Indian Journal of Community Medicine最新文献

{"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}

{"title":"Influence of Health-Seeking Behavior on Treatment Initiation of Cancer Patients at a Tertiary Care Hospital in Varanasi.","authors":"Nishu Kesh, Manoj Pandey, Sangeeta Kansal","doi":"10.4103/ijcm.ijcm_469_23","DOIUrl":"10.4103/ijcm.ijcm_469_23","url":null,"abstract":"<p><strong>Background: </strong>Cancer is one of the leading causes of death worldwide, and in order to prevent it, it is vital to understand cancer patients' health-seeking behavior that contributes to patient delays in receiving cancer treatment globally; however, no similar studies have been conducted in India. Therefore, this study made an effort to know health-seeking behavior among delayed cancer patients receiving treatment at a tertiary care hospital, Varanasi.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at the Department of Surgical Oncology OPD, Sir Sunder Lal Hospital, IMS, BHU, Varanasi. Randomly selected 440 registered patients were interviewed with the help of semi-structured questionnaire. Binary logistic regression analysis and 2-test were used in this study.</p><p><strong>Results: </strong>Out of total 440 patients included in this study, 207 (47.05%) were males and 233 (52.95%) were females. The majority (59.32%) of patients were more than 45 years of age group. Most (80%) of the patients had delay in cancer treatment of more than 60 days from onset of symptoms. Only 29.55% of patients were aware of any symptoms of Cancer. Those patients who were doing self-medication (<i>P</i>=0.03) and did not attend any cancer screening program (<i>P</i>=0.04) showed a statistically significant association with delayed initiation of treatment. Patients referred from another centre (<i>P</i> = 0.03) also show a significant association with delayed treatment initiation. Cancer patients who visited the screening program (AOR= 0.22, <i>P</i>=0.003) were significantly associated with a lower likelihood of delayed treatment initiation.</p><p><strong>Conclusion: </strong>The study showed that 80% of patients were delayed in seeking treatment for Cancer and highly influenced by low awareness, self-medication and visiting multiple health centres for diagnosis and treatment. Therefore, there is a strong need to address the reasons for the delay in seeking treatment.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"445-452"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286762","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":"Nutrition Care Model for Nutritional Assessment and Dietary Counseling of Adults Living with HIV in India.","authors":"Aakriti Gupta, K Pramod, Anuja Aggarwal, Madhavi Bhargava, Ashima Phadiyal, Fazlur R Gulfam, Rochana Mitra","doi":"10.4103/ijcm.ijcm_580_23","DOIUrl":"10.4103/ijcm.ijcm_580_23","url":null,"abstract":"<p><strong>Background: </strong>A high prevalence of undernutrition (40%) exists among adults living with HIV (ALHIV) in India due to their increased metabolic demands. Diminished nutritional status in turn has been associated with increased risk of morbidity and mortality among ALHIV. Nutritional assessment and its management are an integral part of HIV care; however, no strategy exists for screening of undernutrition among ALHIV.</p><p><strong>Materials and methods: </strong>The nutrition care model has been developed for undertaking nutritional assessment by classifying the severity of undernutrition based on body mass index (BMI) and identification of early signs of undernutrition including anemia and hypoalbuminemia among ALHIV.</p><p><strong>Results and conclusion: </strong>The model suggests energy and protein intake based on the BMI and indicates desirable body weight corresponding to a BMI of 21 kg/m². Based on these requirements, the portion size of each major food group is provided for individualized dietary counseling by frontline workers. ALHIV found with signs and symptoms of anemia, low hemoglobin, and serum albumin are referred to the nearest health facility. Large-scale operational research and field validation studies are planned to better understand the effectiveness of the model in improving the nutritional and clinical outcomes and the strengths and limitations as an operational tool in programmatic settings.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"407-412"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286768","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":"Oral Vaccination of Dogs in India as a Strategy for Elimination of Rabies: Scope of Implementation.","authors":"Athira Prathapan, Shibajee Debbarma, H Haripriya, Sanjay Pandey","doi":"10.4103/ijcm.ijcm_34_24","DOIUrl":"10.4103/ijcm.ijcm_34_24","url":null,"abstract":"<p><p>India contributes one-third of the global burden of rabies. In 2021, the National Action Plan for Rabies Elimination (NAPRE) was introduced to eliminate dog-mediated human rabies. The major challenges in the path of eliminating dog-mediated rabies are toward achieving the high level of dog vaccination coverage and its sustenance, as well as rigorous tracking of dogs and continuous outreach activities. Oral vaccination of dogs (OVD) is a measure that has been implemented in several countries. For a deeper understanding of the OVD strategy, a systematic search was conducted and free full-text articles related to feasibility of OVD adoption and field trials published in the past ten years were included in the present review. Based on evidence, OVD can be implemented in India along with existing government initiatives as a pilot project in selected hotspots and subsequently expanded to improve vaccination coverage.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"413-416"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286770","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":"Five-year Trends in Various Communicable Diseases Reported under the Integrated Disease Surveillance Program during 2014-2019 in Puducherry.","authors":"K Sivaranjini, Durgesh Roy, Yuvaraj Krishnamoorthy, Ravivarman Lakshmansamy, Srividya Vissvesvaran, G Ragunathan, Mahalakshmy Thulasingam, Sitanshu S Kar","doi":"10.4103/ijcm.ijcm_671_23","DOIUrl":"10.4103/ijcm.ijcm_671_23","url":null,"abstract":"<p><p>The current study aimed to determine the trend in the incidence of various communicable diseases reported under the Integrated Disease Surveillance Program (IDSP) in Puducherry. This record-based study obtained disease details in terms of the number of suspected cases reported, tested, and positive for the selected diseases reported under IDSP from 2015 to 2019. Dengue disease has shown a recent declining trend in the number of cases and test positivity (7.2% in 2015 to 5.2% in 2019), and there has been a steady increase in the burden of Chikungunya over the years (4.1% in 2015 to 12.6% in 2019). Malaria has been controlled well in Puducherry, but the testing rate was only 3%-4%, well below the national recommendation of testing 10% of the total population. In 2018, there was a recent increase in influenza cases, with test positivity reaching up to 21%. The study unveils valuable insights into communicable diseases in Puducherry, highlighting the fluctuating burden of vector-borne, water-borne, and influenza infections.