Journal of Family Medicine and Primary Care最新文献

{"title":"A diagnostic approach incorporating a predictive model based on simple parameters for differentiating dimorphic anemia from nutritional macrocytic or microcytic anemia.","authors":"Ailing Luan, Ying Zhu, Chengxin Luan, Hongguo Zhao","doi":"10.4103/jfmpc.jfmpc_308_26","DOIUrl":"10.4103/jfmpc.jfmpc_308_26","url":null,"abstract":"<p><strong>Background: </strong>The red blood cell (RBC) indices of dimorphic anemia (DA) may present as macrocytic, microcytic, or normocytic, leading to missed diagnoses when relying solely on empirical judgment of these indices. This is particularly problematic in underdeveloped regions where tests for iron, vitamin B12, and folate status are unavailable.</p><p><strong>Methods: </strong>We retrospectively analyzed patients diagnosed with iron deficiency anemia (IDA) and megaloblastic anemia (MA) at our institution. We compared patient characteristics and complete blood count (CBC) parameters between IDA, MA, and DA, and subsequently developed a diagnostic model.</p><p><strong>Results: </strong>About 142 DA, 288 IDA, and 60 MA patients were included. DA showed predominant microcytosis, with minor normocytic and rare macrocytic cases, enabling clear differentiation from MA by mean corpuscular volume (MCV) but not IDA. To distinguish DA from IDA, we analyzed patient characteristics and CBC parameters. By univariate analysis and logistic regression, sex, RBC, and WBC were identified as independent predictors. A predictive model assigned scores: 3.5 points for male sex, 1 point for RBC <3.36 × 10¹²/L, and 2 points for WBC > 5.87 × 10⁹/was built and internally validated. A flowchart for the diagnosis of nutritional anemia was proposed, with a focus on the rational measurement of iron, folate, and vitamin B12 to discover DA.</p><p><strong>Conclusions: </strong>Our algorithm provides a clinical model for DA prediction using simple parameters, enabling targeted guidance for the measurement of iron, vitamin B12, and folate. Noting the single-center limitation and sample constraints, this diagnostic approach requires validation in diverse populations and regions to potentially derive corresponding new models.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2082-2087"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549316","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":"Erratum: Prevalence of intestinal parasites in humans and domestic animals in Jirel community, Dolakha, Nepal.","authors":"","doi":"10.4103/jfmpc.jfmpc_1081_26","DOIUrl":"10.4103/jfmpc.jfmpc_1081_26","url":null,"abstract":"<p><p>[This corrects the article on p. 3408 in vol. 13, PMID: 39228571.].</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2187"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549204","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":"From disruption to recovery: Trends in acute condition attendances at Western Singapore polyclinics during and after the COVID-19 pandemic.","authors":"Zeenathnisa M Aribou, Clement Kweh, Ying X Chua, Fong S Lim, Yi-Fu J Hwang, See M Lim","doi":"10.4103/jfmpc.jfmpc_2048_25","DOIUrl":"10.4103/jfmpc.jfmpc_2048_25","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic (2020-2022) significantly disrupted healthcare delivery, with primary care utilization patterns shifting in response to public health interventions and system adaptations. Understanding these changes is essential to inform future preparedness and service planning.</p><p><strong>Methods: </strong>We conducted a retrospective descriptive study of weekly attendances at five public polyclinics in western Singapore from January 2019 to June 2022. Attendances were categorized using ICD-10-CM codes into three groups: acute respiratory infections (ARI), acute non-respiratory infections (ANRI), and acute non-infective conditions (ANI). Trends were examined across three phases: pre-pandemic, pandemic, and transition to post-pandemic.</p><p><strong>Results: </strong>A marked decline in attendances was observed across all three condition categories during the pandemic, with the most pronounced and sustained reductions seen in ANRI and ANI visits. ARI attendances also declined initially, but later rebounded and constituted an increasing proportion of acute presentations over time. Shifts were temporally aligned with key national policy changes, including movement restrictions and changes in healthcare access points.