National Journal of Community Medicine <p align="Justify">The National Journal of Community Medicine is a monthly published peer-reviewed open-access journal. It has a wide circulation amongst the health professionals, researchers, teaching faculties, and postgraduates in the specialty of Community Medicine and public health. The main objective of the journal is to promote wider dissemination of the research conducted by researchers in the fields of public health and community medicine.</p> Medsci Publications en-US National Journal of Community Medicine 0976-3325 <p>The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.</p> Food Labelling Exemptions: A Scientific and Comprehensive Analysis <p>Nutrition constitutes a vital element of health and development. In India, there is an alarming rise in the food industry and this has led to an increased uptake of foods high in fats, salt, and sugar (HFSS) and ultra-processed foods. Food labelling is a procedure where a label, containing printed, written, or graphic materials, is provided with the food thereby facilitating communication between the consumer and the manufacturers. In 2022, FSSAI has exempted specific food products from the stringent requirements of detailed nutritional labelling. Exemptions are applied to commodities such as raw agricultural products, liquid products in reusable bottles, alcoholic beverages, self-serve condiments, and modified meals as per the customer's request, single unit packaging, and packets under 100 sq. cm. In conclusion, these exemptions strike a balance between reducing the regulatory burden for smaller packaging and ensuring consumers' right to essential information.</p> Dhanashree Manjrekar Yogesh Bahurupi Pradeep Aggarwal Mahendra Singh Copyright (c) 2024 Dhanashree Manjrekar, Yogesh Bahurupi, Pradeep Aggarwal, Mahendra Singh 2024-04-01 2024-04-01 15 04 332 335 10.55489/njcm.150420243739 Development of Self Stigma Assessment Tool for People Living With HIV/AIDS (PLWHA) <p><strong>Introduction:</strong> Stigma does not only come from people who give negative judgment to HIV/AIDS patients but also from patients themselves. This study explored the experiences of the self-stigma of people living with HIV/AIDS (PLWHA) and developed the self-stigma tool for PLWHA.</p> <p><strong>Methodology:</strong> We conducted a mixed-method study using an exploratory-sequential design in the East Java community, Indonesia. In the first phase, we identified 12 PLWHA through snowball sampling, and in the second phase, 133 PLWHA participated. We collected data through indepth interviews. Subsequently, the insights gained from these interviews were utilized to develop a tool for assessing self-stigma among PLWHA, known as the MARSUDI self-stigma tool.</p> <p><strong>Results:</strong> The first phase of the study revealed three main themes: 1) the feeling of self-stigma, 2) the coping mechanism, and 3) suggestions to combat the stigma. Moving on to the second phase, the MARSUDI self-stigma tool for PLWHA was developed. This tool comprises 26 items, achieving a s-cvi score exceeding 0.80. Following factorial analysis, 20 items remained with a loading factor surpassing 0.6, and contributing to 66.24% of the total variance. These items were categorized into three factors: Factor 1 (self-perception) includes 7 items, Factor 2 (self-labelling) consists of 11 items, and Factor 3 (self-discrimination) comprises 2 items.</p> <p><strong>Conclusion:</strong> The results of this study revealed that the MARSUDI self-stigma of PLWHA is valid, reliable, and acceptable.</p> Wiwin Martiningsih Suprajitno Arif Mulyadi Sri Winarni Ekowati Retnaningtyas Copyright (c) 2024 Wiwin Martiningsih, Suprajitno, Arif Mulyadi, Sri Winarni, Ekowati Retnaningtyas 2024-04-01 2024-04-01 15 04 251 258 10.55489/njcm.150420243639 Exploring A Decade of Research on Down Syndrome: A Bibliometric Analysis <p><strong>Aims: </strong>Trisomy 21, the presence of a supernumerary chromosome 21, results in a collection of clinical features commonly known as Down syndrome (DS). DS is among the most genetically complex of the conditions that are compatible with human survival post-term, and the most frequent survivable autosomal aneuploidy. The research landscape of Down Syndrome is not portrayed clearly by published literature. This study aimed to analyse published literature globally by the medical fraternity in the field of Down syndrome using bibliometric analysis.