Journal of Family Medicine and Primary Care最新文献

{"title":"Prevalence of deficiencies of serum vitamin D3 and vitamin B12 among urban and rural population in and around Pune, India: An observational study.","authors":"Swati Ghonge, Hetal Rathod, Amitav Banerjee, Shweta Chauhan, Tanu Baxi, Deepu Palal, Jitendra Bhawalkar, Sai Mahesh Vajjala","doi":"10.4103/jfmpc.jfmpc_1511_24","DOIUrl":"10.4103/jfmpc.jfmpc_1511_24","url":null,"abstract":"<p><strong>Introduction: </strong>Vitamin D and vitamin B12 deficiencies are major public health problems in many populations. Studies report a deficiency in the range of 20-80% of both micronutrients. Hence, a comparative study was conducted among a rural and an urban population to see the prevalence and factors associated with their deficiency.</p><p><strong>Methodology: </strong>The institutional ethics committee approved the study. Informed consent was taken from all the participants. Cross-sectional comparative analytical study among participants of rural and urban field practice areas of a medical college was undertaken. Measurements were made on 121 participants, 67 from urban areas, and 54 from rural regions. Participants were selected in a simple random sampling technique. Blood samples were collected in a standardized technique following aseptic conditions and transported to the laboratory maintaining a cold chain for analysis. Data were entered into Microsoft Excel and analyzed using Jamovi v2.4.11. Chi-square test, <i>t</i>-tests, and Mann-Whitney U tests were used, and tests of significance with <i>P</i> < 0.05 cut-off for rejecting the null hypothesis.</p><p><strong>Results: </strong>Apart from education, body mass index (BMI), and socioeconomic status, all factors were similar among rural and urban participants. The mean BMI of urban participants was more than rural counterparts. Deficiency of vitamin B12 was 52.2% in urban and 64.8% in rural areas; deficiency of vitamin D was 34.3% in urban and 13% in the rural sample. Mean values of vitamin D and vitamin B12 were significantly different, 17.77 ng/mL vis-a-vis 19.02 ng/mL and 254.82 pg/mL vis-a-vis 185.48 pg/mL, respectively, for urban and rural participants. Vitamin D was more deficient in urban areas, and vitamin B12 was more deficient in rural areas.</p><p><strong>Conclusion: </strong>Both deficiencies found in the participants are of concern and require different interventions. Urban participants should be advised more of outdoor activities, and rural participants should be educated more on dietary interventions. Supplements at the individual level may be advised as needed.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 4","pages":"1231-1237"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of muscle performance and heart rate variability in middle-aged type 2 diabetes mellitus.","authors":"Md Akmal Ansari, Amina Sultan Zaidi, Perveen Akhter, Shikha Gautam, Sunil Kohli, Iqbal Alam","doi":"10.4103/jfmpc.jfmpc_1803_24","DOIUrl":"10.4103/jfmpc.jfmpc_1803_24","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance, which impairs the metabolism of carbohydrates, lipids, and proteins. Recent findings indicate that skeletal muscle atrophy, decreased muscle strength, and reduced muscle performance have become prevalent complications of diabetes. Additionally, dysfunction of cardiac autonomic nerves also leads to skeletal muscle impairment. These issues further exacerbate diabetes, thereby leading to a vicious cycle. This study investigates the association between muscle performance and cardiac autonomic neuropathy in middle-aged T2DM patients.</p><p><strong>Material and methods: </strong>In this case-control study, we included 51 diagnosed T2DM patients aged 30-55 years, with a duration of T2DM less than 5 years and HbA1C level below 8%. We also included 51 age-, sex-, and BMI-matched healthy control subjects. Muscle performance was assessed by evaluating the core endurance through the trunk flexor endurance test (TFET), trunk lateral endurance test (TLET), trunk extensor endurance test (TEET), along with hamstring muscle flexibility through the active knee extension (AKE) test. Cardiac autonomic function was evaluated using the heart rate variability test. Statistical analyses were performed using GraphPad Prism version 9. The Mann-Whitney test was used to compare the two groups, and data were represented as median (interquartile range). Values were considered statistically significant at <i>P</i> value ≤ 0.05.