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"525-529"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286758","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":"Protecting Children from Tobacco Industry Interference in India.","authors":"Diksha Walia, Chirag Goel, Sonu Goel","doi":"10.4103/ijcm.ijcm_638_24","DOIUrl":"10.4103/ijcm.ijcm_638_24","url":null,"abstract":"","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"401-403"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286771","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 Instrument-assisted Soft-tissue Mobilization Versus Dry Cupping on Pain and Cervical Range of Motion in Treatment of Neck Pain.","authors":"Afreen Jahan","doi":"10.4103/ijcm.ijcm_834_23","DOIUrl":"10.4103/ijcm.ijcm_834_23","url":null,"abstract":"<p><strong>Background: </strong>Neck pain is characterized by symptoms of a nonspecific nature of the pain, which is of mechanical origin.[12] Frequently observed manifestations of neck discomfort encompass muscle pain, muscle spasms, headaches, facet joint pain, nerve pain, referred pain, and bone pain.[3] Instrument-assisted soft-tissue mobilization (IASTM) stands as a proficient myofascial intervention used for the treatment of soft tissues. Here, using instruments typically crafted from stainless steel featuring beveled edges and anatomically contoured designs to accommodate various body regions, this technique allows for enhanced depth of penetration.[4] Primarily used for the identification and therapeutic management of soft-tissue disorders, the approach involves the application of these specialized instruments.[5] Dry cupping, alternatively recognized as air cupping or suction cupping, constitutes a therapeutic methodology, wherein a vacuum is generated within cups and subsequently applied to targeted regions of the body. These cups, fabricated from diverse materials such as glass, silicone, or plastic, induce suction effects. Through the application of this suction, dry cupping serves to promote circulation, alleviate muscle tension, and facilitate the energetic flow within the treated areas.</p><p><strong>Material and methods: </strong>The purpose of the study to effectiveness of instrument-assisted soft-tissue mobilization versus dry cupping on pain and cervical range of motion in treatment of neck pain. The study is comparative in nature, and total subjects were 15 subjects in each group. The assessment of pain and range of motion of cervical flexion and lateral flexion were taken before starting the treatment of both the groups. The patients were randomly assigned by lottery method for both the groups, and assessments were taken on 0 day and at the end of 4^th week by VAS and ROM by a goniometer.</p><p><strong>Results: </strong>In IASTM treatment, the <i>P</i> value is 0.031. This suggests that there is a statistically significant difference between the pre-treatment and post-treatment values for the IASTM group. But, in dry cupping, the <i>P</i> value is 0.001. This indicates a highly significant difference between the precupping and postcupping values for this treatment group. The scores of variables VAS and ROM were improved significantly better in the subjects treated with dry cupping as compared to the group variables treated with instrument-assisted soft-tissue mobilization.</p><p><strong>Conclusion: </strong>The study conclude that the dry cupping is more beneficial for the treatment of neck pain and range of motion.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"506-511"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286756","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 Health Awareness: How Media can Transform Community Wellbeing.","authors":"Amit Verma","doi":"10.4103/ijcm.ijcm_793_24","DOIUrl":"10.4103/ijcm.ijcm_793_24","url":null,"abstract":"","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"535-536"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286759","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":"Interest in Online Tobacco Cessation Services During the COVID-19 Pandemic in India- insights from Google Trends.","authors":"Madhur Verma, Sonu Goel, Praveen Sinha, Mahendra Singh, Kritika Upadhyay","doi":"10.4103/ijcm.ijcm_265_23","DOIUrl":"10.4103/ijcm.ijcm_265_23","url":null,"abstract":"<p><strong>Background: </strong>With concerns about higher mortality and morbidity attributed to COVID-19 infection among tobacco users, the pandemic has been an opportune time to further our efforts towards tobacco cessation. The present study thus aims to assess the interest in tobacco cessation services during the pandemic.</p><p><strong>Materials and methods: </strong>An ecological study was done using data from Google Trends for five years. The trends depicting the interest in internet search terms like \"Quit-tobacco\" and \"Quitline\" were retrieved and compared over the study period and with the Global Adult Tobacco Survey-India (GATS-II) data estimates (2016-17). The results were reported using descriptive statistics and line graphs.</p><p><strong>Results: </strong>Between 2017 and 21, the search interest regarding quitting tobacco depicted the highest peak corresponding to the second wave of the COVID-19 pandemic. There were significant geographical disparities in the Google searches made across India. As per GATS-II, only 0.2% of the smokers had used a Quitline, corresponding to a smaller peak in Google Trends. Interest in \"Quitline\" compared to \"quit tobacco\" was in a ratio of 1:11, and the gap increased further during the pandemic by 1:12.</p><p><strong>Conclusions: </strong>We observed an increasing interest in the searches related to \"Quit-tobacco\" like terms during the pandemic but an increasing gap in the interest around the \"Quitline\" searches. The present study hypothesizes that the pandemic increased concerns regarding tobacco, leading to a higher interest in tobacco cessation services, thus calling for a proactive approach to propagate 'Quitline' through generous advocacy to have efficient tobacco control per the National Tobacco Control Program.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"50 3","pages":"417-422"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12156087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286763","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}