Indian Journal of Community Medicine最新文献

{"title":"From Awareness to Autonomy: Exploring the Knowledge Gap and Acceptability of Self-Injectable DMPA-SC among Women in Central India.","authors":"Anita Yadav, Anusha Kamath, Jyoti Baghel, Neha Gangane, Amruta Choudhary, Shuchita Mundle","doi":"10.4103/ijcm.ijcm_479_25","DOIUrl":"10.4103/ijcm.ijcm_479_25","url":null,"abstract":"<p><strong>Background: </strong>Self-administered subcutaneous depot medroxyprogesterone acetate (DMPA-SC) provides a novel contraceptive modality that can expand access, autonomy, and continuation rates, especially among low-resource populations. While endorsed worldwide, the use and awareness of DMPA-SC in India remain undocumented.</p><p><strong>Objectives: </strong>To assess awareness, acceptability, and willingness toward self-administration of DMPA-SC among married women of reproductive age in central India.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 320 women aged 18-49 years at a tertiary hospital in central India. Data were collected through pretested questionnaires assessing sociodemographic factors, contraceptive history, knowledge of intramuscular DMPA (DMPA-IM) and DMPA-SC, and willingness for self-injection.</p><p><strong>Results: </strong>While 90% had heard of DMPA-IM, no participant had heard of DMPA-SC before. Despite this, 78% showed interest in learning about DMPA-SC and were ready to self-administer after demonstration (62.5%). The most prominent motivators were saving time (37.5%) and decreasing travel expenses (18.8%). Barriers for using DMPA were fear of side effects and myths like infertility or chances of abortion.</p><p><strong>Conclusion: </strong>DMPA-SC awareness does not exist among women in central India, but acceptability for self-injection is high when accompanied by education. Inclusion within India's family planning basket, combined with systematic training for community health workers and information, education, and communication interventions, can increase contraceptive accessibility and autonomy.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"924-931"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138719","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":"Risk Factors and Acute-Phase Blood Markers in Stroke Among Young Adults: A Hospital-Based Case-Control Study from South India.","authors":"Gokulakrishnan Sankaran, Harishkannan Devarajan, Gurunathan Srinivasan, Colin I Shelby, Sanjay Gopal, Premkumar Madhavan, Abhinav Ramraj","doi":"10.4103/ijcm.ijcm_600_25","DOIUrl":"10.4103/ijcm.ijcm_600_25","url":null,"abstract":"<p><strong>Background: </strong>Early-onset stroke carries profound health and socioeconomic consequences and is an escalating concern owing to increased cardiovascular risk in young adults. This study explores lifestyle and comorbid risk factors in predicting stroke occurrence among young Indian adults. We also analyze post-admission blood markers to reveal acute-phase metabolic and inflammatory dysregulation.</p><p><strong>Methods: </strong>Unicentric case-control study of 40 cases of imaging confirmed acute stroke and 81 sex-matched controls all aged ≤45. Self-reported demographic, lifestyle and comorbidity histories, and laboratory reports within 6-8 hours post-admission were collected. Conditional and multivariate logistic regression estimated stroke odds associated with risk factors. Age- and sex-stratified analyses explored clustering of risk and pathophysiological derangements among subgroups.</p><p><strong>Results: </strong>Hypertension (OR: 22.0, <i>P</i> < 0.001) and regular alcohol consumption (OR: 6.7, <i>P</i> = 0.047) independently conferred the strongest stroke odds. The youngest subgroup (18-30 years) carried 17-fold higher odds with alcohol use (<i>P</i> = 0.024) and had elevated bilirubin (<i>P</i> = 0.014). Elevated white blood cells, creatinine, post-prandial blood sugar, and hyponatremia were found among cases, with females exhibiting higher platelets (<i>P</i> = 0.002) and depressed ALT (<i>P</i> = 0.010), and males, elevated hemoglobin (<i>P</i> = 0.027). Significant risk-factor clustering was found between hypertension and diabetes among male and female cases (<i>P</i> = 0.027, <i>P</i> = 0.041) with complete concomitance of smoking and alcohol use in male cases and controls (<i>P</i> = 0.031, <i>P</i> = 0.012).</p><p><strong>Conclusions: </strong>This study compellingly identifies hypertension and alcohol use as major, independent predictors of early-onset stroke, underscoring distinct pathogenesis in this cohort and the urgent need for early detection, aggressive management, and behavioral modification. Stratified analyses further unveiled novel insights on age- and sex-specific heterogeneity in risk profiles and pathophysiology.