Indian Journal of Medical Research最新文献

{"title":"Challenges in medicine procurement through GeM in a tertiary care hospital in northeast India.","authors":"Anuj Vashisht, Jithesh Vishwanathan, Shruti Vashisht, Chetan Sood, Puneet Sarin, K Rahul Ray","doi":"10.25259/IJMR_944_2024","DOIUrl":"10.25259/IJMR_944_2024","url":null,"abstract":"<p><p>Background & objectives The procurement of medical items (drugs and consumables) through the Government e-marketplace (GeM) is a recent initiative. This study aimed to comprehensively assess the bottlenecks, procedural pitfalls, and delays impacting the supply chain in the procurement process of a tertiary care hospital in northeast India. Methods A retrospective analysis was conducted on the procurement data obtained from the hospital's procurement cell over 12 months. The study primarily focused on the total demand for medicines and consumables through the e-portal and compared it with the actual quantity/quality received by healthcare facilities. Results The initial demand was placed for 1507 medicines and 1219 medical consumables. However, the healthcare facility received only 695 (46.1%) medicines and 945 (77.5%) consumables. Major bottlenecks identified were non-quotation of medicines, price negotiation rejections, and vendor failure to supply. Interpretation & conclusions This study identifies a few bottlenecks: non-quotation by vendors, price negotiation rejections and failure to supply medicines and consumables by the vendors in procurement through the GeM. Efforts like flexibility in matching previous purchase rates, International Organisation for Standardisation/World Health Organization (ISO/WHO) qualified vendor base at the GeM level and porting in reliable pharmaceutical companies must be directed towards optimising procurement processes and enhancing supply chain management to bridge the identified gaps and promote seamless healthcare delivery.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"32-37"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of leading COVID-19 vaccines: A network meta-analysis.","authors":"Sanjay Rai, Shashank Tripathi","doi":"10.25259/IJMR_750_2024","DOIUrl":"10.25259/IJMR_750_2024","url":null,"abstract":"<p><p>In the fight against the COVID-19 virus, various vaccines using different technologies such as mRNA, viral vectors, protein subunits, and inactivated whole viruses have become primary defence strategies. This study aims to compare their effectiveness in controlling the spread of the pandemic. Using the comprehensive resources from three major databases-PubMed, EMBASE, and the Cochrane Library-we conducted an extensive literature review up to April 30, 2023. By employing a frequentist network meta-analysis, we analysed both direct and indirect estimates of vaccine efficacy, providing a clear comparison of the leading candidates in the global fight against COVID-19. Fifteen vaccines from 26 articles were used in our network meta-analysis. The statistically significant direct estimates were obtained by Spikevax [VE: 93.29 (91.31, 95.27); P<0.05], Pfizer BioNTech [VE: 92.07 (90.03, 94.12); P<0.05], Sputnik [VE: 91.60 (85.60, 97.60); P<0.05], Novavax [VE: 88.99 (83.55, 94.42); P<0.05], Sinovac [VE: 83.50 (65.40, 101.60); P<0.05], Covifenz [VE: 77.27 (68.48, 86.06); P<0.05], Zifivax [VE: 75.94 (70.86, 81.02); P<0.05], Covishield [VE: 72.34 (67.12, 77.56); P<0.05], S-Trimer [VE: 71.61 (56.23, 86.98); P<0.05], Covaxin [VE: 70.81 (65.33, 76.29); P<0.05], Soberna [VE: 69.70 (56.50, 82.90); P<0.05], Zydus Cadila [VE: 66.60 (47.60, 85.60); P<0.05], CVnCoV [VE: 63.70 (52.20, 75.20); P<0.05], Convidecia [VE: 57.50 (39.70, 75.30); P <0.05], and Jcovden [VE : 52.42 (47.28, 57.57); P<0.05]. Spikevax emerged triumphant with an unparalleled P score of 0.95, solidifying its status as a top ranking prevention tool against the COVID-19 in our investigation. Our analysis reveals a ranking of vaccine efficacy, with Spikevax emerging as the most effective, followed closely by Comirnaty, Sputnik, and others, collectively providing strong protection against the ongoing threat of COVID-19.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"9-20"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the impact of the Aarambh nurturing care model on the capacity & support structures for caregiver empowerment: A qualitative study.","authors":"R Naveen Shyam Sundar, Pranali Kothekar, Abhishek V Raut, Subodh Gupta","doi":"10.25259/IJMR_343_2024","DOIUrl":"10.25259/IJMR_343_2024","url":null,"abstract":"<p><p>Background & objectives The provision of nurturing care during the crucial developing phase from pregnancy to three years is essential for enduring health. The Aarambh project, executed in specific districts of Central India, utilised existing Integrated Child Development Scheme (ICDS) and healthcare facilities to improve nurturing care. This study assessed the influence of loving care interventions on the skills, functionality, and support systems of anganwadi workers (AWWs) to enhance the capabilities of primary carers. Methods This qualitative study evaluated the competencies of AWWs by observing house visits and mothers' meetings in both control (Deoli, Wardha) and intervention blocks (Ralegaon, Yavatmal), Maharashtra. Comprehensive interviews were performed with AWWs, primary carers, ICDS supervisors, CDPOs, ASHAs, and parents. Results AWWs in the intervention group exhibited substantial enhancements in providing age-appropriate guidance, play, and communication activities along with effective community-based events. Interpretation & conclusions The findings of this study suggest empowerment of beneficiaries and child development through this discussed programme framework. In light of this, it is apparent that the soft skills of service providers hold paramount importance for achieving sustainable outcomes.