National Journal of Community Medicine

Beyond the Stethoscope: Burnout Syndrome Among Interns and Postgraduates in a South Indian Tertiary Care Setting

Vijayakarthikeyan M, Megan Sarah Mathew, Raju Kannan S, Sangeetha S — Sun, 01 Jun 2025 00:00:00 +0000

Background: Burnout is a troubling clinical syndrome characterized by excessive stress, dissatisfaction and a sense of being overworked. Prevalence of burnout varies from 50% to 76%, depending on the specialty across studies. The objectives of the study are to estimate the prevalence of burnout syndrome among interns and residents, and to identify the factors associated with it.

Materials and Methods: It is a facility based analytical cross-sectional study conducted among 300 interns and postgraduates of a tertiary care hospital. Data was collected using a semi-structured questionnaire. The Copenhagen burnout inventory (CBI) scale was utilized to assess the prevalence of burnout. Chi-Square test was used to test the association and p value < 0.05 was considered as statistical significance.

Results: Nearly 37.7% (113) were working for 41-60 hours in a week. 17.8% had high personal burnout, 14% had high work-related burnout and 47.8% had moderate patient related burnout. Hours of work (>60 hours in a week) were significantly associated with personal, work related and patient related burnout.

Conclusion: Addressing this issue is crucial in the Indian context since burnout has a negative impact on patient care quality in addition to having major effects on the resident's physical and mental health.

Expanding AB-PMJAY For the Elderly: A Policy Shift Toward Universal Health Coverage in India

Kiruba Sankar G, Rajalakshmi Mahendran — Sun, 01 Jun 2025 00:00:00 +0000

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is India's flagship health insurance scheme with the aim of Universal Health Coverage (UHC). With its recent expansion to all senior citizens above the age of 70, the scheme will have a greater impact on elderly health care and financial security. This review examines the effect of AB-PMJAY on access to healthcare, catastrophic health expenditure (CHE), and the infrastructure for geriatric care in India. The elderly population normally suffers from not only a high burden of non-communicable diseases but also several chronic health issues along with financial instability arising from low-income sources. The pool of reserves traditionally used to provide up to ₹5 lakh per person is expected to reduce out-of-pocket health expenses, increased hospital utilization, and improves overall health outcomes; however, issues relating to access, enrolment difficulties, lack of hospital infrastructure, and financial sustainability still linger. For policymakers, recommendations must be made in relation to improving enrolment processes, strengthening geriatric services, and being on guard against fraud, all in an effort to ensure the effectiveness of the scheme. Targeting these will be critical in enabling equitable access to healthcare and financial protection for the rapidly growing elderly population in India.

Dengue Fever: Addressing Ghana’s Emerging Public Health Crisis

Sun, 01 Jun 2025 00:00:00 +0000

This study explores the public health concerns, challenges, and solutions surrounding dengue fever reemergence in Ghana. Several environmental factors such as open drainage system, improper waste disposal, improper storage of water influence the transmission of dengue disease in Ghana. Ghana is also dealing with issues related to increased global commerce and tourism, inadequate sanitation such as open drainage system, improper waste disposal and inadequate mosquito control measures which could lead to increased vulnerability to dengue outbreaks. Poor healthcare infrastructure, poverty, geographical inaccessibility, a shortage of skilled healthcare workers, lack of awareness among community members, and weak vector surveillance system further exacerbate the issue. Thus, there is an urgent need for coordinated efforts among policymakers, healthcare professionals, and the general public. Increasing public awareness through co-creation approaches, strengthening laboratory diagnostics, investing in healthcare professionals training, scaling up integrated vector management activities stakeholders can mitigate the risk of severe dengue complications in Ghana.

Knowledge of HIV/AIDS and Perceived Contraceptive Access among Indian Adolescents: Evidence from UDAYA Data

S Prinitha, Tony P Jose — Sun, 01 Jun 2025 00:00:00 +0000

Background: Access to contraceptive methods among adolescents is a critical factor in improving sexual and reproductive health outcomes. The study investigated the determinants of perceived contraceptive access among Indian adolescents by exploring role of HIV/AIDS knowledge, condom awareness, health facility accessibility, and socio-demographic variables, while analysing gender differences.

Methodology: Data from Understanding the Lives of Adolescents and Young Adults (UDAYA) – Wave 2 (2018-19) included 2,716 adolescent boys and 10,425 adolescent girls, both aged 15–19 years. Descriptive analysis, Chi-square test and multivariate logistic regression were employed.