</p><p><strong>Results: </strong>We observed a significant decrease in core endurance (TFET, TLET, TEET) with <i>P</i> values < 0.001, as well as reduced hamstring muscle flexibility shown by a decrease in the degree of AKE test with <i>P</i> value < 0.001 in the T2DM patients when compared with the controls. Furthermore, heart rate variability in both time domain parameters (SDRR, CVRR, SDSD, RMSSD, pRR50%) and frequency domain parameters (Total power, VLF, LF, HF, LF/HF) also showed significant decreases, with <i>P</i> values < 0.001 in the T2DM group compared to the control group.</p><p><strong>Conclusion: </strong>The observed decrease in muscle performance and heart rate variability parameters in middle-aged newly diagnosed T2DM patients suggests early skeletal muscle atrophy and cardiac autonomic dysfunction.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 4","pages":"1502-1512"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The application of high-intensity interval training in college physical education and the improvement of students' physical and mental quality.","authors":"Xinghao Wang, Hongyan Wu, Qiao Meng, Jiancong Chen, Taofeng Liu","doi":"10.4103/jfmpc.jfmpc_1376_24","DOIUrl":"10.4103/jfmpc.jfmpc_1376_24","url":null,"abstract":"<p><strong>Purpose: </strong>With the increase of employment pressure in modern society and the influence of the long-term static learning mode, the obesity problem of college students is becoming more and more serious, which has become an important factor affecting their physical and mental health. The traditional methods of losing weight, such as dieting, are not effective and have health risks. High-intensity interval training (HIIT), as a new form of exercise, for patients, can significantly boost the basal metabolic rate, thereby aiding in fat burning and facilitating weight management. It also improves cardiopulmonary function, enhances heart health, reduces the risk of cardiovascular diseases, and promotes muscle growth, leading to better body composition. Furthermore, the exercise effects of HIIT help release endorphins, alleviating anxiety and depression and thus enhancing overall mental health. For study benefits, practitioners can develop personalized HIIT plans based on patients' health status and abilities, thereby enhancing the specificity and effectiveness of treatment.</p><p><strong>Method: </strong>This paper reviews the status quo of obesity in Chinese college students and its health problems, analyzes the limitations of traditional weight loss methods, and introduces the development history, research status, and mechanism of HIIT in enhancing exercise ability, reducing fat, and relieving depression in detail.</p><p><strong>Result: </strong>This paper further discusses the challenges and improvement strategies of physical education in colleges and universities and puts forward the necessity of introducing HIIT into physical education in colleges and universities and the concrete implementation plan. Finally, the paper summarizes the application effect and future development trend of HIIT in college physical education, aiming at providing useful reference for the reform and development of college physical education.</p><p><strong>Conclusion: </strong>Through the scientific and reasonable introduction of HIIT training programs, it is expected to effectively improve the health of college students and promote their all-round development.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 4","pages":"1513-1520"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving pain score and restraint duration during circumcision.","authors":"Ramzi A Kilani","doi":"10.4103/jfmpc.jfmpc_852_24","DOIUrl":"10.4103/jfmpc.jfmpc_852_24","url":null,"abstract":"<p><p>The American Academy of Pediatrics (AAP) recommends providing adequate analgesia during circumcision. Ring block is the most effective method of analgesia, while topical crème (EMLA: lidocaine and prilocaine topical) alone is ineffective. We conducted a quality improvement (QI) project. The aim was to reduce pain scores and restraint duration during circumcision by 20% from baseline over six months.</p><p><strong>Methods: </strong>We followed the standard QI process using PDSA cycles and standard QI charts.</p><p><strong>Results: </strong>Our preintervention data over six weeks revealed significantly higher pain scores if residents performed the procedure or if EMLA was used compared to nerve block. Our intervention included but was not limited to having a new policy to stop using EMLA and have residents watch a video on ring block before performing the procedure. Data collected over subsequent 3.5 months showed that the mean restraint time was reduced by 29% by attendings and by 15% by residents, the use of EMLA cream was eliminated, mean pain score was reduced by 82% when performed by residents and by 20% by attendings, and pain score above 3 was reduced by 100% by residents and attendings. We conducted a sustainability phase over two months. We demonstrated the sustainability of reduced restraint time among attendings but to a lesser extent among residents and the sustainability of mean pain score among both.