International Journal Of Community Medicine And Public Health

Toward evidence-based laser dentistry: wavelength selection, parameter standardization and clinical outcomes

2026-09-01T01:19:39+00:00

Lasers in dentistry represent a range of wavelength-specific technologies and biological mechanisms rather than a uniform treatment category. This structured comprehensive narrative review examined the principal foundations and clinical domains of contemporary laser dentistry, including laser–tissue interaction, wavelength and parameter selection, periodontics and peri-implant therapy, endodontics, restorative dentistry, prosthodontics, oral surgery, pediatric dentistry, orthodontics, photobiomodulation, and antimicrobial photodynamic therapy. Literature from PubMed, Scopus, and Web of Science was reviewed and interpreted comparatively according to wavelength, target chromophore, emission characteristics, operating parameters, clinical indication, comparator, outcome measures, and degree of clinical support. The evidence showed considerable variation across applications. Selected soft-tissue surgical procedures and wavelength-matched ablative or debonding applications had the clearest clinically established roles, although superiority over conventional approaches was not universal. In periodontics, peri-implant therapy, and endodontics, lasers and antimicrobial photodynamic therapy were better supported as adjuncts to mechanical debridement or chemomechanical disinfection than as independent alternatives. Prosthodontic applications offered useful options for material-specific surface treatment and conservative restoration retrieval, although their effectiveness remained dependent on substrate characteristics and thermal control. Pediatric applications appeared relevant to minimally invasive care and patient acceptance. In orthodontics, evidence was stronger for selected soft-tissue procedures and ceramic bracket debonding than for accelerating tooth movement or consistently reducing pain. The available evidence indicates that lasers should not be considered a single therapeutic category or a universal replacement for conventional methods. Their clinical value is indication-specific and, in many applications, primarily adjunctive.

Role of alveolar ridge resorption and occlusal changes in denture instability over time

2026-09-01T01:19:38+00:00

Complete dentures remain an established treatment for edentulous patients, yet their stability may progressively deteriorate as the oral supporting structures change over time. Residual alveolar ridge resorption is a continuous biological process following tooth loss, characterized by reductions in ridge height, width, and morphology. These changes modify the denture-bearing foundation and gradually reduce the adaptation of the denture base to the underlying tissues. The mandibular ridge is particularly vulnerable to extensive resorption, making lower denture instability a frequent long-term clinical problem. Loss of intimate tissue contact reduces support and resistance to horizontal and rotational displacement, particularly during mastication. Changes in the residual ridge can also modify maxillomandibular relationships and disturb previously established occlusal contacts. Denture settling, artificial tooth wear, tissue displacement, and progressive ridge remodeling may produce premature contacts and occlusal interferences that generate unfavorable lateral or tipping forces. The interaction between reduced anatomical support and altered occlusion can therefore accelerate functional deterioration of an otherwise satisfactory prosthesis. Clinically, persistent instability may be presented as impaired mastication, reduced bite force, mucosal soreness, difficulty during speech, food avoidance, and decreased confidence while wearing dentures. These effects may negatively influence patient satisfaction, dietary choices, social functioning, and oral health-related quality of life. Long-term management requires periodic assessment of residual ridge morphology, denture base adaptation, border extension, occlusal relationships, tissue health, and functional movement of the prosthesis. Occlusal adjustment and clinical remount procedures may correct discrepancies, while relining or rebasing can restore adaptation when tissue changes have compromised fit. Denture replacement may become necessary when extensive structural or occlusal deterioration is present. For patients with severe mandibular ridge resorption and persistent instability, implant-retained overdentures can provide improved retention and functional stability. Regular prosthodontic maintenance remains essential because anatomical remodeling and prosthetic wear continue throughout denture service.

The interplay of digital fatigue and sleep deprivation in adolescent mental health: a post-pandemic imperative for school nursing

2026-09-01T01:19:41+00:00

The risk of high pre-sleep screen use, delayed sleep onset time, and increased insomnia among adolescents has increased significantly following and during the COVID-19 pandemic, which has also significantly increased their digital technology use. Sleep loss also exacerbates mental health concerns including depression, anxiety, emotional dys-regulation and suicidality, disproportionately affecting female adolescents, youth with attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorders, and socioeconomically disadvantaged groups. This is a narrative review of peer-reviewed literature (2020-2024) that reviews the relationships among digital fatigue, sleep deprivation and adolescent mental health, and the role of school nurses in multi-tiered systems of support (MTSS) to address the interlinked risks. Peer-reviewed articles, systematic reviews, and meta-analyses were identified through PubMed, Scopus, and Google Scholar using a combination of the following terms: adolescents, digital fatigue, sleep deprivation, screen time, mental health, school nursing, and COVID-19. Studies were included if they included adolescents aged 10–19 years, and addressed digital screen use and sleep or psychological outcomes, and were published in or after 2020. Evidence was integrated within and across domains. Screen time, especially in the hours leading up to sleep, was consistently linked to a reduced sleep onset, poor sleep quality, and an increase in insomnia, through the suppression of melatonin and stimulation of cognitive activity. Disruption of sleep was associated with depression, anxiety, and suicidality, with a bidirectional relationship exacerbated by pandemic-related stress and less physical activity. School nurses became the front-line MTSS moderators in screening, education and policy advocacy. Culturally responsive, longitudinal studies, and more robust implementation of school nursing programs are needed to safeguard adolescent mental health and combat adolescent digital fatigue and sleep loss.

Social stigma and risk determinants associated with tuberculosis transmission to vulnerable residents in India

2026-09-01T01:29:19+00:00

Due to enduring socioeconomic disparities and deep-rooted societal stigma, tuberculosis (TB) remains one of India's most urgent public health concerns. This review article assesses how societal stigma and important risk factors are linked to the onset and spread of TB, especially in vulnerable groups, including slum dwellers, migrants, and people with little access to healthcare. Stigmatization frequently leads to social isolation, non-adherence to treatment, and delayed diagnosis, all of which raise the risk of ongoing transmission within the community settings. Malnutrition, poverty, and co-infection with HIV increase the vulnerability to infection and the course of the disease. A misconception about TB is that it is an ethically motivated disease that discourages people from seeking treatment through healthcare organisations and reinforces discrimination in many Indian communities. Subsequently, failing to report and insufficient treatment remain major obstacles to controlling this disease. The perceived threat of TB infection transmission among susceptible inhabitants in both urban and rural India is highlighted in this article as a result of these intersecting social and epidemiological factors. Thus, it is imperative to develop stigma-reduction initiatives, integrate TB services into primary healthcare, and strengthen community-based awareness campaigns to break the chains of transmission and assert equal access to healthcare. To achieve India's aim of TB elimination, it is vital to address the combined problem of biological and social risk factors. Knowing the social aspects of TB transmission is essential for developing focused treatments that enhance treatment results and promote a more inclusive, stigma-free public health strategy.

Designing data collection tools for psychiatric research: a practical guide for postgraduate psychiatry trainees

2026-09-01T01:25:38+00:00

Data collection tools are used to document information gathered from participants or clinical records. Their structure and content vary depending on the study type, instruments used, and variables of interest. A poorly designed tool introduces systematic errors that no statistical method can correct. Since data collection is an irreversible step, and the quality of all downstream analyses depends on what is collected and how it is documented, careful attention to tool design is essential. This guide provides a structured, practically oriented framework for designing paper-based data collection tools in psychiatric research, covering study type, format, language, ordering, coding, and data entry compatibility.

Navigating the future of Indian nursing: nurse practitioner in midwifery as an innovation nexus in maternal healthcare

2026-09-01T01:20:54+00:00

The Nurse Practitioner in Midwifery (NPM) programme represents a transformative initiative in India's maternal healthcare system, aiming to strengthen skilled birth attendance, improve the quality of maternity services, and address persistent shortages of qualified maternal healthcare professionals. This narrative review synthesizes current evidence on the evolution, educational framework, clinical roles, policy landscape, implementation challenges, and future prospects of the NPM programme. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, CINAHL, Embase, Google Scholar, and grey literature from the World Health Organization, International Confederation of Midwives, Indian Nursing Council, and the Ministry of Health and Family Welfare. Evidence indicates that competency-based NPM education aligns with international midwifery standards and prepares nurses to provide autonomous, evidence-based, respectful, and woman-centred maternity care. Midwifery-led continuity models are associated with improved maternal satisfaction, reduced unnecessary obstetric interventions, enhanced breastfeeding practices, and favourable maternal and neonatal outcomes. The review also highlights the growing role of digital health, telehealth, simulation-based education, and artificial intelligence in strengthening advanced midwifery practice. However, implementation remains constrained by regulatory ambiguity, limited professional autonomy, inadequate educational infrastructure, workforce shortages, and uneven adoption of Midwifery-Led Care Units across India. Strengthening legislation, expanding competency-based education, enhancing leadership capacity, and integrating digital innovations are essential for maximizing the impact of NPMs. The Nurse Practitioner in Midwifery programme has substantial potential to advance universal health coverage, improve maternal and newborn health outcomes, and strengthen India's nursing workforce through high-quality, evidence-based maternity care.

Infectious and respiratory vulnerability among elderly women in urban slums in India: the role of informal work and social disadvantage

2026-09-01T01:26:23+00:00

Elderly women working in the informal sector of urban slums in India are highly vulnerable due to the combined effects of ageing, poverty, hazardous occupations, and limited access to healthcare. This review examined published evidence on infectious disease risks in this population, focusing on respiratory health and the influence of social determinants. The evidence showed that biomass fuel exposure, ambient air pollution, overcrowding, poor ventilation, inadequate sanitation, and unsafe waste handling substantially increased respiratory and infectious disease risks. Women engaged in ragpicking and similar occupations faced additional hazards from direct contact with unsegregated municipal and biomedical waste, lack of personal protective equipment, prolonged work hours, anemia, addiction, and social insecurity. Studies also reported a high burden of chronic respiratory disease, recurrent respiratory symptoms, tuberculosis associated with biomass smoke, multi-morbidity, and delayed healthcare seeking due to financial constraints, poor health literacy, limited healthcare access, dissatisfaction with public services, and misattribution of symptoms to ageing. Overall, infectious disease vulnerability is driven by interacting biological, environmental, occupational, and social factors. Targeted policies should prioritize clean household energy, safer waste management, improved slum conditions, accessible geriatric and primary healthcare, and community-based screening and support for socially disadvantaged older women.

Nurses today – is this the dream of Florence Nightingale

2026-09-01T01:24:44+00:00

Florence Nightingale's enduring influence on contemporary nursing practice through a comprehensive analysis of her seminal work is "Notes on Nursing: What It Is, and What It Is Not" (1859). The study explores whether modern nursing fulfills Nightingale's original vision by comparing the foundational attributes she identified with the competencies required of today's nurses. Nightingale's core principles emphasized keen observation skills, common sense judgment, meticulous attention to cleanliness and hygiene, quiet demeanor, punctuality, organizational management, and genuine empathy for patients. These qualities, articulated over 160 years ago, remain remarkably relevant in contemporary healthcare settings. This review presents a detailed comparative analysis contrasting Nightingale's era with modern nursing across multiple dimensions including compassion and care, clinical skills, leadership, evidence-based practice, education, advocacy, work ethic, innovation, communication, courage, cultural awareness, and adaptability. Through eighteen clinical scenarios, the analysis demonstrates how Nightingale's principles translate into today's complex healthcare environments, from Intensive care and infection control to crisis management and end-of-life support. While technological capabilities and clinical interventions have advanced dramatically, the fundamental commitment to patient-centered care, environmental management, systematic observation, data-driven practice, and patient advocacy remains unchanged. The review concludes that Nightingale's vision of nursing as both an art requiring personal qualities and a science demanding systematic knowledge continues to shape excellence in contemporary nursing practice. Her legacy transcends historical significance, actively informing professional standards, educational requirements, infection control protocols, and the ethical foundation of modern nursing, proving that her pioneering principles remain vital to quality patient care in the 21st century.

Beyond the operating room: a narrative review of paediatric surgical diseases as a neglected child health priority in low and middle-income countries

2026-09-01T01:22:14+00:00

Paediatric surgical diseases contribute substantially to childhood morbidity, disability, and mortality worldwide, yet they continue to receive limited attention within public health policies and child health programs, particularly in Low and middle-income countries (LMICs). While remarkable progress has been achieved in reducing deaths from infectious diseases and malnutrition, surgically treatable conditions remain a significant but under-recognized cause of adverse health outcomes among children. Congenital anomalies, acute appendicitis, intestinal obstruction, inguinal hernia, trauma, and surgical infections collectively account for a considerable burden of preventable morbidity and mortality. Delayed recognition, inadequate referral systems, shortage of trained personnel, financial constraints, and geographical barriers often impede timely access to surgical care. Consequently, many children present with advanced disease, resulting in increased complications, prolonged hospitalization, disability, and avoidable deaths. This narrative review examines the burden of paediatric surgical diseases in LMICs, explores major health-system barriers affecting access to care, and highlights their implications for child health outcomes. The review further discusses opportunities for integrating paediatric surgical conditions into existing child health programs and proposes public health strategies aimed at improving access to safe, timely, and affordable surgical care. Recognizing paediatric surgical diseases as a public health priority is essential for strengthening health systems, reducing preventable childhood morbidity and mortality, and advancing progress toward universal health coverage and Sustainable Development Goals.

Women’s health: the new dimensions and homoeopathy of AYUSH

2026-09-01T01:22:13+00:00

Women’s health is an integral part of public health and especially the reproductive health. The Reproductive and Child Health (RCH) is a big component in National Health Mission (NHM) where primarily the target is woman. This article discusses the span of women health across the various stages in the life of a woman. It traverses through the fact that reproductive health is not exclusively hormonal but also cellular. Here cellular means the mitochondria generated cellular energy. The cellular approach will help masses to see a variety of clinical conditions in women’s health but also understand the issues of ageing, fertility and vitality in women. With the new census coming up in 2027, almost half of the population or about 75 crores (750 million) will be women in India. It will also help policy makers to understand the complexity both clinically and culturally. It is a priority under the domain of Community Medicine and Public Health (CMPH). With the new view, health policies will be impacted and accordingly the women’s health approach has to be relooked. It clearly needs a holistic approach as the approaches till date were based on hormones. Future clinical approaches have to be preventive, resilient, cost effective, clinical effective and no side effects. Homoeopathy of AYUSH ministry of India has the quality to meet the future demands. NFHS 6 says that the menace of Non-Communicable Diseases (NCD) has surged. NCDs are the triggers in women’s health. Dealing with women’s health effectively means impacting future generations positively.

Plantago ovata as a low-cost community-based dietary fibre intervention: a narrative review of evidence and public health applications

2026-09-01T01:23:15+00:00

Dietary fibre is an important but often underemphasized component of preventive nutrition and community health practice. Plantago ovata Forssk., commonly known as psyllium or Isabgol, is a soluble, gel-forming fibre widely used in South Asia and traditionally described in Unani dietotherapy as a demulcent and bulk-forming agent for digestive balance. A narrative review was conducted to synthesize traditional Unani descriptions and contemporary biomedical evidence on Plantago ovata, with emphasis on gastrointestinal and metabolic outcomes and public health applications. Literature was searched in PubMed, PubMed Central, Google Scholar, Scopus and Web of Science, with a supplementary search updated in May 2026. Evidence from randomized controlled trials and meta-analyses supports psyllium for improving stool frequency and consistency among adults with constipation, with additional modest benefits on low-density lipoprotein cholesterol and selected glycaemic indices. Its physiological effects are related to water-holding capacity, stool bulking, delayed glucose absorption, bile acid binding and possible modulation of gut microbiota. Psyllium has practical relevance as a low-cost, culturally familiar and generally safe adjunct that can be incorporated into dietary counselling at primary care and community levels. Public health messages should emphasize food-based fibre intake, adequate fluid intake, gradual introduction, medication spacing and recognition of warning symptoms.

Prevalence of lifestyle diseases in Goa: a comparison between NFHS-5 and NFHS-6

2026-09-01T01:22:12+00:00

Non-communicable diseases (NCDs) account for 74% of all global deaths and represent the foremost public health challenge of the twenty-first century. India is home to over 101 million adults with diabetes, the second-highest national burden in the world, and an estimated 315 million with hypertension. Goa, with its high urbanisation, above-average per capita income, rapidly ageing population, and distinct dietary practices, is expected to be at an advanced stage of India’s epidemiological transition. The sixth round of the National Family Health Survey (NFHS-6, 2023-24), released by the Ministry of Health and Family Welfare in May 2026, provides, for the first time, the opportunity to compare key lifestyle disease indicators in Goa across two consecutive NFHS rounds. This study undertakes a comparative secondary analysis of published state and national fact sheet data for three core indicators: overweight/obesity, hyperglycaemia, and hypertension, disaggregated by sex and residential setting. The findings reveal a sharp and accelerating rise in obesity, from 36.1% to 45.1% among women (+9.0 percentage points) and from 32.6% to 43.6% among men (+11.0 pp), both exceeding the national trajectory. Hyperglycaemia similarly rose from 20.8% to 27.5% in women (+6.7 pp) and from 24.1% to 32.1% in men (+8.0 pp), with Goa’s rates substantially above national averages. Hypertension remained stable overall, but with a notable compositional shift towards better pharmacological control. These findings place Goa’s NCD burden among the highest in India and call for urgent, evidence-based community medicine responses, including population-level obesity prevention, expanded metabolic screening, and culturally adapted dietary intervention.