Results: Significant gender disparities exist across all variables (p<0.001), particularly in health facility accessibility (χ²=2200), condom awareness and HIV/AIDS knowledge, and perceived contraceptive access. Multivariate analysis revealed condom awareness most strongly associated with perceived contraceptive access for both boys (OR=2.69, 95%CI:2.07-3.50) and girls (OR=1.45, 95%CI:1.32-1.60). HIV/AIDS knowledge and health facility access also significantly increased perceived contraceptive access odds in both groups. Socioeconomic factors played a crucial role in determining perceived contraceptive access.

Conclusion: Enhancing adolescents perceived contraceptive access requires improving HIV/AIDS knowledge, condom awareness, and healthcare accessibility. Especially for teenagers from different socioeconomic strata, policy interventions need to focus on removing barriers to healthcare access.

Study Effect of the COVID-19 Lockdown on the Transition from Mild Cognitive Impairment to Dementia

Jigar Sanjiv Padhiar, Uddipak Rai, Reema Singh — Sun, 01 Jun 2025 00:00:00 +0000

Background: Dementia represents a significant global health challenge, contributing to high fatality and frailty rates. The worldwide prevalence of dementia is projected to increase by 150% from 2018 to 2051. Countries with low to moderate incomes are expected to experience demographic shifts starting in 2017. The impact of the COVID-19 pandemic on cognitive decline is unclear, but increased social engagement is associated with a lower risk of dementia. We hypothesized that the first nationwide lockdown would lead to a rise in dementia diagnoses, accelerate cognitive decline in at-risk populations, and alter diagnostic patterns due to limited healthcare access.

Methodology: Data collection continued via telephone or audio-video calls during lockdowns, excluding participants with pre-existing dementia. Mild cognitive impairment (MCI) was defined using established criteria, with Clinical Dementia Rating (CDR) scores of 0.5 and Mini-Mental State Examination (MMSE) scores between 24 and 27. Poisson regression with cubic splines adjusted for age was used to estimate dementia incidence before and after 01-Mar-2020.

Results: Among 2140 participants, 200 were diagnosed with dementia before 20-Mar-2020, and 40 after. The incidence rate post-lockdown was not significantly different (p = 0.470). Secondary analysis revealed a decreased association between MCI and dementia after February 2020 (p = 0.021).

Conclusion: Dementia prevalence did not significantly change after the first lockdown. However, the relationship between MCI and dementia incidence weakened, possibly indicating faster progression to dementia or diagnostic challenges due to remote assessments.

Risk Factors for Pulmonary Tuberculosis Transmission Among Prisoner in Correctional Facilities in Lhokseumawe City, Aceh, Indonesia

Sun, 01 Jun 2025 00:00:00 +0000

Background: TB remains a significant public health issue in prisons, facilitating its transmission and affecting both inmates and the wider community. This study aimed to develop a predictive model for TB prevalence and risk factors in prisoners, specifically in class 2A correctional institutions in Lhokseumawe City, Aceh Province, Indonesia.

Methodology: This case-control study included 100 prisoners who were selected through random sampling. Data were gathered through questionnaires and prison medical records. Bivariate analysis and multivariable logistic regression were performed, and p-values ≤ 0.05 set statistically significant.

Results: Medical records revealed 12 inmates with TB. Bivariate analysis identified marital status (odds ratio [OR], 1.2; 95% CI [1.08–1.34]; p=0.017), nutritional status (OR, 3.63; 95% CI [1.05–12.55]; p=0.033), comorbidities (OR, 4.47; 95% CI [1.28-15.56]; p=0.013), and contact with active TB patients (OR, 9.8; 95% CI [5.45-17.63]; p=0.013) as risk factors. Multivariate analysis showed that comorbidities (OR, 5.52; 95% CI [5.45-17.63]; p=0.025) and nutritional status (OR, 4.46; 95% CI [5.45-17.63]; p=0.012) were the most significant risk factors.

Conclusions: Marital status, nutritional status, comorbidities, and contact with patients with active TB were significantly associated with TB incidence of TB among prisoners. Nutritional status and comorbidities were the most significant risk factors.

Decomposition Analysis of Anemia Among Women of Reproductive Age in Northeast India: Evidence from NFHS-4 and NFHS-5

Sabrina Sultana Rahman, Ruma Talukdar — Sun, 01 Jun 2025 00:00:00 +0000

Background: Anemia, characterized by low red blood cell and haemoglobin levels, affects 1.62 billion people globally. It is a major public health concern among reproductive-age women in India, particularly in Northeast regions, where prevalence remains high. The study aims to analyze trends in anemia among reproductive-age women in Northeast India, drawing on data from the NFHS. By employing decomposition analysis, the research seeks to evaluate the extent to which socioeconomic, demographic, and dietary factors have contributed to changes in anemia prevalence over time.