</p> <p><strong>Methodology: </strong>Bibliometric information on literature regarding said topic using specific keywords was searched and collected in the Scopus database. VOSviewer (1.6.18) was applied to conduct bibliometric analysis and visualization.</p> <p><strong>Results: </strong>The study highlighted the most significant journals, authors, co-cited authors, institutions, keywords co-occurrence, and most contributed countries in the area of Down syndrome based on bibliometric analysis of studies taken from the database of Scopus for the past ten years (2014–first quarter of 2023).</p> <p><strong>Conclusion:</strong> This analysis applied state-of-the-art bibliometric and scientific mapping methods to provide researchers and other stakeholders with a panoramic view of Down syndrome from 2014 –2023. Publications in the field show a stable trend, within developed countries. Funding support is much needed to proceed with such topics as Down syndrome and that may be the reason why underdeveloped countries are still behind in the field.</p> Rinu J George Manoj Kumar L Deepa T Unnikrishnan Jibin Kunjavara Shiny T Sam Copyright (c) 2024 Rinu J George, Manoj Kumar L, Deepa T Unnikrishnan, Jibin Kunjavara , Shiny T Sam 2024-04-01 2024-04-01 15 04 259 267 10.55489/njcm.150420243588 Post-Traumatic Growth Among Patients Suffering From Burn: A Cross-Sectional Study <p><strong>Background: </strong>Burn and wounds are one of the most serious hospital cases in all healthcare settings, both social and psychological support are needed to overcome all depressive and anxious feelings afterward the burns' incidence. This study aims to assess and evaluate all posttraumatic growth experiences from healthcare professionals after burns and wounds on selected patients with various degrees of burns.</p> <p><strong>Methods:</strong> It was a cross-sectional descriptive design. The present study utilized regression analysis as a statistical tool to examine the variables linked to posttraumatic growth in a sample of 191 individuals who had undergone significant burn injuries.</p> <p><strong>Results:</strong> The study revealed that those undergoing therapy for mild depression exhibited a modest degree of depressive symptoms and a diminished feeling of positive self-perception compared to those in the acute phase. Therefore, a statistically significant difference in the averages was noticed between the two groups. An important correlation was found between depressive symptoms and social support, which had a significant impact on posttraumatic growth during the recovery phase.</p> <p><strong>Conclusions:</strong> The present study revealed that social support exerted a noteworthy influence in promoting posttraumatic growth among individuals belonging to the acute phase group.</p> Shirin Abdallah Alimour Shaima Aljasmi Mhd Emad Alnono Nouha Alaji Hani El Farran Mohamed Mahmoud Alrabeei Copyright (c) 2024 Shirin Abdallah Alimour, Shaima Aljasmi, Mhd Emad Alnono, Nouha Alaji, Hani El Farran, Mohamed Mahmoud Alrabeei 2024-04-01 2024-04-01 15 04 268 275 10.55489/njcm.150420243775 Private Sector Involvement in Tuberculosis Control in An Urban City of Western India– A Cross-Sectional Study <p><strong>Background: </strong>In India, TB diagnosis and treatment practices among Private Practitioners (PPs) vary widely and are not properly regulated by the national TB program. Despite their irrational and inequitable practises, PPs remain an important and preferred primary care provider for many people. The study was done to with the objectives to describe different diagnosis and treatment practices of Tuberculosis among private practitioners and their involvement in National Tuberculosis Elimination Program (NTEP).</p> <p><strong>Material and Methods</strong>: A cross sectional study was performed among 303 PPs during October 2020 to March 2021 by using stratified random sampling to select private practitioners based on their speciality.</p> <p><strong>Results: </strong>Most preferred investigation was Chest X ray (45.2%) followed by sputum smear microscopy (29.7%). Only 71.3% PPs practiced the correct regimen for new cases of Pulmonary TB according to NTEP. More than half of the PPs had TB training (59.7%). Majority of the PPs (90.1%) were involved in NTEP mainly by referral of TB patients to local government centres for treatment purpose.