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"21-31"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methicillin-resistant Staphylococcus aureus (MRSA) carriage among the critical care personnel in a tertiary care hospital in Sikkim: An observational study.","authors":"Anusha Subba, Dechen Chomu Tsering","doi":"10.25259/IJMR_1224_2024","DOIUrl":"10.25259/IJMR_1224_2024","url":null,"abstract":"<p><p>Background & objectives Persistent nasal colonisation of methicillin-resistant Staphylococcus aureus (MRSA) among healthcare personnel (HCP) remains a significant challenge. MRSA carriers are crucial to the spread of the infection, with healthcare professionals often acting as vectors for both hospital- and community-acquired MRSA. This study aimed to evaluate the MRSA carriage rate among healthcare professionals from critical care units at a tertiary care hospital in Gangtok, Sikkim. Furthermore, the study undertook to analyse antibiotic susceptibility patterns of isolated MSSA and MRSA strains, and identify associated risk factors for MRSA infection. Methods Three hundred samples from healthcare workers (HCW) posted in the critical care units of a tertiary care hospital were cultured and identified by routine biochemical methods. Antibiotic susceptibility test was performed by Kirby Bauer disk diffusion method for all MRSA and MSSA isolates. Association with various risk factors was understood by the Chi square test. Results Nineteen of the 300 participants were identified as nasal MRSA carriers having an overall carriage rate of 6.33 per cent in this study. The prevalence of MRSA was seen to be the highest among the attendants (9.52%), and the highest carriers were from the surgical Intensive Care Unit (ICUs). All the MRSA and MSSA isolates showed 100 per cent resistance to penicillin and 100 per cent susceptibility to linezolid. A significant correlation among hand hygiene practices and patient contact was reported from this study. Interpretation & conclusions Despite existing infection control policies, the MRSA carriage seen in HCWs in critical care units was 6.33 per cent, highlighting the need for regular systematic screening and decolonisation of all healthcare professionals to decrease the carrier status and prevent the spread of infection.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"91-98"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of progressive muscle relaxation therapy on diabetes distress & anxiety among people with type 2 diabetes.","authors":"Manjula Arunraj, Vaishnavi Vijay, Satyavani Kumpatla, Vijay Viswanathan","doi":"10.25259/IJMR_1227_2024","DOIUrl":"10.25259/IJMR_1227_2024","url":null,"abstract":"<p><p>Background & objectives Diabetes distress (DD) is a mental condition that can develop in people with diabetes and shares characteristics with stress, anxiety, and depression. The aim was to determine the effect of Jacobson's Progressive Muscle Relaxation (PMR) therapy on DD, anxiety, glycemic control, hemodynamic and lipid measures among people with type 2 diabetes (T2DM). Methods A total of 80 participants were recruited for this prospective randomised intervention study and divided into two groups equally; group 1 (Control) (n=40) received general counselling for stress reduction and group 2 (Intervention) (n=40) received PMR therapy and general counselling for stress reduction. A pre-, and post-test was done with diabetes distress Scale (DDS) and generalized anxiety disorder (GAD) Scales. Baseline data on anthropometric, hemodynamic, biochemical details were collected and repeated after three months. Thirty-six participants, with four dropouts in each group, reported for follow up. Diabetes medication regimens in both groups remained unchanged throughout the study period. Results There was a significant reduction in the total mean scores of DDS (Pre vs. Post) (3.8 vs. 1.6) and GAD Scale (17.9 vs. 6.3; P<0.0001) in the intervention group. The PMR therapy group showed a significant reduction in HbA1c, fasting and post prandial (PP) glucose levels with HbA1c (baseline vs. follow up; 9.2% vs. 7.6%), fasting (194.5 mg/dl vs. 142.4 mg/dl) and PP glucose levels (266.5 mg/dl vs. 175.5 mg/dl) (P=0.001) whereas control group showed an increase in HbA1c, fasting and PP glucose levels. The impact of PMR therapy was also reflected in the lipid profile. Seventy per cent of the intervention group participants followed PMR therapy regularly. Interpretation & conclusions Our study findings highlighted that PMR therapy had a positive effect on diabetes distress and anxiety among people with T2DM. It also improved glycemic control and can be used as an adjunctive to the medications for better management of T2DM.