Indian Journal of Community Health
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Integration of Non Alcoholic Fatty Liver Diseases (NAFLD) into NPCDCS programme: A recent initiative in India
Get PDFNon-alcoholic fatty liver disease (NAFLD) is an emerging public health problem globally. NAFLD is one of the most common liver diseases worldwide and is the most common cause of abnormal liver enzymes in many developed countries. NAFLD is estimated to afflict approximately 1 billion individuals worldwide. An estimated 20-30 % of general population is afflicted from it globally. In India NAFLD could be a silent epidemic with its prevalence ranging from 9-32%. Studies have shown, strong association of NAFLD with major Non Communicable diseases (NCD) like Diabetes, Obesity, CVD, Chronic Kidney diseases, Cancers, etc. Perceiving the threat of NAFLD and the central role of hepatic accumulation of fat in the pathogenesis of other NCD, the Government of India (GoI) has taken steps to include NAFLD in the public health agenda. It has included it in the national NCD programme, i.e., National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 2021. India has become the first country in the world to start a national programme for preventive efforts for NAFLD. The present review describes public health relevance of NAFLD and the process of integration of Non Alcoholic Fatty Liver Diseases (NAFLD) into NPCDCS programme in India
Coverage evaluation of Mass Drug Administration (MDA) for lymphatic filariasis in a district of Bundelkhand Region of Uttar Pradesh
Get PDFIntroduction: Lymphatic filariasis results in severe disability that leading to severe social and economic burden at each level from individual to family, and community. This study was carried out to assess the coverage and compliance of MDA. Methods: From 300 households (1837 individuals) in both rural & urban area were covered in coverage evaluation survey by systematic selection of subunits using probability proportionate to size (PPS). Each household was visited by WHO designated team and data were collected using predesigned questionnaire. Data was compiled on MS-excel spreadsheet, frequency and percentage were calculated. Results: The overall effective coverage for all drugs was low (19.1%). The coverage was low, compliance was higher in urban as compared to rural area. Females had better coverage and compliance than males. The primary reasons for drug not offered was nobody came to offer drug, drug not swallowed was not sick, drug swallowed was useful information from drug administrator (DA). Only one female reported adverse effect. Conclusion: Increase in coverage along with decrease in coverage-compliance gap is needed to achieve filariasis elimination that warrants intense IEC activities using different platforms, development of better drug delivery strategies and strengthening monitoring system
Progressive Trends of Childhood Immunization in Rajasthan: A study based on the NFHS database
Get PDFAny public health program\u27s efficacy may be evaluated solely based on the available statistics. A program\u27s ability to be tracked relies heavily on data. There are several systems in place in India for gathering data on the health of individual states and the country as a whole. The National Family Health Survey (NFHS) is one of these mechanisms. Children\u27s vaccination status is one of the many data points collected by the National Health Interview Study (NFIS), a representative sample survey. NFHS is commonly used to evaluate and monitor the progress of any health program in the country, therefore, to sum it up: According to Rajasthan\u27s NFHS-4 and NFHS-5 reports, there has been a significant increase in the state\u27s coverage status. Despite the difficulties and the closure of the corona, this research will investigate the data that has demonstrated extraordinary rises and the causes that have made it possible or the huge efforts by the state government
Effect of digitization of medical case files on doctor patient relationship in an Out Patient Department setting of Northern India: A comparative study
Get PDFBackground: Digitization of health records and health delivery processes in health care settings may have an impact on the Patient-Physician communication, wait times, that affect the overall patient satisfaction with the health care services. Aim & Objective: We ascertained the effect of digitization of medical case files on the doctor patient relationship (DPR) domain of patient satisfaction at an urban primary health center in India. Settings and Design: Comparative, cross-sectional study in primary health centres. Methods and Material: The patient satisfaction was compared between the patients attending the Public Health Dispensary (PHD) that uses digitized medical case file system and a Civil Dispensary (CD) which follows the conventional paper based medical records, using a Patient Satisfaction Questionnaire (PSQ). Statistical analysis used: Univariate analysis was done by chi-square test and adjusted analysis was done by multiple linear regression. Results: Patient satisfaction in DPR was found to be same between the digitized medical case files based and conventional OPD (p=0.453). Significantly higher overall patient satisfaction was reported in the conventional paper based OPD than the digitized OPD (p<0.001). Conclusions: Patient satisfaction towards the doctor-patient relationship (DPR) was same between paper based OPD and the digitized medical case files based OPD
