National Journal of Community Medicine

How To Do Critical Appraisal of Any Research Article

Mon, 31 Oct 2022 00:00:00 +0000

In both biomedical research and medical academia, research publications serve a critical role. There are a huge number of research publications published all around the world. However, only a small percentage of them are good and have any research or academic worth. So, properly evaluating published publications has become vital in this circumstance. This article is intended with medical graduates and postgraduates in mind, in order to clarify them how to critically evaluate research publications. It may also be used to write published research articles in an indirect way. A collection of questions is supplied to cover all aspects of a published research paper. To assess the quality of an article, a score system based on the following questions can be established.

What Does Physical Inactivity Cost? - WHO Reports

Prakash Patel — Mon, 31 Oct 2022 00:00:00 +0000

Tobacco Consumption and Legislations Regarding Tobacco Use in India – Is It Time for A Policy Change?

Anantha Eashwar V M, Timsi Jain, Madhumita JR, Keerthana R — Mon, 31 Oct 2022 00:00:00 +0000

One of the most consumed and readily available products causing psychological dependence among the population is tobacco and its related products. Though the government of India is undertaking measures to reduce tobacco consumption, factors like easy availability, lack of monitoring of tobacco use among youngsters, low cost and rapid absorption into the central nervous system is prompting people from a young age to the elderly to consume tobacco-related products. Legislative measures to reduce tobacco consumption seldom reach or benefit people as laws differ across States. This increases the prevalence of respiratory diseases like Chronic Obstructive Pulmonary Disease (COPD) and lung cancer. This review article discusses the status of tobacco consumption in India with emphasis on tobacco-related legislation in States and associated health inequities.

Future of TB Prevention: An Alternative To BCG

Sneka P, Sangamithrav V, Hamsadwani KP — Mon, 31 Oct 2022 00:00:00 +0000

Mycobacterium tuberculosis is a killer bacteria endangering the life of many innocent people worldwide. There is an emergency need for newer TB vaccines to combat this deadly disease. The BCG vaccine currently being delivered has been in use for more than a decade but still the threat has been increasing day-by-day worldwide and more particularly among the developing nations. It is necessary to develop a candidate vaccines which can keep a check on the primary progression of the disease and also reactivation of Latent TB Infection.

Reduced Heart Rate Variability as A Risk Factor for Cardiovascular Disease in Young Healthy Adults with Low and High Body Mass Indexes – A Descriptive Study

Mon, 31 Oct 2022 00:00:00 +0000

Background: Heart rate variability (HRV) is a used to assess autonomic nervous system input to the heart. Studies on the impact of HRV on underweight are limited.

Aims/Objectives: To evaluate HRV in age matched young adults of different BMI category.

Methodology: This cross-sectional study was done among healthy young adult volunteers between 18 and 25 years of age. Anthropometric variables were measured. ECG was recorded in lead II configuration for 5 minutes. Heart rate variability was analysed with Kubios HRV analyzer.

Results: HRV indices were reduced in underweight (UW), overweight (OW) and obese group compared to normal weight (NW) BMI group. Second order polynomial regression between BMI and HF log power in both genders shows an inverted U-shaped relationship with BMI. The association between BMI, waist circumference and body fat (percentage) with HRV indices shows a significant relation to heart rate variability among which waist circumference (WC) shows a greater association with HRV indices than BMI. Comparison of HRV parameters among men and women of different BMI group shows female had greater heart rate variability compared to males across BMI

Conclusions: underweight individual also have increased cardiovascular risk like obese group and abdominal obesity is better indicator of cardiovascular risk than BMI.

Association Of the Methylene Tetrahydrofolate Reductase (MTHFR) Gene Polymorphism with Susceptibility to Recurrence of Cardiovascular Outcomes Among Ischemic Stroke- A Randomized Controlled Trial

Mon, 31 Oct 2022 00:00:00 +0000

Background: Hyperhomocystenemia and genetic variants are factors for causing young age stroke globally. This study aims to identify homocysteine related-MTHFR gene polymorphism that associated with recur-rent cardiovascular outcomes.

