Indian Journal of Community Medicine最新文献

{"title":"Extension Health Clinic: \"Reaching the Unreached.\"","authors":"Debkumar Pal, Binod Kumar Behera, Prajna Paramita Giri","doi":"10.4103/ijcm.ijcm_656_23","DOIUrl":"10.4103/ijcm.ijcm_656_23","url":null,"abstract":"<p><p>The healthcare services should be delivered to the community's doorstep with their participation at an affordable cost to achieve \"Health for All.\" The healthcare services should also be delivered to the vulnerable population to achieve \"Health for All.\" The three-tier government healthcare delivery services can be complemented with the community-level healthcare services through the Extension Health Clinics (EHC). This study describes the EHC activities of a tertiary healthcare institute in Eastern India. Utilizing resources from the local government healthcare facilities with available resources and a workforce from medical colleges should complement the resources or logistics available at the community level. Vulnerable populations, such as residents of slums, can benefit from achieving an improved health status through this EHC activity. The EHCs provide essential healthcare services and services such as domiciliary care for bedridden patients and referral and follow-up. We conducted EHCs in urban slums for more than two years, encountering 2521 EHC beneficiaries in the last six months, including first-time visits and follow-ups. The mean age of the patients was 32.97 years (SD 20.72 years). Females majorly attended EHCs, with most diagnoses being comprised of non-communicable diseases and communicable diseases such as type-2 diabetes mellitus hypertension and upper respiratory tract infection. The EHCs are helping us to provide quality patient care at the doorstep of an urban slum community to the unreached and unattended ones. It also helps to strengthen undergraduate and postgraduate teaching-learning activities.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"512-515"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286757","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":"Temporal Trends of Dog Bite Cases and their Correlation with Meteorological Factors in a Metropolitan City.","authors":"Dinesh Asokan, Anjali Mall, Lalit Sankhe, Nagaraj Jaganathasamy, Geeta Pardeshi","doi":"10.4103/ijcm.ijcm_784_23","DOIUrl":"10.4103/ijcm.ijcm_784_23","url":null,"abstract":"<p><strong>Background: </strong>Dog bites are a major public health concern in India. Understanding the temporal trends of dog bites and their correlation with meteorological data will help develop effective strategies for prevention under one health program. Assessment of temporal trends of dog bite cases and their correlation with meteorological factors.</p><p><strong>Methodology: </strong>A retrospective secondary data analysis was conducted using the data of 2022 dog bite cases reported at a tertiary care hospital in Mumbai. The month-wise temporal trend was described, and its correlation was assessed with meteorological data retrieved from the regional meteorological center by using Spearman's correlation coefficient.</p><p><strong>Conclusion: </strong>Of the 3350 dog bite cases that attended the outpatient department, 2368 (70.7%) were below 40 years of age, 2733 (81.6%) were males, and 2621 (78.18%) had category III bites. We found a positive correlation between the number of dog bites and temperature (ρ = 0.650, <i>P</i> = 0.022) and average sun hours (ρ =0.804, <i>P</i> = 0.002). A negative correlation was found between rainfall (ρ = -0.845, <i>P</i> = 0.001), humidity (ρ = -0.730, <i>P</i> = 0.007), and rainy days (ρ = -0.804, <i>P</i> = 0.002). A similar correlation pattern was found for category III bites.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"423-427"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286773","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 New Era of mRNA Vaccines: The Success of the COVID-19 Vaccines and the Safety Concerns in Adolescents.","authors":"Muthu Gopal, Anusiga S Rajan, Kavita Vasudevan, Ashwani Kumar, Vijesh S Kuttiatt","doi":"10.4103/ijcm.ijcm_544_23","DOIUrl":"10.4103/ijcm.ijcm_544_23","url":null,"abstract":"<p><p>A remarkable scientific achievement during the Covid pandemic is the rapid development and deployment of the mRNA vaccines which played a crucial role in reducing the Covid-related morbidity and mortality. The first-time safe use of the mRNA vaccine platform in humans opened up a new era in vaccinology. In the near future, the mRNA vaccine platform is likely to be used for other diseases as well. Though the Covid mRNA vaccine has been found to be safe in children, a matter of concern is the rare adverse event myocarditis, which was mostly observed among male adolescents. In this setting, we briefly discuss mRNA vaccine-related myocarditis and suggest that the safety concerns need to be alleviated by larger studies with long-term follow-up. We also stress the need for the generation of safety data from children in lower- and middle-income countries as there is limited experience with mRNA vaccines in such settings. The underlying mechanisms need to be understood well as the mRNA vaccine platform holds enormous promise for the future development of vaccines for several diseases.