PTB 参与者中，ACD 所占比例最大。在 ATT 开始时，新诊断的痰涂片阳性 PTB 患者的急性期反应物和炎症标记物会增加。要防治 PTB 患者的贫血，就必须解决炎症问题。
{"title":"Anaemia of chronic disease among pulmonary tuberculosis patients is associated with inflammatory marker at the start of intensive phase","authors":"Jovita Leon, Sonali Sarkar, Debdatta Basu, Nivedita Nanda, N. M. Joseph","doi":"10.4103/jfmpc.jfmpc_1374_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1374_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Tuberculosis (TB) disrupts iron balance through systemic inflammation. Pulmonary tuberculosis (PTB) is linked to diverse anaemia types, necessitating intricate haematological and biochemical assessments for diagnosis. This study aims to describe the prevalence of anaemia of chronic disease (ACD), iron deficiency anaemia (IDA) among PTB patients and factors associated with these types of anaemia.\u0000 \u0000 \u0000 \u0000 A cross-sectional analysis was conducted from community-based cohort study involving sputum-positive PTB patients from 2018 to 2020 in urban Puducherry. Participants were enrolled from 10 primary health centres within 2 weeks of initiating anti-tubercular treatment (ATT). Blood samples were collected for assessing haematological and biochemical parameters. The sTfR/log ferritin ratio was used to distinguish between ACD and IDA. Data were captured using Epicollect5 and analysed using STATA V14.\u0000 \u0000 \u0000 \u0000 Of the 176 PTB patients included, 63.07% (111/176) had anaemia, with ACD being the predominant type (84.6%, 94/111). The C-reactive protein (CRP) levels were higher among the anaemic group [40.77 (16.66-58.51) mg/dl vs 24.65 (14.23-47.26) mg/dl] and higher among the ACD as compared to IDA [46.9 (22.3-61.2) vs 20.8 (13.0-39.1) mg/dl]. Undernourished [adjusted prevalence ratio (APR) =3.43; confidence interval (CI): 1.21-9.69] and patients having low risk of dependence on tobacco [APR = 1.52; CI: 1.10-2.11] had higher risk of ACD. Female patients had higher risk of IDA [APR = 4.95, P < 0.01].\u0000 \u0000 \u0000 \u0000 The largest proportion of the PTB participants with anaemia had ACD. Acute-phase reactant and inflammatory marker are increased among newly diagnosed new sputum smear-positive (NSP) PTB participants at the start of ATT. Addressing inflammation is needed for combating anaemia in PTB patients.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783714","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 : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1610_23
ShivKumar Mudgal, Vipin Patidar, Sanjay Kumar, Suman Kumar, Rakhi Gaur, R. Agarwal, S. R. Varikasuvu, Pratima Gupta, Saurabh Varshney
ABSTRACT Sleep disruption and reduced quality of life are common long coronavirus disease (COVID) manifestations, affecting survivors irrespective of initial COVID-19 severity. Limited research investigates symptoms beyond 24 months post-infection. We aimed to address this gap by longitudinally studying sleep patterns and overall quality of life in non-hospitalized adults, 24 months after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This prospective observational study involved the enrolment of 337 adult non-hospitalized patients in a consecutive fashion. Individuals with past COVID-19 (from 15 April 2020 to 30 June 2021) were examined at two Government hospitals and completed a telephone interview between 1 May 2023 and 30 June 2023, located in Jharkhand, India. Participants were queried about their sleep patterns and quality of life, utilizing the DSM5 LEVEL 2 and EQ-ED-5L tool, respectively. Among 337 non-hospitalized participants, 212 completed the survey. Within this group (59.4% men, mean age 38), 36 (17.0%) experienced sleep impairment. All five dimensions of quality of life (QoL) were adversely affected in long COVID patients. Advanced age, high income, residing in rural or semi-urban areas, and having comorbidities were associated with a higher likelihood of decreased quality of life across various domains. Conversely, participants who were married, employed in healthcare or government positions, and vaccinated exhibited a reduced likelihood of experiencing lower quality of life. Long COVID-19 affects sleep and quality of life, with various demographic and clinical factors influencing outcomes. This study provides insights into the extended consequences of long COVID-19 and aids healthcare systems in addressing the challenges posed by this condition.
