Indian Journal of Community Health
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Breaking the Cycle: A Case of Child Maltreatment in a Problem Family
No full textChild maltreatment is a masked evil with multiple social phenomena influencing it. One in four adults reported having faced any form of maltreatment during their childhood. VACS (Violence Against Children and Youth Survey) reported that 23-54 % of children disclose their incidents of maltreatment, and of them, 25 % seek any help. Social factors such as caregivers’ educational status, Socioeconomic status, past experiences, low social support, and addictions pile up to form a problem family that lags behind the standard norms of the community. Children in such problem families may face challenges in cognitive development, academics, mental health, and forming healthy peer relationships due to instability and trauma. This case describes the negligence of the family, community, and administrative side in dealing with a case of child maltreatment
Health Equity in the Era of Free Trade Agreements: A Scoping Review of Mechanisms, Evidence, and Policy Options
No full textBackground: Free trade agreements (FTAs) increasingly extend beyond tariffs to include intellectual property (IP), investment protections, regulatory cooperation, and standards for labour and the environment. These provisions can reshape social determinants of health and the distribution of health outcomes. This review synthesizes how FTAs influence health equity through identifiable mechanisms and appraises the strength and direction of the evidence.
Methods: We conducted a scoping review (PRISMA-ScR aligned) of peer-reviewed and credible grey literature in English from database inception to 31 December 2024 across PubMed/MEDLINE, PubMed Central, BioMed Central, and Google Scholar; we also screened key agency sites (WHO, UNITAID, APHA). We included studies assessing bilateral, regional, or “mega-regional” FTAs that reported health outcomes, equity-relevant determinants (e.g., access to medicines, nutrition environments, employment, environmental exposure), or distributional effects. Screening and extraction followed a predefined framework, with methodological appraisal appropriate to design. Synthesis was thematic, mapped to a priori pathways: (1) policy-space constraints (TRIPS-plus IP; investor–state dispute settlement, ISDS); (2) market and risk-environment shifts (food systems, alcohol/tobacco, product flows); and (3) income, employment, and environmental channels.
Results: Evidence linking FTAs to restricted medicine access via TRIPS-plus provisions and to deterrent effect on public health regulation under ISDS is consistent but context-dependent. Quasi-experimental studies associate specific agreements with higher calorie availability and diet shifts and with heterogeneous changes in NCD risk, while multi-country analyses suggest some health gains via employment and environmental improvements under deeper RTAs. Post-COVID scholarship foregrounds vaccine equity and trade/IP flexibilities as critical equity levers. Overall certainty varies by mechanism and design; distributional impacts are greatest where regulatory capacity is limited.
Conclusions: FTAs can both create opportunities and pose risks for health equity. Equity-concordant trade governance requires transparent negotiation, ex-ante health impact assessment, preservation of TRIPS flexibilities and public-health exceptions, narrowing or excluding ISDS, and targeted measures to mitigate distributional harms—especially in low-capacity settings. We highlight actionable options for negotiators, regulators, and public-health actors and specify priority evidence gaps
A Cross-Sectional Study Among Stroke Survivors of the Indian Himalayan Region Assessing Motor Function, Quality of Life, Depression, and Anxiety
No full textStroke impacts 16 million people annually worldwide, often resulting in lasting disabilities and psychological complications such as depression and anxiety, affecting the quality of life. This study assessed the motor function, depression, anxiety, and quality of life among stroke survivors in the Indian Himalayan region, with their sociodemographic profile. 164 stroke patients were examined at a tertiary teaching hospital. The sample was predominantly male (70%), with an average age of 50.61 years. Motor Assessment Scale scores indicated poor motor function (mean = 12.05), while Stroke-Specific Quality of Life Scale scores revealed low quality of life (mean = 91.71). On Beck Depression Inventory and Beck Anxiety Inventory, 36% of participants had severe depression while, 20.7% had moderate anxiety levels. As the study indicated a high prevalence of severe depression and anxiety, affecting also the motor functions and quality of life, addressing the psychological issues is critical for improving rehabilitation outcomes and overall well-being among stroke survivors
Machine Learning Models for the Development of a Probabilistic Screening Tool for Polycystic Ovary Syndrome