Methodology: The study used descriptive statistical analysis to examine anemia trends and a logit-based multivariate decomposition analysis to quantify the contributions of compositional (endowment) and behavioural (coefficient) factors. Statistical significance was set at p<0.05.

Findings: Anemia prevalence among women in Northeast India rose from 38.7% (NFHS-4) to 50.1% (NFHS-5), with significant variations across demographic, socioeconomic, and dietary factors. Decomposition analysis showed 18.9% of the increase was due to compositional shifts, notably wealth index and residence, while 81.1% was attributed to behavioural factors like diet and socioeconomic status. Consumption of vegetables, fish, and milk significantly influenced anemia trends.

Conclusions: Addressing socioeconomic disparities and promoting balanced diets through targeted interventions are essential to reducing anemia prevalence in Northeast India.

Adult Vaccination Knowledge, Attitudes, and Behavior in Rural Tamil Nadu: A Cross-Sectional Study

Kiruthika Narayanan, Shanthi Edward, Krishna Prasanth — Sun, 01 Jun 2025 00:00:00 +0000

Background: Adult vaccination is a crucial yet underutilized component of public health, especially in rural areas where access to healthcare services is limited. Inadequate awareness regarding adult immunization adversely impacts individual health, healthcare systems, and economic productivity. Objective: To assess the knowledge, attitude, and behavior related to adult vaccination among rural population, Tamil Nadu.

Methods: A cross-sectional study conducted among 260 healthy adults (18 to 80 years) in rural Chengalpattu District, Tamil Nadu, used simple random sampling method. Data were collected using a pre-tested, structured, and validated self-administered questionnaire, focusing on adult vaccination knowledge, attitude, and behavior. Data analysis was performed using IBM SPSS version 25.

Results: Among 260 participants, 41.9% were aged 18-40 years. Covid-19 vaccine had the highest knowledge level (77%). Logistic Regression showed literacy (AOR:4.95) and socioeconomic status (AOR:2.43) significantly associated with knowledge. Likewise, literacy (AOR:3.65) and socioeconomic status (AOR:3.53) were significantly associated with attitude towards adult vaccination (p <0.05).

Conclusion: The study findings underscore education, occupation, and socioeconomic status have a significant impact on adult vaccination acceptance. Addressing barriers to immunization through awareness campaigns and policy interventions is critical to improving adult vaccine uptake in rural populations.

Effectiveness of Colour-Coded Diabetes Monitoring Chart on Glycemic Control Among Adults with Diabetes Mellitus: A Community Trial in Rural South India

Imaad Mohammed Ismail, Poonam R Naik — Sun, 01 Jun 2025 00:00:00 +0000

Background: Uncontrolled diabetes remains a major challenge, especially in developing countries, necessitating low-cost interventions. The objectives of this study were to assess, among adults with diabetes mellitus, (1) the effectiveness of colour-coded diabetes monitoring chart on glycemic control, (2) the change in knowledge and practice related to the control of diabetes, and (3) the perceptions regarding the use of the chart.

Methodology: This community trial was conducted from Oct 2021 to Dec 2024 in Jokatte (Intervention site) and Madani Nagar (Control site) rural areas of Mangalore, India. A total of 180 adults with diabetes (90 per site) were recruited. The intervention arm was given the colour-coded diabetes chart designed by the authors to be used for one year. Statistical analyses were performed using SPSS Ver27.

Results: The intervention led to a 0.58% reduction in HbA1c after adjusting for covariates. Additionally, there were significant improvements in knowledge and practices related to diabetes management. The participants had favourable perceptions of the chart, with most desiring to continue using it.

Conclusion: The colour-coded diabetes chart significantly improved glycemic control and enhanced diabetes-related knowledge and practices. This low-cost chart can be utilized in both government settings such as PHCs as well as private clinics.

Factors Affecting Anxiety Among Patients with Oro-Digestive Cancer: A Cross-Sectional Descriptive Study

Sarita Ahwal, Kanika Rai, Ankur Jindal, Puja Sahai — Sun, 01 Jun 2025 00:00:00 +0000

Introduction: A cancer diagnosis is perceived as life-altering and carries a deep emotional burden, leading to significant psychological distress. This cross-sectional descriptive study was aimed to assess anxiety and its contributing factors among Oro-digestive cancer patients.

Methods: A study was conducted at a tertiary care hospital, after ethical clearance and participants’ consent. Purposive sampling technique was used to enroll 72 adult Oro-digestive cancer patients receiving chemotherapy from August 2024 to January, 2025. Depression anxiety stress scale (DASS-21) was used to assess the anxiety and a validated structured questionnaire was used to elicit data related to socio-demographic & clinical profiles. The scales were pilot tested and administered using face to face interview technique by the principal investigator.

