National Journal of Community Medicine

Time To Re-Think and Rebuild: Need to Minimize the Pill and Re-Emphasize the Role of Risk Factors Modification in Life Style Disorders

Rahul Bogam, Mariya P Jiandani, Mohamed Iheb Bougmiza, Yousef Al-Hamaid — Thu, 30 Jun 2022 00:00:00 +0000

An increase of lifestyle diseases (LSDs) has been driven by predominantly four important risk factors viz. unhealthy diet, hazardous alcohol use, tobacco use and physical inactivity. The present paper is envisioned to emphasize personal viewpoints and elucidations about vital role of behavioral risk factors in the management of lifestyle diseases particularly regarding Obesity, Type 2 Diabetes (T2DM) and Hypertension as well as an associated risk of pharmacological measures in treating such illnesses. Type 2 Diabetes is considered as irreversible and incurable chronic disease based on traditional means of management. Though, the current research promotes complete reversal of diabetes with the help of simple lifestyle measures. Health care professionals are encouraged to converse with their patients regarding health benefits of exercise, healthy diet and other lifestyle measures. Patient centered behaviour involving reducing tobacco use, controlling alcohol consumption, improving sleep patterns, balanced diet and mental wellbeing should be targeted by health care professional. Early diagnosis, prompt initiation of healthy lifestyle measures and delayed drug treatment could be an effective strategy not only to combat LSDs but also to develop positive attitudes towards life.

Is A Journal indexed? Here's How to Find it

Kalpesh Chodvadiya, Prakash Patel — Thu, 30 Jun 2022 00:00:00 +0000

This article describes simple method to check indexing status of any journal on the internet. Author can use this method to check indexing status of the journal before submission of their article.

Contextual Narratives Associated With Immunization Services During COVID-19 Disease Outbreak in Chennai, Tamil Nadu

Sree T Sucharitha, Aravind Manoharan, Jaishree Vasudevan, Aaditya Fernando — Thu, 30 Jun 2022 00:00:00 +0000

Background: Essential health services including immunization were significantly impacted due to COVID-19 with devastating outcomes in low- and middle-income countries (LMIC). The disruption in immunization services due to global pandemic and measures undertaken at regional levels to overcome need to be studied as pandemic preparedness strategy.

Objective: To document the contextual narratives related to immunization services during the Covid-19 disease outbreak by interviewing qualified pediatricians in the field practice area of private tertiary care teaching medical college

Methodology: In-depth phone-based interviews were conducted with pediatricians in diverse settings during November 2020 to March 2021. Reflexive thematic analysis was performed, major themes identified, and case studies documented.

Results: Pediatricians shared rich experiences related to immunization services impacted due to COVID-19 especially during the earlier months due to imposition of lockdowns leading to discontinuation, disruption of services, decrease in volume of immunizations, modest transition to telehealth service delivery, facility-level changes brought in to ensure immunization services, capacity building measures for upskilling.

Conclusions: Contextual narratives revealed in this study provide rich narrative about the disruption of immunization services due to COVID-19. These findings need to be understood and leveraged to be future ready and prevent further disruptions by identifying and scaling up key solutions piloted in this study.

Impact Of Communication Skills Training in Postgraduate Medical Education

Thu, 30 Jun 2022 00:00:00 +0000

Background: Effective communication is a key feature of optimal doctor-patient relationship. As the postgraduate curriculum lacks standardized teaching and assessment, this study aimed to assess effectiveness of training program on communication skills of postgraduate medical students.

Materials and methods: A prospective interventional study was conducted among first year postgraduate medical students from different clinical specialty. Training program included introduction to principles of communication with basics of doctor-patient relationship, administering informed consent, breaking bad news and counselling patients with HIV/cancer. Pre-test and post-test skill assessment by Faculty and postgraduate (PG) self-rating was carried out using KEECC-A Assessment tool for seven core communication competencies. Perception of students on training program was collected via feedback questionnaire.