Methodology: A randomized controlled trial conducted upon 90 hyperhomocysteinemic ischemic stroke patients were taken from the neurology wards of a tertiary care hospital were randomly selected into vita-min B therapy group and control groups (n=45 in each group). Baseline subject details were collected ve-nous blood sample for MTHFR genetic testing via PCR-RFLP technique along with blood homocysteine lev-els, vitamin B12, folic acid levels.

Results: The results showed that the frequency of CT genotype polymorphism was 15.5% vs 13.3% for the MTHFR C677T gene without any significant difference between vitamin group and control group respective-ly (p-value >0.05). The reduction in mean homocysteine up to -6.77±4.50 versus -2.08±0.71 µmol/L in the vitamin group as compared to control group respectively, p value 0.001.

Conclusion: Considerable amount of MTHFR gene polymorphism found among hyperhomocysteinemic is-chemic stroke of sub-Himalayan region. Nutritional deficiencies including vitamin B 12 & folic acid, and some hidden reasons found, which could lead to the primary cause of hyperhomocysteinemia. Vitamin B therapy is an effective for reducing homocysteine.

Effectiveness Of Yoga Versus Exercise on Lipid Profile, BMI, And Blood Pressure Among Patients with Type II Diabetes Mellitus - A Community Based Randomised Control Trial

Rajesh Kulkarni, Padmaja Walvekar — Mon, 31 Oct 2022 00:00:00 +0000

Context/Background: Lifestyle interventions have proven to reduce the incidence of type 2 diabetes mellitus and prevent the complications. Yoga is considered safe, simple to learn, and can be practiced even by ill, obese, elderly, or disabled persons at home. The present study was conducted to assess the effect of one year of yoga therapy on lipid profile, BMI, and blood pressure in subjects with type 2 diabetes mellitus.

Methodology: This randomized controlled trial was conducted in an Urban Health center, Belagavi from July 2018 to December 2019. Around 120 participants diagnosed with type 2 diabetes mellitus were randomized into “Yoga” and “Exercise” groups. Fasting lipid profile, BMI, and blood pressure were examined at baseline, six months, and after one year of intervention.

Results: GEE model analysis showed that there were significant effects of Intervention × Time on Cholesterol (p=0.001), LDL (p=0.006) and VLDL (p=0.000). It was identified that the exercise intervention was found to decrease cholesterol and TG significantly more than the yoga group. Also, there was a significant reduction in BMI in both the exercise and yoga groups at the end of six months and one year (p=0.247).

Conclusions: Yoga can be a complementary therapy for type 2 diabetes, along with medications and exercise.

Does Nutritional Status Affects Oral Health Related Quality of Life Among Elderly? A Cross-Sectional Study at A Tertiary Care Health Centre, Rishikesh, India

Mon, 31 Oct 2022 00:00:00 +0000

Aim: Present study was conducted to evaluate the impact of nutritional status on oral health related quality of life using Geriatric Oral Health Assessment Index (GOHAI) among geriatric population attending outpatient department (OPD) of tertiary health care centre in Rishikesh.

Settings and Design: Present cross-sectional study was conducted on geriatric male & female participants attending Outpatients Department (OPD) of tertiary care centre, RISHIKESH.

Methods and Material: Nutritional assessment was recorded by using Mini Nutritional Assessment (MNA) tool. Oral health related quality of life was assessed using pre-validated Hindi version of Geriatric Oral Health Assessment Index (GOHAI) questionnaire.

Statistical analysis: Kruskal-Wallis and Mann-Whitney U test were applied using SPSS 22.0 Software. Logistic regression analysis was done to find out risk factors.

Results: A total of 281 participants completed the questionnaire with mean age of 66.89 ± 6.43 years. About three fourth (73%) of total participants were at risk of malnourishment. A statistically significant difference (P=0.005) was observed when the median GOHAI scores were compared with nutritional status (MNA scores).