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"72-80"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beating leprosy: Unmasking challenges, ending stigma, & prioritizing mental well-being.","authors":"Sukhdeep Singh, Tarun Narang, Sunil Dogra","doi":"10.25259/IJMR_2212_2024","DOIUrl":"10.25259/IJMR_2212_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"1-4"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Wastewater-based genomic surveillance of SARS-CoV-2 in vulnerable communities in Mumbai.","authors":"","doi":"10.25259/ijmr_299_24_CR","DOIUrl":"10.25259/ijmr_299_24_CR","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"107"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Misdiagnosis of leprosy: An underappreciated reason for its continued prevalence.","authors":"Kabir Sardana, Savitha Sharath, Ananta Khurana","doi":"10.25259/IJMR_15_2025","DOIUrl":"10.25259/IJMR_15_2025","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"5-8"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Piloting an event-based surveillance model in private hospitals for early detection of disease clusters, Kerala, India.","authors":"Raman Swathy Vaman, Sunil Solomon, Francisco Averhoff, Alan L Landay, Jeromie Wesley Vivian Thangaraj, Rizwan Suliankatchi Abdulkader, Flory Joseph, Gavin Cloherty, Manoj V Murhekar","doi":"10.25259/IJMR_1395_2024","DOIUrl":"10.25259/IJMR_1395_2024","url":null,"abstract":"<p><p>Background & objectives Event-based surveillance (EBS) is a critical component of early warning systems for detecting and responding to infectious disease outbreaks. While EBS is widely used in public health settings, its integration into private healthcare facilities remains limited. This study undertook to pilot an EBS in private hospitals in Kasaragod, Kerala and to assess its added value in early detection of disease clusters. Methods Clinical nurses abstracted the data on hospitalisation dates, places of residence, and presenting illnesses from case records of patients with acute febrile illness (AFI) admitted in six private hospitals. A software algorithm analysed the data to identify spatiotemporal clustering of case-patients or deaths (signals), for syndromes of interest [acute febrile illness with rash (AFIR), acute encephalitis syndrome (AES), acute febrile illness with haemorrhage (AFIH) and severe acute respiratory illness (SARI)]. The District Surveillance Unit (DSU) verified these signals, flagged verified signals as events, and conducted a risk assessment to determine if the events were outbreaks. Results From May to December 2023, data from 3294 (73%) of 4512 AFI patients were analysed using the EBS algorithm. Of the 88 signals identified, 67 (76%) were due to SARI, 9 (10.3%) were due to AES, and 9 (9%) were due to AFIR. Ten signals were verified as events, of which nine were classified as outbreaks (dengue-1, H1N1-3, H3N2-1, H1N1 and H3N2 - 1, H1N1 and SARS-COV2 - 1, no pathogen detected- 2). Five outbreaks were not detected by the existing indicator-based surveillance (IBS). Interpretation & conclusions EBS pilot in private health facilities complemented the IBS system by early detecting outbreaks. This EBS model has the potential for implementation in other districts, especially in districts at higher risk of zoonotic spillover.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"54-63"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development & evaluation of a training programme to address complex post-COVID psychological needs.","authors":"Aruna Laxmy, Himani Kashyap, Rajakumari P Reddy, Manoj Kumar Sharma, Paulomi Matam Sudhir, K S Meena","doi":"10.25259/IJMR_416_2024","DOIUrl":"10.25259/IJMR_416_2024","url":null,"abstract":"<p><p>Background & objectives In India, mental health treatment gaps are significant, and related to shortage of trained personnel. Published literature has identified gaps in existing training programmes including - delivering psychological interventions for complex concerns such as intensified post-COVID grief, trauma, suicidality; ongoing mentoring; and culture-sensitive interventions. Despite government initiatives, gaps in treatment and training have been compounded by a surge in psychological distress following COVID-19. This study aimed to develop, implement and evaluate a training programme for psychologists to identify, assess, and treat complex post-COVID psychological concerns. Methods The study employed a sequential mixed exploratory research design with tailored programme development (Phase I) and programme delivery with pre-post evaluations of participation, satisfaction, learning and competence using Moore's framework (Phase II). Psychologists with postgraduate qualifications, engaged in direct client contact were invited through flyers to participate in the free online training programme. Results The final programme included ten modules; with knowledge, skills, and application components; comprising synchronous and asynchronous elements. Fifty-three participants enrolled in the programme and 70 per cent completed the course. Pre-post evaluations indicated high satisfaction (93.54% rated as met/exceeded expectations); improvements in competence (pre training mode = 3; post-training mode = 4); and average to above average learning scores (mean scores ≥3 on 7 out of 9 module quizzes). Participant feedback revealed that the focus on complex concerns, practical learning through interactive sessions and role play recordings, and case-based supervision were helpful. Interpretation & conclusions The programme focused on training gaps identified through a needs assessment survey. It was received well in terms of participation, satisfaction, content, accessibility and learning. The indigenous and skill-focused training has implications to contribute to future mental health preparedness and scope for large-scale deployment.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"43-53"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}