No full textBackground: Polycystic ovary syndrome (PCOS) is a common hormonal disorder in women of reproductive age that can lead to infertility and other long-term health problems. Early detection using simple, non-invasive tools is important to support timely intervention and improve outcomes. Objective: The study aimed to compare the performance of decision tree and naive Bayes models in predicting the likelihood of PCOS using non-invasive clinical features. Methodology: The study included 100 diagnosed cases of PCOS and 100 controls based on ultrasonographic findings. Clinical and lifestyle information was collected through a structured questionnaire. The models were evaluated using accuracy, precision, recall, F1 score, and area under the receiver operating characteristic curve. Five-fold cross-validation was used for validation. Results The decision tree model had high training accuracy but lower test accuracy, indicating overfitting. The naive Bayes model showed more consistent performance with 81 percent test accuracy and an F1 score of 0.81. Conclusion: The naive Bayes model shows promise as a simple, non-invasive screening tool for early identification of PCOS, particularly in primary care and low-resource settings
Redefining Assistive Technology: A Shift from Disability to Functional Impairments in Policy and Practice
No full textAchieving the Sustainable Development Goals (SDG) and ensuring inclusive universal health coverage (UHC) with the goal of “leaving no one behind” has sparked a global dialogue on Assistive Technology (AT) or Assistive Products (AP).(1) This conversation has driven innovation and transformed lives, yet the unmet needs for AT are significant globally. The WHO-UNICEF Global Report on Assistive Technology (GReAT) 2022 reported that in low- and middle-income countries (LIMCS), as low as 3% of the population needing AT has access to these life-changing tools.(2) Further, it is estimated that by 2050, two billion people will require AT, yet 90% of them, particularly in LMICs, will lack access.(3)
The International Organization for Standardization (ISO) has defined “assistive product as any product (including devices, equipment, instruments, and software), specially produced or generally available, used by or for persons with disability for participation; to protect, support, train, measure or substitute for body functions/structures and activities; or to prevent impairments, activity limitations or participation restrictions.(4) For ease of understanding, the authors use AT as the umbrella term in the rest of the article for Assistive technology or aids or products or services
Development of an Android-friendly E-video to raise awareness of E-waste management as part of the Swachch Bharat Mission in Pali District, Rajasthan
Full text linkBackground: Electronic/Electrical products, which are of no use anymore, are referred to as electronic waste. Electronic waste causes contamination of the environment with heavy metals during the process of informal dismantling. Initiatives such as Extended Producer Responsibility and Design for Environment, together with the 3Rs (Reduce, Reuse, and Recycle), were suggested by the Swachch Bharat Mission (SBM2.0). The purpose of this study was to evaluate urban dwellers\u27 knowledge and practices around e-waste and raise awareness through an e-video created by Phase III MBBS students. Objectives: 1. To estimate the knowledge, attitudes, and practices on E-waste management in PALI urban. 2. To increase awareness and assess satisfaction levels among the residents regarding prepared E video. Methods: 384 residents of the UHTC\u27s catchment region participated in an analytical cross-sectional study using the purposive sampling technique. They were interviewed using a semi-structured pre-validated questionnaire on e-waste-related knowledge and practice parameters and were shown a video on recommended disposal practices. Data was analyzed using Epi info 7.2 using appropriate tests of significance. Results: Among respondents, 95% had heard of E-waste from media. Domestic e-waste generated was kept at home (3.5%), given to the kabari wala/scrap collector (73%), exchanged at electronic shops (4.2%), or thrown in dustbins (3.5%). Some knew of companies willing to collect their e-waste (16%) but only 6% utilized that service and 4 % knew what was finally done with it. Younger ages <27 years and Higher levels of education were found to be statistically significant with respect to better knowledge and practices (p-value <0.05). The e-video increased knowledge of respondents by 68% and 83% were satisfied by its content. Conclusions: No streamlined system of disposal, collection, or dismantling of e-waste existed in the town and the video on recommended practices was well received. Increased awareness of E-Waste Tax Credits for Manufacturers, E-waste ATMs for encouraging recycling, and E-waste tracking and certification are feasible solutions
Facilitating acquisition of critical thinking skills using jigsaw instructional method