Conclusions: A statistically significant difference was found between nutritional status and geriatric oral health related quality of life (GOHAI). Nutritional status affects oral health related quality of life among elderly population.

Cardiovascular Disease Risk Profile and Risk Prediction Among Unskilled Workers of a Tertiary Care Teaching Hospital

Ganesh Sekar, Vinayagamoorthy Venugopal, Iswarya Santhanakrishnan — Mon, 31 Oct 2022 00:00:00 +0000

Background: Cardiovascular disease is the single largest cause for mortality and morbidity in the world and also in India. The prevalence of CVD risk factors in India is steadily increasing moreover CVD in Indians has been shown to occur prematurely. The study was designed to estimate the 10-year cardiovascular risk using region specific WHO/ISH risk prediction chart among unskilled workers of a tertiary care teaching hospital and to determine factors associated with risk.

Material and methods: It were a hospital based cross sectional study. Based on the calculated sample size, 250 eligible workers were selected by simple random sampling. Using structured questionnaire, life style related risk factors namely, average daily consumption of fruits and vegetables, physical activity, perceived stress, tobacco and alcohol use was collected. BMI and BP were measured using standard protocol and classified following standard guidelines. Bio-chemical parameters were also measured.

Results: Among 250 workers 37.2% and 10% consumed daily minimal recommended level of vegetables and fruits respectively, 21.1% was current tobacco user, 17.2% was alcohol drinkers, 50.4% were obese, 18.8% had high blood pressure, 6% had elevated cholesterol levels. Among the workers 46.7 % had <10% risk, 5.3% had 10% to <20% risk and, 3.3% had 20% to <30% risk to develop CVD within future 10 years of lifetime. Drivers and current alcoholics were significantly associated with being in the high-risk group.

Conclusion: Employer initiated regular work place health screening and services need to be aimed at the unskilled workers, especially for CVD targeting drivers and alcoholics.

Burden Of Care and Depression in Caregivers of Patients with Schizophrenia

Mon, 31 Oct 2022 00:00:00 +0000

Background: Schizophrenia, a chronic psychiatric disorder affecting all major domains of a patient’s life, leads to significant disability. Since the deinstitutionalization policy, the onus of care is on families especially the primary caregiver who experiences physical and emotional burden. Depression among caregivers has been estimated to be higher than the general population. This cross-sectional study aimed to assess burden of care and depression in primary caregivers and associated caregiver variables.

Methods: 75 consenting primary caregivers of patients with ICD-10 diagnosis of schizophrenia were assessed for burden of care and depression using the Burden Assessment Schedule and the Patient Health Questionnaire - 9 after collecting socio-demographic and caregiving details.

Results: All the caregivers, 49 females and 26 males, had moderate to high levels of burden with a majority having moderate to severe levels of depression. Spouses (p=0.0038), older caregivers (p=0.01) and those with lower educational levels (p=0.01) experienced more burden. There was a significant positive correlation between burden of care and depression (p=0.000).

Conclusion: In one of India’s largest metropolitan cities, though psychiatric services are easily available, caregivers continue to feel burdened and depressed. This can impact not just the caregiver but also care being provided to the patient and illness outcome.

Pre-Treatment Loss to Follow Up of Tuberculosis Patients; Prevalence and Reasons for It in Central Karnataka, India

Satish Ghatage, Shubha D B, Latha S, Shameem R Kanganolli — Mon, 31 Oct 2022 00:00:00 +0000

Background: Pre-treatment loss to follow up (PTLFU) is defined as diagnosed TB patients not initiated on treatment within 14 days of TB diagnosis. Bringing these PTLFU cases into care can reduce the disease transmission and mortality. The present study was undertaken with main objectives to study the prevalence of PTLFU in TB patients and to know the reasons for PTLFU.

Methodology: A cross-sectional study was conducted among 38 PTLFU TB patients of Davangere district, Karnataka from January to March 2019. Study participants were personally interviewed using pre-tested, semi-structured questionnaire. Data was analyzed using SPSS software.