Impact of paternity leave on maternal postpartum recovery and mental health: policy frameworks in India and Kerala

2026-09-01T01:23:12+00:00

The recognition of paternity leaves as a key element in supporting maternal recovery and improving postnatal care quality is increasing. Although there is increasing global evidence highlighting its advantages, the implementation and effects of paternity leave policies differ widely, with India exemplifying this variation. This review aimed to gather and analyse current evidence on how paternity leave influences maternal physical and mental health during the postpartum period, with a particular focus on the policy frameworks and practices in India and Kerala. An extensive search was carried out across several databases, such as PubMed, Scopus, web of science, and google scholar, to locate pertinent studies published between 2004 and 2025. The search utilized keywords associated with “paternity leave,” “postnatal care,” “maternal recovery” and “parental leave policies.” Official documents, policy papers, and government notifications from India and international organizations were examined to understand the legislative and policy contexts. Paternity leave is increasingly viewed as a public health measure aiding maternal recovery. Fathers’ involvement during this time helps alleviate physical strain, musculoskeletal stress, and fatigue. Additionally, it acts as a safeguard against postpartum depression and stress in mothers. Yet, policy implementation varies widely. In India, Central Government employees are entitled to 15 days of paid leave, while Kerala State Government employees receive 10 days. In contrast, the private sector lacks a uniform statutory provision, resulting in considerable disparities in family support. Ensuring statutory, paid, and job-protected paternity leave of adequate length is crucial for enhancing health outcomes for both mothers and infants.

Innovative strategies to strengthen geriatric healthcare in India: bridging gaps through digital health and community-based interventions

2026-09-01T01:19:45+00:00

India is experiencing a demographic shift with a rapidly growing elderly population projected to reach 20% by 2050. However, geriatric healthcare remains underdeveloped and inadequately integrated within the public health system. This article explores the status of elderly healthcare in India, highlighting key gaps in infrastructure, trained human resources, and service delivery. The National Programme for Health Care of the Elderly (NPHCE), though well-intentioned, suffers from limited implementation, particularly in rural and remote areas. The article examines the potential of digital health technologies such as telemedicine, mobile health units, and smart health monitoring to enhance access and continuity of care. Community-based approaches, including home visits by frontline health workers and family caregiver training, are presented as practical strategies to strengthen geriatric care. In addition, the psychosocial needs of the elderly mental health, family support, and palliative care are addressed as integral components of healthy ageing. The paper concludes by recommending a multi-sectoral approach involving policy integration, public-private partnerships, and targeted capacity building. Bridging the gap in geriatric care is essential not only for health equity but also for achieving India’s Sustainable Development Goals (SDGs), especially SDG 3, 9, and 17.

India's efforts towards improving maternal healthcare: a narrative review of government maternal health schemes

2026-09-01T01:19:45+00:00

Maternal mortality is still a major public health concern. India stands second across the globe in absolute maternal deaths. Even though the country has reduced the maternal mortality ratio (MMR) from 570 in 1990 to 97 per 100,000 live births in 2020. The present narrative review traces the evolution of centrally sponsored Government of India maternal health schemes from 1952 to 2019, and examines their objectives, key interventions and outcomes against the national targets and sustainable development goal (SDG) 3. Literature was identified from PubMed/MEDLINE, Scopus, google scholar and the Cochrane library and supplemented by government policy documents, NFHS data and WHO/UNICEF reports and synthesized narratively in chronological order. From the family planning programme (1952) to the launch of SUMAN scheme in 2019, several schemes have strengthened the maternal health continuum of care in India. JSY and JSSK have significantly increased institutional delivery (41% in 2005 to 88.6%, NFHS-5) and reduced out of pocket expenditure. Continued persistence of socioeconomic inequities, disparities and urban–rural gaps limit universal coverage of maternal health schemes in India. India’s estimated 2023 MMR of 116 which means it is off track to meet the SDG 3.1 target of below 70 by 2030. India’s maternal health policy architecture is characterised by sustained government commitment. but equity-focused implementation, demand-side interventions and evidence-based programme refinement are crucial to achieving zero preventable maternal deaths.

ASHA-community health nurse collaboration for improving maternal and child health outcomes in India: a narrative review

2026-09-01T01:20:24+00:00

India has achieved substantial progress in maternal and child health; however, preventable morbidity, mortality, inequitable access, delayed referral, and discontinuity of care remain important public health challenges. Accredited Social Health Activists and community health nurses occupy complementary positions within the primary healthcare system. Accredited Social Health Activists provide household-level mobilisation, counselling, surveillance, and linkage to health services, whereas community health nurses contribute clinical assessment, risk identification, skilled care, referral coordination, supervision, and continuity across community and facility settings. This narrative review examines how collaboration between these frontline cadres can improve maternal and child health outcomes in India. A structured literature search was undertaken using PubMed, Google Scholar, and relevant government and international health agency sources. Evidence suggests that effective collaboration can strengthen early pregnancy registration, antenatal care utilisation, identification of high-risk pregnancies, birth preparedness, institutional delivery, postnatal follow-up, home-based newborn care, breastfeeding support, immunisation, growth monitoring, and timely referral. However, fragmented communication, role ambiguity, hierarchical relationships, excessive workload, uneven supervision, delayed incentives, inadequate transport, weak referral feedback, and digital fragmentation limit the effectiveness of this partnership. This review proposes the CONNECT-MCH model, an integrated framework based on community identification, ongoing information exchange, nursing assessment and risk stratification, navigation and timely referral, escalation of high-risk cases, closed-loop continuity, and team learning with supportive supervision. Strengthening structured collaboration between Accredited Social Health Activists and community health nurses may transform parallel frontline activities into a coordinated continuum of care and improve equity, responsiveness, continuity, and accountability within India’s maternal and child health system.

Corticosteroids for community-acquired pneumonia in non-ICU patients presenting to the emergency department: a systematic review and meta-analysis

2026-09-01T01:20:56+00:00

Community-acquired pneumonia (CAP) is among the most common infectious indications for emergency department attendance and hospitalization and carries a heavy mortality burden despite advances in antimicrobial therapy. Because a dysregulated host inflammatory response independently drives clinical deterioration, corticosteroids have been proposed as adjunctive treatment, but their benefit in non-ICU patients presenting to the emergency department remains unclear. A systematic search of PubMed, Web of Science, and EMBASE was conducted to identify randomized controlled trials evaluating systemic corticosteroids versus placebo or standard care in adults with CAP managed outside the ICU. The primary outcome was all-cause mortality; secondary outcomes included time to clinical stability, length of hospital stays, ICU admission, and adverse events. Twelve RCTs were included. Pooled analysis showed no significant difference in mortality between the corticosteroid and control groups (RR=0.98, 95% CI: 0.87–1.10, p=0.71; I²=0%). Neither time to clinical stability nor length of hospital stay differed significantly between groups, though both outcomes showed substantial heterogeneity. Corticosteroid use was associated with a significantly higher risk of hospital readmission (RR=1.35, 95% CI: 1.11–1.64, p<0.001) and hyperglycemia (RR=1.69, 95% CI: 1.49–1.92, p<0.001). Early corticosteroid therapy in non-ICU adults with CAP does not reduce mortality or meaningfully accelerate clinical recovery, while consistently increasing the risks of hyperglycemia and hospital readmission. Routine use in this population cannot be recommended on current evidence, and future trials should incorporate biomarker-guided designs to identify inflammatory phenotypes most likely to benefit from corticosteroid therapy.

Association of depression, anxiety and quality of life in patients with diabetes mellitus: a systematic review

2026-09-01T01:22:05+00:00

Diabetes mellitus (DM) is frequently associated with psychological comorbidities such as depression and anxiety, both of which may adversely affect quality of life (QoL). This systematic review aimed to evaluate the association between depression, anxiety, and QoL among patients with DM. A systematic literature search was conducted in PubMed/MEDLINE, Google Scholar, DOAJ, and the Cochrane Library according to PRISMA 2020 guidelines. Only studies that used validated instruments to measure depression, anxiety, and QoL in adult patients with type 1 or type 2 DM were included. Data extraction and risk-of-bias assessment were performed independently by two reviewers using ROBINS-I and RoB 2 tools. A total of 17 studies with 45 to 5,259 participants were included. The rate of depression varied from 8% to 57.8% and the rate of anxiety varied from 9% to 57.9%. QoL scores were consistently reported as being significantly negatively related to depression and anxiety across studies. Included data demonstrated strong negative correlations between wellbeing scores and depression (p=-0.579) and anxiety (p=-0.632). Significant inverse correlations between depression and QoL (r=-0.690, p<0.001) and anxiety and QoL (r=-0.646, p<0.001) were also observed. Many studies indicated that the combination of depression and anxiety was linked to physical, psychological, and social impairments. A reduction in depressive and anxiety symptoms was associated with improvement in the dimensions of QoL in intervention studies. There is a strong correlation between depression and anxiety with patient QoL in individuals with diabetes, highlighting the need to incorporate psychological assessment and mental health management into general diabetes care.

Barriers and enablers to diabetic retinopathy screening uptake: a systematic literature review

2026-09-01T01:27:24+00:00

Diabetes mellitus is a growing worldwide health concern with fast-rising prevalence and serious health complications. Early detection through routine Diabetic retinopathy screening is effective in preventing vision loss. Objective: The study sought to identify factors that hinder and promote uptake of diabetic retinopathy screening. This study followed PRISMA to conduct and report findings. Relevant literature was identified; data were extracted, summarized in a table and analyzed. References were cited using EndNote. Diabetic retinopathy screening uptake in low- and middle-income countries, especially in sub-Saharan Africa, was consistently low. Studies from Malawi, and Kenya reported screening rates ranging from 10.5% to 25.6%, with annual uptake between 13.3% and 20%. This demonstrates a substantial gap between recommended screening guidelines and actual practice. Knowledge of Diabetic retinopathy screening services by patients and referral by healthcare workers were the strongest predictors of screening uptake. In Kenya, higher education level, family history of diabetes and provider referral were associated with increased screening utilization. Worldwide evidence reveals marked inequities in DR screening adherence, with higher uptake in developed countries at around 66% compared to less developed ones at approximately 39%. Europe observed the highest adherence to screening at 81.3%. Studies indicate that diabetic retinopathy screening uptake remains suboptimal, highlighting the need for integrated diabetes and eye care services, provider-initiated referrals, and enhanced patient awareness to improve screening coverage. The role of data management systems in DR screening reporting, monitoring, and evaluation remains underexplored in many studies.

Oral cancer awareness among male adolescent population in Kanpur, Uttar Pradesh: a systematic review

2026-09-01T01:22:07+00:00

Oral cancer is one of the most common cancers in India and constitutes a major public health challenge. Tobacco use, areca nut consumption, smoking, alcohol use, and poor awareness regarding oral cancer contribute significantly to disease burden. Adolescents are particularly vulnerable because many risk-related behaviours begin during this period of life. Understanding the level of oral cancer awareness among male adolescents is essential for designing effective preventive interventions. Objectives were to systematically review the available literature on oral cancer awareness among male adolescents, with a focus on evidence relevant to Kanpur, Uttar Pradesh, and comparable Indian populations. A systematic review of published literature was conducted using electronic databases including PubMed, Google Scholar, Scopus, and Web of Science. Studies published in English between 2010 and 2025 assessing oral cancer awareness, knowledge of risk factors, symptoms, prevention, and screening among adolescents were included. Relevant studies conducted in India and similar socio-cultural settings were critically appraised and synthesized narratively. The review identified consistently low to moderate levels of oral cancer awareness among adolescents. Knowledge regarding tobacco as a risk factor was relatively common, whereas awareness of smokeless tobacco, areca nut products, early signs of oral cancer, and the importance of regular oral examinations was considerably lower. School-based educational interventions demonstrated significant improvements in awareness and preventive attitudes.

Nutritional status and dietary adequacy in people living with HIV: a systematic review

2026-09-01T01:29:18+00:00

HIV infection adversely affects nutritional status by increasing metabolic demands, impairing nutrient absorption, and reducing dietary intake. Malnutrition and dietary inadequacy among people living with HIV (PLHIV) contribute to immune suppression, poor treatment response, and accelerated disease progression, yet nutrition remains an underemphasized component of HIV care. This systematic review aimed to assess the nutritional status and dietary adequacy of PLHIV by synthesizing evidence from Indian and international studies. A systematic literature search was conducted using PubMed, Google Scholar, and Scopus for studies published between 2010 and 2025. Observational and cross-sectional studies evaluating dietary intake, nutritional status, anthropometric parameters, dietary diversity, and related clinical outcomes among PLHIV were identified using predefined inclusion criteria and synthesized narratively following PRISMA reporting guidelines. Most studies reported inadequate energy and protein intake among PLHIV, with intakes frequently below recommended levels. Micronutrient deficiencies, anemia, and poor dietary diversity were common. Anthropometric findings revealed a dual burden of malnutrition, with both undernutrition and emerging overweight observed. Poor dietary diversity, food insecurity, and socioeconomic factors were consistently associated with adverse nutritional and clinical outcomes. PLHIV remain vulnerable to nutritional inadequacy and malnutrition, with energy and protein intakes consistently below recommended levels and dietary diversity scores below five food groups in most populations studied. Both undernutrition and emerging overweight represent a dual burden requiring individualized assessment. Integrating structured nutritional screening, counselling, and food supplementation into routine HIV care programs is essential to improve immunological recovery, reduce opportunistic infections, and enhance quality of life.

Urolithin A-induced mitophagy: a mitochondrial therapeutic axis for decelerating musculoskeletal aging and modulating knee osteoarthritis pain

2026-09-01T01:31:00+00:00

Knee osteoarthritis (OA) is a disease characterized by cellular energy dysregulation, in which structural joint deterioration and chronic pain are caused by mitochondrial dysfunction. OA is now recognized as a multifactorial condition caused by disturbed cellular homeostasis, metabolic imbalance, and typical biological processes of aging, notably mitochondrial dysfunction. However, it was once thought to be caused by mechanical wear and cartilage degradation

Suspected case of rabies in a patient immunized with anti-rabies vaccine

2026-09-01T01:30:36+00:00

Rabies remains a major public health threat, especially in developing countries like India, where stray dogs account for 99% of human cases. The disease is almost always fatal once symptoms appear, with death occurring within days. Despite highly effective pre- and post-exposure prophylaxis (PEP) with WHO-recommended vaccines, challenges like occasional vaccine failure persist. In India, rabies causes approximately 20,000 deaths annually. This case highlights a suspected rabies infection that developed despite receiving PEP, exploring potential reasons for the failure. This case emphasizes the necessity for a deeper understanding of factors that may lead to vaccine ineffectiveness. It also underscores the critical role of administering rabies immunoglobulin (RIG), proper wound care and following established guidelines.

A case study of acute toxicity after consumption of kokkumarundhu (carbamate compounds)

2026-09-01T01:22:08+00:00

Acute poisoning due to ingestion of toxic compounds remains an important medical emergency associated with significant morbidity and mortality. Traditional herbal preparations and locally used substances are increasingly being implicated in poisoning casesbecause of their easy accessibility and lack of awareness regarding their toxic effects. Kokkumarundhuis a traditional paste preparation containing rice and other grains mixed with carbamate compounds and may produce toxic manifestations after ingestion.The presence of associated substance abuse and alcohol consumption may further complicate the clinical presentation and management of such cases. We report the case of a 20-year-old male with a history of chronic smoking, alcohol dependence, and suspectedmulti-substance abuse who presented to the emergency department with complaints of sudden onset abdominal pain and dizziness following three days of binge alcohol intake. The patient denied nausea, vomiting, chest pain, and dyspnea but complained of chills. Further history from family members revealed ingestion of kokkumarundhuapproximately four hours prior to presentation. On examination, the patient was conscious, alert, oriented, and afebrile with mild hypertension (BP: 170/60 mmHg). Investigations including serum electrolytes, cardiac biomarkers, and echocardiography were within normal limits, indicating stable cardiovascular status. The acute clinical manifestations were likely due to the combined effects of kokkumarundhuingestion, alcohol consumption, and chronic substance use. Early supportive treatment with intravenous fluids, thiamine, atropine, and close monitoring was initiated to prevent deterioration. This case highlights the importance of prompt recognition and early management ofacute toxicity, particularly in patients with associated substance abuse, to prevent complications and ensure favorable outcomes

A case report on Clostridium baratti in placenta: pathogen or commensal

2026-09-01T01:22:01+00:00

Clostridium baratti is a rarely reported anaerobic bacterium, primarily isolated from immunocompromised patients. We report a case of C. baratti isolated from placental tissue in a 32-week pre-rupture of membranes patient with acute chorioamnionitis. The mother presented with fever, elevated inflammatory markers (CRP 42 mg/l, WBC 16,500/μl), and fetal tachycardia. Placental culture revealed C. baratti (anaerobic culture) and non-pathogenic organisms (aerobic culture). The neonate developed early-onset sepsis with leukopenia, thrombocytopenia, elevated CRP, and coagulopathy. Neonatal blood culture grew commensals; anaerobic cultures were not obtained on day 0. Four lines of evidence- isolation during active maternal infection, polymicrobial ascending flora, growth in infected tissue, temporal relationship to neonatal sepsis, coverage by empiric metronidazole, and isolation from protected placental tissue, may suggest C. baratti as pathogenic. This case suggests C. baratti as a pathogen in obstetric-neonatal infections and highlights the need for routine anaerobic culture of placental tissue and anaerobic blood cultures from chorioamnionitis-exposed neonates.