</p><p><strong>Conclusion: </strong>Pandemic-related interventions and behavioral adaptations led to substantial and lasting shifts in primary care acute illness attendances. Reduced medical certification requirements, telehealth uptake, and diversion to Public Health Preparedness Clinics likely contributed to these patterns. The findings underscore the importance of adaptive service models, and integrated data monitoring to strengthen health system resilience in future public health emergencies.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"1975-1980"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549320","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":"Impact of fortified food distributed through Anganwadi centers in the prevention of anemia among children in Andhra Pradesh.","authors":"Arti Gupta, Desai Vidya Sripad, Ramireddy Gari Likhitha, Kishore Eswaramoorthi, Rajeev Aravindakshan, Naga Guhan, Bathina Sritha Reddy, Asu Satya, Bhukya Kamal, E Bharath","doi":"10.4103/jfmpc.jfmpc_379_26","DOIUrl":"10.4103/jfmpc.jfmpc_379_26","url":null,"abstract":"<p><strong>Background: </strong>Anemia remains a significant public health problem among young children in India despite long-standing supplementary nutrition interventions under the Integrated Child Development Services (ICDS). Balamrutham, a fortified food provided through Anganwadi Centers, aims to improve nutritional and biochemical outcomes; however, evidence of its effectiveness under routine program conditions is limited. This study assessed the burden of anemia and iron deficiency among children attending AWCs and examined the association between Balamrutham consumption and anemia-related biochemical parameters.</p><p><strong>Methods: </strong>A community-based cross-sectional mixed-methods study was conducted among 230 children aged 1-6 years attending 23 AWCs in rural Andhra Pradesh. Sociodemographic, feeding, and dietary information were collected using a structured questionnaire. Anthropometric and biochemical assessment, including hemoglobin, serum ferritin, and serum iron was performed. Quantitative data were analyzed using descriptive statistics and logistic regression analysis. Qualitative data on barriers to Balamrutham consumption were collected through in-depth interviews and analyzed thematically.</p><p><strong>Results: </strong>Among 230 children, 51 (22.2%) were consuming Balamrutham. The overall prevalence of anemia was 85.1%, with moderate anemia most common (57.8%). Low serum ferritin and low serum iron were observed in 47.0% and 44.8% of participants, respectively. Balamrutham consumption was not significantly associated with hemoglobin, serum ferritin, or serum iron levels. On multivariable logistic regression, younger age (1-3 years) and infrequent non-vegetarian food intake were independently associated with low ferritin levels. Thematic analysis identified five key barriers to Balamrutham utilization: perceived adverse effects, poor child acceptability, parental misconceptions, logistical constraints, and intra-household sharing.</p><p><strong>Conclusion: </strong>Despite the availability of fortified supplementary nutrition, inconsistent and inadequate consumption limited its measurable biochemical impact. Enhancing awareness, adherence, and implementation is key to improving ICDS nutrition outcomes.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2062-2068"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549323","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":"Uptake of influenza and pneumococcal vaccines among older adults attending primary health care centers in Riyadh, Saudi Arabia.","authors":"Moath A Alkathiri, Abdulrahman K Almousa, Maha H Alakeely, Sultan A Alqasim, Rakan E Alotaibi, Naila Shaheen","doi":"10.4103/jfmpc.jfmpc_396_26","DOIUrl":"10.4103/jfmpc.jfmpc_396_26","url":null,"abstract":"<p><strong>Context: </strong>Influenza and pneumococcal infections cause substantial morbidity and mortality in older adults, particularly those with chronic comorbidities. Despite proven benefits, vaccination coverage remains low.</p><p><strong>Aims: </strong>To assess utilization of influenza and pneumococcal vaccines and identify predictors of uptake among adults aged ≥65 years.</p><p><strong>Settings and design: </strong>Longitudinal retrospective study using electronic health records of patients aged ≥65 years attending Ministry of National Guard Health Affairs (MNGHA) primary health care centers in Riyadh, Saudi Arabia (2020-2023).