Results: Forty-three postgraduate medical students participated. Statistically significant increase in communication skills scores post training was observed with mean post-test assessment scores of 24.26±2.94, p<0.001(faculty rating), 25.19±3.76, p<0.001(PG self-rating) and high degree of internal consistency was found. Students perceived the training program as valuable and highlighted its importance as a part of curriculum.

Conclusion: Training program significantly enhanced communication skills of postgraduate medical students. Integration of standardized teaching and assessment of communication skills is essential for better healthcare practice and optimal doctor-patient relationship.

A Study on Prevalence and Socio Demographic Risk Factors for Hypertension Among Bus Drivers and Conductors of Southern India

Sudheera Sulgante, Rahul C Kirte — Thu, 30 Jun 2022 00:00:00 +0000

Background: Hypertension is one of the diseases of occupational origin. The percentage of hypertensive increases when selected occupational groups are screened. Transport personnel are one such group who are at risk of developing hypertension due to the nature of their profession.

Objective: To study the prevalence of hypertension and socio demographic risk factors for hypertension among bus drivers and conductors of NEKRTC, Raichur division.

Methods: A cross sectional study comprising of 360 bus drivers and 338 bus conductors was undertaken in two NEKRTC depots of Raichur division, Raichur. Data was collected by interviewing study subjects and by physical examination and analyzed using percentages and Chi square test.

Results: Prevalence of hypertension among bus drivers and conductors were found to be 25.3% and 19.8% respectively. Socio-demographic factors like age, marital status, type of family, socioeconomic status were significantly associated with hypertension in bus drivers while in conductors only age and marital status were significantly associated with hypertension.

Conclusion and recommendations: Prevalence of hypertension is higher in bus drivers and conductors, thus periodic screening and monitoring of blood pressure in these transport personnel along with the provision of preventive and curative services to them at the earliest will be an effective strategy.

Effectiveness Of Self-Instructional Module (Sim) On Paternal Attitude Of Expectant Fathers And Maternal Satisfaction On Perinatal Outcome

Thu, 30 Jun 2022 00:00:00 +0000

Introduction: Paternal involvement (PI) has been recognized to have an impact on pregnancy and infant outcomes. The mother’s satisfaction during the birthing process is the most frequently reported indicator in the evaluation of the quality of maternity services. Male involvement reduces maternal stress increases uptake of prenatal care leads to cessation of risk behaviours and ensures men’s involvement in their future parental roles from an early stage. The aim of the study is to assess the effectiveness of self instructional module paternal attitude towards perinatal outcome and maternal satisfaction on paternal attitude.

Methodology: A cross-sectional study was conducted on 320 expectant fathers attending antenatal clinic. A five point rating scale was used to assess the attitude of paternal on pregnancy and labour outcome and Observational check list to assess the postnatal mother satisfaction.

Results: The scores were significantly improved after intervention, in the experiment group, in pre-test, the mean score was 78.61 and the post-test mean score was 120.56, the mean difference is 41.95 whereas, in the control group, the mean score of 79.43 and the post-test mean score was 80.25, the mean difference is 0.82. After self instructional module intervention, in experimental group, 81.88% of them are having satisfied, 18.12% of them are having not satisfied. In control group, 48.75% of them are having satisfied level of score, 51.25% of them are having not satisfied level of score.

Conclusion: Most fathers were very positive about their partner’s pregnancy. They, however, need to be motivated to use that knowledge into practice.

A Case Control Study on Risk Factors of Obesity Among Adolescents

Angeline Grace G, Shanthi Edward, Gopalakrishnan S — Thu, 30 Jun 2022 00:00:00 +0000

Background: Adolescence is the transition period from childhood to adulthood and adolescent obesity can lead to systemic complications affecting the quality of life in later stages. This study aimed to assess the risk factors of obesity among school children of adolescent age.

Methods: This Case control study included 110 obese and 110 non-obese adolescents between 10 and 17 years of age. Children with Body Mass Index (BMI) >+2 SD of WHO growth reference median for their age and sex were included as cases. Children with BMI between -2SD and +1SD were included as controls. Data was collected using a structured questionnaire and analyzed with SPSS software.

