Journal of Family Medicine and Primary Care最新文献

{"title":"Challenges and reforms in family medicine: Perspective of Indian family physician.","authors":"D Hemavathi, Mohan Kubendra, Ruby Aleyamma Roy, Resmi S Kaimal, Vandana Boobna, S Ramya","doi":"10.4103/jfmpc.jfmpc_1955_24","DOIUrl":"10.4103/jfmpc.jfmpc_1955_24","url":null,"abstract":"<p><strong>Introduction: </strong>Family medicine in India has been growing steadily, from the last two decades. In this period, a review on the challenges faced by the family physicians and reforms that can be aimed for from a family physicians' perspective can give a direction to the growth of family medicine in India.</p><p><strong>Aims and objectives: </strong>1. To assess the common challenges faced by family physicians practicing in India. 2. To list the reforms a family physician envisions in the field of family medicine. Methodology: It is a cross-sectional, questionnaire-based study. Inclusion criteria: 1. Doctors practising as family physicians, who do not hold a postgraduate degree in Family Medicine (those with MBBBS or post-MBBS fellowships or diplomas in Family medicine through distance education, nonresidentially trained) 2. Doctors practising as family physicians, who hold an NMC recognised postgraduate degree or diploma in Family Medicine (residentially trained-MD, DNB or DFM-NBEMS).</p><p><strong>Results and conclusions: </strong>1. The most common challenges faced by family physicians include achieving an adequate income, time for academic and research activity and managing stress and burnout. However, these issues are not unique to family physicians but could be prevalent across the medical profession as a whole 2. The least challenging are adequate intellectual stimulation and referral to a specialist. 3. The prevalence of challenges is more among the nonresidentially trained family physician 4. The reforms proposed by family physicians emphasize the need for greater recognition and acceptance of the specialty, both within the medical community and among the public. There is also a strong desire for expanded training opportunities, enhanced academic roles, and more support in practice establishment. Ultimately, family physicians envision a healthcare system where they serve as the first point of care for all patients, contributing to a well-structured and accessible healthcare delivery model.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2416-2425"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731646","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":"Comparison of inflammatory markers and nerve conduction studies in prediabetes and type two diabetes mellitus: A possible role in neuropathy.","authors":"Zarghuna Khan, Syed H Habib, Thamir Al-Khlaiwi, Najma Baseer, Mohammed M Khalifa, Syed S Habib","doi":"10.4103/jfmpc.jfmpc_1739_24","DOIUrl":"10.4103/jfmpc.jfmpc_1739_24","url":null,"abstract":"<p><strong>Background and objective: </strong>Data on the role of anti- and proinflammatory markers in diabetes and prediabetes and their associations with diabetic neuropathy are limited. Therefore, the aim of this study was to determine and compare the associations of inflammatory markers and nerve function with blood glucose levels among diabetic patients and prediabetic patients.</p><p><strong>Methods: </strong>This was a cross-sectional study consisting of 80 participants (40 diabetic patients and 40 prediabetic patients). The assessment involved a detailed history and neurological examination, including neuropathy symptom scoring (NSS) and the neuropathy deficit score (NDS), to grade neuropathy if present. Baseline investigations were performed, and HbA1c values were assessed in all the subjects. Serum TNFα and IL-10 levels were measured via enzyme-linked immunosorbent assay (ELISA). Nerve function was evaluated through a nerve conduction study. The data were subjected to an independent sample <i>t</i> test.</p><p><strong>Results: </strong>The results revealed a significant increase in the concentrations of IL-10 (<i>P</i> = 0.016) and TNFα (<i>P</i> < 0.001) in diabetic patients compared with prediabetic patients. Nerve conduction velocity in the sural nerve (right side, <i>P</i> = 0.019; left side, <i>P</i> = 0.001) and ulnar nerve (right side, <i>P</i> = 0.007; left side, <i>P</i> = 0.005) was also lower in both limbs of diabetic patients than in those of prediabetic patients. Latency was greater in diabetic patients than in prediabetic patients.