Knowledge factors associated with the uptake of improved hygiene and sanitation facilities among households in Kuresoi South Sub-County, Nakuru County, Kenya

2026-09-01T01:29:21+00:00

Background: Access to improved hygiene and sanitation facilities remains a major public health challenge in many rural communities, contributing to persistent burden of preventable infectious diseases. Knowledge of hygiene and sanitation practices is considered an important determinant of household adoption of improved facilities. This study assessed knowledge-related factors associated with the uptake of improved hygiene and sanitation facilities among households in Kuresoi South Sub-County, Nakuru County, Kenya.

Methods: A descriptive cross-sectional study using a mixed-methods approach was conducted among 346 households selected through stratified and systematic random sampling. Data were collected using structured questionnaires, observation checklists, and focus group discussions. Quantitative data were analyzed using descriptive statistics, chi-square tests, and binary logistic regression at a 95% confidence level. Qualitative data were analyzed thematically.

Results: Overall, 61.3% of households had poor uptake of improved hygiene and sanitation facilities. Chi-square analysis showed significant associations between uptake and knowledge of diseases caused by poor hygiene (χ²=9.849, p=0.007) and knowledge of critical handwashing times (χ²=21.877, p<0.001). Logistic regression indicated that households with low knowledge of hygiene-related diseases were 57% less likely to adopt improved hygiene and sanitation facilities (OR=0.43, 95% CI: 0.186-0.980), while those with low knowledge of critical handwashing times were 68% less likely to adopt improved facilities (OR=0.32, 95% CI: 0.177-0.592).

Conclusions: Knowledge significantly influences uptake of improved hygiene and sanitation facilities. Targeted, behavior-specific health education interventions should be strengthened to improve sanitation adoption and sustain appropriate hygiene practices in rural communities.

Acceptance of donor breastmilk by mothers in Lagos: a cross-sectional survey

2026-09-01T01:29:20+00:00

Background: Human breast milk meets the nutritional needs of babies and reduces the incidence of infection. Not all babies benefit from this nature’s gift. WHO recommends that such babies should receive the next preferred choice of donor breast milk (DBM), which is not common in Nigeria. This study aimed to determine the acceptance of donor breast milk by the mothers in Lagos State, South-Western Nigeria.

Methods: A questionnaire-based, descriptive, cross-sectional study. Questionnaires were administered to mothers of babies attending the immunization and neonatal clinics at seven Lagos State government-owned hospitals from September to November 2021.

Results: A total of 1750 questionnaires were analyzed. The mean age of the respondents was 30.9±6.3 years. Most respondents (59.2%) had a tertiary education. Most (88.8%) had no prior knowledge of DBM, and 83.5% would not allow their babies to receive DBM. Maternal education (p=0.031) and the mode of delivery (p=0.049) are significantly associated with the knowledge of DBM, and a significant association exists between knowledge of DBM and perception of receiving DBM (p=0.001). All mothers who had heard of DBM (100%) were willing to allow their babies to receive DBM, compared to only 5.9% of mothers who had not heard of DBM.

Conclusions: Mothers in Lagos are not willing to give their babies DBM. Religious and cultural reasons strongly influence acceptance of DBM. These mothers, however, are willing to donate their milk for other babies.

Dietary factors and associated health effects among patients with vitamin D deficiency

2026-09-01T01:29:14+00:00

Background: Vitamin D deficiency is prevalent among men and women alike and is often left untreated in developing countries. Vitamin D deficiency and its associated health problems can be controlled if dietary intake is properly maintained. The study objective was to understand the dietary habits and the problems faced by patients of a hospital in Dhaka due to vitamin D deficiency.

Methods: Total 133 patients were selected through convenience sampling, and their vitamin D levels were collected from the medical records. Other data were collected from a previously set questionnaire.

Results: Total 56 (42.1%) were men, and 77 (57.9%) were women among the patients. 42 (31.6%) of the vitamin D-deficient people were obese in this study. 17 (12.8%) people still had severe (level <12 ng/ml) vitamin D deficiency even after receiving treatment and needed more. The egg and meat intake among the participants was satisfactory, but milk intake was low among them. 88 (66.1%) patients took vitamin D supplements at the time of study. However, there is no significant association between dietary intake and vitamin D deficiency. Vitamin D status is associated with chronic health problems, such as hypertension and diabetes mellitus, as well as with the intake of vitamin D and calcium supplements (p<0.05). Bone pain, joint pain, hair fall, anxiety, depression, etc., were some of the problems that the patients faced before receiving treatment.

Conclusions: Those who are suffering from vitamin D deficiency should get their bodies checked regularly to diagnose the associated diseases.

Feasibility of nationwide mapping of health facilities and community health workers in low-resource humanitarian contexts: lessons from Afghanistan

2026-09-01T01:29:13+00:00

Background: Reliable, up-to-date data on health facilities and community health workers (CHWs) are essential for effective health system planning, particularly in fragile and humanitarian settings where information gaps are common. However, large-scale mapping exercises are often considered impractical in such contexts.

Methods: In 2025, a nationwide mapping of health posts and CHWs was conducted across all provinces of Afghanistan. A total of 1,291 community health supervisors were trained and deployed using a cascading model to collect georeferenced data through digital tools. Data collected included facility functionality, CHW demographics, education levels, and training status.

Results: The mapping covered 16,547 health posts and 32,849 CHWs, representing the first comprehensive CHW dataset since 2010. Findings confirmed that all health posts were operational. Approximately half of CHWs had at least a high school education. The use of digital tools improved data accuracy and timeliness, while local engagement enhanced implementation efficiency.

Conclusions: Nationwide mapping of health systems is feasible even in complex humanitarian settings. Key success factors include structured training, digital data collection, and strong local ownership. These findings highlight the importance of investing in routine mapping to strengthen evidence-based planning and optimize CHW deployment.

Knowledge, attitude and preventive practices of hepatitis B infection among health trainees, northern region of Ghana

2026-09-01T01:25:20+00:00

Background: Hepatitis B virus (HBV) infection remains a major global health challenge, causing chronic liver diseases such as cirrhosis and hepatocellular carcinoma. Despite the availability of a safe and effective vaccine, infection rates remain high, particularly among healthcare workers and trainees. This study assessed the knowledge, attitude, and preventive practices regarding hepatitis B infection among health trainees at the University for Development Studies (UDS), Tamale, Ghana.

Methods: A cross-sectional study was conducted among 400 health trainees selected through stratified random sampling from six schools and faculties within the UDS Dungu Campus. Data were collected using a structured questionnaire and analysed with SPSS version 23. Descriptive statistics summarized participants’ characteristics, while Chi-square and multivariable logistic regression identified factors associated with preventive practices. Statistical significance was set at p<0.05.

Results: Overall, 58.3% of participants demonstrated good knowledge of hepatitis B. Most participants (70.5%) had positive attitudes, and 70% exhibited good preventive practices. 61% of participants had received at least a dose of Hepatitis B vaccine, though only 10.5% completed post-vaccination antibody testing. Good attitude significantly predicted good practice (AOR=4.495, 95% CI: 2.613-7.731, p<0.001). Female students were more than twice likely to practice prevention (AOR=2.212, 95% CI: 1.262-3.877, p=0.006).

Conclusions: Health trainees demonstrated moderate knowledge and generally positive attitudes toward hepatitis B prevention. However, gaps in screening, post-vaccination testing, and exposure reporting indicate the need for strengthened health education and institutional vaccination programmes in Ghana.

Knowledge, attitude, practices and awareness of cervical cancer among female medical students at Faculty of Indigenous Medicine, University of Colombo: a cross-sectional study

2026-09-01T01:26:25+00:00

Background: Cervical cancer, major health problem particularly in South Asia. While it is preventable via vaccination and screening, even were knowledge and practice gaps, among future health care providers. Study aimed to determine the knowledge, attitude, practice and awareness (KAP) regarding cervical cancer among the female medical students at faculty of indigenous medicine (FIM), University of Colombo (UoC).

Methods: A descriptive cross-sectional study was conducted among 100 indigenous medical students at Faculty of Indigenous Medicine, Sri Lanka, from January–March 2023. Simple randomization was done Data were collected via a self-administered questionnaire. Among 116 students, 86.21% of the eligible students responded to this study. Data were analysed with descriptive statistics in Ms excel.

Results: Most students (90%) aware about cervical cancer, but only (46%) knew that it is preventable. Awareness of risk factors was good, HPV infection (89%) and multiple sexual partners (81%). Symptom awareness was moderate: intermenstrual bleeding (59%) and post-coital bleeding (41%). Despite the high level of awareness about treatment for cervical cancer (84%), but inadequate screening practice, with only 1/14 (7.14%) of married students stating they were screened. The major problem was lack of information (84.62%). Attitudes were favourable with 87% feeling that screening helps to prevent.

Conclusions: Students aware of cervical cancer’s risk factor but lacked knowledge about the symptoms, prevention and screening practices. Targeted education and screening access are needed.

Vulnerability profile of the elderly population in primary health care in Canoas-RS using the VES-13

2026-09-01T01:27:26+00:00

Background: Population aging has been accompanied by an increased prevalence of frailty and vulnerability among older adults, especially in more advanced age groups. This study aimed to assess the vulnerability of older adults residing in Canoas, RS, using the Vulnerable Elders Survey (VES-13), and to analyze its association with sociodemographic variables, self-rated health, and functional capacity.

Methods: This was a cross-sectional study including a sample of 1,260 older adults seen at Primary Health Care Centers in Canoas, RS, during the post-pandemic period. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) and Pearson’s chi-square test.

Results: Most participants were younger than 75 years (56.7%), and 67.8% were female. Individuals aged 85 years or older showed a progressive increase in negative self-rated health (67.6%; p=0.02), as well as in physical limitations and disabilities in activities of daily living (p=0.01). The mean VES-13 score increased from 2.01 among those younger than 75 years to 8.10 among the oldest-old (p<0.05). High-risk classification accounted for 30.8% of the sample and was more frequent among older individuals with poorer self-rated health and greater functional impairment. Women showed a higher prevalence of physical limitations and functional disability compared to men (p=0.01).

Conclusions: There is a need for more targeted care and monitoring strategies, especially for individuals aged 85 years or older, in order to prevent functional decline and improve quality of life.

Descriptive study: anemia and concentration levels in elementary school students receiving free nutritional meals

2026-09-01T01:27:58+00:00

Background: Elementary school is a crucial period in a child's growth and development, both physically, cognitively, and psychosocially. During this phase, children are developing basic learning skills, which are greatly influenced by their health and nutritional status. Breakfast plays a strategic role in meeting a child’s daily energy and nutrient needs. Morning food intake contributes to stable blood glucose levels, which the brain needs for cognitive functions such as attention and concentration. In addition to breakfast habits, anemia is still common among school-age children. Anemia, particularly iron deficiency anemia, can disrupt oxygen transport to body tissues, including the brain, potentially reducing children’s concentration, physical endurance, and learning ability.

Methods: This was a descriptive study, with 82 students receiving MBG as respondents. Data collection was carried out 03 April 2025-03 September 2025. Active 5^th grade elementary school students and who were able to read, willing to participate as research subjects and sign the informed consent were included. Statistics using descriptive methods. Statistical tests described the nutritional status, anemia, and concentration levels of the students.

Results: Students received MBG for three months. 35.4% were anemic and 64.6% were non-anemic. Meanwhile, concentration levels were categorized as poor (50%), and very good (2.4%).

Conclusions: The results of this study are expected to provide basic information for schools, health workers, and parents in designing promotive and preventive efforts to support children’s health and learning abilities from an early age.

Antepartum depression and its predictors among pregnant adolescents in the northern part of Nigeria

2026-09-01T01:27:56+00:00

Background: Antepartum depression is a major public health issue, particularly among adolescents in low and middle-income countries, where early marriage and limited education are common. Although the religious and cultural beliefs in northern Nigeria concerning early marriage are common knowledge which prompted this study. Information on the predictors and prevalence of antepartum depression is limited. The study aimed to determine the prevalence and predictors of antepartum depression among pregnant adolescents in Kaduna state, north-western part of Nigeria.

Methods: A cross-sectional design was used. Data was collected using a structured interviewer administered questionnaire among 349 pregnant adolescents attending antenatal clinics at six selected health facilities from January to May 2019. Depression was screened using the Edinburgh post-natal depression scale (EPDS≥13). Data were analysed using descriptive statistics, means and percentages, and logistic regression was used for predictors of antepartum depression. P value was set at <0.05.

Results: Mean age of pregnant adolescents was 16.6±1.4 years, with a mean age at marriage of 13.7±2.4 years. Prevalence of antepartum depression was 54.7% with EPDS score of ≥13. Adolescents with secondary education had 53% lower likelihood of depression compared to those without formal education (aOR=0.47; 95% CI: 0.25-0.89; p=0.020).

Conclusions: Antepartum depression is common among pregnant teenagers in northern Nigeria, especially those who haven’t finished school. Integrating routine mental health screenings and evaluations into antenatal care services and educational empowerment is essential for improving maternal mental health outcomes in this vulnerable population.

Assessment of the effect of maternal health education on danger signs recognition among women in Ifako Ijaiye, Lagos State

2026-09-01T01:22:11+00:00

Background: Maternal mortality remains a significant challenge in low- and middle-income countries, particularly in Nigeria. Maternal mortality is often attributed to various factors, including delays in seeking care due to a lack of awareness regarding danger signs during pregnancy and childbirth. This study aimed to assess the effect of maternal health education on danger signs recognition among women in Ifako Ijaiye, Lagos State, Nigeria.

Methods: A pre-test post-test quasi-experimental design was employed, involving 80 women of reproductive age (40 in the intervention group and 40 in the control group). Participants' baseline knowledge of maternal danger signs was assessed using structured questionnaires. The intervention group received a training package on maternal danger signs. Follow-up assessments were conducted one-month post-intervention to measure changes in knowledge.

Results: The mean age of participants was 34.2±7.6 in the control group and 30.4±6.8 in the intervention group. Most participants had secondary education, were self-employed and married. At baseline, there was no significant difference in the mean number of danger signs recongnized between the groups (mean difference=0.225, t (78)=0.565, p=0.574). Post-intervention, the intervention group showed a significant increase in the recognition of maternal danger signs (mean difference=3.70, t (78)=7.13, p=<0.001), with 90% of the intervention group recognizing six or more danger signs compared to 30% at baseline.

Conclusions: The maternal health education intervention significantly improved the recognition of maternal danger signs among women in Ifako Ijaiye.

Evaluation of the effects of a flipped classroom model versus lecture method on BSc nursing students’ knowledge in a health assessment course

2026-09-01T01:19:49+00:00

Background: Conventional teacher-centred pedagogy has dominated nursing education. However, these methods have been associated with passive learning, inability to develop problem-solving and critical thinking skills among nursing students, and an increasing theory and practice gap. Adoption of innovative student-centred teaching methods such as the flipped classroom has been proposed as a strategy to bridge this gap. The study aimed to evaluate the effect of a flipped classroom model versus the lecture method on knowledge acquisition among second-year BSc. nursing students undertaking a health assessment course at a Kenyan University.

Methods: A mixed-method study consisting of a non-equivalent control group pre-test post-test quasi-experimental design was adopted. Forty-one students received training through the lecture method, while 39 were exposed to the flipped classroom approach over consecutive academic years. A knowledge test was administered pre-course and post-course. Data were analyzed using descriptive and inferential statistics, including the chi-square test and paired and independent t-tests.

Results: There was a significant difference in post-test health assessment knowledge mean scores, with the flipped classroom group attaining higher scores compared to their traditional lecture counterparts (p=0.004).

Conclusions: The flipped classroom had a positive effect on nursing students’ knowledge of health assessment. This student-centred pedagogy can be recommended for teaching foundational nursing courses.

Investigating the hygiene-related factors influencing prevalence of trachoma among children below nine years in Turkana West Sub-County, Turkana County, Kenya

2026-09-01T01:19:46+00:00

Background: Turkana County is one of the counties where trachoma is endemic. Trachoma impact survey of 2024 indicated Turkana West Sub County having a prevalence of 11.8%. The purpose of the study is to investigate factors influencing prevalence of trachoma in children below nine years in Turkana West Sub County. The objective of the study includes investigating the hygiene related factors among children below nine years.

Methods: The target population consisted of 23,493 households in wards in Turkana West Sub County. Stratified random sampling was used to obtain a sample of 223 households from all the wards in Turkana West Sub County. Purposive sampling was used to select 21 healthcare workers. Questionnaires and interview were used to collect data. University supervisors from Turkana University College assessed validity of the questionnaires. Piloting of the study was done in Loima Sub County. Data was presented using tables and graphs where frequencies and percentages were used to describe the data.