{"title":"Long-COVID-19 Impact in non-hospitalized patients: Sleep and quality of life 24 months after SARS-CoV-2 infection","authors":"ShivKumar Mudgal, Vipin Patidar, Sanjay Kumar, Suman Kumar, Rakhi Gaur, R. Agarwal, S. R. Varikasuvu, Pratima Gupta, Saurabh Varshney","doi":"10.4103/jfmpc.jfmpc_1610_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1610_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Sleep disruption and reduced quality of life are common long coronavirus disease (COVID) manifestations, affecting survivors irrespective of initial COVID-19 severity. Limited research investigates symptoms beyond 24 months post-infection. We aimed to address this gap by longitudinally studying sleep patterns and overall quality of life in non-hospitalized adults, 24 months after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection.\u0000 \u0000 \u0000 \u0000 This prospective observational study involved the enrolment of 337 adult non-hospitalized patients in a consecutive fashion. Individuals with past COVID-19 (from 15 April 2020 to 30 June 2021) were examined at two Government hospitals and completed a telephone interview between 1 May 2023 and 30 June 2023, located in Jharkhand, India. Participants were queried about their sleep patterns and quality of life, utilizing the DSM5 LEVEL 2 and EQ-ED-5L tool, respectively.\u0000 \u0000 \u0000 \u0000 Among 337 non-hospitalized participants, 212 completed the survey. Within this group (59.4% men, mean age 38), 36 (17.0%) experienced sleep impairment. All five dimensions of quality of life (QoL) were adversely affected in long COVID patients. Advanced age, high income, residing in rural or semi-urban areas, and having comorbidities were associated with a higher likelihood of decreased quality of life across various domains. Conversely, participants who were married, employed in healthcare or government positions, and vaccinated exhibited a reduced likelihood of experiencing lower quality of life.\u0000 \u0000 \u0000 \u0000 Long COVID-19 affects sleep and quality of life, with various demographic and clinical factors influencing outcomes. This study provides insights into the extended consequences of long COVID-19 and aids healthcare systems in addressing the challenges posed by this condition.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140781429","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 : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1349_23
S. Pallerla, Shanivaram Reddy Krishnareddy, Nirmala Berigai Parthasarathy, J. Navaneetham, Anupam Gupta
ABSTRACT Spinal cord injury is a high-cost long-lasting disability and a life-changing experience for family caregivers (FCGs). The current study aimed to explore the psycho-social needs of the FCGs of persons with spinal cord injury (PwSCI). An exploratory qualitative approach was used, and sixteen FCGs of PwSCI participated in the face-to-face interviews. All the interviews were audio-recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify the main themes. Three main themes have emerged, namely, awareness needs, resource needs, and personal care needs, from the data as a result of the qualitative analysis: The main themes have been categorised into nine sub-themes, such as want to know, alternative ways of contacting, the helpful or conducive environment of arrangements, sources to get money, pension certificate needs, resources for livelihood, resources for continuing the treatment, need my own time, and controlling of feelings. The findings of this research aid in designing or developing need-based tailor-made psychosocial interventions for the FCGs of PwSCI in India. Multidisciplinary team professionals involved in managing spinal cord injury and other stakeholders should understand the importance of meeting the mentioned psycho-social needs of FCGs of PwSCI and delivering such tailor-made psycho-social interventions in a timely.
{"title":"A qualitative study on psycho-social needs of the family caregivers of persons with spinal cord injury","authors":"S. Pallerla, Shanivaram Reddy Krishnareddy, Nirmala Berigai Parthasarathy, J. Navaneetham, Anupam Gupta","doi":"10.4103/jfmpc.jfmpc_1349_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1349_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Spinal cord injury is a high-cost long-lasting disability and a life-changing experience for family caregivers (FCGs). The current study aimed to explore the psycho-social needs of the FCGs of persons with spinal cord injury (PwSCI).\u0000 \u0000 \u0000 \u0000 An exploratory qualitative approach was used, and sixteen FCGs of PwSCI participated in the face-to-face interviews. All the interviews were audio-recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify the main themes.\u0000 \u0000 \u0000 \u0000 Three main themes have emerged, namely, awareness needs, resource needs, and personal care needs, from the data as a result of the qualitative analysis: The main themes have been categorised into nine sub-themes, such as want to know, alternative ways of contacting, the helpful or conducive environment of arrangements, sources to get money, pension certificate needs, resources for livelihood, resources for continuing the treatment, need my own time, and controlling of feelings.\u0000 \u0000 \u0000 \u0000 The findings of this research aid in designing or developing need-based tailor-made psychosocial interventions for the FCGs of PwSCI in India. Multidisciplinary team professionals involved in managing spinal cord injury and other stakeholders should understand the importance of meeting the mentioned psycho-social needs of FCGs of PwSCI and delivering such tailor-made psycho-social interventions in a timely.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140778503","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 : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_1789_23
Marium Ahmed, Rabeeya Saeed, L. Kamani, Noureen Durrani, Faraz Ahmed
ABSTRACT Non-alcoholic fatty liver disease (NAFLD) is an escalating global health issue. Early detection and precise diagnosis are imperative for effective management. To evaluate the sociodemographic and clinical attributes of study participants concerning their ultrasound grading with FibroScan and FLI values. A cross-sectional study was carried out among patients visiting gastroenterology clinics at a tertiary care hospital situated in Karachi, Pakistan. We included participants after written informed consent underwent an extensive array of laboratory assessments, encompassing liver function tests, lipid profile, fasting blood sugar analysis, hepatitis B and C screening, and abdominal ultrasound, while those with positive hepatitis B or C markers, documented alcohol use, or those who declined to offer informed consent were excluded from the study. Data were analyzed using SPSS version 26. Around 225 patients were studied with a median age of 42 years (IQR = 34–50 years). Metabolic syndrome (MetS) was present in 61.8%. Steatosis was not found among 4.9% of patients, whereas severe steatosis was seen among 51.1% of patients. Significant variations in BMI, WC, GGT, and TG levels were identified when comparing FLI scores. The same was observed for the frequency of MetS as FLI scores increased. The agreement between FLI and ultrasound observations was found to be slight (k = 0.077, P = 0.027). On the multivariable regression model, having diabetes, elevated serum glutamate pyruvate transaminase levels and mild disease on ultrasound were associated with increased odds of severe steatosis. FLI is a good predictor of frequency of MetS and NAFLD and correlates well with increasing steatosis score (CAP) on FibroScan which can be utilized for early detection of NAFLD in primary care.