</p> <p><strong>Conclusion</strong>: Preferred investigation for diagnosis of pulmonary TB was chest X-ray followed by sputum examination among PPs. The treatment regimen and duration of treatment varies among PPs as per their clinical judgement and practice.</p> Khushboo Hadiya Rahul Damor Hiteshree Patel Mohamed Anas Mohamed Faruk Patni Kavita Bodar JK Kosambiya Copyright (c) 2024 Khushboo Hadiya, Rahul Damor, Hiteshree Patel, Mohamed Anas Mohamed Faruk Patni , Kavita Bodar, JK Kosambiya 2024-04-01 2024-04-01 15 04 276 282 10.55489/njcm.150420243424 Correlation of Body Mass Index and Disease Activity Score (DAS-28) in Patients with Rheumatoid Arthritis <p><strong>Background: </strong>Rheumatoid Arthritis (RA) is the most common autoimmune disease. RA can cause permanent deformity and loss of productivity. The primary objective of the study was to evaluate the relationship of BMI with Disease Activity Score in RA patients. The secondary objective was to evaluate the presence of comorbidities such as diabetes, thyroid, hypertension, periodontitis, and pregnancy outcomes (in the case of females) in the RA patients population presented at the tertiary healthcare centre.</p> <p><strong>Method:</strong> The presented study was a cross-sectional study. 100 Patients presented to the joint clinic were recruited. RA diagnosis of patients was based on the ACR/ELULAR criteria. Their demographic and clinical data was collected through one-on-one interviews.</p> <p><strong>Results:</strong> The recruited population shows that BMI has a moderate positive correlation (r=0.347, p=0.001) with disease activity scores. 51% of RA patients have one or more comorbidities. 45.2 % of female RA patients suffered one or two miscarriages during their pregnancy. It is significantly higher as compared normal female population.</p> <p><strong>Conclusions:</strong> Active control of BMI may be required to prevent RA symptom aggravation. RA patients are prone to develop comorbidities and females with RA may need close monitoring during their pregnancy period.</p> Nishtha Agarwal Shweta Dubey Sanjeev Kapoor Shriram Garg AN Malaviya Puja Nagpal Copyright (c) 2024 Nishtha Agarwal, Shweta Dubey, Sanjeev Kapoor, Shriram Garg, AN Malaviya, Puja Nagpal 2024-04-01 2024-04-01 15 04 283 288 10.55489/njcm.150420243436 Development and Validation of a Food Frequency Questionnaire for Use in Epidemiological Studies Among North Karnataka Population <p><strong>Background:</strong> Dietary records, such as food diaries (FD) and food frequency questionnaires (FFQs), are widely employed in large-scale epidemiological analyses. Given the regional diversity in dietary habits, this study aimed to develop and assess the reproducibility and construct validity of a novel FFQ tailored for northern Karnataka (FFQ-NK).</p> <p><strong>Methodology:</strong> A detailed food list was created based on food use and market surveys in the region. Utilizing data from 24-hour diet recalls and a supplemental focus group discussion, a 116-item semi-quantitative FFQ was developed for adults in north Karnataka.</p> <p><strong>Setting and Subjects:</strong> Involving 100 participants from north Karnataka, the FFQ was interviewer administered and the participants also completed three 24-hour dietary recalls (DR), serving as a reference for validity assessment.</p> <p><strong>Results:</strong> Though the FFQ indicated higher food and nutrient intake compared to food records. Significant correlations were found for nutrient intake. Pearson’s correlation coefficients between FFQs and DRs ranged from 0.717-0.965 (isoflavonols to energy).</p> <p><strong>Conclusions</strong>: The developed and validated FFQ is a valuable tool for epidemiological studies requiring nutrient intake estimates in the north Karnataka population. It serves as an effective dietary assessment tool for individuals aged 20 and older in large-scale epidemiological studies.