Results: The findings revealed that presence of excess flies (47.3%), presence of human faeces (21.6%), sharing of clothing (45%) and poor facial hygiene (66.7%) contribute to trachoma transmission.

Conclusions: These results underscore the urgent need for integrated public health interventions focused on improving sanitation, water access, and hygiene education to reduce trachoma prevalence and enhance child health in the region. The findings of this study help to reduce cases of trachoma in children below nine years. This study also benefit medical practitioners and other stakeholders for planning purposes.

Prevalence of depression, anxiety and stress among medical undergraduate students of a Medical College in Central India: a cross-sectional study

2026-08-11T01:56:04+00:00

Background: Depression, anxiety, and stress are common psychological problems among medical students and may adversely affect their academic performance and overall well-being. Medical training involves substantial academic pressure and lifestyle changes that predispose students to psychological distress. The present study was conducted to estimate the prevalence of depression, anxiety, and stress and assess their association with selected personal characteristics among undergraduate medical students.

Methods: A cross-sectional study was conducted among 210 undergraduate medical students of a Government Medical College in Central India from September to November 2025. Data were collected using a pre-designed semi-structured questionnaire. Depression, anxiety, and stress were assessed using the Depression Anxiety Stress Scale-21 (DASS-21). Associations between depression, anxiety, stress, and selected personal characteristics were assessed using the Chi-square test, with p<0.05 considered statistically significant.

Results: The prevalence of depression, anxiety, and stress was 47.1%, 61.0%, and 26.7%, respectively. Depression was significantly associated with satisfaction with education (χ²=6.26, p=0.044). Anxiety showed significant associations with gadget use (χ²=14.2, p=0.003) and substance use (χ²=5.30, p=0.021). Stress was significantly associated with year of study (χ²=12.4, p=0.006), satisfaction with education (χ²=15.8, p<0.001), sleeping duration (χ²=15.3, p<0.001), and water consumption (χ²=10.3, p=0.006).

Conclusions: Nearly half of the medical students experienced depression, more than half had anxiety, and about one-fourth had stress. Depression was significantly associated with educational satisfaction, anxiety with gadget use and substance use, and stress with year of study, educational satisfaction, sleep duration, and water consumption. Strengthening mental health promotion through regular screening, counselling services, healthy lifestyle practices, and academic support programmes may help improve the psychological well-being of medical students.

Smart phone addiction and reading comprehension among medical undergraduates: a cross-sectional study

2026-08-11T01:56:03+00:00

Background: The demanding nature of medical education requires continuous access to updated information, online learning platforms, and e-books. Smartphone have therefore become indispensable educational tools, enabling students to access learning resources anytime and anywhere. The widespread adoption of digital learning, further accelerated by the COVID-19 pandemic, has strengthened the dependence of medical students on smartphone for both academic and non-academic purposes.

Methods: All phases of students of Bachelor of Medicine and Bachelor of Surgery (MBBS) course were enrolled and a total of 504 students participated in study. Data was collected through Google form survey on sociodemographic details, smartphone addiction scale-short version and reading comprehension questionnaires.

Results: Our study show 46% (232) prevalence of smartphone addiction among 504 participants, more common in male 27.8% in comparison to female students 18.3%. Majority reported 3-4 hours per day use of smartphone primarily to access social media. Similarly, they continue to use smartphone before sleep and majority for more than 30 minutes to 1 hour was reported significant predictor to smartphone addiction. Craving for phone during routine activities and feeling uncomfortable without phone were significant predictors to addiction of smartphone. The correlation r=0.405 (p=0.00) seen between smartphone addiction and reading comprehension show weak positive association (r²=0.164).

Conclusions: Due to alarming use of smartphone, its addiction has become a public health concern of community. The study reported a statistically significant positive correlation between reading comprehension and smartphone addiction explaining the profound influence of smartphone usage on academic performance. Hence, there is to bring out various intervention strategies in the community and educational settings through awareness programmes, campaigns, to develop appropriate technology to assess reading comprehension among students.

A qualitative study to assess lived experience of patients with COVID-19 at a tertiary care hospital, Uttarakhand

2026-08-12T04:12:06+00:00

Background: Most people infected with the COVID-19 virus faced physical symptoms like mild to moderate respiratory distress but recover without requiring special treatment and also experienced psychosocial barriers like fear stress and stigma related to this pandemic.

Methods: A Phenomenological study for COVID-19 positive patients was conducted during 2^nd outbreak of COVID-19 at tertiary care hospital. Purposive sampling technique (maximum variance) was employed to collect information from COVID-19 patients admitted in COVID-19 isolation ward. Sample size was based upon data saturation which was achieved after 8 interviews. Participant’s inclusion criteria as aged above 18 years, one COVID-19 positive report by RT-PCR method and admitted in IPD. Questionnaire was administered through WhatsApp video call using ‘cube call recorder’ and it will be recoded with consent of the patient for the purpose of assessing data validity at later stage of research. Ethical permission was obtained from research review board of the institute.

Results: Patients admitted in COVID-19 ward narrates mixed emotions of physical parameters health like severe body ache, respiratory problems like dyspnea, fever, weakness and cough as well psychological stress, tension and fear of loss of life. Opposed to this study our study participants narrate that doctors and nurses assist patients in their daily activity of living like provide timely medication food and warm water and assists during urination and defecation as patients unable to do so. But patients were experienced marginalization due VIP culture in the ward and hospital.

Conclusions: Patients with COVID-19 experienced physical as well as psychosocial issues during hospitalization and at home due to lack of COVID-19 related information.

Psychological distress among college students during high air pollution: a cross-sectional correlational study

2026-08-19T04:06:29+00:00

Background: Air pollution is the fourth leading global risk factor for human health and is associated with major causes of mortality, including stroke. Developing nations bear a greater burden of its health and economic consequences. Emerging evidence indicates that air pollution also negatively impacts mental well-being, with prolonged exposure to pollutants such as PM2.5 linked to emotional distress and impaired cognitive and social functioning.

Methods: The present study employed a cross-sectional correlational design with a sample of 257 college students. Data was collected between October 2025 and January 2026. Participants completed the Beck anxiety inventory, perceived stress scale, and mood and feelings questionnaire. Data was analyzed using t tests, Pearson correlation, one-way ANOVA, and linear regression in SPSS.

Results: AQI showed a significant positive correlation with mood and feelings scores. Anxiety was strongly and positively associated with both perceived stress and mood disturbances. Female participants reported significantly higher anxiety and perceived stress than males. Participants residing in areas with poor to severe AQI demonstrated higher anxiety and mood-related scores compared to those in satisfactory AQI areas.

Conclusions: The findings suggest that deteriorating air quality may be associated with adverse psychological outcomes among young adults. Although the associations were modest, they highlight the importance of environmental factors as contributors to mental health and underscore the need for further research.

Impact of health education on knowledge, attitude and practices regarding menstruation and menstrual hygiene among school-going adolescent girls in rural Gurugram, Haryana: a school-based interventional study

2026-09-01T01:29:10+00:00

Background: Menstrual hygiene management remains a significant public health concern among adolescent girls, particularly in rural settings where misconceptions, stigma, and inadequate resources persist. Health education has been identified as an effective strategy to improve knowledge, attitude, and practices (KAP) related to menstruation.

Methods: A school-based interventional study with a single-group pre-test and post-test design was conducted among 300 adolescent girls aged 10-18 years who had attained menarche. Data were collected using a pre-tested structured questionnaire assessing KAP. A structured health education intervention was delivered in two sessions. The post-intervention assessment was conducted 3 months after the intervention.

Results: Among 300 participants, the majority belonged to the 13-15 years age group (48.7%) and studied in government schools (60.7%). Awareness about menstruation prior to menarche was reported by 59.3% of participants, with mothers being the primary source of information (37.3%). Regarding practices, 68.7% used sanitary pads, whereas 17.3% relied on old cloth. More than half (56%) did not change absorbents ≥3 times per day. Attitudinal assessment revealed that 66.7% felt uncomfortable discussing menstruation, and 60% considered cessation of menstruation as fortunate. Post-intervention, there was a statistically significant improvement in knowledge, attitude, and practice scores (p<0.05).

Conclusions: The health education intervention significantly improved menstrual hygiene-related knowledge, attitudes, and practices among adolescent girls. School-based educational programs are effective and should be strengthened to promote safe menstrual hygiene practices and reduce stigma.

Evaluation of knowledge regarding malnutrition and its prevention among mothers in rural areas of Uttarakhand: a cross-sectional study

2026-09-01T01:30:37+00:00

Background: Childhood under-nutrition is a major cause of child mortality in India. By providing appropriate nursing care and prompt interventions, mothers can prevent malnutrition among children. This study aimed to assess the knowledge of mothers regarding childhood malnutrition and its prevention.

Methods: A cross-sectional study was conducted among mothers in Dehradun, Uttarakhand, to evaluate their knowledge related to malnutrition and its prevention. One hundred mothers were selected using purposive sampling technique through door-to-door visit. Data were collected using structured knowledge questionnaire.

Results: Most mothers (92%) had basic understanding of malnutrition. About 70% of mothers were aware of importance of balanced diet in prevention of malnutrition. 61% of mothers were unaware of duration of exclusive breastfeeding and 77% were unaware of exact age of weaning among infants. 90% of the mothers recognized weight loss as the major symptom of malnutrition among children and were unaware of other symptoms of malnutrition such as stunting and edema.

Conclusions: The study revealed that majority of the mothers possessed a basic understanding of malnutrition and recognized weight loss as its primary symptom. However, significant knowledge gaps remain regarding exclusive breastfeeding duration, appropriate weaning age, and other signs of malnutrition such as stunting and edema. Strengthening maternal education on infant feeding practices and comprehensive malnutrition indicators is essential for improving child health outcomes.

Prevalence and associated factors of self-medication among the Bengali Hindu population of north 24 Parganas, West Bengal, India: an ethnographic study

2026-09-01T01:29:24+00:00

Background: Self-medication is now a global concern, and self-medication is described as medication practices without knowing the doses and duration by individuals’ own concern without any suggestion of a medical practitioner or healer. The main objective of the study is to understand the prevalence and associated factors behind self-medication practice among the Bengali Hindu population of North 24 Parganas. This ethnographic study examines the knowledge, patterns, and implications of self-medication without a doctor.

Methods: From this perspective, a cross-sectional ethnographic study has been conducted among the Bengali Hindu population of north 24 Parganas district, West Bengal, India. Through the purposive sampling method, about 327 individuals have been selected as a sample to complete the study. Some ethnographic research tools and techniques, such as intensive interviews, case studies, participant observation, etc., have been used for data collection.

Results: The prevalence of self-medication is 57.18% among the studied population. Overall, minor illnesses were the main reason for self-medication (27.27%), followed by previous experience or knowledge (25.13%) and money saving (19.79%). The Bengali Hindu population of this area reveals a complex interplay of Western Bio-medicine (WBM) or modern pharmaceuticals, healthcare access challenges, and socio-cultural norms and beliefs.

Conclusions: The prevalence of self-medication is high among the Bengali Hindu population of north 24 Parganas due to easy access to Western bio-medicine and the availability of local medicine shops. Local pharmacists have a great role in the practice of self-medication in the studied area.

Knowledge, attitude and practice regarding menstrual cup among adolescent girls in Savadatti taluka, Belagavi district, Karnataka

2026-09-01T01:29:23+00:00

Background: Menstrual hygiene management (MHM) is a vital component of adolescent health. Despite being safe, reusable, and eco-friendly, menstrual cups are underutilized in India due to cultural taboos and lack of awareness. This study assessed the knowledge, attitude, and practices (KAP) regarding menstrual cup use among adolescent girls.

Methods: A community-based cross-sectional study was conducted from January to June 2025 among adolescent girls aged 15–19 years from 10 schools and 5 colleges, selected through multistage random sampling. Data were collected using a pre-tested, semi-structured questionnaire and analysed using descriptive statistics and Chi-square tests.

Results: Among 426 participants, 43.9% were aware of menstrual cups, yet only 21.1% had adequate knowledge and 9.2% reported use. Positive attitudes were observed in 43.7%. Social media and the internet were the most common sources of information (39.6%), followed by family/friends (24.1%), healthcare professionals (18.7%), teachers (10.2%), and advertisements (7.5%). Knowledge was significantly associated with age, residence, and family income (p<0.05), while attitudes correlated with educational status and income. Fear of insertion was a major barrier to use menstrual cups among 60.4% participants. A strong positive association was observed between knowledge and attitude toward menstrual cups (p<0.001).

Conclusions: Although awareness and attitudes toward menstrual cups are improving, actual use remains limited. Strengthening school-based menstrual education and improving access to accurate information are essential to enhance adoption and promote sustainable menstrual hygiene among adolescents.

Prevalence of risk factors for non-communicable diseases among adult population residing in urban areas of Gangtok

2026-09-01T01:29:23+00:00

Background: Non-communicable diseases (NCDs) place a massive burden on global health and the economy, with cardiovascular diseases, cancer, and diabetes receiving the most focus. This study aimed to determine the prevalence of NCD risk factors among adults in urban Gangtok and identify associations between these risk factors and demographic variables.

Methods: A descriptive survey design was utilized. A sample of 375 adults aged 29–59 residing in Ranipool was selected using probability sampling. Data was collected via interviews using the Community-Based Assessment Checklist (CBAC).

Results: The point prevalence of NCD risk factors was 49.5%. Based on CBAC scores, 13.8% of respondents were at high risk (score > 4). Major risk factors included physical inactivity (71.2%) and clinical symptoms like shortness of breath (4%) and weight loss (2.9%). Risk factors were significantly associated with age, gender, religion, family income, and occupation (p < 0.05).

Conclusions: These findings underscore the urgent need for lifestyle-based public health interventions in urban Gangtok to improve long-term health outcomes.

Distribution of temperament/mizāj among patients with knee osteoarthritis: a cross-sectional study

2026-09-01T01:29:22+00:00

Background: Knee osteoarthritis (KOA) is a common degenerative joint disorder with multifactorial etiology. While established risk factors such as age, obesity, and mechanical stress are well known, constitutional factors like temperament (Mizāj) described in Unani medicine remain underexplored. Hence the present study was conducted to describe the distribution of Mizāj among patients with KOA.

Methods: A hospital-based cross-sectional study was conducted at the Regional Research Institute of Unani Medicine (RRIUM), Srinagar, from April to October 2021. A total of 60 patients aged 40-70 years with clinically and radiologically confirmed KOA (Kellgren-Lawrence grade I and II) were included. Mizāj was assessed using a structured proforma based on classical Unani parameters. Data were analyzed using SPSS version 20.0. Descriptive statistics (frequencies and percentages) were calculated, and the Chi-square test was applied, with p<0.05 considered statistically significant.

Results: Balghamī Mizāj was observed in 52 (86.67%) patients, followed by Damawī Mizāj in 5 (8.33%) and Ṣafrāwī Mizāj in 3 (5%). No cases of Sawdāwī Mizāj were found. The difference in the distribution of temperament was not statistically significant (χ²=2.21, df=2, p=0.509).

Conclusions: KOA was found to be more prevalent among patients with Balghamī Mizāj and may therefore be considered a predominantly phlegmatic disorder (Marad-i-Balghamī) or a manifestation of phlegmatic distemperament (Sūʾ-e-Mizāj Balghamī). However, in view of the lack of statistically significant association and the cross-sectional nature of the study, these findings should be interpreted with caution, and further analytical studies are warranted to substantiate this observation.

Comparative assessment of the awareness and utilization of government-initiated geriatric health and welfare schemes among the elderly population of urban and rural communities of western Maharashtra

2026-09-01T01:30:37+00:00

Background: India is experiencing a rapid demographic transition, leading to a growing elderly population with increasing health and social welfare needs. Although the Government of India and the Government of Maharashtra have introduced several geriatric health and welfare schemes, limited awareness and poor utilization continue to hinder their effective implementation. This study assessed and compared the awareness and utilization of government-initiated geriatric health and welfare schemes among elderly individuals residing in urban and rural communities of western Maharashtra and examined their association with selected socio-demographic variables.

Methods: A descriptive comparative cross-sectional study was conducted over six weeks from October to November 2024 in selected urban and rural communities of western Maharashtra. A total of 200 elderly individuals (100 urban and 100 rural) were recruited using non-probability consecutive sampling. Data were collected using a validated structured interview schedule and analyzed using descriptive statistics, the Chi-square test, and the Mann-Whitney U test.

Results: Rural participants demonstrated significantly higher awareness scores than urban participants (6.97±2.61 versus 5.41±2.15; Z=4.20, p<0.001). Utilization scores were also significantly higher in the rural group (2.66±1.05 versus 0.48±0.81; Z=10.74, p<0.001). However, overall utilization remained low in both groups. The major barriers reported were lack of awareness, procedural complexity, and limited access to information.

Conclusions: Rural elderly demonstrated greater awareness and utilization of geriatric health and welfare schemes than urban elderly, although utilization remained low overall. Targeted awareness programmes, simplified enrolment procedures, and improved accessibility are essential to promote equitable utilization and support healthy ageing.