</p><p><strong>Conclusions: </strong>The inflammatory markers TNF-α and IL-10 were significantly elevated in patients with diabetes compared with those with prediabetes, and these markers might contribute to neuropathy in patients with diabetes. However, no associations were found between inflammatory markers and nerve function.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2358-2364"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731651","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":"Correlation of fractional exhalation of nitric oxide values with asthma control test score and spirometric parameters in steroid naïve asthmatic children at 6-8 weeks follow up.","authors":"Ramya Thangavel, Saji James, Anitha Palani, Elayaraja Sivaprakasam","doi":"10.4103/jfmpc.jfmpc_3_25","DOIUrl":"10.4103/jfmpc.jfmpc_3_25","url":null,"abstract":"<p><strong>Context: </strong>In pediatric asthma, it is critical to have a reliable airway inflammation marker that may be used to assess its severity and prognosis. Fractional exhalation of nitric oxide (FeNO) is a non-invasive objective method can be utilized as a supplemental tool if proven to correlate with clinical parameters.</p><p><strong>Aims: </strong>To study the correlation between FeNO, and asthma control test (ACT) scores and spirometry data in steroid naive asthmatic children 6-18 years at visit one and after 6-8 weeks follow-up.</p><p><strong>Settings and design: </strong>This was observational follow-up study conducted among steroid naïve asthmatics attending the Outpatient Department.</p><p><strong>Materials and methods: </strong>At baseline visit, they were classified as well controlled, not well controlled, and poorly controlled as per ACT, FeNO and Spirometry done as per standard technique. After 6-8 weeks of follow-up, all the above parameters were repeated.</p><p><strong>Statistical analysis used: </strong>Pearson correlation coefficient/Kendall's tau 2 of 10 analysis was used for the association of two related variables. <i>P</i> <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Among 56 enrolled, mean FeNO at visit 1 was 41.8 ± 33.26, which decreased to 20.26 ± 14.57 at visit 2. Changes in mean FeNO values between both visits and ΔACT scores (<i>P</i> = -0.001) and change in forced expiratory volume in 1 sec (ΔFEV1) were statistically significant (<i>P</i> = 0.001). A decrease in FeNO values from baseline was accompanied by significant increase in ACT scores and an improvement in FEV1.</p><p><strong>Conclusion: </strong>The FeNO values correlated inversely with the ACT scores as well as FEV1 proving its scope for incorporating it in the clinical setting for monitoring asthma treatment.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2552-2557"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731653","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":"Effectiveness of video-assisted planned teaching intervention on knowledge regarding weaning among mothers.","authors":"Archana Yadav, Nitasha Rai, Sunita Devi, Devendra Singh, Prabhawati Singh, Priyanshi Dixit","doi":"10.4103/jfmpc.jfmpc_1648_24","DOIUrl":"10.4103/jfmpc.jfmpc_1648_24","url":null,"abstract":"<p><strong>Aim: </strong>It is an integral part of the transitional phase in a child's life as weaning for satisfactory growth and development. Effective weaning in the child requires proper knowledge and good technique skills in the mother. The present study aimed to evaluate the effectiveness of education video intervention in increasing weaning knowledge among rural mothers.</p><p><strong>Method: </strong>A quasi-experimental one-group pre-test and post-test design were adopted to study conveniently selected 60 mothers of 0-4-year-old infants in a designated rural area of Kanpur district.</p><p><strong>Result: </strong>In the pre-test, the majority of mothers of infants i.e., 70.0% had average knowledge and only 26.66% had good knowledge regarding Weaning with a mean knowledge score was 17.33 ± 4.95. In the post-test, the majority of mothers of infants i.e., 83.33% had excellent knowledge and none of the participants had poor knowledge. After implementing the video Teaching Intervention programme knowledge score increased to 33.0 ± 4.76 and was found to be significant (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The study suggests that video teaching programmes regarding weaning have a great impact on knowledge regarding weaning among mothers of infants aged 0-4 years Some socio-demographic variables like parity of mothers and educational background influence the post-test knowledge score significantly.