</p><p><strong>Conclusions: </strong>We conclude that improving effective analgesia during circumcision can be achieved and sustained using the QI project.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 4","pages":"1174-1178"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of asthenopia prevalence and related factors in university students with ordered logistic regression.","authors":"Halil Sengul","doi":"10.4103/jfmpc.jfmpc_1516_24","DOIUrl":"10.4103/jfmpc.jfmpc_1516_24","url":null,"abstract":"<p><strong>Background: </strong>Asthenopia, eye strain, occurs with prolonged use of digital devices and causes symptoms such as blurred vision and headaches. Its prevalence is increasing among university students and office workers; studies report a prevalence of 50-90%, with screen use and ergonomic factors in particular appearing to increase the risk.</p><p><strong>Aims: </strong>This study investigated the prevalence of asthenopia and associated risk factors among university students in Turkey.</p><p><strong>Methods: </strong>A web-based survey was administered to 547 students, and 234 met the inclusion criteria. Statistical analyses were performed with the SPSS 29.0 package program. Frequency and percentage distributions of variables were analyzed in descriptive statistics. First, the prevalence of asthenopia was investigated. Participants who showed any of the symptoms of blurred vision, dry eyes, redness in the eyes, pain in the eyes, itching in the eyes, and eye fatigue were defined as patients with asthenopia, and participants who did not show them were described as \"patients without asthenopia.\" Multiple logistic regression analysis was applied to identify variables that most contributed to asthenopia. The study evaluated the significance level based on a <i>P</i> value of 0.05 and a 95% confidence interval.</p><p><strong>Results: </strong>Results showed that 75.6% of participants experienced asthenopia; the most common symptom was eyestrain (37.6%). Logistic regression analysis revealed that women were 3.385 times more likely to develop asthenopia than men. Wearing glasses increased the risk by 4,645 times compared to not wearing corrective lenses. Interestingly, while using digital devices for studying had a protective effect, recreational use for more than 2 hours significantly increased the risk.</p><p><strong>Conclusion: </strong>The high prevalence of asthenopia among digital device users highlights the need for targeted interventions. The protective effect of work-related device use and the increased risk from recreational use provide fundamental information for developing strategies to reduce eye strain.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 4","pages":"1395-1402"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of sociodemographic factors and perceptions of women in the reproductive age group with anaemia - A hospital-based cross-sectional study in South India.","authors":"N Bushra Thasneem, Resmi S Kaimal, Abdul Hakeem Thengu Murichathil","doi":"10.4103/jfmpc.jfmpc_1456_24","DOIUrl":"10.4103/jfmpc.jfmpc_1456_24","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Anaemia is one of the significant public health problems faced by developing countries. It occurs more frequently in women of childbearing age. Anaemia causes poor work capacity, and severe forms may even cause cardiac failure. In pregnant women, anaemia may lead to preterm labour, low-birth-weight babies, and increased risk of maternal mortality due to post-partum haemorrhage. Even though there are national programmes to supply iron free of cost and other measures to tackle anaemia, it is still prevalent in our country. Anaemia prevalence has increased between NFHS-4 and NFHS-5, from 53% in 2015-16 to 57% in 2019-21 among women. Poor perception about anaemia is the main reason for failure of these programmes. Through this study, we evaluate the perceptions about anaemia in urban women, which is not widely studied unlike in rural women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To study the sociodemographic factors and perception of women in the reproductive age group with anaemia in an urban population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess sociodemographic factors contributing to anaemia and their association with severity of anaemia. 1. To assess their perception about anaemia and factors associated with it.