Effectiveness of telerehabilitation versus physical rehabilitation on postural angles in adolescent girls: a cluster randomized controlled trial

2026-09-01T01:29:17+00:00

Background: Postural deviations such as forward head posture and rounded shoulders are increasingly prevalent among adolescents. Despite growing interest in corrective interventions, limited evidence exists regarding their effect on objectively measured postural angles. This study compares the effectiveness of tele-rehabilitation and physical (in-person) rehabilitation on Postural angles in adolescent girls.

Methods: A cluster randomized controlled trial was conducted among school-going adolescent girls aged 12-16 years. A total of 120 participants were recruited and allocated into three groups: telerehabilitation (n=40), physical rehabilitation (n=40), and control (n=40). Due to attrition, 114 participants were included in the final analysis. Interventions were delivered three times per week for eight weeks. Postural angles cervical angle, sagittal head angle, and shoulder angle were assessed using photogrammetry. Statistical analysis was performed using a generalized linear model (GLM) adjusting for baseline values. The intervention in tele rehabilitation group was given on an online video platform and physical rehabilitation was given in person in school.

Results: Both telerehabilitation and physical rehabilitation demonstrated significant improvements in all postural angles compared to the control group (p<0.001). Physical rehabilitation showed significantly greater improvements in sagittal head angle and shoulder angle compared to telerehabilitation (p<0.001), whereas no significant difference was observed between the two interventions for cervical angle (p=0.214).

Conclusions: Both physical rehabilitation and telerehabilitation significantly improved cervical posture, sagittal head angle, and shoulder angle compared to no treatment. Physical rehabilitation consistently demonstrated the greatest improvement across all measures.

Prevalence and socioeconomic correlates of depression, anxiety and stress among undergraduate students from reserved social categories in a rural college of West Bengal: a cross-sectional study

2026-09-01T01:29:16+00:00

Background: Common mental disorders such as depression, anxiety and stress are increasingly reported among young adults, particularly college students. Evidence from India suggests that socio-economic disadvantage and social stratification may influence mental health outcomes; however, limited data exist focusing specifically on students from socially reserved categories. This study aimed to estimate the prevalence of depression, anxiety and stress and to examine their socio-demographic correlates among undergraduate students belonging to reserved social categories in a rural college of West Bengal.

Methods: A census-based cross-sectional study was conducted among 176 undergraduate students aged 18–24 years belonging to Scheduled Castes, Scheduled Tribes and Other Backward Classes in a government college of Purulia district. Data were collected using a pretested questionnaire and the Depression Anxiety Stress Scale-21 (DASS-21). Scores were categorized using standard cut-offs. Associations between socio-demographic variables and outcomes were assessed using the chi-square test, with p<0.05 considered statistically significant.

Results: The prevalence of depression, anxiety and stress was 34.1%, 42.0% and 43.2%, respectively. Nearly half of the participants (48.9%) had at least one form of mental morbidity. Most cases were mild to moderate; however, severe to extremely severe forms were observed in 3.9% (depression), 14.2% (anxiety) and 9.1% (stress). No statistically significant associations were found between socio-demographic variables and mental health outcomes.

Conclusions: A substantial burden of psychological morbidity was observed among students from reserved social categories, highlighting an important yet underexplored vulnerable group. Targeted mental health interventions and institutional support systems are needed. Future research using qualitative or mixed-method approaches is recommended to explore contextual and psychosocial determinants not captured in quantitative assessments.

Maternal awareness regarding vitamin D supplementation and its deficiency among their infants in a tertiary care hospital, Puducherry: a cross-sectional study

2026-09-01T01:29:11+00:00

Background: Vitamin D deficiency is a common public health problem affecting mothers and infants, even in sun-rich countries like India. Maternal awareness plays a key role in preventing deficiency and its complications in infants. This study aimed to assess maternal awareness regarding vitamin D supplementation and its deficiency among infants, and to determine the association with sociodemographic factors.

Methods: A hospital-based cross-sectional study was conducted among 200 postnatal mothers attending the Paediatrics OPD of a private medical college in Puducherry from September to December 2025. Participants were selected using systematic random sampling. Data were collected using a pre-tested, self-administered questionnaire via an online platform. Descriptive statistics were expressed as frequencies and percentages, and associations were tested using the Chi-square test (p<0.05 considered significant).

Results: Among participants, 78.0% had heard about vitamin D, with doctors as the main information source (74.3%). While 47.0% recognized its role in bone health, 21.0% lacked knowledge of its benefits. Only 39.0% and 23.0% reported vitamin D supplementation during pregnancy and lactation, respectively. However, 89.0% provided supplements to their infants, though only 24.0% did so regularly. Most mothers (87.0%) exposed infants to sunlight. Significant associations were observed between knowledge and age (p=0.035), education (p<0.001), residence (p<0.001), family type (p=0.007), and housing (p<0.001).

Conclusions: Despite moderate awareness, gaps in knowledge and practices persist. Strengthening maternal education and counselling is essential to improve vitamin D supplementation and reduce deficiency among infants.

Menstrual hygiene practices and WASH practices among women residing in an urban slum in Delhi: a community-based study

2026-09-01T01:29:09+00:00

Background: Menstrual hygiene management (MHM) is a vital component of women’s health, yet it remains a neglected issue in low-resource settings. Despite improved product availability, women in urban slums continue to face challenges related to sanitation, privacy, and hygiene. This study aimed to assess menstrual hygiene practices among women in an urban slum of Delhi and examine their association with WASH (water, sanitation, and hygiene) behaviours.

Methods: A community-based cross-sectional study was conducted among 307 women of reproductive age residing in an urban slum of Delhi. Data were collected using a pretested, semi-structured questionnaire based on the menstrual practice questionnaire (MPQ) and WASH indicators. Descriptive and inferential statistics were applied to analyse menstrual hygiene practices and their association with hygiene-related outcomes.

Results: Of the 307 participants, 60% were below 30 years and 81.4% were literate. Use of disposable sanitary pads was nearly universal- 93.5% at home and 95.1% outside- while 2.6% used cloth. Only 66.1% reported washing hands before changing menstrual materials compared to 92.8% after. Most women (94.1%) used soap or detergent, and 90.6% practiced daily genital washing. Household garbage was the most common disposal method (69.7%), while 8.1% used unsafe methods. Symptoms suggestive of urinary tract infection (UTI) were significantly associated with inadequate handwashing (p<0.05). Cultural restrictions were reported by 85.3% of women.

Conclusions: Despite high adoption of sanitary pads, gaps remain in hygiene behaviour, disposal practices, and cultural attitudes. Improving WASH facilities, waste management, and menstrual health education is essential for ensuring safe and dignified menstruation in urban slum communities.

Effect of suryanamaskar on pain, workability and quality of life in college students with primary dysmenorrhea: an experimental study

2026-09-01T01:25:19+00:00

Background: Dysmenorrhea is a common gynecological issue affecting women of all ages, especially adolescents and young adults, affecting 67% to 90% of women aged 17-24 years. Pain in dysmenorrhea can severely impact daily life, leading to reduced concentration, absenteeism from college or work, and limited social engagement. These limitations directly affect quality of life, a concept defined by the World Health Organizations. Women with dysmenorrhea often experience lower quality of life scores, especially in areas such as physical functioning, bodily pain, general health, and vitality. Pharmacological treatments like NSAIDs and oral contraceptives are commonly used but may not be suitable for all. Yoga, particularly surya namaskar, has gained recognition as a safe and holistic approach.

Methods: Sixty college going students participated in this study. Participants were selected based on the inclusion and exclusion criteria. Subjects were given suryanamaskar thrice a week for 8 weeks. Pre and post assessment was taken using three outcome measures that is numerical pain intensity scale (NPRS), work ability index score (WAI) and World Health Organization quality of life scale-Bref (WHOQOLBREF).

Results: The present study included 60 female participants with a mean age of 22.15±2.02years. All changes were statistically significant (p=0.001), indicating that regular practice of surya namaskar had a substantial positive effect on pain reduction, work ability, and overall quality of life in females with primary dysmenorrhea.

Conclusions: The study concluded that suryanamaskar is effective in reducing pain, enhancing workability and improving quality of life in college students with primary dysmenorrhea.

Is the “dream physique” a mental health paradox? A mixed-methods study on body image perception among adult male bodybuilders from Kolkata, India

2026-09-01T01:25:53+00:00

Background: The rise of bodybuilding for aesthetic purposes has increased the risk of body image disorders among males. This study aimed to determine the magnitude of body image dysmorphia (BID), identify its associated factors, and explore the perspectives of adult male bodybuilders in an urban area of West Bengal.

Methods: An explanatory sequential mixed-methods study (QUAN → qual) was conducted among 123 adult male bodybuilders in gymnasiums in Dum Dum, Kolkata. In the quantitative phase, study participants were selected via simple random sampling and interviewed using tools, including the PHQ-9, EAT-26, and bodybuilders image grid-original (BIG-O). The qualitative phase was followed by five key-informant interviews (KIIs) with experienced gym trainers, selected via purposive sampling. Quantitative data were analysed using SPSS 16.0, while qualitative data underwent thematic analysis.

Results: The overall magnitude of BID was 68.2%, with 56.9% experiencing fat-related BID and 45.5% muscle-related BID. Participants desired significantly lower fat content and higher muscle mass compared to their current state (p value <0.001). Factors significantly associated with BID included depression (p value <0.001), eating disorders (p value <0.001), shorter training duration (p value 0.009), and anabolic steroid use (p value 0.025). Qualitative findings identified “perceptual drivers”, “psychological impact”, and “high-risk lifestyle factors”, such as social media influence.

Conclusions: A significant portion of bodybuilders suffer from BID, which is linked to clinical depression and disordered eating. The “beginner’s trap” makes novices particularly vulnerable. Strategic interventions, including mental health screening in gyms, trainer training, and stricter regulation of anabolic steroids, are recommended.

Health-seeking behaviour and empowerment dimensions among married women with special reference to Kudumbashree units

2026-09-01T01:25:40+00:00

Background: The background of this study was about the health seeking behaviours of married women who are the active members of Kudumbashree units. Health seeking behaviour of an individual refers to the actions taken by them to prevent, cure or reduce the risk of a disease to maintain good health. The measures through which they seek medical care for better health outcomes are refereed as health care services.

Methods: A cross-sectional quantitative study was conducted using a structured questionnaire administered to assess the health seeking behaviours of married women in Kudumbashree units in Ernakulam District. Simple random procedure was employed to recruit the participants for the study.

Results: Health-seeking behaviour was largely positive, with a majority of women that is over 60% of women seeking treatment promptly and primarily depending on government hospitals due to affordability, proximity and trust. Kudumbashree participation significantly strengthened health awareness and autonomy, with more than two-thirds of the respondents reporting improved health knowledge and confidence in taking health-related decisions and regular meeting attendance showing a strong association with health care utilisation.

Conclusions: Financial constraints were the most prominent barrier, reported by over half of the respondents, often combined with transport difficulties and lack of awareness, while around one-third of women avoided healthcare for certain conditions due to stigma. Kudumbashree functioned as an effective empowerment platform, with a large majority indicating greater confidence in discussing health issues and increased participation in household health-related decision-making.

Faculty development for interprofessional education in resource-constrained West Africa: priorities, institutional gaps and implementation pathways

2026-09-01T01:25:39+00:00

Background: Interprofessional education (IPE) is a recognised strategy for addressing healthcare workforce challenges in sub-Saharan Africa, but evidence on faculty preparation in resource-constrained settings is limited.

Methods: Between September and November 2024, we conducted a cross-sectional needs assessment of all eligible faculty (n=28; 100% response) at a West African regional medical education and research institute. A validated, pilot-tested semi-structured questionnaire (content validity index 0.89; Cronbach's α=0.82) assessed demographics, professional development priorities, institutional support, and programme-design preferences. Quantitative data were summarised using frequencies, percentages, weighted priority scores, and five-point Likert means; open-ended items underwent thematic analysis.

Results: Most participants held master's degrees (67.9%, n=19); 60.7% were female, 50.0% held lecturer rank, and 78.6% had under ten years' teaching experience. Research methodology (85.7%) and data analysis (89.3%) were the top development priorities. Enhanced mentorship was the highest improvement priority (92.9%; mean 4.3/5), yet only 28.6% currently accessed formal mentorship programmes. Institutional support ratings were modest (grand mean 3.1/5), with professional development rated lowest (mean 2.8/5). Key programme characteristics identified were institutional leadership support (89.3%), research-practice integration (85.7%), resource allocation (82.1%), collaborative learning (78.6%), flexible delivery (75.0%), and comprehensive assessment (71.4%). Faculty preferred quarterly delivery (50.0%) in blended formats (75.0%), and 89.3% reported readiness to participate.

Conclusions: A pronounced gap exists between faculty demand for mentorship and existing institutional provision. Research-integrated, blended faculty development anchored in formal mentorship is a feasible, contextually appropriate approach to strengthen IPE capacity at this institution; broader generalisability requires multisite investigation.

Association between mood episode severity and c-reactive protein levels in bipolar disorder: an exploratory cross-sectional study

2026-09-01T01:26:21+00:00

Background: Bipolar disorder is a chronic, recurrent mood disorder associated with significant disability, functional impairment, and medical comorbidities. Increasing evidence suggests that immune-inflammatory mechanisms contribute to its pathophysiology. C-reactive protein (CRP), a widely used biomarker of systemic inflammation, has been reported to be elevated in bipolar disorder, particularly during manic episodes. However, data from the Indian population examining the association between CRP levels and severity of mood episodes using standardized rating scales remain limited. Therefore, this study was conducted to evaluate the association between severity of manic and depressive episodes and serum CRP levels in patients with bipolar disorder.

Methods: This hospital-based cross-sectional analytical study was conducted at a tertiary care center. Thirty patients diagnosed with bipolar disorder were assessed during either a manic episode (n=15) or a depressive episode (n=15). Severity was evaluated using the young mania rating scale (YMRS) and Hamilton depression rating scale (HAM-D). Serum CRP levels were measured and categorized as normal (≤5 mg/l) or elevated (>5 mg/l). Correlations were analysed using Pearson’s correlation coefficient.

Results: Fourteen participants (46.7%) had elevated CRP levels. Mean CRP levels were higher in manic episodes (17.82±16.38 mg/l) than depressive episodes (9.80±8.14 mg/l). A significant positive correlation was found between YMRS scores and CRP levels (r=0.5622, p=0.0292), whereas no significant correlation was observed between HAM-D scores and CRP levels (r=−0.1672, p=0.5515).

Conclusions: Severity of manic symptoms is positively associated with systemic inflammation, supporting inflammation as a state-dependent correlate of mania.

Frailty-driven burden of falls in older adults: a cross-sectional study estimating QALY loss and YLD in an urban Indian population

2026-09-01T01:26:21+00:00

Background: Frailty is a multidimensional geriatric syndrome associated with increased vulnerability to adverse outcomes, particularly falls. Although both frailty and falls are common among older adults in India, their combined impact in terms of health loss remains inadequately quantified. This study aimed to estimate the burden of falls among frail and non-frail elderly using quality-adjusted life years (QALY) and years lived with disability (YLD).

Methods: An analytical cross-sectional study was conducted among 200 adults aged ≥60 years in an urban field practice area attached to a tertiary care center in central India. Frailty was assessed using the Edmonton Frail Scale, quality of life using EQ-5D-5L (Indian value set), and fall-related disability using global burden of disease weights. Differences in QALY loss and YLD between frail and non-frail groups were analyzed using appropriate statistical tests, and multivariable linear regression was used to identify determinants of QALY loss.

Results: The overall prevalence of falls was 28.0%, with a higher prevalence among frail individuals (46%) compared to non-frail (10%). Mean QALY loss was significantly higher among frail elderly (0.475±0.185) than non-frail (0.203±0.155; p<0.001). Similarly, mean YLD was higher among frail individuals (0.0102±0.0429) compared to non-frail (0.0008±0.0076; p<0.001). Frailty was the only significant predictor of QALY loss (β=0.294; 95% CI: 0.229-0.359; p<0.001).

Conclusions: Frailty substantially amplifies the burden of falls among older adults. Incorporating frailty assessment into primary care may help identify high-risk individuals and guide targeted fall-prevention strategies.

Influence of traditional dietary practices on dental caries: a study of Changal among the Hmar tribe

2026-09-01T01:27:25+00:00

Background: Among the Hmar tribes of northeast India, traditional dietary practices involving the consumption of Changal continue to be widely prevalent; however, their impact on dental caries has received little scientific attention. Therefore, the present study was undertaken to investigate the potential impact of traditional dietary practices and their associations with dental caries among the Hmar tribe of Cachar district of Assam.

Methods: A comparative cross-sectional study was conducted among 200 Hmar participants. The samples consisted of 100 consumers and 100 non-consumers, both male and female. Statistical analysis was performed using chi-square test to evaluate the association between Changal consumption and the prevalence of dental caries.

Results: In the present study, age was not significantly associated with dental caries (p>0.05). The prevalence of dental caries among non-consumers of Changal individuals was high (52% males and 62% females). However, lower prevalence of dental caries was observed among those who consumed Changal daily (p<0.05 among males and p<0.001 among females). The findings of the present study suggest that the prevalence of dental caries can be reduced by regular consumption of Changal.