Results: The prevalence of PTLFU in TB patients is 3.6%. The reasons for PTLFU were, out of the 38 study subjects, 17 (47%) of them were initiated on treatment in private sector but reported as PTLFU. 7 (18%) died in hospital before treatment initiation. 7 (18%) did not start the treatment because of fear of side effects following anti tuberculosis treatment, whereas 2 (6%) of them did not take treatment by seeing the side effects in others and 5 (13%) had alcoholic withdrawal effects.

Conclusions: Improvement in recording of contact details, biometric registration of all presumptive TB cases and pre-treatment counselling of all diagnosed TB patients may reduce PTLFU.

Prevalence of Asymptomatic Bacteriuria Among Pregnant Women Attending a Tertiary Care Hospital in Western India

Paresh Patel, Manish Patel, Khanjan Desai — Mon, 31 Oct 2022 00:00:00 +0000

Introduction: Asymptomatic bacteriuria refers to the presence of bacteria in urine having overall incidence during pregnancy ranges between 2%-10%. The study was conducted to assess prevalence of asymptomatic bacteriuria in pregnant women. The study also aimed to find out the most common Pathogenic organism isolates from urine sample.

Methodology: Pregnant women with varying gestational periods attending the tertiary care hospital without any symptoms of UTI were included in the study. Their urine was tested for routine microscopy, culture, and certain biochemical testing.

Results: Prevalence rate of asymptomatic bacteriuria was seen 13.8% in pregnant women. Proportion of asymptomatic bacteriuria is highest 14.70% in age group 26-30 year, 23.33% in first trimester. Both gram negative and gram-positive bacteria were isolated, but gram-positive cocci isolates were higher comparatively gram-negative bacilli. Organisms recovered in order of frequency were E. coli, Coagulase Negative Staphylococci (CONS), S. aureus, Klebsiella spp, Acinetobacter spp, Citrobacter spp and Enterobacter spp.

Conclusion: High prevalence of asymptomatic bacteriuria demands routine bacteriological screening of pregnant women. This will help in early treatment of asymptomatic bacteriuria which will help in prevention of acute and chronic pyelonephritis.

Prevalence And Predictors of Exposure to Second-Hand Smoke Among Never-Tobacco Smokers

Deepak Sharma, Naveen Krishan Goel — Mon, 31 Oct 2022 00:00:00 +0000

Background: Exposure to Second-hand tobacco smoke (SHS) harms health. It is a risk factor for various diseases like asthma, hypertension, diabetes, heart disease and lung cancer. This study aimed to determine the prevalence and predictors of second-hand tobacco smoke among adult never-smokers.

Methods: A cross-sectional study was conducted among 220 participants aged 18 years and above. A pre-tested questionnaire was used to elicit information regarding exposure to second-hand smoke at the home, workplace and various public places. The data was analysed using the Epi Info software for windows.

Results: The second-hand smoke exposure at home and workplace was 11.4% and 19.1%, respectively. The SHS exposure at bus stops, public transport, government buildings and health care facilities were 33.3%, 13.0%, 7.6% and 3%, respectively. The in-home study participants with a current tobacco smoker, family member and/or friend had comparatively higher exposure to second-hand tobacco smoke. In the workplace and or public places, male study participants and illiterate individuals had higher exposure to second-hand tobacco smoke.

Conclusion: The observed level of SHS exposure among non-smokers is a public health concern. Family members should not allow anyone to smoke in their home environment. The public health law prohibiting tobacco smoking in workplaces and public places needs further strengthening.

Demographic Risk Factors for Mortality of Covid 19 Patients Admitted in A Tertiary Care Hospital: A Cross-Sectional Study

Sandhya Singh, Shraddha Mishra, Shubhra Dubey — Mon, 31 Oct 2022 00:00:00 +0000

Context/Background: During the COVID-19 pandemic, government worldwide imposed severe restrictions on public life to limit its spread. For informed decision making it is important to quantitatively assess how the age, gender, and length of stay affects mortality of COVID 19 patients. It is important to find out more useful prognostic factor for mortality. This study revealed prevalence of mortality across age, gender, and length of stay and assessed determinants of mortality using independent variable age, gender, and length of stay.