No full textFor a successful professional career as a medical practitioner, it is vital that students must be trained in critical thinking during their period of undergraduate training. Critical thinking enables students and healthcare professionals to analyze clinical features, comprehend patient history, and prescribe specific laboratory or radiological tests to reach a correct diagnosis. The employment of the jigsaw method in theory or clinical training plays a crucial role in the acquisition of critical thinking skills by medical students. In conclusion, the employment of the jigsaw method for teaching-learning as one of the pedagogical approaches in medical training is crucial in the development of critical thinking skills. It is the need of the hour that medical teachers understand its scope and significance and utilize this approach to develop and refine critical thinking among medical students and thereby empower them for their future clinical practice
Respiratory tract infection: Current pattern of pathogens involved and related antibiotic resistance observed at a tertiary health care institute of Rajasthan
Full text linkBackground: Antibiotic resistance is one of the contributing factors responsible for increased morbidity and mortality. Objectives: The study was designed to assess the current pattern of involved pathogens in respiratory tract infections with relevant antibiotic sensitivity and resistance to improve patient outcomes. Methodology: The study was conducted for 6 months and positive cultured sample reports of respiratory secretions in the form of sputum, tracheal secretion, bronchial aspirate, and pus were included in the study. Pathogens involved and antibiotic sensitivity, resistance were observed for respiratory secretion and pus separately. Results: A total 129 samples including 83 respiratory secretion samples and 46 pus samples cultures were found positive for organisms and included in the study. Among respiratory secretion cultures, Pseudomonas were most common organism (60%) followed by E. Coli, Klebsiella, Acinetobacter, Staphylococcus aureus, Citrobector, and Candida. Among pus cultures, Staphylococcus was the most common organism (23.90%) followed by E.Coli, Klebsiella, Pseudomonas, Citrobactor, Coagulase negative staphylococcus, Proteus. These pathogens were resistant to many first-line antibiotics. Conclusion: Antibiotic resistance to first-line antibiotics has emerged as alarming situation and contributes to morbidity and mortality. The current pattern of involved pathogen and antibiogram may help to decide appropriate empirical treatment
Mental Health among Health Care Providers due to Workplace Violence
No full textBackground: Undergraduate students, especially those in medical and engineering fields, face significant academic pressures coupled with other stressors which makes them susceptible to mental distress, including anxiety, depression, and sleep disturbances. Objective: To assess and compare mental distress among undergraduate medical and engineering students and factors affecting it. Materials and Methods: A comparative cross-sectional study was conducted among 300 students (150 each from medical and engineering colleges of Delhi, India. Data was collected using a structured online questionnaire, which included demographic details and the Kessler Psychological Distress Scale (K10) to assess mental distress. Results: We observed that 61.3% of participants were likely to have some sort of stress disorder, with higher prevalence in medical students (62.7%) than in engineering students (60%). Longer sleep latency was significantly associated with moderate to severe stress disorders (p < 0.001). Association of gender with mental distress was also found to be significant (p value= 0.022). Conclusions: Medical students were more prone to severe stress disorders compared to engineering students. Prolonged sleep latency was a strong predictor of psychological distress. Early intervention and mental health support are essential for improving student well-being
Study to assess psychological distress among undergraduate Medical and Engineering students of Delhi
No full textBackground: Undergraduate students, especially those in medical and engineering fields, face significant academic pressures coupled with other stressors which makes them susceptible to mental distress, including anxiety, depression, and sleep disturbances. Objective: To assess and compare mental distress among undergraduate medical and engineering students and factors affecting it. Materials and Methods: A comparative cross-sectional study was conducted among 300 students (150 each from medical and engineering colleges of Delhi, India. Data was collected using a structured online questionnaire, which included demographic details and the Kessler Psychological Distress Scale (K10) to assess mental distress. Results: We observed that 61.3% of participants were likely to have some sort of stress disorder, with higher prevalence in medical students (62.7%) than in engineering students (60%). Longer sleep latency was significantly associated with moderate to severe stress disorders (p < 0.001). Association of gender with mental distress was also found to be significant (p value= 0.022). Conclusions: Medical students were more prone to severe stress disorders compared to engineering students. Prolonged sleep latency was a strong predictor of psychological distress. Early intervention and mental health support are essential for improving student well-being