</p> Deepa S Sajjanar Indira A Hundekari Rekha Udgiri Vijay Warad Sanjeev L Sajjannar Copyright (c) 2024 Deepa S Sajjanar, Indira A Hundekari, Rekha Udgiri, Vijay Warad, Sanjeev L Sajjannar 2024-04-01 2024-04-01 15 04 289 298 10.55489/njcm.150420243758 Effectiveness of Sacral Massage on Labor Pain and Satisfaction Among Antenatal Mothers in Active Phase of Labor <p><strong>Background: </strong>Massage is a powerful old technique &amp; non pharmacological pain control during 1<sup>st</sup> stage. Satisfaction of mothers during birth is rather important in terms of women's health and positive family relations. Objective of the study is to assess the effectiveness of Sacral Massage on labour pain and satisfaction among antenatal mothers.</p> <p><strong>Methodology: </strong>A quantitative research approach and true experimental research design was adopted; 60 antenatal mothers were selected by simple random sampling. Sacral massage was administered for 3 cycles each for 30 minutes at 5-10cm using superficial massage, deep friction &amp; effleurage during active phase of labor and routine care was given to the control group. After intervention post test was conducted.</p> <p><strong>Results: </strong>Study showed before Sacral massage the computed ‘t’ value (-0.36) was found to be statistically non-significant at 0.05 level of significance and after Sacral massage it was (-24.7) was statistically significant at &lt;0.01 level of significance, there were significant difference in mean post test score of labor pain in both groups. Majority (86.6%) mothers were moderately satisfied, followed (13.3%) were highly satisfied with Sacral massage.</p> <p><strong>Conclusion: </strong>Sacral massage was found effective to reduced pain and increase satisfaction.</p> Neha Patyal Santosh Kumari Divya Verma Harshita Yadav Jasbir Kaur Harpreet Kaur Copyright (c) 2024 Neha Patyal, Santosh Kumari, Divya Verma, Harshita Yadav, Jasbir Kaur, Harpreet Kaur 2024-04-01 2024-04-01 15 04 299 306 10.55489/njcm.150420243670 Key Dimensions of Refractive Errors Screening at School in Indonesia: A Primary Educator’s Perspective <p><strong>Introduction: </strong>The school-based refractive error screening program is important in preventing visual impairment caused by uncorrected refractive errors and enhancing students' academic performance. This study aimed to identify key dimensions for establishing an effective school-based refractive error screening program from the perspective of elementary teachers.</p> <p><strong>Methodology: </strong>The focus group discussion (FGD) using the qualitative-exploratory method among ten elementary teachers from one public school in Jakarta. The voice records of participants were transcribed verbatim, coded, and qualitatively analyzed to generate relevant dimensions. Several dimensions in the conceptual framework were concluded within the twelve categories.</p> <p><strong>Results: </strong>Four key dimensions to establish an effective school-based refractive error screening program were identified ranging from resources, screening procedure, education and awareness, and spectacles. These dimensions emphasized the significance of having trained teachers as screeners, understanding the comprehensive screening and referral process, offering incentives and user-friendly tools, and ensuring accessible and affordable spectacles to enhance students' compliance.</p> <p><strong>Conclusion: </strong>This study identified four dimensions for effective school-based refractive error screening programs, which are resources, screening procedures, education and awareness, and spectacles.</p> Ray Wagiu Basrowi Kianti Raisa Darusman Yitro Wilar Tri Rahayu Yeni Dwi Lestari Nila Djuwita Moeloek Copyright (c) 2024 Ray Wagiu Basrowi, Kianti Raisa Darusman, Yitro Wilar, Tri Rahayu, Yeni Dwi Lestari, Nila Djuwita Moeloek 2024-04-01 2024-04-01 15 04 314 319 Role of Triglyceride to High Density Lipoprotein (TG/HDL) Ratio as A Marker of Insulin Resistance in Adults of Central India: A Narrative Review <p>One of the main risk factors for the onset of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) is insulin resistance (IR). But because there aren't many easy-to-use and trustworthy biomarkers or tests, the entity is frequently under diagnosed. The present review was performed with an aim to provide the available data regarding the role or efficacy of TG/HDL ratio as an indicator of IR in adults of central India, a region popular for high prevalence of T2DM and CVD. An extensive