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"833-841"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138668","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":"Extension of Occupational Safety and Health Measures for the Protection of Beedi Workers in India.","authors":"Rishika Khare, Sohini Mahapatra, Amit Yadav, Yogesh Pratap Singh","doi":"10.4103/ijcm.ijcm_729_25","DOIUrl":"10.4103/ijcm.ijcm_729_25","url":null,"abstract":"<p><p>Beedi workers in India, working in unorganized pockets with poor working conditions, suffer severe health impacts due to long-term exposure to the chemicals involved in beedi-making. Beedi rollers are piece-rated workers who undertake work from home. These workers lack occupational safety and protective mechanisms at home, and establishing accountability of the employers towards these workmen has also been challenging. Legislations like the Beedi and Cigar Workers (Condition of Employment) Act, 1966 (BCWA), and the Beedi Workers Welfare Fund Act, 1971 (BWWFA), have addressed various aspects of beedi workers' working conditions; however, they have failed to extend the protections relating to occupational health and safety to beedi workers working at home instead of industrial premises. The Occupational Safety, Health and Working Conditions Code (OSHWC) of 2020, which is proposed to be implemented in India, also fails to address this issue. As laws dealing with the health and safety of beedi workers only apply to \"establishments,\" the beedi manufacturing should be taken out of homes (through legislative amendment) to industrial premises, by declaring beedi-making as a hazardous process. Legislative amendments are needed to avoid engaging children in beedi rolling. Livelihood diversification needs to be prioritized to provide alternative employment to beedi workers.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"770-774"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138711","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":"Strengthening Research Orientation among Undergraduate Medical Students Through an Indian Council of Medical Research-sponsored Research Methodology Workshop.","authors":"Umesh Gajanan Kawalkar, Manoj Talapalliwar, Sumit Aggarwal","doi":"10.4103/ijcm.ijcm_96_26","DOIUrl":"10.4103/ijcm.ijcm_96_26","url":null,"abstract":"<p><strong>Background: </strong>Research competence is an essential attribute of a contemporary medical graduate, but structured research training remains inconsistent across Indian medical institutions.</p><p><strong>Objective: </strong>To evaluate a three-day Indian Council of Medical Research-sponsored Basic Research Methodology Workshop using Kirkpatrick's four-level framework.</p><p><strong>Methods: </strong>A single-group pre-post educational intervention study was conducted at Government Medical College, Akola, from October 17 to 19, 2024. Thirty-three undergraduate medical students completed pre- and post-workshop knowledge assessments (20-item questionnaire) and a structured feedback questionnaire. Scores were compared using the paired t-test.</p><p><strong>Results: </strong>Knowledge scores increased significantly from 8.87 ± 2.93 before the workshop to 14.43 ± 3.01 after it (paired <i>t</i>-test, <i>P</i> < 0.001). Participants reported high satisfaction with the interactive lectures, hands-on sessions, literature searching, reference management, and group activities. Following the workshop, 23 of 33 participants (69.7%) submitted proposals to the ICMR Short-Term Studentship programme, and one participant subsequently published a peer-reviewed manuscript.</p><p><strong>Conclusion: </strong>Structured workshops combined with practical training and mentorship may strengthen undergraduate research orientation.