Results: The risk factors which showed a statistically significant association with adolescent obesity were less educated father and mother, being a single child in the family, adolescents from nuclear type of family, having an obese parent, increased waist hip ratio and lack of exclusive breastfeeding during infancy.

Conclusion: Educating children and parents on the importance of preventing obesity and harmful effects of adolescent obesity is the need of the hour. This can be done through intensive health education campaigns in community and schools, and regular reinforcement on primary preventive measures.

Sleep As Preamble Of Optimal Health Among Elderly Hypertensive Adults

Thu, 30 Jun 2022 00:00:00 +0000

Introduction: Healthy Aging is for everyone, not just those who are currently disease-free. Many factors influence the health of the elderly, including underlying physiological and psychological changes, health-related behaviour, disease status and also environments in which people are living strongly influence their health.

Methodology: The 240 elderlies between the age group of 60-75 years from Primary Health Centre, Muthukur, Nellore, Andhra Pradesh, India was selected as study participants by simple random sampling technique and excluded those who were mentally and physically sick at the time of data collection. The Pittsburgh Sleep Quality Index (PSQI) scale was used to collect and Sleep promoting measures were taught and followed to experimental group for the period of six months.

Results: In this study, the posttest mean PSQI sleep score among experimental group was 6.16 and control group was 7.95, with the mean difference was 1.79, as it was large and it was statistically significant difference at the value of t=3.34 at p≤ 0.001 level which indicate sleep promoting measures was effective to enhance sleep quality and to maintain normal blood pressure.

Conclusion: Compared to the control group, the experimental group's elderly had better sleep quality; hence healthy sleep promoting measures are effective to manage and to maintain normal blood pressure.

Factors Influencing Oral Anti-diabetic Medication Adherence among Type 2 Diabetes Mellitus in Urban Health Training Centre, Bengaluru.

Lakshmi Hulugappa, Chethana Ramegowda, Anwith Huluvadi Shivalingaiah — Thu, 30 Jun 2022 00:00:00 +0000

Background: Medication adherence is a major challenge in treatment of type 2 diabetes. Hence the present study was undertaken to assess the factors influencing drug adherence in Type 2 diabetes Bengaluru.

Methods: A descriptive study was conducted in urban health training centre Bengaluru for a period of 9 months. A total of 70 type 2 Diabetes patients only on oral drugs willing to give informed consent were included. Institutional Ethical Committee clearance was obtained and pre-tested semi structured proforma was administered and the probable factors that affect adherence was included. Data was entered in Microsoft excel and analyzed in SPSS-21. Descriptive statistics and inferential statistics like Binary logistic regression was used to assess the factors influencing drugs.

Results: Around 92.8% consumed ≤2 drugs and consumed single or combination of drugs. Most common anti-diabetic drug consumed was Biguanides in 64(91.4%). Good adherence (0-2 score) to oral anti-diabetic drugs was observed in 43 (61%) study subjects the factor significantly associated with poor adherence in Binary Logistic Regression Model is sometimes forgetting to consume the medication.

Conclusion: The factors that influenced oral anti-diabetic drugs good adherence is consuming the medications without forgetting. Efforts are needed to improve adherence and self-management techniques to prevent complications.

The Magnitude of Psychological Distress Among Interns During COVID-19 Pandemic: A Multicentric Cross-Sectional Study

Thu, 30 Jun 2022 00:00:00 +0000

Background: COVID-19 has raised serious concerns about the wellbeing of frontline health care workers. Healthcare staff are at increased risk of psychological health problems when dealing with challenges of the COVID-19 pandemic. Among the healthcare professionals, the most commonly affected are those working on the frontline, who are the first to come in contact with the patients.

Objectives: To determine the levels of depression, anxiety and stress among interns during COVID-19 pandemic, and, to assess the factors affecting mental health of the interns during COVID-19 pandemic.

Methodology: This was a web-based multicentric cross-sectional study conducted among interns of various tertiary care teaching hospitals providing COVID care services, during July – August 2021. Data was collected using a self-administered online questionnaire based on the standard DASS-21 scale that assessed the various domains of psychological distress.