</p><p><strong>Methods and material: </strong>Demographics, comorbidities, visit frequency, and vaccination status for influenza vaccine and pneumococcal conjugate vaccine (PCV13) were extracted. Multivariable logistic regression was used to identify predictors of influenza and PCV13 uptake, reported as odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Statistical analysis used: </strong>Descriptive statistics and multivariable logistic regression; two-sided <i>P</i> < 0.05 was considered significant.</p><p><strong>Results: </strong>Among 18,950 patients (mean age 73.7 ± 7.3 years; 52.3% female), influenza vaccination coverage was 467 (2.46%) and PCV13 uptake was 147 (0.77%). Males had higher odds of receiving influenza (OR 1.3, 95% CI 1.12-1.63) and PCV13 (OR 1.4, 95% CI 1.05-2.03). Uptake was higher among patients with dyslipidemia, asthma, diabetes, or hypertension. Vaccination peaked in 2021 and declined sharply in 2022-2023. Dirab clinic showed the highest vaccination rates.</p><p><strong>Conclusions: </strong>Influenza and PCV13 coverage among older adults in Riyadh primary care was very low, with variation by gender, comorbidities, and clinic. Targeted interventions are needed to improve uptake and reduce preventable infectious disease burden.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2088-2093"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549207","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":"Triglyceride Glucose Index as a screening tool for subclinical heart failure with preserved ejection fraction in type 2 diabetes mellitus in resource-limited settings.","authors":"Balachandra Routhu, Ravi Kant, Barun Kumar, Meenakshi Khapre, Vinay Tulsian","doi":"10.4103/jfmpc.jfmpc_1713_25","DOIUrl":"10.4103/jfmpc.jfmpc_1713_25","url":null,"abstract":"<p><strong>Context: </strong>Diabetic cardiomyopathy is an entity with a multifactorial pathophysiology, in which insulin resistance plays a key role. It increases the risk of heart failure with preserved ejection fraction (HFpEF) in type 2 diabetes mellitus (T2DM). The Triglyceride-Glucose Index (TGI) is a novel measure of insulin resistance which is simple to use and may serve as an accessible marker for subclinical HFpEF.</p><p><strong>Aims: </strong>To evaluate the association between TGI and subclinical HFpEF in asymptomatic patients with T2DM and assess its diagnostic performance.</p><p><strong>Methods: </strong>This was a cross-sectional observational analytic study in which 274 asymptomatic T2DM patients aged 18-60 years were enrolled. Patients with known cardiovascular disease, hypertension, macro- and microvascular complications, and other major comorbidities were excluded. TGI was calculated, and all participants underwent 2D echocardiography to assess left ventricular diastolic function.</p><p><strong>Results: </strong>LV diastolic dysfunction (LVDD) was detected in 62.4% of participants. TGI was significantly higher in patients with LVDD (mean 9.69 ± 0.49) versus those without (mean 9.23 ± 0.63), <i>P</i> < 0.001. ROC analysis identified a TGI cutoff of 9.34 as optimal for detecting LVDD, yielding a sensitivity of 80%, a specificity of 63%, and an AUROC of 0.734. To achieve high sensitivity (100%) and NPV (100%), the cutoff of 8.32 is best for screening for LVDD.</p><p><strong>Conclusions: </strong>TGI demonstrates fair diagnostic accuracy for identifying subclinical HFpEF in T2DM. Given its simplicity and cost-effectiveness, it may be considered a valuable screening tool in resource-limited settings.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"1932-1937"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549225","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":"Comments on \"Optimizing use of innovative medical devices in the family medicine and primary care settings\".","authors":"Sameena Khan, Fuzail Wani","doi":"10.4103/jfmpc.jfmpc_2023_25","DOIUrl":"10.4103/jfmpc.jfmpc_2023_25","url":null,"abstract":"","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2159-2160"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549195","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":"Family typology among Mexican families after the COVID-19 pandemic.","authors":"Brian González-Pérez, Kenia L Villegas-Saldívar, Edgar E Torres García, Félix I Islas-Ruz, Dulce A Rivera-Ávila, María V Jiménez-Báez, Sujey A Ruíz-Magallon","doi":"10.4103/jfmpc.jfmpc_2270_25","DOIUrl":"10.4103/jfmpc.jfmpc_2270_25","url":null,"abstract":"<p><strong>Context: </strong>The COVID-19 pandemic had a significant impact, profoundly altering household composition, income levels, and economic support structures.</p><p><strong>Aims: </strong>Explore the changes in family typology after the COVID-19 pandemic among Mexican families affiliated with a Family Medicine Unit (FMU) in Tampico, Tamaulipas.