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;We studied 100 participants who fitted the inclusion criteria (women in the age group 15-49 years) attending various departments diagnosed with anaemia based on laboratory results. A brief introduction was given to the participants regarding the purpose of study by the primary researcher. After receiving their informed consent, sociodemographic factors and clinical and lab results were noted. A pre-tested, semi-structured validated questionnaire was administered to the participants to elicit awareness and perception about anaemia and its health impacts. To eliminate repeats, caution was taken not to include previously recorded data if such a situation arose where previously the interviewed person came for subsequent visit during the study period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results and conclusions: &lt;/strong&gt;A total of 100 women in the reproductive age group (15-49 years of age) were taken up for study. Almost half(44%) of the study participants belonged to the age group of &gt; 40 years. Almost half (41%) of the study participants were Hindus. With respect to distribution of Hb levels, we observed that around 2/3&lt;sup&gt;rd&lt;/sup&gt; of the study participants (61%) had moderate anaemia and 32% had severe anaemia. Regarding overall perception regarding anaemia among reproductive age group women, only 9% have excellent perception. 50% have good perception, and 41% only have poor perception. There is no significant association between age group, symptoms, body mass index, parity, number of family members, and socioeconomic status with anaemia severity (&lt;i&gt;P&lt;/i&gt; value &gt; 0.05). Moderate and severe anaemia were more common in women who had birth interval ≤ 3 years, and it is statistically significan","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 4","pages":"1338-1345"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study to understand the health seeking behaviour pattern and healthcare utilisation of peri-urban people in Vadodara district, Gujarat.","authors":"Rucha Dave, Piyushkumar C Parmar, Pooja Singh, Maulik Desai, Niraj Pandit","doi":"10.4103/jfmpc.jfmpc_1401_24","DOIUrl":"10.4103/jfmpc.jfmpc_1401_24","url":null,"abstract":"<p><strong>Background: </strong>The definition of delivering healthcare services is \"the timely use of personal health services to achieve the best possible health outcomes\". Due to social, economic and health policy considerations, different countries, groups and individuals may have varying degrees of access to healthcare. Limitations on healthcare services have a negative influence on treatment effectiveness, consumption of medical services. The objective of this study is to understand the pattern of healthcare-seeking behaviour in adults and also their healthcare services utilisation.</p><p><strong>Methodology: </strong>A cross-sectional community-based study in peri-urban population of Vadodara, Gujarat, was done for a period of 3 months.</p><p><strong>Results: </strong>51% participants were male, and 48% participants were female. Most the participants belonged to Class 1 and 2 socio-economic class. The factors such as socio-economic status, visitation and awareness about full body checkup, travelling and cost-related variables were found to be statistically significant. The awareness and health-seeking nature was seen more in the younger (40-59) population than the older population, mainly because of the distance. However, doctors' advice was more followed through by the elderly population.</p><p><strong>Conclusion: </strong>Financial limitations, distance and transportation costs, the ability to take paid time off work to use services, personal constraints and poor health literacy are some of the factors to consider when it comes to healthcare access.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 4","pages":"1225-1230"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile of restless leg syndrome and its effect on sleep and quality of life.","authors":"Agrata Sharma, Nirendra Kumar Rai, Ruchi Singh","doi":"10.4103/jfmpc.jfmpc_1194_24","DOIUrl":"10.4103/jfmpc.jfmpc_1194_24","url":null,"abstract":"<p><strong>Background: </strong>Restless leg syndrome is a sensorimotor disorder characterized by unpleasant sensations primarily involving lower limb but may involve trunk, neck and upper limb. The present study analyzed the clinical profile of RLS patients and explored its association with sleep and quality of life.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among adult patients diagnosed of RLS based on the IRLSSG (International RLS Study Group) diagnostic criteria. Severity of RLS was assessed using the IRLSSG rating scale. Sleep quality, daytime sleepiness, and quality of life were assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and RLS Quality Of Life Scale (RLSQOL).