Indian Journal of Community Health
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Why do we need Lifestyle Medicine?
Get PDF“While the search for the magic bullets continues, other studies are revealing that the environment in which the individuals’ lives and his manner of living are of great importance in determining his susceptibility to the diseases of modern times.”
Rene Dubos
(Mirage of Health-Utopias, Progress, and Biological change, 1959)(1)
This quote by one of the greatest microbiologist of 20th century is even more relevant today where Non-communicable diseases have taken the center stage in the world as well as in India. The impact of NCD’s in India is quite alarming. NCD’s account for 60%of all deaths and 53% of disease burden, over 20% of the population in India has at least one chronic disease, NCD’s are estimated to cost India 62 million during the period 2012 – 2030.(2)
Most of these NCD’s are related to some common risk factors like lack of physical activity, tobacco use, alcohol abuse, unhealthy diet, stressful lifestyle, lack of adequate sleep. That is the reason NCD’s are now being called as lifestyle diseases and interestingly, most of the NCD’s are preventable (and some of the important ones also reversible in early stages) through lifestyle approaches also being called as ‘Lifestyle Medicine’
Are Health Caregivers safe from workplace violence? A cross sectional study on workplace safety from Tertiary Care Hospital of Uttarakhand
Get PDFBackground: The prevalence of workplace violence in the healthcare sector is a problem that is frequently ignored and underreported. The performance of healthcare workers who have been the target of violence may suffer, which may have a negative effect on patient satisfaction and health. Aims & Objectives: The purpose of the current study was to determine the prevalence of workplace violence (WPV), risk factors for violence against healthcare workers, and their experiences regarding the same. Methodology: It was a cross-sectional study conducted on 157 hospital staff at Tertiary Care Medical College of Uttarakhand. Data was gathered using a semi-structured, self-administered questionnaire that was modified from the ILO, ICN, WHO, and PSI. Data were analyzed using SPSS software (version 20). Results: Factors like age, gender, job profile, lesser work experience, night shifts, and fewer staff on duty were found to have a positive association with workplace violence. It was observed that the majority of incidents took place in the ward, and the patient’s relatives were the attacker in most of the cases. It was also seen that the majority of Hospital staff did not get bothered by the incident except by staying super alert while dealing with other patients or their relatives. Conclusion: The study concludes that while caring for patients, Hospital staff are at risk of being victims of aggressive and violent situations. To reduce this problem, strategies like training staff in order to handle such incidents in the future should be brought into practice. Laws should be made stricter & assaulting staff on duty should be made a cognizable offense with serious consequences & heavy penalties. Also, the young budding MBBS students should be trained by incorporating these strategies, laws & policies in the CBME curriculu
Public Health Management a Curative Tool for the Public Health Related Problems
Get PDFHealth always remains a core component in the life of human beings and considered as a major instrument of overall socio-economic development. Concept of health has been defined and understood in different ways by different cultures. The two major division of medicine namely curative and preventive medicine came into light at the close of 19th century. Although origin of Medicine and Public health goes back to ancient Greek mythology, Asclepius was the Greek god of Healing. He was the son of Apollo and the Coronis. Asclepius was married to Epione, with whom he had five daughters: Hygieia, Panacea, Aceso, Iaso, and Aglaea. Hygieia was the goddess of health, cleanliness and hygiene. Follower of panacea practiced curative medicine and were called healer and followers of Hygieia were called as Hygienist or Public Health experts (1). Concept of Public Health came from this hygienist category of healthcare personals.
The Constitution of the World Health Organization, which came into force on April 7, 1948, defines health “as a state of complete physical, mental and social well-being.”(2) In today’s world more emphasis is given on physical health and most of the resources are diverted for the care of physical health especially for the medical treatment. Other domains of health care remain neglected.
Public health applies to the holistic approach for the care of health. Physical health is best taken care by the judicious mix of public health and medical domain of health. The evolution of concepts of public health tries to address new challenges of population health like non communicable diseases, cancers, accidents, injuries, inequities, increasing cost of care, poor quality of care, and poor patient satisfaction etc.