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"932-934"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138656","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":"Human-first, AI-assisted Peer Review: A Proposed Workflow for Community Medicine and Public Health Journals.","authors":"Urvish Joshi","doi":"10.4103/ijcm.ijcm_174_26","DOIUrl":"10.4103/ijcm.ijcm_174_26","url":null,"abstract":"<p><p>Growth in community medicine and public health publications has increased peer-review workload and the risk of missed methodological and statistical issues. Because peer review is largely voluntary and often performed alongside clinical, teaching, administrative, and research duties, reviews may be delayed or rushed. Generative artificial intelligence (AI) may help, but unstructured use raises concerns about confidentiality, integrity, and automation bias. This viewpoint proposes a human-first, AI-assisted workflow in which reviewers first complete an independent manual review. With editor permission, a constrained AI tool is then used only for checklist-based cross-checking of reporting completeness and internal consistency. Conceptually, this workflow may reduce missed checklist items, improve consistency checks, and support reviewer calibration. Purpose-built, standardized AI tools may offer additional advantages through predefined task boundaries, uniform outputs, and greater control over data retention and disposal. AI-assisted peer review may be acceptable in community medicine and public health journals if journals require permission before use, approved confidentiality-protecting systems, data minimization, disclosure to editors, and full reviewer accountability. The same principles could later be adapted for other disciplines.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"787-791"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138735","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":"Stakeholder Perspectives on the Family Adoption Program in a Newly Established Rural Medical College, Odisha: A Qualitative Study.","authors":"D Shobha Malini, Sithal Dalai, Shrabani Palai, Pradyuspita Sahoo, Sitaram Mahapatra","doi":"10.4103/ijcm.ijcm_65_26","DOIUrl":"10.4103/ijcm.ijcm_65_26","url":null,"abstract":"<p><strong>Background: </strong>The Family Adoption Program (FAP), introduced under India's Competency-Based Medical Education (CBME) framework, aims to promote early community engagement, empathy, and contextual understanding among medical students. This study explored multi-stakeholder perspectives on FAP implementation in a newly established rural medical college in Odisha.</p><p><strong>Materials and methods: </strong>A qualitative exploratory study was conducted using focus group discussions (FGDs), key informant interviews (KIIs), and in-depth interviews (IDIs) among first-year MBBS students (<i>n</i> = 20), faculty (<i>n</i> = 8), community health workers (<i>n</i> = 2), and community households (<i>n</i> = 10). Data were collected using semi-structured guides, audio-recorded, transcribed, and analyzed using Braun and Clarke's thematic analysis approach with inductive coding and triangulation across stakeholder groups. Analytical approach: Manual coding and thematic analysis.</p><p><strong>Results: </strong>Five core themes emerged: emotional connection and trust, role expectations and identity confusion, communication and cultural barriers, learning and transformation through exposure, and program facilitation and orientation. Strong concordance across stakeholders highlighted rapid rapport-building and experiential learning, facilitated by frontline health workers. However, discordance was evident in role expectations, with communities often anticipating curative services, and in program facilitation, where gaps in orientation and preparedness were noted. Communication challenges extended beyond language to sociocultural and structural factors influencing engagement.</p><p><strong>Conclusions: </strong>FAP is an effective platform for early experiential learning and social accountability in rural settings. However, its implementation is shaped by context-specific challenges, including role misinterpretation and facilitation gaps. Strengthening community sensitization, continuous mentorship, and systematic integration of frontline health workers as community partners may enhance the social accountability and effectiveness of FAP.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"871-878"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138710","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":"Healthcare Waste Management in Rural and Remote India: Challenges and Sustainable Solutions.","authors":"Renaldo S Rajkumar, R Revanth, Gowtham Ram","doi":"10.4103/ijcm.ijcm_194_25","DOIUrl":"10.4103/ijcm.ijcm_194_25","url":null,"abstract":"<p><p>Healthcare waste management in rural and remote India should not be treated as merely a technical disposal problem but as a governance, behavioral, and community health challenge. Although India has a regulatory framework for biomedical waste management, implementation remains uneven in rural primary healthcare settings because of weak segregation practices, limited