Assessment of effectiveness of Cinemeducation as a tool to impart communication skills among the MBBS 1st Professional students
Get PDFBackground: Improvements in healthcare providers’ communication skills have been linked to more effective healthcare delivery, improved patient compliance, better patient and provider satisfaction, and fewer lawsuits. Cinemeducation is a relatively new method of medical education where movies or movie clips are used to stimulate discussions and reflections, which is a part of an active learning process. Hence, the present study was undertaken. Methods: We conducted an educational research, mixed method study among the MBBS 1st Professional students. A pre & post test to assess the knowledge and attitude of the students about the importance of communication skills in doctor-patient relationship. Students wrote the reflection and feedback after watching the movie clip. Quantitative analysis was done using paired t test by SPSS v. 20. Qualitative data analysis was done by two investigators independently. Results: The pre & post test for knowledge was statistically significant while communication skill attitude scale score for both positive & negative was not significant. Conclusion: The student’s knowledge improved significantly after the sessions on communication skills, while negligible change in attitude was observed. Reflective writing by the students shows that cinemeducation can be used as one of the tool for teaching communication skills to the medical students
Self-medication and its associated factors in Amdanga block of West Bengal
Get PDFBackground: The WHO defines the use of medications without prior medical consultation regarding indication, dosage and duration of treatment as self-medication. The practice is a global problem. Aims and Objectives: The study was conducted to describe the care seeking behavior of rural self-medicators living in Amdanga Block of West Bengal and to assess the belief in medicines by the self-medicators. Material & Methods: A descriptive cross-sectional study was conducted by interviewing with a pretested semi-structured questionnaire on 665 self-medicators out of 1740 adults who were interviewed in 80 villages of Amdanga Block, West Bengal. A three-stage sampling method was used to reach the study population. A three month recall on self-medication practice was considered operationalizing the “pull” and “push” factors of self-medicators using a Pshycho-social framework. The variables were Socio-demographic factors, Care Seeking Behaviors, Health System related factors, Belief in Medicines according to the framework. Results: The prevalence of self-medication was found to be 38.2%. 63% of the study subjects were female and 56.3% had a literacy status of middle school and above. 54.4% relied on their old prescription for self-medication. 68.7% had an initial choice to consult a doctor but later self-medicated of whom 53.2% changed their choice due to monetary and transport issues while 38.5% thought of self-medication considering their disease was mild in nature. Conclusion: Awareness and health education can link rural subjects with primary care facility and right decisions on care can be provided
Myths and misbelieves regarding COVID vaccines in India
Get PDFBackground: - COVID-19 is the most important public health problem of recent time. Many people require hospitalization after infection. COVID vaccination is the most effective way to prevent the disease. Due to extensive negative publicity through social media channels/platforms,significant number of individuals are not coming forward for vaccination. Therefore, study is needed to evaluate adverse effects associated with different vaccines available in India. Objectives: - To assess the adverse effects associated with COVID-19 vaccination and compare the side effect of two most commonly used COVID vaccines in India. Methods:- In the current report, a cross sectional study was conducted among beneficiaries of COVID-19 vaccines at the vaccination center of the LLRM Medical college, India. After institutional ethical clearance and informed consent, patients were asked about the symptoms they experienced after vaccination. A very simple random sampling approach was used to select beneficiaries. Information was collected on predesigned Google form and total 391 patients submitted the responses. Results:- Out of total respondents 77 % individuals reported one or more symptoms. Fever was reported to be most common problem (59.3%) followed by body ache (57.5%). Out of total beneficiaries, 68.3% experienced mild symptoms while 23% remain asymptomatic. Only few subjects reported moderate adverse effects (8.7%). None of the respondent reported severe and serious adverse effect. Conclusions:- Vaccine associated adverse effects were found less than 3 days and of mild variety in most of the beneficiaries. There was no difference in adverse effect profile of two commonly used vaccines in India. People must come forward for vaccination in mass without fearing of adverse effects of vaccines