</p><p><strong>Results: </strong>We enrolled 133 participants, of mean age 45.9 ± 15.2 years and 57.14% (76) being females. Different sensory-motor complaints were present, predominant sensory complaints being pain in 56.39% (75) and motor complaint being excessive movements (78.20% (104)). 80.45% (107) of individuals had sleep complaints including delayed onset sleep, repeated awakening, and nonrefreshing sleep. Excessive daytime sleepiness was present in 56.39% (75), and 78.2% (104) were poor sleepers. Upper limb was involved in 12.78% (17) of patients. Symptoms were majorly bilateral, but 6.02% (8) of patients had unilateral symptoms. RLSQOL score was 35.23 ± 10.3, and there was significant deterioration of sleep quality as well as quality of life with the increasing severity of RLS.</p><p><strong>Conclusion: </strong>RLS remains an underdiagnosed, misdiagnosed, and undertreated clinical entity which has a negative effect on individuals' sleep as well as quality of life. Early detection of RLS by primary care physician will not only reduce the morbidity but also enhance the QOL of these individuals.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 4","pages":"1359-1367"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between impaired cognition status and activities of daily living among elderly: Evidence from longitudinal ageing study in India.","authors":"Pritam Halder, Anshul Mamgai, Pragyan Parija","doi":"10.4103/jfmpc.jfmpc_1314_24","DOIUrl":"10.4103/jfmpc.jfmpc_1314_24","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the association of impaired cognition status with activities of daily living among elderly Indian (≥ 60 years) population.</p><p><strong>Methods: </strong>Cross-sectional comparative analysis was conducted using nationally representative data from a longitudinal ageing study in India (LASI) survey (2017-18). The univariate and multivariate logistic regression established associations between impaired cognition status and activities of daily living.</p><p><strong>Results: </strong>Among the study subjects, 41.6% and 16.3% faced difficulties in activities of daily living and instrumental activities of daily living. The significant adjusted odds of having ADL difficulty was 1.46 times more and IADL difficulty was 2.31 times more in participants with impaired cognition status than normal.</p><p><strong>Conclusion: </strong>With ageing, activities of daily living worsen which is found in our study results. Due to the rapidly increasing ageing population, early detection and prevention of disability or preservation of daily functioning for ageing population and females in particular should be the highest priority for public health decision-makers.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 4","pages":"1271-1278"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 pandemic versus six \"A\"s of health care services - accessibility, affordability, availability, appropriateness, adequacy, and adherence.","authors":"Kalidas Sandhya, Priyadharsini R Palanisamy, R Sandhya","doi":"10.4103/jfmpc.jfmpc_1535_24","DOIUrl":"10.4103/jfmpc.jfmpc_1535_24","url":null,"abstract":"<p><strong>Background and rationale: </strong>COVID-19 pandemic resulted in a huge setback in health care sector causing morbidity, mortality, lack of manpower, resources, in hospitals. Apart from the direct effects of the disease, the indirect effects include, lockdowns, restriction of movement of people for food, work, medicines, etc. There are certain non-communicable diseases for which lifelong treatment and continuation of care is required and the patients suffering from these diseases were also highly affected during pandemic. The major pillars of health care services are accessibility, affordability, availability appropriateness, adequacy and adherence and it is true that the pandemic had its impact on all these pillars.</p><p><strong>Methodology: </strong>A prospective cross sectional study in which 284 patients with NCD answered a questionaire and the responses were analysed.</p><p><strong>Results: </strong>There was a lack of accessibility (48%), affordability (42%) availability (54%) appropriateness and 71% of population took self-medication during the period. There was discontinuity in 16% of the population and the reasons for discontinuation include depression, lack of motivation, forgetfulness, financial crisis etc.</p><p><strong>Conclusion: </strong>The pandemic exerted a greater influence on saturation of health care services by increasing the mortality, morbidity and as a consequence decreased the health care services to communicable/non-communicable diseases. Our study shows the need and demand for robust health care services during critical times.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 4","pages":"1320-1324"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}