access to common biomedical waste treatment facilities, inadequate staff training, poor monitoring, and low community awareness. This viewpoint argues that rural healthcare waste management requires a decentralized and community-engaged model that links regulatory compliance with local participation and resource-sensitive sustainability. The paper proposes an adapted \"Four Joints of Power\" framework involving government agencies, healthcare institutions, communities, and non-governmental or private-sector partners. However, its application to India must be context-specific, aligned with the Biomedical Waste Management Rules, 2016, State Pollution Control Boards, district health authorities, and primary healthcare institutions. The Circular Economy approach can strengthen this framework by promoting waste minimization, safe segregation, recycling of non-hazardous waste, and appropriate decentralized treatment technologies, while recognizing rural barriers such as limited skilled manpower, weak supply chains, inadequate infrastructure, and regulatory constraints. Social workers can play a strategic role as facilitators of community awareness, behavior change, stakeholder coordination, and monitoring. The paper recommends an integrated rural healthcare waste management approach that combines policy enforcement, capacity-building, community participation, gender-sensitive occupational safety, and locally feasible sustainable waste practices.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 Suppl 4","pages":"S583-S590"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897642","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 District Residency Program in India: A Community Medicine Resident's Perspective.","authors":"Anisha Thakur, Sunil Kumar Raina","doi":"10.4103/ijcm.ijcm_552_25","DOIUrl":"https://doi.org/10.4103/ijcm.ijcm_552_25","url":null,"abstract":"","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 Suppl 4","pages":"S728-S729"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897898","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":"LTBI Prevalence and Risk Factors in Field Practice Areas of a Tertiary Care Hospital, Jodhpur, Rajasthan.","authors":"Devisowmiya Thiruvengadam, Vinoth Rajendran, Srikanth Srinivasan, Akhil Dhanesh Goel, Manoj Kumar Gupta, Pankaj Bhardwaj, Neeti Rustagi","doi":"10.4103/ijcm.ijcm_536_25","DOIUrl":"10.4103/ijcm.ijcm_536_25","url":null,"abstract":"<p><strong>Background: </strong>Latent tuberculosis (LTBI) affects 33% globally, with 5-10% progressing to active TB within five years. Diabetes triples the risk, driving high TB rates in countries like India. This study aims to determine prevalence of LTBI among patients visiting outpatient department in the field practice areas of Department of Community Medicine and Family Medicine at AIIMS Jodhpur and to assess the relationship between LTBI and diabetes mellitus.</p><p><strong>Methodology: </strong>This analytical cross-sectional study involved 384 participants aged ≥30 years attending AIIMS Jodhpur's health training centers from October 2021 to March 2023. Tuberculin skin test (TST) was used to diagnose LTBI. Positive thresholds: >5 mm for recent tuberculosis contact, >10 mm for diabetes, >15 mm in participants without risk factors.</p><p><strong>Results: </strong>Among 384 TST participants, 346 (90.1%) were evaluated. LTBI prevalence was 20.5% with 95% CI: 16.3%-24.8%, (71 participants). Of 118 diabetes cases, 113 were evaluated, with 27.4% having LTBI. Multivariate analysis identified significant LTBI predictors such as type 2 diabetes (OR: 3.47, 95% CI 1.61-7.46), tuberculosis contact (OR: 18.13, 95% CI 8.08-40.64), and obesity (OR: 2.26, 95% CI 1.04-4.91).</p><p><strong>Conclusion: </strong>Type 2 diabetes significantly associated with LTBI, making systematic testing and treatment crucial to prevent complications. Diagnosing LTBI in diabetes patients is key to addressing these linked health issues.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 Suppl 4","pages":"S684-S690"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897879","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":"Sporadic Tetanus Cases in Children from Jharkhand: A Reminder of the Need for Sustained Immunization Efforts.","authors":"Shambhavi","doi":"10.4103/ijcm.ijcm_774_25","DOIUrl":"10.4103/ijcm.ijcm_774_25","url":null,"abstract":"","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 Suppl 4","pages":"S724-S725"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897922","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}