A Randomized controlled trial to assess the effectiveness of group-based Diabetes Self-Management Education (DSME) program on glycemic control and self-care activities among type-2 diabetics in South-East Delhi
Get PDFIntroduction: India has the second-largest population of diabetes globally. The long-term complications due to poor glycemic control are concerning. Diabetes Self-Management Education (DSME) is a fundamental component in managing diabetes better. Objectives: This study was conducted to compare the effectiveness of group-based DSME in achieving glycemic control and improving self-care practices among people with type-2 diabetes as against the usual care. Methods: A non-blinded parallel-arm RCT among adults (? 30 years) diagnosed with Type-2 DM. Written informed consent was taken from each patient before enrollment. The sample size is estimated to be 85 in each arm according to the formula for equivalence design for an RCT. Randomization was done using a computer-generated random number table. The control arm received usual care, while the intervention group received group-based DSME in addition to usual care. At the end of 6 months, the change in glycemic control and self-care activity scores were compared between the two arms. Results: A total of 139 individuals (intervention =69; control =70) were analyzed. The proportion of females (62.1%) was higher than males (37.9%). There was no statistically significant difference at baseline. At end line, HbA1c showed a reduction from 9.3% to 6.9% in the intervention arm (P<0.001), which was greater than that in the control arm (p=0.017). All the self-care components showed a statistically significant improvement, except the medication score. Conclusions: Group-based DSME effectively increases self-care practices among people with diabetes, resulting in better glycemic control
Omicron: The new variant of concern needs preparedness, not panic
Get PDFSARS-CoV-2 continues to be a Public Health Emergency of International Concern. On November 26, the World Health Organization (WHO) labeled the omicron type as a covid-19 variant of concern, prompting travel restrictions, a rush to accelerate booster immunization programmes, and new attempts to address vaccination disparities. According to the WHO, omicron is a "very high" concern throughout the world, and preliminary research indicates that it may be a more transmissible type, leading to infection surges (1,2). The Indian government keeps a close eye on the issue and gives appropriate guidelines as needed.
Omicron threat will depend on its transmissibility, Virulence, and capacity to evade immunity in those previously vaccinated or infected. Even if the disease is milder, the rapid onslaught of the virus could overwhelm health care systems (doubling time of 2.5 days means 50X increase in 2 weeks) (3). We should ensure mitigation plans are in place to maintain essential health services and that necessary resources are in place to respond to potential surges
Prevention of initiation of smokeless tobacco (SLT) consumption among rural children
Get PDFBackground: India Global Youth Tobacco Survey 2019 observed that 8.5% of the young age group (13-15 years) consume tobacco (9.6 % are boys and 7.4 % are girls). No interventional studies among adolescents were conducted before the initiation of the SLT use. Aims & Objectives: To estimate the prevalence of consumption of tobacco and non-tobacco products and to provide school based interventions to bring behavioral changes. Materials and Methods: An interventional study was carried out in Primary Schools. For estimation of the prevalence of tobacco and non tobacco use all the students of 1st to 5th while for the interventions, 4th and 5th standard were selected. Baseline data and change in the behavior at the end of one year was collected. FGD with key informants were also conducted. Descriptive Statistics was conducted. Results: The prevalence of smokeless tobacco consumption and non-tobacco product was found to be 1.3% and 36.5% respectively. After intervention 40.5% students had quit non tobacco products. Findings of FGD suggested that children should not be sent to purchase tobacco products on behalf of their parents. Conclusion: School based intervention and sensitization of the field workers along with knowing their perceptions for the predictors of consumption could be useful