Result: Among the study subjects 46% suffered with all three psychological domains like depression, anxiety and stress, 15% had only anxiety, around 10% had anxiety and depression during the COVID-19 pandemic while 22.5% had no psychological problems.

Conclusions: Significant proportions of interns were suffering from depression, anxiety and stress. Fear of COVID-19, long working hours, usage of PPE, COVID vaccination status, and COVID-19 infection status were identified as potential predictors of psychological distress.

A Case Control Study on Alcohol Consumption and Pancreatitis

Thu, 30 Jun 2022 00:00:00 +0000

Introduction: In Western population, a threshold of 5 drinks per day may exist for alcohol to increase pancreatitis risk. Given ethnic differences in alcohol metabolism, we examined the associations between smoking, alcohol, and pancreatitis in Western Indians.

Methods: A case control study was conducted in a surgery department of a hospital in western India. Information on drinking was collected by in-person interview. Baseline characteristics and alcohol consumption was compared between cases of pancreatitis and control (without pancreatitis).

Results: Baseline characteristics of cases and control are Among 4% of the cases and 2% of the control, bile stone was found to be present and this difference was also statistically not significant. Alcohol use was associated with pancreatitis in a dose-dependent way. Those who were taking heavy amount of alcohol had more than five and half-time risk of developing pancreatitis compared to those who are not taking alcohol.

Conclusions: Indians are more prone to alcohol-related pancreatitis than Westerners, and alcohol consumption is the leading cause of pancreatitis in India.

Lifestyle Behaviour and Obstructive Sleep Apnea (OSA): An Association Study Among Young Adults

Remya Krishnan Jyothi, Mathangi Damal Chandrasekhar, Vinoth Chellaiyan Devanbu — Thu, 30 Jun 2022 00:00:00 +0000

Introduction: Lifestyle changes like low physical activity, smoking and consumption of alcohol have been reported to have an impact on Obstructive Sleep Apnea. Smoking was found to be associated with nocturnal hypoxemia and disturbed sleep. Apneic episodes are increased after alcohol consumption.

Objectives: To determine the risk of developing Obstructive Sleep Apnea among young adults.

Material and Methods: Participants were asked to fill in an online generated questionnaire on lifestyle habits in addition to the modified Berlin questionnaire and Epworth questionnaire. A total of 209 study participants were included in the study. A Chi-square test was applied.

Results: Among 209 participants, 47(22.5%) were females and 162 (77.5%) were males. Snoring was reported in 90 (43.1%) of study participants. Around thirty-three, percent of participants were at higher risk of developing Obstructive Sleep Apnea and Obstructive Sleep Apnea was predicted in 21.5%. No association was found between the lifestyle behavioural factors and Obstructive Sleep Apnea.

Conclusion: Though a significant association was not found between selected lifestyle factors and Obstructive Sleep Apnea risk, the role of lifestyle factors could not be undermined. A healthy lifestyle helps in preventing the occurrence of Obstructive Sleep Apnea.

A Review of Risk Factors for Non-Communicable Diseases Among Bus Drivers

Arun R, Meriton Stanly A — Thu, 30 Jun 2022 00:00:00 +0000

A significant threat among the developing countries towards health and development in the current era is attributed by non-communicable diseases. These diseases contribute to major portion of morbidity and mortality globally. It has been predicted that with such an alarming rise in these cases, NCDs will exceed communicable, maternal, perinatal, and nutritional disease as the common causes of death by 2030. Without any action towards this menace the burden of these diseases will continue to escalate overwhelming our capacity to address them. Metropolitan drivers are a group of people who spend their majority of time in a polluted, noisy and a dangerous workplace. With the very few data on the predisposing risk factors among this population, this review help us identifying such factors among the drivers which can help in formulating new policies and improve their health.

How to Avoid Manuscript Rejection: Common Reasons for Rejection of Manuscript

Prakash Patel — Thu, 30 Jun 2022 00:00:00 +0000