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2301-2306"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731573","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":"Addressing the gap in kidney care: A call for algorithmic approach with multiple-biomarker assessment.","authors":"Seema Shah, Rathore Vinay, M S P Reddy","doi":"10.4103/jfmpc.jfmpc_1120_24","DOIUrl":"10.4103/jfmpc.jfmpc_1120_24","url":null,"abstract":"","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2576-2577"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731613","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":"Bilateral ovarian mass due to primary hypothyroidism: A case report.","authors":"Fathima Mubeena, Vimal Mavila Veetil, K Nikitha, P N Ajitha, Jesheera Mohammedkutty","doi":"10.4103/jfmpc.jfmpc_1090_24","DOIUrl":"10.4103/jfmpc.jfmpc_1090_24","url":null,"abstract":"<p><p>This is a case of a young lady who presented with irregular periods, oligomenorrhoea, and abdominal pain. On evaluation, she was found to have bilateral ovarian cysts and planned for a major surgery. Hypothyroidism was coincidentally detected. With a diagnosis of hypothyroidism and TSH-induced ovarian stimulation, she was started on thyroxine supplementation. The response to thyroxine was satisfying, with a significant reduction in the size of the lesions along with symptomatic improvement.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2569-2571"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731643","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":"Predictive value of platelet counts to detect grade of esophageal varices in liver cirrhosis.","authors":"Sushma Swaraj Rapelly, Shalini Suri, Nabila Nishat, Afreen Saif","doi":"10.4103/jfmpc.jfmpc_1598_24","DOIUrl":"10.4103/jfmpc.jfmpc_1598_24","url":null,"abstract":"<p><strong>Introduction: </strong>Bleeding from esophageal varices (EVs) causes a significant risk in cirrhotic patients, often leading to life-threatening complications. While screening endoscopy is the recommended method to identify those at risk, its invasive nature and limitations prompt the search for alternative predictors. Thrombocytopenia has emerged as a potential marker for assessing the presence and severity of EVs. This study aims to establish a relationship between platelet count and predicted grading of EVs in individuals with liver cirrhosis.</p><p><strong>Aim: </strong>To study platelet count as a predictor of EVs in liver cirrhosis. Materials and Methods: This cross-sectional research was undertaken at KGMU, Lucknow. It encompassed newly identified cases of cirrhosis with varices of any degree detected through endoscopy. The endoscopic observations were standardized utilizing the Paquet grading system. Patients were categorized into four subgroups based on platelet count, and correlations between platelet count groups and EVs grading were examined using Spearman rank correlations. The association between platelet count and EVs grade was assessed using the Chi-square test.</p><p><strong>Results: </strong>The study comprised 50 patients, with 84% (n = 42) being male, and the mean age was 45.66 ± 10.26 years. Platelet counts were categorized as follows: <50,000/uL in 36% of patients, 50,000-99,000/uL in 28%, 100,000-150,000/uL in 14%, and >150,000/uL in 22% of patients. EVs were classified as grade I in 26% of patients, grade II in 20%, grade III in 34%, and grade IV in 20% of patients. When the platelet count is <50,000/uL, the patients present grade IV varices. With a platelet count of 50,000-99,000/μL, they present grade III varices; 100,000-150,000/μL corresponds to grade II; and > 150,000/μL to grade I EVs. The mean platelet count was 223245.53/mm³ in patients with grade I varices, decreasing to 109505.42/mm³, 57345.46/mm³, and 20502.00/mm³ in patients with grade II, III, and IV varices, respectively (<i>p</i> = <0.0001). A notable negative correlation was observed between platelet count and EVs grades (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Platelet count serves as a predictive factor for EVs grade in cirrhotic patients, with a significant negative correlation between platelet count and varices grades.