Methodology: A Cross-sectional observational study was conducted on 3084 Covid 19 positive patients admitted during April 2020 to June 2021 at Bundelkhand Medical College Sagar.

Results: In this study mortality occurred in 510 patients. Age group analysis presented that majority of patients died in 60–74-year age group whereas maximum patients who died are having length of stay for 0-7 days, whereas gender has no significant role. There was significant influence of age group and length of stay on the mortality of Covid-19 positive patients (χ2₍₉₎ =495.30, P<.001).

Conclusions: Mortality of covid positive patients being impacted by demographic risk factors like age group, length of stay.

SNORE (Sleep Deprivation Among Night Shift Health Staff on Rotation Evaluation) Study Protocol

Vinoth Gnana Chellaiyan D, Nirupama AY, Ravivarman G — Mon, 31 Oct 2022 00:00:00 +0000

Background: SNORE (Sleep deprivation among Night shift health staff On Rotation Evaluation) study is conceptualized to study the effects of sleep deprivation on healthcare professionals working night shifts on rotation.

Materials and Methods: A comparative cross‑sectional study is devised including health‑care professionals working night shifts on rotation at a tertiary level health‑care facility, using a semi‑structured questionnaire which can test sleep deprivation, cognitive ability, and quality of life. The process is to approach 309 probable study participants based on stratified random sampling, after exclusion of health‑care professionals with other factors which may interfere with sleep deprivation testing.

Discussion: The study protocol was set in such a way as to randomly include participants from all cadres of healthcare providers as per population proportion. By measuring the effects on cognitive effect and quality of life necessary steps can be taken to provide better quality of life and to decrease cognitive impairment, especially among health care professionals working night shifts.

Influence Of Digital Gaming on Relationship and Social Health

Anganabha Baruah — Mon, 31 Oct 2022 00:00:00 +0000

The transition from the stone age to the digital era has radically altered our way of life. No matter their socioeconomic status, everyone around us currently has a mobile device. Immediately, we want to speak with someone, and within a second, we do. Facebook, Instagram, and online games simplify our daily lives, leaving little room for interpersonal relationships. This paper will examine how digitization has affected our interpersonal connections and also changed the way we view relationships from a social/mental health viewpoint. Since technology has lessened the necessity for social interaction, does this imply that we have all become digital natives? To gain a deeper understanding of the topic, this paper proposes a novel perspective supported by prior research. Since this problem has not been substantially investigated, more targeted research is required in the Indian setting.

A Fire Incident Whilst Handling an Oxygen Cylinder: Preventive Measures and Recommendations

Raman Sharma, Sumit K Sangat, Ashok Kumar, Vipin Koushal — Mon, 31 Oct 2022 00:00:00 +0000

Healthcare fires have always been one of the major internal hazards and an oxygen-rich environment further aggravates these threats. The present case study reports such a fire incident in an Advanced Trauma Centre of a tertiary care hospital in North India wherein a tiny spark generated while handling an oxygen cylinder a health care worker got caught in a fire blaze. Fortunately, the flare was controlled within no time due to prompt action by a fellow HCW, and a major unexpected incident was averted. A formal investigation conducted by a team of experts ascertained that oxygen enrichment from leaking equipment, improper handling, and repeated striking of cylinder regulator by the spanner which attained the required threshold temperature was the probable cause for the onset of a flare. Henceforth, to mitigate such incidents users shall follow manufacturer recommendations, and ensure only safe and suitable components are used as part of a compressed oxygen system. Maintenance of cylinders, valves, and regulators should be done periodically to mitigate the risks of such incidents. All hospitals shall carry out risk-assessment exercises and provide oxygen safety training to all healthcare staff.