Conclusions: The present study highlights that the daily consumption of Changal decreases the prevalence of dental caries among the Hmar of Cachar District, Assam. The high alkalinity of ash filtrates such as Changal may help to neutralize acids in the oral cavity if a significant amount contacts teeth during eating, thereby reducing caries risk. Further longitudinal studies are recommended to confirm these findings.

Gap between maternal preferences and actual mode of delivery in Agra District of Uttar Pradesh: observational study

2026-09-01T01:26:24+00:00

Background: The raising trend of cesarean section deliveries worldwide is a matter of concern. Most of the women prefer normal institutional normal vaginal delivery but their actual mode of delivery depends on their obstetric and healthcare factors. Objective was to assess the gap between preference and practice regarding the delivery mode and to identify factors associated with delivery against maternal preference among women in Agra, Uttar Pradesh.

Methods: A community based cross sectional study conducted among women who had delivered a live baby within the previous one year in selected rural and peri-urban areas of Agra district. A multistage stage random sampling, 300 women were interviewed with pre tested and structured questionnaire, 272 institutional deliveries were included. Data on socio-demographic characteristics, obstetric history, antenatal care and preference were collected and analyzed using descriptive statistic, chi- square test fisher’s exact test and logistic regression analysis using JAMOVI software.

Results: Out of 272 deliveries, 223 (82.0%) were normal vaginal and 49 (18.0%) were cesarean section. Most women (97.4%) preferred normal delivery. Maternal education, husband’s education, parity, previous mode delivery and type of health facility were significantly associated. Logistic regression identified place of delivery (AOR=2.93, p=0.004) and previous mode delivery (AOR=7.69, p<0.001) as significant predictors.

Conclusions: A considerable gap exists between preference and practice. Institutional factors and previous obstetric history influence delivery outcomes. Strengthening antenatal counselling and promoting evidence-based obstetric practices, may help reduce unnecessary cesarean sections.

Impact of depression severity on quality of life and functional impairment: a comparative cross-sectional study

2026-09-01T01:28:21+00:00

Background: Major depressive disorder (MDD) is a widespread health issue linked to high mortality rates, functional impairment, disability, increased healthcare expenses, reduced quality of life, and psychosocial dysfunction. Dysfunction in social participation, productivity, and sense of subjective well-being persists even after reduction in depressive symptoms. Achieving symptomatic remission is not enough in the treatment of depression, but also understanding, assessing functional impairment, and Quality of Life together with symptom severity should be a holistic approach for the treatment of depression.

Methods: A cross-sectional comparative study design was used. 60 individuals with depression samples were collected based on the purposive sampling method from a tertiary care hospital. Another 60 samples were collected from the general population for the normal control group on the basis of inclusion and exclusion criteria.

Results: There were significant differences found in all four domains of QoL between the experimental and control groups, where the normal control group outperformed in all four domains of QoL with higher mean scores than the experimental group. The global score of the experimental group in WHODAS varies significantly (p=0.00) from the control group. The experimental group has higher dysfunction (83.28±10.29) in comparison to the control group (59.50±9.54).

Conclusions: Functional impairment and QoL functioning are significantly affected in persons with depression. Shifting focus from only depression symptoms severity to consideration of functional impairment and QoL functioning would be a holistic approach for depression assessment and management.

A study using patient feedback to predict the effects of quality improvement initiatives in a tertiary care hospital of India

2026-09-01T01:24:47+00:00

Background: Patient feedback is increasingly recognized as an important indicator of healthcare quality and quality improvement (QI), but evidence from tertiary care hospital in India remains limited. Aim was to assess whether patient feedback predicts perceived QI effectiveness and identify key influencing factors.

Methods: A descriptive cross-sectional study was conducted among 872 patients at a tertiary care hospital for a period of 6 months. Data were collected using a standardised 21-item questionnaire and analysed using descriptive statistics, correlation, and regression analysis.

Results: Overall patient satisfaction was high (94%). Patient satisfaction showed a strong positive correlation with perceived QI effectiveness (r=0.701, p<0.001) and explained 49.2% of its variation. Service quality (β=0.730, p<0.001) and staff behaviour and communication (β=0.333, p<0.001) were significant positive predictors, while infrastructure satisfaction showed a negative association (β=–0.183, p<0.001). Together, predictors explained 73.7% of the variation in perceived QI effectiveness.

Conclusions: Patient feedback is a strong predictor of perceived QI effectiveness. Service quality and staff communication strongly influence patient perceptions, highlighting the value of integrating patient feedback into routine QI strategies.

Community-based assessment of bone health and associated factors among elderly in an urban slum of Kolkata, West Bengal: a cross-sectional study

2026-09-01T01:29:15+00:00

Background: Osteoporosis and osteopenia are common metabolic bone disorders among the elderly, increasing fracture risk and disability. Urban slum populations are particularly vulnerable due to poor living conditions, limited health care access, and low awareness. This study aimed to assess bone mineral density (BMD) and its determinants, and to examine awareness and health-seeking behaviour among elderly residents of the Chetla slum, Kolkata, West Bengal.

Methods: A community-based cross-sectional study was conducted from January 2024 to February 2026 among 240 adults aged ≥60 years residing in the Chetla slum for at least one year. Participants were selected using a two-stage cluster sampling method. Data on sociodemographic characteristics, lifestyle, morbidity, and bone health awareness were collected via structured interviews. Anthropometry was measured using standard methods, and BMD was assessed at the calcaneus using a portable quantitative ultrasound densitometer. Osteopenia and osteoporosis were defined according to WHO criteria. Bivariate and multivariable logistic regression analyses identified independent predictors of low BMD.

Results: Mean participant age was 63.6±3.6 years; 67.5% were male. Low BMD was observed in 77.5% of participants. Independent predictors of low BMD included age >63 years (AOR 4.27, 95% CI 1.59-11.50), lower educational attainment (AOR 9.68, 95% CI 3.42-27.35), low physical activity (AOR 4.65, 95% CI 1.29-16.81), and lower socioeconomic status (AOR 2.10, 95% CI 0.96-4.57). Awareness of BMD testing was only 20%, and 35.5% of those with low BMD had not sought treatment.

Conclusions: Elderly residents of the Chetla slum exhibit a high prevalence of low BMD. Community-level interventions including routine BMD screening with portable densitometers, promotion of weight-bearing physical activity, nutritional supplementation, and improved access to geriatric care are recommended to reduce osteoporosis-related morbidity.

A comparative study of anemia prevalence and associated factors among rural and urban adults in Bangalore, India

2026-09-01T01:27:55+00:00

Background: Anemia is a major public health concern, particularly among women of reproductive age, and is influenced by socioeconomic, dietary, and health-related factors. This study aimed to compare the prevalence of anemia and associated factors among rural and urban adult populations in Bangalore.

Methods: A community-based cross-sectional comparative study was conducted among 300 participants (150 urban and 150 rural residents). Sociodemographic characteristics, dietary practices, anemia awareness, iron supplementation, and hemoglobin levels were assessed using a structured questionnaire and a digital hemoglobinometer. Data were analysed using descriptive statistics and the chi-square test.

Results: The overall prevalence of anemia was 29.3%, with significantly higher prevalence among urban participants (42.0%) than rural participants (16.7%) (p<0.001). Urban participants had higher educational attainment (80.0% vs. 2.0%), greater awareness of anemia (51.3% vs. 2.7%), and higher iron supplementation use (25.3% vs. 10.0%) compared to rural participants (all p<0.001). Significant differences were also observed in green leafy vegetable consumption, fruit intake, vitamin C consumption, and healthcare utilization between the two groups.

Conclusions: Anemia prevalence differed significantly between urban and rural populations. Despite better awareness and healthcare access among urban participants, anemia burden remained higher, suggesting that complex nutritional, physiological, and lifestyle factors contribute to urban anemia. Targeted, context-specific interventions integrating regular screening, dietary improvement, and supplementation adherence are required.

Assessment of dietary knowledge, lifestyle and management of long-duration type 2 diabetes in middle-aged adults (55-65 years) residing in Mumbai city: a cross-sectional study

2026-09-01T01:27:54+00:00

Background: Type 2 Diabetes Mellitus (T2DM) is a major public health problem in India. Dietary knowledge and self-management are important for effective diabetes management, yet adherence to recommended dietary practices may remain suboptimal in individuals with long-duration disease. This study assessed lifestyle, dietary knowledge and management practices among middle-aged adults with long-duration T2DM attending a tertiary care hospital in Mumbai.

Methods: An observational cross-sectional study was conducted among 75 participants aged 55-65 years with T2DM for more than five years. Data were collected from January 2023 to February 2023 using a structured interview schedule covering sociodemographic profile, lifestyle, medical management, and dietary knowledge and management. Data were analyzed using SPSS version 25, and descriptive statistics were computed.

Results: Most participants (97.3%) recognized that diet influences diabetes. Awareness of the My Plate Method was 60.0%, while 50.7% recognized low-carbohydrate diets as a management approach. Carbohydrates were correctly identified as the macronutrient most affecting blood glucose by 82.7% of participants. However, 34.6% were unaware of established dietary frameworks, 18.7% considered jaggery a safer sweetener, and 53.3% selected farsan as an appropriate snack. Medication adherence was high (90.4%), while 34.7% reported no physical exercise. Despite good dietary knowledge, practices remained inconsistent with recommendations.

Conclusions: A substantial knowledge-to-practice gap was observed among middle-aged adults with long-duration T2DM. Structured, individualized and culturally sensitive dietary counselling, reinforced through regular follow-up, is needed to improve dietary self-management.

Effectiveness of an integrated 4T intervention test, treat, talk and track in mitigating anemia among tribal communities in Telangana, India

2026-09-01T01:24:46+00:00

Background: Anaemia affects over 1.6 billion people worldwide, with India bearing a disproportionate burden despite five decades of national programming. Telangana’s 70% prevalence exceeds the 67.1% national average, with tribal districts like Bhadradri Kothagudem suffering from poor dietary diversity, limited healthcare access, and socioeconomic disadvantages. This study evaluated whether an integrated "4T" intervention- Test, Treat, Talk, and Track - could reduce Anaemia in this vulnerable population.

Methods: A community-based longitudinal study was conducted in Laxmidevipally Mandal, Bhadradri Kothagudem, covering 1,228 households across 16 villages with a baseline population of 5,291. Haemoglobin levels were screened using the non-invasive EzeCheck device. Anaemic participants received targeted medical treatment, Behaviour Change Communication (BCC), and Nutri-kits for home kitchen gardens.

Results: Following quarterly follow-ups and matched endline analysis, overall anaemia prevalence dropped significantly from 64.59% to 53.75% (p<0.001), representing a 10.84 percentage point reduction, with the largest reduction occurring among adolescent girls. Severe anaemia fell by 63% (from 9.8% to 3.6%), and mean haemoglobin levels rose from 11.0 to 11.6 g/dl. Among baseline severe cases, 24.4% recovered to normal or mild status, though 51.7% of the total cohort remained persistently anaemic. Furthermore, a notable knowledge-practice gap remained, while 96% of participants recognized green leafy vegetables as essential, only 56% had consumed them in the past 24 hours.

Conclusions: The 4T model successfully yielded measurable health gains. However, high residual Anaemia and behavioural gaps underscore the need for extended, region-specific interventions, consistent Iron Folic Acid (IFA) supply chains, and sustained community communication.

Prevalence of hypertension and associated risk factors among petrol pump workers in Panvel city, Maharashtra: a cross-sectional study

2026-09-01T01:24:45+00:00

Background: Hypertension is a major public health challenge and an important risk factor for cardiovascular diseases worldwide. Petrol pump workers are exposed to occupational and lifestyle factors that may predispose them to hypertension. This study aimed to determine the prevalence of hypertension and associated risk factors among petrol pump workers in Panvel city, Maharashtra.

Methods: A cross-sectional study was conducted among 156 petrol pump workers aged 30 years and above in Panvel city, Raigad district, Maharashtra. Data were collected using a structured pre-tested questionnaire covering socio-demographic characteristics, occupational profile, dietary habits, tobacco and alcohol consumption, sleep pattern, and physical activity. Blood pressure was measured using standard procedures. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Statistical analysis was performed using Chi-square test and odds ratios with 95% confidence intervals.

Results: The overall prevalence of hypertension was 30.8% (48/156). Additional salt intake was significantly associated with hypertension. Long-term tobacco use (≥10 years) was associated with increased odds of hypertension. Occupational factors such as duration of employment, standing duration, and working hours were not significantly associated with hypertension.

Conclusions: Nearly one-third of petrol pump workers were hypertensive. Additional salt intake was a significant risk factor for hypertension. Regular screening, dietary counselling, tobacco cessation services, and workplace-based lifestyle interventions are recommended for early detection and prevention of hypertension among petrol pump workers.

Awareness and usage pattern of cosmeceuticals among undergraduate medical students and their dermatological concerns

2026-09-01T01:24:43+00:00

Background: Cosmetic products have become an integral part of daily life across all age groups and socioeconomic strata. Medical students are expected to possess adequate knowledge regarding cosmetic safety and evidence-based skincare practices. Present study attempts to assess their awareness and usage pattern of cosmetic and skin care products with associated factors.

Methods: A cross-sectional descriptive study was conducted during August 2025 to December 2025 among 241 undergraduate medical students using Google forms.

Results: Study included 153 (63.5%) females and 88 (36.5%) males. Advertisements and social media were the primary sources of awareness regarding cosmetic products (41.9%) with significantly higher proportion of females (P=0.003). followed by. Whereas, family members (24.9%) being the second most common source and significantly higher proportion of males relied on it (p=0.005). Awareness of skincare products was 53.1% and overall user rate of these products was 41.9%, with sunscreen being the most recognized (17.8%) and frequently used (19.1%) product. Acne, blackheads, and whiteheads were the most common skincare concerns reported by 34.0% students, and cosmetic use was mainly for the purpose of treating these conditions reported by 61.8% of users. Overall, 58.1% of users experienced at least one cosmetic-related adverse reaction with no significant gender differential.

Conclusions: Cosmetic use was highly prevalent among medical students mainly due to influence of social media and advertisements. More than half of the users reported cosmetic-related adverse effects. Study suggests the need to strengthen cosmetovigilance and to integrate cosmetic safety education into medical training.

A comparative analysis of health indicators in India and Madhya Pradesh using NFHS-4 and NFHS-5 data

2026-09-01T01:19:47+00:00

Background: The national family health survey (NFHS) provides important evidence for monitoring health indicators in India. This study compared changes between NFHS-4 (2015–16) and NFHS-5 (2019–21) for India and Madhya Pradesh.

Methods: Key health indicators were compared using descriptive statistics, Wilcoxon Signed Rank, Mann–Whitney U, Kruskal–Wallis, Spearman’s correlation, and regression analysis. Coefficients of variation were also assessed to examine changes in variability.

Results: Mean health indicator scores increased from 38.12 to 40.81 in India and from 37.52 to 40.72 in Madhya Pradesh. Improvement was statistically significant for India (Z=2.611, p=0.009), but not for Madhya Pradesh (Z=1.576, p=0.115). The magnitude of improvement did not differ significantly between India and Madhya Pradesh (Z=−0.133, p=0.894). No significant domain-wise variation in percentage change was observed for India (p=0.280) or Madhya Pradesh (p=0.212). Strong positive correlations were observed between India and Madhya Pradesh in NFHS-4 (r=0.936) and NFHS-5 (r=0.968). Baseline NFHS-4 values did not significantly predict subsequent improvement in India (R²=0.011, p=0.455) or Madhya Pradesh (R²=0.048, p=0.120). Variability increased over time.

Conclusions: India showed significant improvement, while Madhya Pradesh demonstrated positive but non-significant progress. Increasing variability highlights persistent disparities, emphasizing the need for targeted and region-specific interventions to achieve equitable health improvements.

Knowledge, attitude and practice toward anemia among mothers of adolescent girls in Puducherry, South India: a community-based cross-sectional study

2026-09-01T01:22:12+00:00

Background: Anemia remains a major public health problem among adolescent girls in India, with adverse effects on growth, cognitive development, and future maternal health. Mothers play a key role in influencing adolescents’ dietary and health behaviors. This study assessed the knowledge, attitude, and practice (KAP) regarding anemia among mothers of adolescent girls in Puducherry and examined their association with selected demographic variables.

Methods: A community-based descriptive cross-sectional study was conducted among 160 mothers of adolescent girls selected through convenience sampling. Data were collected using a structured knowledge questionnaire, attitude scale, and practice checklist. Descriptive statistics and Chi-square tests were used for data analysis. A p value <0.05 was considered statistically significant.

Results: Adequate knowledge regarding anemia was observed in 42.5% of mothers, while 38.8% had moderate knowledge. Most mothers (83.8%) demonstrated a positive attitude toward anemia prevention. Moderate preventive practices were reported by 68.8% of mothers, and 25.0% exhibited good practices. The mean±SD scores for knowledge, attitude, and practice were 12.22±4.60, 36.02±6.90, and 6.22±1.71, respectively. Maternal age was significantly associated with knowledge (p=0.014) and practice (p=0.010). Educational level was significantly associated with knowledge and practice (p<0.001). Monthly family income (p=0.016) and place of residence (p=0.036) were also significantly associated with practice.