search of all materials related to the topic was carried out in the PubMed search engine. Relevant research articles focusing on use of TG/HDL as a marker of insulin resistance published in the period 2002 to 2023 were included in the review. A total of 33 articles were selected based upon their suitability with the current review objectives and analyzed. The review concludes that TG/HDL ratio is a simple, affordable, and feasible marker of IR that can be used in economically poor regions of the India or world for screening IR and risk stratification of T2DM and CVD in adults. However, more studies are needed in India and all over the world to validate this marker and its cut-off values.</p> Khalid Khan Sabiha Quazi Anil Wanjari Copyright (c) 2024 Khalid Khan, Sabiha Quazi, Anil Wanjari 2024-04-01 2024-04-01 15 04 320 326 10.55489/njcm.150420243789 Digital Innovations in Pneumonia Care: A Mini Review <p><strong>Introduction:</strong> Pneumonia is a severe respiratory disease threatening public health and requires timely and accurate diagnosis and early intervention for effective treatment. The emergence of telemedicine during COVID-19 has offered new solutions to solve health problem. This review examines recent studies focusing on effectiveness of telemedicine intervention in pneumonia care.</p> <p><strong>Methods: </strong>We systematically searched five databases to retrieve original research that addressed telemedicine's use in pneumonia diagnosis, treatment, monitoring, or patient assistance. Two independent reviewers performed screening to confirm alignment with inclusion criteria. The findings were synthesised narratively.</p> <p><strong>Results: </strong>A total of five studies were included in the review. The interventions across studies were telephonic follow-ups, Smartphone-based algorithm for diagnosing pneumonia, telemedicine set-up at patients' homes and Interactive videoconferencing. The findings suggest that telephone consultation is effective for patients with low-risk respiratory infections and may be more effective in early diagnosis of pneumonia patients.</p> <p><strong>Conclusion: </strong>The planning for work in telemedicine, whether in regulations or private practice, is necessary to ensure the quality, safety, and consistency of telemedicine practices. The use and availability of telemedicine services, especially in rural areas and on mobile phones, must be expanded to reduce problems in the region.</p> Snehasish Tripathy Sapna Negi Ankita Mathur Vini Mehta Copyright (c) 2024 Snehasish Tripathy, Sapna Negi, Ankita Mathur, Vini Mehta 2024-04-01 2024-04-01 15 04 327 331 10.55489/njcm.150420243745 Developing a Dynamic Conceptual Model of a Home-Based Palliative Care Plan Using the Comprehensive Primary Health Care (PHC) Approach <p><strong>Background:</strong> Palliative Care (PC) was a core component of Primary Health Care services during the World Health Assembly Resolution, 2014. The study aims to develop a Comprehensive Palliative Care Model (CPCM) for patients with life-threatening conditions compliant with the local context and unmet needs.</p> <p><strong>Materials and Methods:</strong> A mixed-methods approach will be adopted for the three-phased study in two districts of Telangana. Phase I, a literature review, will be performed to explore globally available PC models, followed by an on-ground observational study. Phase II will address the gaps in existing models while identifying the unmet needs of the patients and caregivers. The outcome of the above phases will help develop a CPCM in Phase III. The developed model will be validated using the Delphi technique.</p> <p><strong>Results:</strong> The expected outcomes of the study are a) Phase-I: Details of the PC models available globally and locally, b) Phase-II: Availability of essential resources in the Health and Wellness Centers (HWCs), Knowledge and Attitude of the PC team, Barriers to provide PC, Unmet needs, and c) Phase-III: CPCM model</p> <p><strong>Conclusion:</strong> The study attempts to provide a holistic PC model, considering the health system, patients, and caregivers and offering policy suggestions to the state.</p> Mousami Kirtania Ajitha Katta Copyright (c) 2024 Mousami Kirtania, Ajitha Katta 2024-04-01 2024-04-01 15 04 307 313 10.55489/njcm.150420243728