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2330-2335"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731655","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":"Addressing the challenges in diagnosing and managing acute febrile illness in Eastern India.","authors":"Swati Sahai, Nikunja K Das","doi":"10.4103/jfmpc.jfmpc_1898_24","DOIUrl":"10.4103/jfmpc.jfmpc_1898_24","url":null,"abstract":"","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2593-2594"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731612","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":"Health insurance coverage and its associated factors amongst households of an urban village in Delhi.","authors":"Suraj P Singh, Anita Khokhar","doi":"10.4103/jfmpc.jfmpc_1099_23","DOIUrl":"10.4103/jfmpc.jfmpc_1099_23","url":null,"abstract":"<p><strong>Context: </strong>Urban poor households mostly comprising of migrants from small towns and villages are prone to residing in overcrowded, unplanned settlements, bearing a higher risk of healthcare ailments and expenditure. There is a need to assess health insurance amongst them to better understand insurance coverage, as well as their experience and attitude towards it.</p><p><strong>Aims: </strong>To find out the prevalence of health insurance and its associated factors amongst households of an urban village in Delhi.</p><p><strong>Settings and design: </strong>A cross-sectional study amongst households that have been residing for the last year in an urban village of Delhi.</p><p><strong>Methods and material: </strong>This 18-month duration study was carried out in an urban village of Delhi, where a sample size of 188 was calculated based on a study conducted in Dakshina Kannada, and households were selected using systematic random sampling. A pre-designed, pre-tested, semi-structured, and interviewer-administered questionnaire was used in Hindi to elicit and record relevant information.</p><p><strong>Statistical analysis used: </strong>Data was recorded and coded in MS Excel, and analysis was done using licensed IBM SPSS v. 26. Tables were generated for relevant data, and cross-tables were used to assess statistical association with Chi-square or Fisher's Exact tests, as required. Multivariate logistic regression was applied to the variables found to have a statistically significant association in cross-tables (<i>P</i> < 0.05).</p><p><strong>Results: </strong>Almost sixty percent of study households had no health insurance coverage, while 39.4% of households had some degree of health insurance, and only 53 (28.2%) had complete health insurance coverage of all household members.</p><p><strong>Conclusions: </strong>Only 28.2% of households in the urban village of Aliganj, Delhi, are covered under health insurance.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2520-2526"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731619","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 QTc prolongation with liver function test and complications in patients with cirrhosis: An observational study.","authors":"Rhythm Yogandh Relekar, Priyavardhan Mishra, Vishal Raghunath Gabale, Iqra Chandmiya Qureshi, Vijaykumar Gupta","doi":"10.4103/jfmpc.jfmpc_1814_24","DOIUrl":"10.4103/jfmpc.jfmpc_1814_24","url":null,"abstract":"<p><strong>Introduction: </strong>Cirrhotic cardiomyopathy is a cardiac abnormality due to hepatic cirrhosis, which presents as a serious electrocardiographic complication and often the patient is asymptomatic. The objective of our study was to find the ECG changes in patients with various aetiologies of cirrhosis and correlate them with their respective LFT parameters.</p><p><strong>Materials and methodology: </strong>We assessed the QTc interval in patients of various aetiologies of liver cirrhosis and correlated them with the prevalence of complication of cirrhosis, such as portal hypertension, splenomegaly, and ascites. Furthermore, we correlated the LFT parameters with their respective QTc interval.</p><p><strong>Results: </strong>Our study evaluated 300 patients of multiple aetiologies of cirrhosis, such as ALD, NASH, DCLD, AIH, HCC, HA, Hep-B, and Wilson's disease. Prolonged QTc was observed in 194 (64.66%) patients. QTc prolongation was most prevalent in DCLD patients. The association of complication including portal hypertension, splenomegaly, and ascites with prolonged QTc were all statistically significant (<i>P</i> = <0.001). QTc ms was significantly related to the Child-Pugh class (<i>P</i> = <0.001). SGOT and SGPT parameters were significantly correlated with QTc intervals (<i>P</i> = <0.001) in all aetiologies of liver disease. However, the correlation between ALP and indirect bilirubin levels with QTc interval was not statistically significant.</p><p><strong>Conclusion: </strong>Prolonged QTc interval is frequently observed as the ECG abnormality in patients with cirrhosis. QT prolongation correlates with elevated LFTs and cirrhotic complications.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 6","pages":"2323-2329"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731629","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}