Conclusions: Despite positive attitudes, gaps in maternal knowledge and preventive practices persist. Targeted educational interventions focusing on socio-demographic determinants may strengthen anemia prevention among adolescent girls.

Morbidity profile of patients seeking care in private Siddha facilities in Tamil Nadu: a cross-sectional study

2026-09-01T01:23:14+00:00

Background: The Siddha system of medicine is one of the widely practiced traditional medical systems in South India. Despite increasing utilization of Siddha services in both public and private sectors, evidence on morbidity patterns in private Siddha healthcare facilities is limited. This study aimed to describe the morbidity profile of patients attending Arogya Healthcare Private Limited in Chennai in 2024.

Methods: We conducted a cross-sectional study using outpatient data collected from January to December 2024 from Arogya healthcare private limited clinics, Tamil Nadu. We extracted patient information, including age, sex, and clinical diagnoses, from the Electronic Health Record (EHR) system using a structured data extraction form. We analyzed the data using Epi Info software and present the findings as frequencies and proportions.

Results: We extracted and analyzed 28,049 outpatient data. The majority of patients were female (57.1 %), and belonged to the 31-45-year age group (31%). The most frequently reported conditions were diabetes (12.5%), ulcers (7.4 %), osteoarthritis (7.4%), cold/cough (5.8%) and sinusitis (4.8%). Diabetes was at top in both sexes, but it varied in the following diseases. According to Siddha classification, vali-related disorders (40%) were more commonly reported.

Conclusions: This study describes the morbidity pattern in private Siddha clinic. Many patients sought care were female, came for follow-up and chronic conditions like diabetes, ulcers, and osteoarthritis. The identification of pattern helps in the integration of data for the surveillance and developing standardized preventive and management strategies to reduce disease burden and improve quality of life.

Can AI see what the surgeons see? Analyzing the accuracy of ChatGPT: publicly available multimodal AI for radiographic interpretation and treatment plan in oral surgery

2026-09-01T01:22:10+00:00

Background: With the rise of AI, patients have been actively doing their own research. With emergence of easily accessible multimodal AI, such as ChatGPT-5 that can interpret images, there is a growing need to evaluate their accuracy, reliability, and potential clinical application. Therefore, this study aimed to evaluate the accuracy of radiographic diagnostics and surgical treatment planning of ChatGPT-5 in the context of oral and maxillofacial surgery.

Methods: We conducted a cross-sectional study using ChatGPT-5’s free version and departmental OPG. Oral surgeons opinions regarding diagnosis and treatment plan were recorded, and a Cohen’s Kappa was calculated for inter-rater agreeability. Furthermore, Cohen’s Kappa was calculated amongst the Surgeons and AI’s response for inter-rater reliability analysis.

Results: The mean number of positive findings per radiograph was significantly higher for ChatGPT (3.69±1.28) compared to oral surgeons (2.8±1.18), with this difference reaching statistical significance (p=0.001). Indicating that AI consistently reported more diagnostic and treatment related observations per OPG.

Conclusions: The findings demonstrated that ChatGPT-5 identified a significantly higher number of diagnostic and treatment related findings per radiograph compared to clinicians. While this suggests high sensitivity, qualitative and agreement analysis (Cohen’s Kappa) revealed that many of these additional findings represented false positive interpretations.

Knowledge, attitude and practices of upright birthing positions in women from semi-urban and rural areas of Raigad district, Maharashtra: a cross-sectional study

2026-09-01T01:22:10+00:00

Background: Maternal-mobility and choice of birthing-position are important components of respectful maternity-care that influence labor-experience and birth-outcomes. Despite growing evidence supporting the use of upright-birthing positions, gap exists about women’s awareness and actual use of different-positions during childbirth. This study aimed to assess the knowledge, attitudes, and practices related to birthing-positions among women of Raigad-district, Maharashtra.

Methods: A community-based cross-sectional-study was conducted among 786 women aged 15-49 years from rural and semi-urban-areas. Data were collected using validated-structured-questionnaire. A standardized-information-booklet containing pictorial-representations of various birthing-positions was used solely to facilitate uniform identification of positions during interviews. Descriptive-statistics were used to summarize participant’s knowledge, perceptions and reported practices.

Results: Awareness of both upright and horizontal birthing-positions was reported by 91% of women in semi-urban areas and 67% of women in rural-areas. However, participants across both settings indicated that they were not offered a choice of birthing-position during labour. During first-stage of labour, dorsal-supine-position was most commonly reported in semi-urban (49%) and rural (32%) women. In the second stage, dorsal-supine remained the predominant-position reported by 54% of semi-urban and 60% of rural-participants. Squatting was the most frequently reported upright-position during second-stage (19% semi-urban and 35% rural women). Dorsal-supine, lithotomy and squatting-positions were commonly perceived as safe-options for childbirth.

Conclusions: Although knowledge of various birthing positions was relatively high, women reported limited-autonomy in choosing their preferred-position during labour. The findings highlight a gap between awareness and practice hence emphasize the need for greater promotion of informed-choice, provider-education and woman-centred maternity care to support the safe use of multiple-birthing positions.

Public awareness and knowledge on rabies: a survey-based analysis

2026-09-01T01:22:09+00:00

Background: Rabies is a fatal yet preventable viral disease that attacks the central nervous system and is endemic in more than 150 countries. Despite advancements in vaccines and treatments, rabies remains a neglected tropical disease. Therefore, present study aims to assess the awareness and knowledge about rabies among general population.

Methods: Quantitative descriptive cross-sectional survey research design was used to conduct the study. A sample of 567 participants from general population was selected for the study using random sampling technique from social media platform across India.

Results: Study revealed that overall, 68.43% participants were aware about transmission of rabies, 48.68% participants were knowledgeable about symptoms of rabies and 69.49% participants had knowledge about preventive measures about rabies. There was no significant association found between awareness regarding transmission of rabies, symptoms of rabies and preventive measures of rabies with any of demographic variables of the participants

Conclusions: Study concluded that there was a mild to moderate level of knowledge among general population. Hence, proper awareness regarding various rabies diseases and its prevention can help in reducing such risk among general population.

Interest of rural youth of Medak district, Telangana, India towards the skill course of medical laboratory technician

2026-09-01T01:22:09+00:00

Background: India’s rapidly expanding healthcare diagnostics sector faces a critical shortage of qualified medical laboratory professionals, yet the Diploma in Medical Laboratory Technology (DMLT) remains poorly recognized among science students who could benefit most. This study assessed DMLT awareness, career preferences, and enrolment-influencing factors among intermediate Bi.P.C students in rural Medak District, Telangana.

Methods: A cross-sectional survey using a validated questionnaire was administered to 486 Bi.P.C students from eight colleges in Medak District. The instrument covered demographics, academic interests, DMLT awareness, laboratory experience, career goals, and enrolment intent (response rate: 100%). Data were analyzed using descriptive statistics, chi-square tests, logistic regression, and a Random Forest classifier (p < 0.05).

Results: Only 38% of students had heard of DMLT; 30% had no knowledge and 20% showed no interest despite being aware. Although 93% expressed interest in medical science, nursing (83%), laboratory technology (62%), and pharmacy (31%) dominated career preferences. Prior laboratory experience was significantly associated with DMLT interest (p < 0.05). Long-term career goals (β = +1.8), Bi.P.C subject preference (β = +1.6), and career counselling (β = +0.8) were the strongest positive predictors; parental influence was negligible (β = −0.4). Random Forest classification achieved 83.7% accuracy (F1 = 0.84), with DMLT knowledge and lab experience as top features.

Conclusions: The principal barrier to DMLT enrolment is informational rather than motivational. Structured awareness sessions, laboratory demonstrations, and periodic career counselling are recommended to convert existing medical science interest into DMLT-specific enrolment among rural youth.

Evaluating attitude towards communication training in medical graduates and postgraduates: a cross-sectional study in a central institute of North India

2026-09-01T01:22:07+00:00

Background: Communication skills play key role in patient satisfaction, fosters trust and empathy. In recognition of this, the attitude, ethics, and communication (AETCOM) module was incorporated into the MBBS curriculum in 2019. The objective of the study is to assess the attitude of medical graduates and postgraduates (PGs) towards communication skill learning programme (CSLP).

Methods: This cross-sectional study was conducted in the department of community medicine at Jawaharlal Nehru Medical College, Aligarh Muslim University. A total of 478 were enrolled and categorized into four groups. Participants completed the communication skills attitude scale (CSAS) questionnaire through an online platform. The questionnaire comprised 26 items with positive and negative statements, and three domains of attitude using a five-point likert scale. Differences between groups were analysed using t-test and ANOVA, and data analysis was performed using statistical package for the social sciences (SPSS) version 20.0.

Results: The mean scores for positive attitude, negative attitude, affective, cognitive, and respect domains were 36.6±7.0, 54.3±6.2, 43.5±4.6, 17.4±2.1, and 17.0±2.3, respectively. Negative attitude scores differed significantly between newly admitted students and the second (34.4 versus 37.5, p=0.003) and third groups (34.4 versus 37.8, p=0.001), while positive attitudes were similar. Significant differences were also observed in affective (p=0.036) and cognitive (p=0.034) domains between the first and fourth groups, with no significant difference in respect attitudes.

Conclusions: Overall positive attitude of students towards communication skills learning. Improved attitudes among interns and PGs may be related to greater clinical exposure, highlighting the importance of integrating communication skills training throughout medical education to enhance quality of care.

Assessment of husbands’ involvement in birth preparedness and complication readiness: a hospital-based study

2026-09-01T01:22:06+00:00

Background: The journey to parenthood starts well before conception and demands righteous involvement of both partners to achieve favourable pregnancy outcomes. BPACR may be influenced by male-partner engagement because husbands are the family’s most powerful decision-makers and their involvement may reduce maternal death by avoiding delays through a well-planned birth and complication readiness. The present study was undertaken to assess the knowledge and role of husbands in birth preparedness and the reasons for lack of participation.

Methods: This hospital based cross-sectional study was conducted among 141 husbands (aged >21 years) of recently delivered postpartum women who were admitted and delivered in the hospital in 2023. A semi-structured interview schedule was used for data collection.

Results: It was found that around half of participants had knowledge of danger signs while 85.1% and 87.2% identified skilled SBA and transportation for delivery respectively. 70.2% wives were satisfied with their husband’s support. Knowledge of danger signs, insisting ANC, arranging food/clothes, allowing wife to rest and providing emotional support had significant association with wives’ satisfaction. The commonest reasons for lack of participation were that men were not allowed to enter labour room (31.9%) and busy arranging food and money (25.5%).

Conclusions: It was found that husbands showed high readiness in logistics and emotional support and active participation in chores. Majority of wives were satisfied with their husband’s support which emphasizes that male involvement is not just a clinical necessity but a psychological one. Hospital and labour room policies to be more inclusive of male partners.

Perceptions and practices of tribal traditional healers of Barwani district in Madhya Pradesh: a mixed-method study

2026-09-01T01:22:05+00:00

Background: Tribal traditional healers are integral to tribal cultures and strongly influence community health behaviors and decisions. Achieving Universal Health Coverage (UHC) in tribal areas requires collaboration with these healers. Recognizing this, the WHO recommends strengthening traditional healing systems through capacity building and standardization of practices. This study aimed to describe ritualistic and non-ritualistic healing practices of tribal healers in selected states, determine the knowledge and attitude of TTHs on other systems of medicine.

Methods: A cross-sectional mixed-methods design was used, involving 275 healers from Barwani district for quantitative analysis and five for qualitative exploration. Quantitative data were analyzed using the Kruskal-Wallis-H test and Poisson regression and thematic analysis of qualitative data was performed.

Results: Findings reported that 211 (99.06%) of 213 Barela healers and 57 (91.93%) of 62 Bhil and Bhilala healers had very poor knowledge of other medical systems. Similarly, 207 (97.18%) Barela healers and 56 (90.32%) Bhil/Bhilala healers were not inclined toward adopting other health systems. Education reported a statistically significant association with knowledge levels. Qualitative analysis generated four key themes: understanding disease and the diseased, diagnostic approaches, treatment practices, and government support. The study recommends development of interventions, capacity-building sessions and behaviour change communication strategies that are culturally acceptable to tribal healers and thereby, developing strategies by fostering collaboration with them to achieve universal health coverage.

Conclusions: In a nutshell, culturally acceptable strategies to integrate tribal healers into PHS are the way ahead to achieve UHC. While studies in different contexts reported TTHs playing significant roles in disease awareness, current study emphasized the masked factors in terms of low knowledge of healers and no inclination towards OHS. Without targeted interventions involving their cultural beliefs and practices, it is challenging not just achieving UHC but also ensuring primary healthcare. The current study strongly recommends a large-scale research to understand the avenues to integrate TTHs into PHS. It also emphasise developing collaborative care models by capacity building of healers and establishing effective referral linkages.

A study to assess the effectiveness of a health education programme on awareness regarding breast self-examination among females

2026-09-01T01:23:13+00:00

Background: Breast cancer remains a major public health concern among women, and limited awareness regarding breast self-examination may delay early recognition and timely reporting of breast-related abnormalities.

Methods: This pre-experimental one-group pre-test post-test study was conducted during November 2025 among females selected according to the study criteria. A structured knowledge questionnaire was used to assess awareness regarding breast self-examination before and after the health education programme. The pre-test was conducted first, followed by the planned health education programme. After the intervention, a post-test was conducted using the same questionnaire. The collected data were analyzed using descriptive and inferential statistics.

Results: The post-test awareness score was higher than the pre-test awareness score, showing improvement in awareness regarding breast self-examination after the health education programme. The findings showed that the health education programme was effective in improving awareness among females.

Conclusions: The health education programme was effective in improving awareness regarding breast self-examination among females.

Prevalence of common oral health problems among school going children aged 12-15 years in a rural block of Haryana: a cross-sectional study

2026-09-01T01:22:03+00:00

Background: Oral diseases among children are a significant public health problem as it can affect the physical, mental and social dimensions of the individual. It can adversely affect the attendance and performance of the child in schools and attendance of the parent in the workplace as well. To estimate the prevalence of oral health problems among school going children aged 12-15 years in a rural block of Haryana.

Methods: A school based cross-sectional study was conducted in government middle and high school. A pre-designed and pre-tested proforma was used for collecting the information. Oral examination was carried out under daylight using a mouth mirror, oral probe and torch (when required), with the child in a sitting position within the school premises in the presence of school authorities. Data was analyzed by using percentages.

Results: Dental caries (48%) emerged as the most common condition, followed by deposits on tooth (46.1%) and fluorosis (43.6%). Other conditions included dental aches (13.8%), foul smell (10.8%), interdental spacing (4.7%), retained deciduous teeth (2.7%), fractured teeth (2.2%), tongue problems (1.6%) and gum problems (0.8%).

Conclusions: The overall pattern indicates a substantial burden of preventable oral conditions among school going adolescents.

Prevalence, patterns and reasons for ever use of tobacco among adult males in a rural field practice area of a tertiary healthcare institute of Haryana: a cross-sectional study

2026-09-01T01:22:02+00:00

Background: Tobacco use continues to be a major public health challenge worldwide and remains highly prevalent in rural populations due to easy accessibility and misconceptions regarding its benefits. Therefore, this study estimates the prevalence, patterns, and reasons for ever use of tobacco among adult males residing in a rural field practice area of a tertiary healthcare institute of Haryana.

Methods: A community based cross-sectional study was conducted in the catchment area of Primary Health Centre Agroha, Hisar, Haryana. A total of 350 adult males were selected through systematic random sampling. Data were collected using a predesigned and pretested interview schedule and analyzed using SPSS version 26.0.

Results: Nearly two-thirds (63.1%) of the study population had experimented with tobacco at least once in their lifetime. Of these, 88.7% were regular users and hookah (46.2%) was the most commonly used smoking product. The majority (90.0%) of the participants reported initiating tobacco use between the ages of 15-25 years and multiple reasons (66.1%) were predominantly observed for initiation of tobacco use.

Conclusions: Ever use of tobacco was highly prevalent among adult males in the study area, with most users being regular smokers. Early age tobacco initiation highlights the need for strengthened community-based preventive interventions, tobacco control, and cessation services in rural settings.

Regional health inequalities in Karnataka: translating NFHS-5 evidence into better district health planning

2026-09-01T01:22:00+00:00

Background: Karnataka, one of India’s most socio-economically diverse states, exhibits considerable regional inequalities in health outcomes. Northern districts consistently lag behind southern districts in socio-demographic development and maternal and reproductive health indicators. These inequalities reflect the effectiveness of local policy implementation. The study assesses district and regional-level inequalities in socio-demographic and maternal and reproductive health indicators across Karnataka and identify priority districts for targeted health planning and resource allocation.

Methods: District-level data from National Family Health Survey (NFHS-5) (2019-21) were analyzed. Indicators were aggregated into four administrative divisions using weighted averages. Composite Health Index (CHI) scores were calculated for socio-demographic and maternal and reproductive health dimensions. Regional inequalities were examined using descriptive statistics, quartile deviation, and district-level rankings, and spatial mapping in QGIS.