Professional Quality of Life and Mental Health among Doctors in Tamil Nadu during COVID19 Pandemic
Get PDFBackground: The pandemic COVID19, a serious global threat has led to elevated levels of pressure on medical professionals. The research shows that occupational stressors has been significantly associated with the pandemic.Objective: To estimate the professional quality of life of doctors in Tamil Nadu and their mental health during the COVID19 pandemic. Settings andDesign: Cross-sectional study in Tamil Nadu, South India. Method: Among 318 doctors from both private and government sectors in Tamil Nadu, South India during April 9th - May 10th 2021, the study was conducted to estimate the professional quality of life [Compassion Satisfaction (CS), Secondary Traumatization (ST) and burnout] using ProQOL-5 scale. Depression and Anxiety were estimated using PHQ-9 and GAD-7 scales respectively. Statistical analysis used: Association between the variables was found using Chi-square test. Results: Among the 318 respondents (170 males and 148 females), CS and ST levels were high in 77(24.2%), and 10(3.1%) respondents respectively. Severe depression and anxiety were among 36(11.3%) and 109(34.3%) respectively. Statistically significant association was found for Burnout (?2=55.671; OR=15.135; 95% CI=6.361-36.013 and ?2=57.518; OR=18.014; 95% CI=7.054-46.007) and ST (?2=56.701; OR=15.432; 95% CI=6.486-36.717 and ?2=26.281; OR=4.558; 95% CI=2.476-8.390) with both depression and anxiety (p<0.05). Conclusions: Doctors of Tamil Nadu, South India are challenged with adverse mental health outcomes during the COVID-19 pandemic with a significant association between the quality of life at work and psychological distress
Exploring Factors of Absenteeism Among Students Attending Community Medicine Department
Get PDFContext: Frequent absence from classes may lead to improper learning and poor academic performance. Absenteeism can make teaching - learning environment unwelcoming and impacting those also who attend classes regularly. Aims & Objectives: To explore factors responsible for absenteeism among second professional students attending Community Medicine Department and to formulate recommendations to deal with absenteeism. Material and Methods : A Cross sectional study was conducted among 132 second professional medical undergraduate students attending Community Medicine Department in a teaching hospital. A self-designed pre validated questionnaire comprising of various sections related to teaching –learning factors was used to explore factors responsible for student absenteeism. Faculty perception regarding student absenteeism and recommendations formulated to deal with it were recorded separately. Data analysis: Data was entered in MS Excel and Chi Square test was used for analysis. Results: Among 132 study participants, majority of the participants (62.1%) were females who were residing in hostels. Highest percentage of absenteeism (40.1%) was during examination time. Extracurricular activities like sports/gym, browsing net and parties were significantly (p<0.001) associated with absenteeism. Conclusions: Absenteeism can adversely affect academic performance and low attendance can demotivate teachers also to teach with keen interest
Knowledge, Attitude and Practice Pattern regarding Diabetic Retinopathy among the patients of Diabetes Mellitus presenting to a Tertiary Health Care Center in Uttarakhand
Get PDFIntroduction: Diabetes Melltius (DM) is an established silent killer in the developed world and is slowly increasing the burden of morbidity in the developing nations as well. Diabetic retinopathy (DR) screening protocols are not standardized in the developing world and not available to many practioners. Methods: This is an observational analytical study aimed to assess the levels of knowledge, attitude and practice patterns regrading DR among the patients of DM in Uttarakhand. These were correlated with the educational status, socio-economic status, duration of DM, residence and gender. Results: Higher levels of knowledge which were statistically significant were observed as the socioeconomic status rose, with the increase in the duration of DM and with higher levels of educational status. A corresponding positive tone was also seen with respect to attitude and practice. However, the levels of knowledge did not correspond to the levels of practice. Conclusion: Integration of the health services along with the educational system would be an advancing step in spreading awareness about the disease entity itself and its morbid consequences. This would create an environment of high awareness and screening protocols will be easily streamlined
Prevalence of needle stick injuries, its associated factors and awareness among nursing staff at tertiary care hospital of North India