</p><p><strong>Settings and design: </strong>An analytical, comparative, and exploratory study. A total of 73 families attended FMU No. 38 were included. Family typology was determined before and 4 years after the COVID-19 pandemic.</p><p><strong>Methods and material: </strong>Data collected included identification, and sociodemographic variables. Family typology was determined based on the Mexican Consensus of Family Medicine and Life Cycle stage was classified according to Huerta. Statistical analysis was performed using IBM SPSS Statistics. Descriptive analysis of quantitative variables was conducted using measures of central tendency and standard deviation (SD), qualitative variables were described using frequencies and percentages. Comparisons between variables were performed using the Chi-square (χ²) test.</p><p><strong>Results: </strong>The mean age was 38.52 ± 12.77 years in the pre-pandemic period. Pre-pandemic marital status was predominantly married (57.5%), followed by single (32.9). An increase in the proportion of divorced and widowed individuals was observed in the post-pandemic period (6.8% and 2.7%, respectively). Statistically significant differences were identified in the post-pandemic period, including a decrease in the proportion of employees (from 78.1% to 65.8%). The proportion of nuclear families decreased (from 39.7% to 11.9%), while non-integrated nucleus increased (8.2% to 19.7% <i>P</i> = 0.029).</p><p><strong>Conclusions: </strong>The findings of this study confirm the profound impact of the COVID-19 pandemic on the structure and dynamics of Mexican families, in labor, economic and family organization aspects.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2054-2061"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549365","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":"Males' perception and involvement in preconception care in Indonesian primary care in Bantul region, Yogyakarta.","authors":"Rifyal S Muhamad, Anis Widyasari, Diannisa I E Sangun, Fitriana M Ekawati","doi":"10.4103/jfmpc.jfmpc_378_25","DOIUrl":"10.4103/jfmpc.jfmpc_378_25","url":null,"abstract":"<p><strong>Background: </strong>Preconception care (PCC) aims to prevent morbidity and optimize the women's health before pregnancy occurs. The success of the PCC would need a mutual involvement of both the women and their spouse. In Indonesia, males' involvement in PCC is rare, and research on this subject is limited. This study aimed to explore men's involvement and factors associated with men's involvement in PCC in Bantul region, Yogyakarta.</p><p><strong>Methods: </strong>This study applied a cross-sectional survey from July to September 2024 at three primary health care centers in Bantul, involving 100 men aged >18 years of those bride-to-be or those planning for conception. The data were analyzed descriptively and sought for any correlation between their perception and involvement in PCC with the aid of SPSS.</p><p><strong>Results: </strong>The results revealed varying levels of males' involvement in PCC, with 46% categorized as high, moderate (28%), and low (26%). Knowledge levels were a critical determinant, with men exhibiting higher knowledge showing greater involvement (<i>P</i> < 0.05). Positive attitudes and effective spousal communication were also correlated with higher levels of engagement in PCC. Men's challenges toward the invovelvement includes, time constraints, financial limitations, and cultural barriers.</p><p><strong>Conclusion: </strong>Males' involvement in PCC programs in Bantul is relatively high; their knowledge, attitudes, and spousal communication are pivotal factors influencing engagement. Further research is needed to address the involvement challenges including cultural norms, financial constraints, and limited awareness through targeted educational campaigns and accessible healthcare services.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2040-2045"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549298","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":"Comment on \"Effectiveness of health promotion intervention on knowledge regarding psychological dependence on the internet and social media among adolescents in South India\".","authors":"Vikas V Pawar, Safia Farooqui","doi":"10.4103/jfmpc.jfmpc_2178_25","DOIUrl":"10.4103/jfmpc.jfmpc_2178_25","url":null,"abstract":"","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2163-2164"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549285","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}