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"404-406"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286774","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":"Implementation of Community-Centric Medical Education through Family Adoption Program: Descriptive Results from Coastal Karnataka.","authors":"K Eshwari, Sneha D Mallya, Ashwini Kumar, Chythra R Rao, Akshaya Sekar, Shyamashree Das","doi":"10.4103/ijcm.ijcm_694_23","DOIUrl":"10.4103/ijcm.ijcm_694_23","url":null,"abstract":"<p><strong>Background: </strong>National Medical Commission (NMC), in their recent notification, included Family Adoption Program (FAP) in the undergraduate curriculum to provide a learning opportunity for community-based health care to Indian Medical Graduates.</p><p><strong>Materials and methods: </strong>As part of FAP, 1000 families living in rural areas of the district were approached. During house-to-house visits, students were accompanied by facilitators, and each student adopted four to five families from the villages. Students were trained regarding data collection tools, which included questions assessing sociodemographic characteristics, awareness, and utilization of various social security schemes. Paper-based data collection and data entry were performed using Google Forms. Geotagging of houses was conducted to facilitate follow-up visits.</p><p><strong>Results: </strong>A total of 768 households were surveyed, which included 3,238 residents with female predominance (51.9%). A significant proportion (59.9%) of the population were in the economically productive age group (20-60 years), with 38.1% educated up to secondary education (8^th to 12^th standard). Nearly half of respondents were aware of widow pension, Old age pension scheme, Pradhan Mantri Suraksha Bima Yojana, whereas the level of awareness was less than 50 percent for Bhagyalakshmi Scheme for girl child (44.7%) and Pradhan Mantri Jeevan Jyoti Bima Yojana (42.6%). Awareness regarding schemes for Maternal & Child Health and Disability was less, and for the Manaswini scheme, it was low. However, all the schemes were severely underutilized (28%-0.4%). The overall prevalence of any one chronic morbidity was found to be 18.4%, with hypertension and diabetes mellitus being the most common morbidities.</p><p><strong>Conclusions: </strong>FAP gives a new perspective to medical education in India by transforming existing hospital-based medical learning to a community-centered approach.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"479-485"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286761","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":"Mpox in India: Current Insights and Strategic Recommendations.","authors":"Tulika Singh, Sanju Sharma","doi":"10.4103/ijcm.ijcm_723_24","DOIUrl":"10.4103/ijcm.ijcm_723_24","url":null,"abstract":"<p><p>Mpox, formerly known as monkeypox, has gained significant attention globally due to recent outbreaks, particularly the emergence of the Clade 1b strain. The World Health Organization declared a Public Health Emergency of International Concern in August 2024, emphasizing the need for robust public health responses. In India, the first case of Clade 1b was reported in September 2024, highlighting the urgent requirement for enhanced preparedness. This article examines the current landscape of Mpox in India, discussing its epidemiology, public health measures, and the challenges faced in controlling the spread of the disease. Key challenges include stigmatization of affected populations, resource limitations in healthcare infrastructure, and the necessity for early detection and public awareness. To address these challenges, recommendations are proposed, focusing on community engagement, strengthening surveillance systems, fostering international collaboration, and implementing effective crisis communication strategies. A coordinated response involving multiple sectors is crucial to combat Mpox and protect public health in India. By adopting a comprehensive approach, India can enhance its resilience against Mpox and similar public health threats.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"539-543"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286766","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":"Normal Weight Obesity Associated with Enhanced Echo Intensity, Insulin Resistance, and Decreased Muscle Strength in Young Adults.","authors":"R Aruna, Armel Arputha Sivarajan, Gunaseelan Revathy, C J Vasanth","doi":"10.4103/ijcm.ijcm_291_23","DOIUrl":"10.4103/ijcm.ijcm_291_23","url":null,"abstract":"<p><strong>Context: </strong>Obesity refers to the accumulation of excess body fat. Even individuals with a normal body mass index (BMI) of <23 Kg/m² but a high percentage of body fat have an increased risk for noncommunicable disease. This condition is referred to as normal weight obesity (NWO).