Get PDFBackground: Needle Stick Injuries (NSIs) are defined as accidental skin penetrating injuries caused by needles. It is the single greatest occupational hazard to a medical personnel. In developing countries, needle stick injury is associated with the highest global prevalence of HIV, Hepatitis B, and Hepatitis C. Aim & Objectives: To estimate the prevalence of needle stick injuries, its associated risk factors and assess the awareness regarding needle stick injuries among nursing staff. Material & Methods: A cross-sectional study was conducted among nursing staff who were working at a tertiary care hospital in Northern India during June 2019 to November 2019. The study commenced after taking prior approval from institutional ethics committee. A census method was used to include the participants. Results: Around 66.7% of the nursing staff was exposed to NSIs during their working hours at the hospital. There was significant association of needle stick injuries with place of working and education of nursing staff in multivariate binary logistic regression. About 26% of the nurses were unaware that recapping should be done or not for used needle, and 35% of staff nurses recapped the needle after the use. Conclusion: Needle stick injuries can be prevented by continued education, effective training, providing better safety devices, a positive work environment
Impact of co-morbidities in COVID -19 infected patients
Get PDFBackground- During the COVID- 19 pandemic in the first wave, infected patients age was range from 4 weeks to 90 years and those who have more age and with comorbidities are more susceptible to develop serious illness and have high mortality rates. Objective-To study the association between survivor vs non survivor on the basis of demographic profile and high risk factors. Material & methods: This study was done in the Government Medical College, Kannauj on the COVID-19 patients who were admitted in the isolation wards, from 1st September 2020 to December 31st 2020. Statistical Analysis- Analysis was done using SPSS- 23 trial version software. Results: case fatality rate was 2.7% in this study. Most common symptoms was cough (61.0%) and among these admitted patients the most common comorbidities was hypertension (26.7%), followed by diabetes (20.7%), and COPD (14.0%) respectively. Platelets (< 0.02), post prandial blood sugar (PPBS) (< 0.01) have significant role in survivability of COVID- 19 patients. Conclusion: This study concludes that those patients who were older in age and with comorbidity especially (hypertension, COPD, high PPBS, High platelets) have poorer prognosis as compare to those without
Quality of life of people living with HIV/AIDS before and after receiving antiretroviral therapy
Get PDFBackground- HIV/AIDS is a chronic illness. Besides having serious morbidities, opportunistic infections, it also adversely affects quality of life of People Living with HIV/AIDS (QOL- PLHIV). Early and prompt initiation of antiretroviral therapy (ART) might improve quality of life of PLHIV in various domains like psychological, physical, environment level of independence, social relationship and spirituality/religion/personal beliefs. Material and methods- The study was conducted at a medical institute of North India. Patients attending ART centre of the institute for the treatment of HIV/AIDS were interviewed on WHOQOL-HIV questionnaire. Aim and objectives- To assess and compare quality of life of people living with HIV/AIDS at initiation and after 6 months of receiving antiretroviral therapy. Result- QOL-PLHIV was improved in various domains when assessed after six months of receiving ART. For physical domain mean score increased from 12.83 to 13.85, for psychological domain from 12.54 to 14.31, for level of independence from 12.95 to 13.21, for social relationship from 12.46 to 14.15, for environment domain from 11.98 to 13.15 and for spirituality/religion/personal belief mean score increased from 11.41 to 11.96. Respective standard deviation was decreased when compared from before initiation of ART to six months after receiving ART. Conclusion – Quality of life of people living with HIV/AIDS was improved significantly after receiving ART
Perception of medical students regarding E-learning during lockdown in COVID–19 pandemic: A cross-sectional study in a medical college, North Kerala
Get PDFBackground: The digital learning in this pandemic era of COVID-19 evolved out in a perplexed environment as a viable alternative to offline or traditional classes. The e-learning carries its own merits as well as demerits, but however, this happened to be the only possible solution in this dreaded situation. With respect to medicos, as they are prone to be exposed to environments connected with Covid infected patients, additional care including online classes turned to be the better option. Aim and Objective: To determine the perception of medical students regarding e-learning during lockdown in COVID-19 pandemic. Settings and Design: A cross-sectional study was conducted among medical students of all the batches in a private medical College, Kozhikode. Methods and Material: Primary data were collected using structured Google questionnaire. Stratified sampling method has been adopted and the sample size was 400. Statistical analysis used: Data analysed using SPSS 18 software. Results: Majority of the participants used Zoom as modality of learning and half of the total participants got adapted to the system over time. During e-learning sessions, most of the medicos expressed their concerns regarding lack of clinical exposure, in addition to their losses in social communication skills. Factors such as the legitimate requirements of clinical phase students, issues of poor internet connectivity and health problems were inclined to demand traditional learning, which were statistically significant. Conclusion: Even though they were subjected to both online and offline methods of education, majority of respondents preferred traditional learning