Results: More than 60% of the patients had some degree of anxiety. The mean anxiety score was significantly associated with age group (F=4.03, p=0.023^*), gender (t=2.09, p=0.040^*), marital status (F=5.74, p=0.016^*) and history of substance use (t=2.48, p=0.015^*) Among the clinical variables, type of cancer (t=2.44, p=0.017^*), time since diagnosis (F=5.39,p=0.007^*), performance status (t=2.29, p=0.025^*) and number of side effects faced (F=26.8, p<0.001^**) by the patients had a significant impact on anxiety scores.

Conclusion: Younger, female, and single patients exhibited significantly higher levels of anxiety. In contrast, those experiencing fewer side effects and better performance status reported lower anxiety levels. Additionally, newly diagnosed individuals showed increased anxiety. Identifying these high-risk groups allows for early intervention, ultimately leading to better patient outcomes.

Analysis of Reference Range Values of Lipid Profile and Lipid Ratio in Healthy Young Adult Population in Makassar, Indonesia

Sun, 01 Jun 2025 00:00:00 +0000

Background: Lipids are essential for energy, hormones, digestion, and cell structure. A reference range of population-specific lipid profiles is essential due to variations. This study aimed to determine reference ranges for lipid profiles and ratios in healthy young adults in Makassar, Indonesia, and to identify specific differences by gender.

Methods: We conducted a cross-sectional study of 120 healthy young adults (61 females, 59 males) aged 20-40 years. Lipid profiles (total cholesterol, LDL, HDL, triglycerides) and ratios (cholesterol/HDL, LDL/HDL, triglycerides/HDL) were measured using spectrophotometry (Cobas C311). Data were analyzed using the Kolmogorov-Smirnov test, and reference ranges were established using 2.5-97.5 percentiles.

Results: The overall reference ranges were: cholesterol 133.02-254.75 mg/dL, LDL 73.00-181.82 mg/dL, HDL 23.02-62.97 mg/dL, triglycerides 34.02-319.90 mg/dL, cholesterol/HDL 2.57-8.52, LDL/HDL 1.34-6.13, and triglycerides/HDL 0.60-10.31. Gender-specific ranges showed: women (cholesterol 114.05-252.65 mg/dL, LDL 65.85-175.95 mg/dL, HDL 25.55-75.70 mg/dL, triglycerides 37.30-294.00 mg/dL, cholesterol/HDL 2.55-8.17, LDL/HDL 1.29-5.05, triglycerides/HDL 0. 59-9.64) and men (cholesterol 135.50-255.50 mg/dL, LDL 78.50-196.00 mg/dL, HDL 20.50-61.50 mg/dL, triglycerides 33.50-360.50 mg/dL, cholesterol/HDL 2.54-9.98, LDL/HDL 1.39-6.40, triglycerides/HDL 0.65-17.74).

Conclusion: This study established population-specific and gender-specific reference ranges for lipid profiles and ratios in healthy young adults in Makassar, Indonesia, providing valuable clinical data.

Epidemiological Insights into Self-Medication Practices: A Study Among Residents in Selected Emirates of the UAE

Sun, 01 Jun 2025 00:00:00 +0000

Background: Self-medication is a growing public health concern in the UAE. It is influenced by the country's diverse population and cultural practices. Defined as using medications without medical consultation, self-medication carries risks such as misuse, antibiotic resistance, and negative health outcomes. This study aimed to assess the prevalence, motivations, and socio-demographic determinants of self-medication, focusing on the use of non-prescriptive antibiotics, to inform interventions for safer practices.

Methodology: A community-based cross-sectional study was conducted over six months (June–December 2023) in Dubai and Ras Al Khaimah. A structured, anonymous questionnaire was administered to 330 participants selected through non-probability consecutive sampling. Data was analyzed using SPSS version 29, with descriptive and inferential statistics applied, including chi-square and logistic regression tests, with p < 0.05 considered statistically significant.

Results: Of the participants, 77.4% practiced self-medication, primarily for fever (89.7%) and cough/cold (85.5%). Antipyretics (92.7%) and analgesics (68.8%) were the most common drugs used, with pharmacies being the primary source (77.3%). Significant predictors of self-medication included education level, family structure, absence of a doctor in the family, and lack of health insurance. Self-medication is prevalent in UAE society.

Conclusion: Regulatory measures, public education, and improved healthcare access are needed to mitigate risks and promote safe practices.