</p><p><strong>Aim: </strong>To assess the association between muscle strength, ultrasound-derived muscle thickness, insulin resistance, and echo intensity in NWO and normal weight nonobese (NWNO) young adults.</p><p><strong>Methods and material: </strong>Eighty young adults of a normal BMI of 18.5 to 22.9 Kg/m² were recruited in this current study. Forty subjects with cutoff points of body fat percentage ≥ 20.6% for men and ≥ 33.4% for women were taken as NWO group and 40 were NWNO. Fasting glucose and insulin were used for calculating insulin resistance, sensitivity, and beta cell function. Ultrasonography (USG) was done to measure forearm radial and ulna muscle thickness. The echo intensity was measured from an ultrasound image as a mean pixel value using Adobe Photoshop. Subjects were tested for handgrip strength using hand dynamometry.</p><p><strong>Results: </strong>Hand grip strength was higher in NWNO group, and subcutaneous fat thickness and echo intensity were higher in the NWO group. Glucose, insulin, and insulin resistance were significantly higher in the NWO group. Linear regression showed a significant correlation between ulna muscle thickness, forearm circumference, echo intensity, and insulin resistance with handgrip strength (r = 0.835 <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>NWO adults have higher insulin resistance and echo intensity, indicating decreased muscle quality compared to NWNO individuals.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"500-505"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286767","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":"Nutritional Status of Under-5 Children in Migrant Laborer Settlements of Ernakulam District, Kerala, Southern India - A Mixed Method Study.","authors":"Renjini B Ambika, Sobha George, Jeby Jose Olickal, Akhil X Manuel, Rakesh P Suseela","doi":"10.4103/ijcm.ijcm_750_23","DOIUrl":"10.4103/ijcm.ijcm_750_23","url":null,"abstract":"<p><strong>Background: </strong>To assess the nutritional status of children under 5 years of age in migrant laborer settlements and their utilization of Integrated Child Development Scheme services in Ernakulam district, Kerala.</p><p><strong>Material and methods: </strong>A mixed method study includes a community-based cross-sectional survey among 165 migrant under-5 children selected through a multistage cluster sampling method and 16 In-Depth Interviews among various stakeholders.</p><p><strong>Results: </strong>Of the children studied<b>,</b> 46% were stunted, 26% were wasted, and 12% had severe wasting. About 72% were aware of the nearest Anganwadi, and 49% and 42% of the eligible children received nutritional supplementation and availed the growth monitoring facilities, respectively. Major barriers to utilizing Anganawadi services were language barrier, inconvenient hours of operation, a lack of nutritional supplementation based on their taste, fear of discrimination from the parents of native children, and frequent family displacements.</p><p><strong>Conclusions: </strong>Nutritional status of migrant under-5 children is a concern and requires urgent attention.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"516-519"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286769","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":"Community Health Workers' Challenges during COVID-19: An Intersectionality Study.","authors":"Jyothi Kurapati, C T Anitha","doi":"10.4103/ijcm.ijcm_53_23","DOIUrl":"10.4103/ijcm.ijcm_53_23","url":null,"abstract":"<p><p>Accredited social health activists (ASHAs) and auxiliary nurse midwives (ANMs) as community health workers (CHWs) have been crucial in providing health assistance and information during the COVID-19 pandemic. These CHWs face various challenges, such as discrimination, long hours of work, and low wages, which were exacerbated during the pandemic. The study uses an intersectionality framework to understand CHWs' marginalization and challenges. A qualitative study with ASHAs and ANMs was conducted in selected primary health centers (PHCs) and subcenters in Suryapet district, Telangana, in 2021. The in-depth interviews of 60 CHWs were analyzed using the software Atlas-ti. The inductive thematic analysis highlighted several challenges faced by CHWs. These challenges include barriers such as discrimination based on class and caste, pay parity, increased workload, lack of training, inadequate safety equipment, and instances of assaults and mistreatment. CHWs, who are often rural women with minimal education, face stigmatization and attacks from community members. They struggled with maintaining records and understanding online training and dealt with rapid adaptation to technology. The study highlights the importance of implementing policies and support systems to protect and empower community health workers. This includes training, fair compensation, safety equipment, and measures against discrimination and violence.