{"title":"Comparison of fatty liver index with fibroscan in non-alcoholic fatty liver disease","authors":"Marium Ahmed, Rabeeya Saeed, L. Kamani, Noureen Durrani, Faraz Ahmed","doi":"10.4103/jfmpc.jfmpc_1789_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1789_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Non-alcoholic fatty liver disease (NAFLD) is an escalating global health issue. Early detection and precise diagnosis are imperative for effective management.\u0000 \u0000 \u0000 \u0000 To evaluate the sociodemographic and clinical attributes of study participants concerning their ultrasound grading with FibroScan and FLI values.\u0000 \u0000 \u0000 \u0000 A cross-sectional study was carried out among patients visiting gastroenterology clinics at a tertiary care hospital situated in Karachi, Pakistan.\u0000 \u0000 \u0000 \u0000 We included participants after written informed consent underwent an extensive array of laboratory assessments, encompassing liver function tests, lipid profile, fasting blood sugar analysis, hepatitis B and C screening, and abdominal ultrasound, while those with positive hepatitis B or C markers, documented alcohol use, or those who declined to offer informed consent were excluded from the study.\u0000 \u0000 \u0000 \u0000 Data were analyzed using SPSS version 26.\u0000 \u0000 \u0000 \u0000 Around 225 patients were studied with a median age of 42 years (IQR = 34–50 years). Metabolic syndrome (MetS) was present in 61.8%. Steatosis was not found among 4.9% of patients, whereas severe steatosis was seen among 51.1% of patients. Significant variations in BMI, WC, GGT, and TG levels were identified when comparing FLI scores. The same was observed for the frequency of MetS as FLI scores increased. The agreement between FLI and ultrasound observations was found to be slight (k = 0.077, P = 0.027). On the multivariable regression model, having diabetes, elevated serum glutamate pyruvate transaminase levels and mild disease on ultrasound were associated with increased odds of severe steatosis.\u0000 \u0000 \u0000 \u0000 FLI is a good predictor of frequency of MetS and NAFLD and correlates well with increasing steatosis score (CAP) on FibroScan which can be utilized for early detection of NAFLD in primary care.\u0000","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786709","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 : 2024-04-01DOI: 10.4103/jfmpc.jfmpc_886_23
Colis Anwari, Nila Raghavan, B. Rao, Ramakrishna Prasad
ABSTRACT Chronic subdural hematoma (CSDH) is a great mimicker. It should be considered in anyone presenting with chronic headaches that show postural variation. Parkinsonism following CSDH, while known, is only rarely reported in the literature. Hyponatremia, rapid correction of hyponatremia, medications, and mechanical pressure are thought to be risk factors. Here, we report a case of a 61-year-old male diagnosed with bilateral CSDH managed by craniotomy and clot evacuation who developed parkinsonism. We share several learnings (clinical pearls) that emerged from the close collaboration and co-learning curve between a family physician and physiotherapist involved in home-based rehabilitation. In conclusion, while managing the postoperative course of patients with CSDH, clinicians should maintain a high index of suspicion for parkinsonism. Early recognition and appropriate management with syndopa with supportive physiotherapy results in significant improvement of function and quality of life. Notably, parkinsonism following SDH is transient and nonprogressive and may not require lifelong therapy.
{"title":"Parkinsonism following bilateral chronic subdural hematoma that presented as orthostatic headache: Highlighting clinical pearls for family physicians and physiotherapists","authors":"Colis Anwari, Nila Raghavan, B. Rao, Ramakrishna Prasad","doi":"10.4103/jfmpc.jfmpc_886_23","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_886_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 Chronic subdural hematoma (CSDH) is a great mimicker. It should be considered in anyone presenting with chronic headaches that show postural variation. Parkinsonism following CSDH, while known, is only rarely reported in the literature. Hyponatremia, rapid correction of hyponatremia, medications, and mechanical pressure are thought to be risk factors. Here, we report a case of a 61-year-old male diagnosed with bilateral CSDH managed by craniotomy and clot evacuation who developed parkinsonism. We share several learnings (clinical pearls) that emerged from the close collaboration and co-learning curve between a family physician and physiotherapist involved in home-based rehabilitation. In conclusion, while managing the postoperative course of patients with CSDH, clinicians should maintain a high index of suspicion for parkinsonism. Early recognition and appropriate management with syndopa with supportive physiotherapy results in significant improvement of function and quality of life. Notably, parkinsonism following SDH is transient and nonprogressive and may not require lifelong therapy.","PeriodicalId":509702,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793234","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}
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