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"520-524"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286748","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":"Determinants of Quality Antenatal Care in Pregnant Women Using NFHS-4 Data: A Path Analysis Approach.","authors":"Sachit Ganapathy, Bhanushree Soni, Akash Mishra","doi":"10.4103/ijcm.ijcm_810_23","DOIUrl":"10.4103/ijcm.ijcm_810_23","url":null,"abstract":"<p><strong>Introduction: </strong>Quality antenatal care (QANC) is an important health care indicator of the public health structure of the country. Causal mediation analysis is a statistical model that can model the complex path that determines the QANC received by women. The objective of the study was to assess the proportion of women receiving QANC in India and to ascertain its determinants using causal mediation analysis.</p><p><strong>Methodology: </strong>The dataset for study was obtained from the NFHS-4 survey. The outcome variable QANC was formulated based on a set working definition. The potential determinants of QANC at individual and population levels were identified by literature search, expert opinion, and availability in the NFHS dataset. The effect estimates of the determinants were estimated by multiple logistic regression. The potential determinant variables were categorized as independent and mediating variables. A schematic path analysis model was conceptualized by plausibility and expert opinion. The direct, indirect, and total effects of independent and mediating variables were estimated by generalized causal path analysis.</p><p><strong>Results: </strong>We found that region, education, wealth, religion, working status, husband's education, and age were significant independent factors influencing QANC. Additionally, we found that husband's alcohol status, pregnancy awareness month, presence of husband during antenatal care (ANC) visit, pregnancy registration month, emotional violence, and timing of the first ANC visit were significant mediating variables.</p><p><strong>Conclusion: </strong>Understanding the factors associated with QANC is statistically more robust using causal path analysis, which would help us better shape policies for improved maternal health care in India.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"428-436"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286749","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":"Fostering Wellness in Medical Education: A Mixed Method Study of Stress, Isolation, and Coping among Undergraduate Students in India.","authors":"Yogesh Murugan, Anjali Dave, Shubham Patel, Rohitkumar Ram","doi":"10.4103/ijcm.ijcm_776_23","DOIUrl":"10.4103/ijcm.ijcm_776_23","url":null,"abstract":"<p><strong>Background: </strong>Medical school is a demanding environment that can negatively impact student well-being. This study aimed to evaluate stress, social isolation, associated factors, and student experiences among Indian undergraduates.</p><p><strong>Methods: </strong>A mixed method study was conducted at a medical college in Gujarat during January-March 2023. The 458 participants completed validated scales measuring stress (GHQ-12) and social isolation (LSNS-R). Associations with sociodemographics were analyzed using logistic regression and ANOVA tests. A qualitative phenomenological arm employed semi-structured interviews with 30 purposively sampled students to explore experiences and perceptions.</p><p><strong>Results: </strong>Over 50% of students reported significant stress, rising with seniority (35% to 38.4% from first to second year). Social isolation was also higher in third years (41%) versus first years (17.5%). Females, rural students, and single children were more affected. Interviews revealed key stressors, such as academics, lack of recreation, and difficult transition to clinics. Impacts included anxiety, reduced motivation, and headaches. Coping methods were family contact and leisure activities. Students suggested curricular reforms, upgrading facilities, and support services.</p><p><strong>Conclusion: </strong>Alarmingly high stress and isolation exist among Indian medical undergraduates, necessitating urgent interventions like mentoring programs, life-skills training, and enhanced student support services to promote well-being. A nurturing academic environment must be fostered.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"453-457"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286760","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}