Results: Districts with higher female education, improved sanitation, access to clean cooking fuel, and health insurance coverage achieved higher socio-demographic CHI scores and better maternal and reproductive health outcomes. Northern districts, including Kalaburagi, Yadgir, Raichur, Koppal, and Vijayapura recorded comparatively lower CHI scores, while southern districts performed better across most indicators. Significant intra-divisional variation highlighted substantial inequalities within administrative regions.

Conclusions: Persistent regional inequalities in Karnataka are driven by adverse social determinants of health and unequal access to maternal healthcare services. Region-specific interventions focusing on female education, sanitation, gender equity, and strengthened maternal health services are essential to reduce inequalities and improve maternal and reproductive health outcomes across the state.

Prevalence of vitamin D deficiency among medical students in central India: a cross-sectional study

2026-09-01T01:19:50+00:00

Background: Vitamin D deficiency is widely prevalent in India despite adequate sunlight availability. Young adults, particularly medical students with predominantly indoor academic schedules, may be at increased risk of inadequate vitamin D status. However, data regarding vitamin D status among healthy young adults from Central India remain limited.

Methods: A cross-sectional observational study was conducted at Central India Medical College, between May 2024 and June 2025. A total of 152 apparently healthy first-year MBBS students aged 17–23 years were enrolled. Demographic characteristics, dietary habits, educational status of the head of the family, socioeconomic status and monthly family income were recorded. Serum 25-hydroxyvitamin D (25(OH)D) levels were estimated using chemiluminescent immunoassay (CLIA) and classified as deficient (<20 ng/ml), insufficient (20–29.9 ng/ml) or sufficient (≥30 ng/ml). Data were analyzed using SPSS version 26.0, with p<0.05 considered statistically significant.

Results: The mean age of participants was 19.69±1.18 years. The mean serum vitamin D level was 13.98±7.51 ng/mL. Vitamin D deficiency was observed in 133 participants (87.5%). No significant association was observed between vitamin D deficiency and gender (p=0.946), dietary pattern (p=0.164) or socioeconomic status (p=0.867).

Conclusions: A high prevalence of vitamin D deficiency was observed among apparently healthy first-year medical students in Central India. The findings highlight the importance of continued attention to vitamin D status among young adults.

Geographic distribution and temporal trends of malnutrition and anaemia among women and children in malaria-endemic districts of India: a comparative analysis of NFHS-4 and NFHS-5

2026-09-01T01:19:49+00:00

Introduction: In India malaria and malnutrition are major public health concerns. However, this interplay between anaemia and malnutrition remain poorly understood at the administrative unit (district) level. This study aims to analyse changes in the geographical distribution and temporal trends of malnutrition, and anaemia among children and women in the malaria endemic districts with Annual Parasite Index > 1.

Methods: This study used district-level data from National Family Health Survey –4 (NFHS-4) (2015–16) and National Family Health Survey-5 (NFHS-5) (2019–21) to assess geographical distribution and temporal patterns of malnutrition and anaemia in 29 malaria-endemic districts of India with API≥1 (2024). District-level trends across survey were compared and mapped using R software.

Results: Between NFHS-4 and NFHS-5, several malaria-endemic districts (API≥1) demonstrated meaningful improvements in child nutrition and anaemia indicators. Stunting declined notably in Uttar Bastar Kanker (36.3% to 24.8%) and Godda (54.0% to 39.4%). Wasting showed reduction in Bastar (33.9% to 20.4%), while underweight decreased in Kabeerdham (38.4% to 27.3%). Encouraging improvements in anaemia were observed among children in South Garo Hills (74.9% to 33.6%) and among pregnant women in Uttar Bastar Kanker (56.7% to 33.4%).

Conclusion: The observed reductions in malnutrition and anaemia across multiple malaria-endemic districts highlight the potential impact of focused nutrition and maternal health interventions. Strengthening and scaling successful district-level strategies can support integrated approaches toward improving nutritional outcomes and advancing malaria elimination goals by 2030.

Factors affecting compliance and health-seeking behaviour of hypertensive patients: a mixed-method study

2026-09-01T01:19:48+00:00

Background: Hypertension is a leading modifiable risk factor for cardiovascular morbidity and mortality worldwide. Despite availability of effective pharmacological and lifestyle interventions, optimal blood pressure control remains suboptimal, largely due to poor treatment compliance and delayed or inappropriate health-seeking behaviour. Objectives were to assess the extent of treatment compliance among hypertensive patients; to identify determinants of antihypertensive treatment compliance; to explore factors affecting health-seeking behaviour; and to qualitatively explore accessibility, availability, challenges and opportunities influencing compliance.

Methods: A mixed-methods cross-sectional study was conducted at the non-communicable disease clinic of a tertiary care hospital in Surat, Gujarat, India from May to October 2023. The quantitative component included 300 adult hypertensive patients selected by convenient sampling. Data were collected using a semi-structured questionnaire capturing socio-demographic details, lifestyle practices, treatment characteristics, and the Hill-Bone compliance to high blood pressure therapy scale. The qualitative component comprised in-depth interviews with 10 hypertensive patients; thematic analysis was performed.

Results: The mean±SD age of 300 participants was 56.8±10.7 years. Overall mean±SD for Hill Bone compliance score was 17.49±3.83 while those of medication compliance, sodium use and appointment keeping subscales were 9.38±2.22, 3.62±1.05 and 4.49±1.68 respectively. Only 61 (20.33%) participants were perfectly adherent according to Hill Bone compliance therapeutic scale while 239 (79.66%) participants were not. Qualitative themes included perceived severity of hypertension, financial constraints, health literacy, access barriers and the enabling role of family and counselling.

Conclusions: Treatment compliance and health-seeking behaviour among hypertensive patients are influenced by an interplay of patient-related, therapy-related and system-level factors.

Effectiveness of a health education intervention on utilization of maternity benefit schemes among tribal pregnant women: a quasi-experimental study

2026-09-01T01:19:47+00:00

Background: Recognizing the pivotal role mothers play in society, government in India, have implemented various schemes and initiatives aimed at supporting maternal health and well-being. Main objective was to evaluate effectiveness of health promotion intervention through community mobilization with women groups facilitated by ASHAs and ANMs on utilization maternity benefit schemes of the government and to find out the reasons for non-utilization of maternity benefit schemes of the government.

Methods: This was a quasi-experimental study design undertaken to evaluate educational intervention package among schedule tribe pregnant women to improve utilization of maternity benefit schemes in Chittoor District of Andhra Pradesh state in south India. A baseline household survey with the help of a semi structured questionnaire was conducted in both intervention group (n=109) and control group (n=119). An educational intervention was implemented. Data was analysed using SPSS Version 26.0.

Results: In the end-line survey, there was improvement in utilization of government maternity benefit schemes among tribal pregnant women with respect to programmes/schemes like Ayushman Bharat, JSY, JSSK, PMSMA, Anemia Mukt Bharat, 102 (Thallibidda Express) and the various reasons reported by them for non-utilization of services were lack of awareness, no bank account, no Aadhar cards etc.

Conclusions: To improve awareness and utilization of health services provided under various maternity benefit schemes, health education should be imparted on regular basis to mothers. For this ASHA, ANM and medical officers should be motivated to educate as they work closely with the community.

An overview of the universal immunization programme in India: a multi-level discussion

2026-09-01T01:20:33+00:00

Background: The World Health Organisation (WHO) first introduced the idea of an immunization programme in 1974 with the inauguration of the “Expanded Programme on Immunization” (EPI). In India, EPI was launched in 1978 and was renamed the universal immunization programme (UIP) in 1985. It is crucial to talk about the situation at the global and local levels to better understand the immunization programme’s implementation status.

Methods: The primary objective of this paper is to illustrate the performance of the immunization programme in India, starting with India and going down to the district level, the study is viewed as a multi-level discussion. The study is based on secondary data gathered from various sources. Several maps and diagrams have been prepared to provide a broad overview of immunization programme’s performance for easier comprehension.

Results: The study revealed regional differences in immunization programme performance across the whole country, including at the state, district and block levels. The discussion highlights that the declining IMR in India and West Bengal which reflects improvement in child healthcare, immunization, nutrition and related health services. India has achieved relatively favourable vaccination coverage compared with several other developing countries. The state of West Bengal has also demonstrated satisfactory immunization coverage over time. However, significant spatial disparities exist within the country, states and different districts.

Conclusions: The study suggests that strengthening the immunisation programme requires a combination of better infrastructure, technology, community engagement and healthcare workforce support.

Examining sleep behavior and its association with academic performance among college students

2026-09-01T01:20:32+00:00

Background: Sleep is essential for physical and mental well-being and may influence academic performance among college students. Irregular sleep habits, inadequate sleep duration, and poor sleep quality may adversely affect concentration, memory, and learning.

Methods: A descriptive-correlational study was conducted among 50 college students using a structured online Likert-scale questionnaire. Sleep patterns were assessed across sleep latency, sleep duration, and sleep efficiency. Academic performance was measured using CGPA/SGPA. Descriptive statistics, reliability analysis, correlation, multiple regression, cluster analysis, and group comparison tests were performed.

Results: The mean CGPA/SGPA was 7.68±1.19. Mean scores for sleep latency, sleep duration, and sleep efficiency were 3.37±0.64, 3.80±0.47, and 3.34±0.52, respectively. The sleep scale demonstrated acceptable reliability (Cronbach’s α=0.692). Significant positive correlations were observed among sleep dimensions; however, no significant correlation was found between sleep patterns and academic performance (p>0.05). Multiple regression analysis showed that sleep variables explained only 4.4% of the variance in academic performance (R²=0.044), with the overall model not statistically significant (p=0.554). Cluster analysis identified two distinct sleep behavior groups, with no significant difference in academic performance between groups.

Conclusions: College students generally demonstrated moderate-to-good sleep patterns and satisfactory academic performance. Although sleep dimensions were significantly interrelated, they were not significantly associated with academic achievement. Academic performance is likely influenced by multiple factors beyond sleep behavior alone. Larger, multicentric studies are warranted to further explore these relationships.

Parent-adolescent communication on sexual and reproductive health among mothers of adolescent girls in Bengaluru urban area: an exploratory study

2026-09-01T01:20:31+00:00

Background: Effective parent-adolescent communication about sexual and reproductive health (SRH) promotes accurate knowledge, dispels misconceptions, and encourages healthy behaviors. Early and open discussions can help reduce teenage pregnancy, sexually transmitted infections, and risky sexual behaviors. However, such communication remains limited, necessitating the exploration of barriers to effective SRH discussions between parents and adolescent girls.

Methods: This exploratory study was conducted with 100 mothers of adolescent girls residing in urban Bengaluru using convenience sampling techniques. A structured questionnaire, derived from relevant literature, was developed to collect data from the participants. The data was analyzed using SPSS V20.0, employing descriptive statistics, and chi-square tests.

Results: Our findings indicate a low level of communication between parents and adolescent girls, with the majority of communication occurring regarding puberty (13.23±4.28) and secondary sexual characteristics changes (8.09±4.07). However, the lowest level of communication was observed in relation to teenage pregnancy (1.37±0.96). Additionally, the study revealed that 16% of parents and adolescent daughters engaged in poor communication, while only 30% exhibited good communication skills. Furthermore, a significant correlation was identified between age and communication levels (r²=0.1019, p=0.04*) educational status (r²=13.97, p=0.05*) family type (r²=15.34, p=0.01**) Source of information (r²=7.13, p=0.03*) at a significance level of 0.05.

Conclusions: Our study revealed inadequate parent–adolescent communication on sexual and reproductive health (SRH), influenced by cultural barriers, limited knowledge, and family dynamics. Early, open communication on SRH may strengthen parent-adolescent relationships and reduce unsafe sexual practices.

Immunization dropout rate and associated factors among children aged 12-35 months in a rural field practice area: a community-based cross-sectional study

2026-09-01T01:19:44+00:00

Background: Immunization is one of the most effective public health interventions for preventing vaccine-preventable diseases and reducing under-five morbidity and mortality. Despite improvements in vaccination coverage under the Universal Immunization Programme, some children fail to complete the recommended schedule. Immunization dropout reflects gaps related to caregivers, health services, and accessibility, making its assessment essential for improving complete immunization coverage.

Methods: A community-based cross-sectional study was conducted among 400 children aged 12-35 months residing in the selected study area. Participants were selected using multistage random sampling. Data were collected using a pre-tested semi-structured questionnaire and verified using immunization cards wherever available. Dropout rates were calculated using WHO indicators, including BCG-to-Measles/MR and Pentavalent-1-to-Pentavalent-3 dropout rates. Associations were assessed using the Chi-square test, followed by multivariable logistic regression. A p value <0.05 was considered statistically significant.

Results: Of the 400 children, 340 (85.0%) were fully immunized, while 60 (15.0%) experienced immunization dropout; none were completely unimmunized. The BCG-to-measles/MR dropout rate was 14.1%, and the Pentavalent-1-to-Pentavalent-3 dropout rate was 6.2%. Common reasons for dropout included lack of awareness of the next vaccination visit (32.1%), child illness (17.9%), fear of adverse events (14.3%), and family migration (10.7%). Low maternal education, lower socioeconomic status, home delivery, absence of an immunization card, poor maternal knowledge, and distance >5 km from a health facility were significant independent determinants.

Conclusions: Strengthening caregiver awareness, defaulter tracking, card retention, institutional deliveries, and accessibility of vaccination services may reduce immunization dropout and improve complete immunization coverage.

The silent struggle: screening for attention-deficit/hyperactivity disorder symptoms and academic performance among undergraduate medical students

2026-09-01T01:20:30+00:00

Background: Attention-deficit/hyperactivity disorder (ADHD) frequently persists into adulthood and can adversely affect academic performance. Medical students are particularly vulnerable due to the demanding nature of medical education. This study estimated the prevalence of ADHD symptoms and examined their association with academic performance among undergraduate medical students.

Methods: A cross-sectional study was conducted among 214 undergraduate MBBS students at LLRM Medical College, Meerut. Participants were selected by convenient sampling. ADHD symptoms were assessed using the adult ADHD self-report scale (ASRS-v1.1). Students with ≥4 positive responses in Part A were classified as ADHD screen-positive. Data were analyzed using Jamovi software, applying Chi-square or Fisher’s exact test.

Results: Of the 214 participants, 31 (14.4%) screened positive for ADHD symptoms. ADHD positivity was significantly associated with lower examination scores (p=0.033), history of failure in professional examinations (p=0.0062), and poor self-rated academic performance (p<0.001). The most common symptoms were misplacing or difficulty finding things (61.2%), difficulty unwinding (58.0%), and difficulty concentrating on conversations (54.8%).

Conclusions: ADHD symptoms were common and significantly associated with poorer academic performance. Early screening and timely support may improve academic outcomes and student well-being.

Predictors of metabolic syndrome among adults: a hospital based cross-sectional study

2026-09-01T01:19:43+00:00

Background: Metabolic syndrome (MetS) is a growing public health challenge globally, with particularly high and rising prevalence in rapidly urbanizing nations like India. Characterized by a cluster of interrelated metabolic abnormalities, MetS significantly elevates risk of type 2 diabetes mellitus and cardiovascular disease. Hospital-based prevalence data from tier-2 cities of Maharashtra remain limited.

Methods: A hospital-based cross-sectional study was conducted from July to September 2025 among 381 adults (aged ≥18) at the outpatient services of a district hospital ch. Sambhajinagar. Data were collected using a WHO STEPS-based structured questionnaire. Metabolic syndrome was diagnosed by the modified NCEP ATP III criteria with Asia-specific waist circumference thresholds. Data were analysed using SPSS v29; chi-square test and multivariable binary logistic regression were applied; p<0.05 was considered significant.

Results: Of 381 participants, 138 (36.22%) fulfilled diagnosis criteria for MetS. Elevated blood pressure, elevated blood glucose, central obesity, raised non-HDL cholesterol and physical inactivity were significantly associated with MetS (p<0.05). On multivariable logistic regression, central obesity (adjusted OR: 48.6), physical inactivity (adjusted OR: 3.21) and elevated non-HDL cholesterol ≥ 130 mg/dl (adjusted OR: 1.74) emerged as independent predictors.

Conclusions: The prevalence of MetS was substantially high among hospital outpatients. Central obesity and physical inactivity were the strongest independent predictors. Structured lifestyle modification programmes focusing on physical activity promotion and weight management should be integrated within outpatient services to curb the rising NCD burden.

A cross-sectional study on the level of physical activity and perceived barriers to adherence of physical activity among individuals with type 2 diabetes mellitus aged 30-60 years in Chennai

2026-09-01T01:19:42+00:00

Background: The prevalence of type 2 diabetes mellitus (T2DM) is increasing rapidly in India, driven by sedentary lifestyles and environmental constraints that limit physical activity. Regular physical activity is essential for glycemic control and the prevention of complications. This study assessed the level of physical activity and perceived barriers among individuals with T2DM aged 30-60 years who were residing in urban field practice area of Madras Medical College in Chennai.

Methods: A cross-sectional study was conducted among 155 individuals aged 30-60 years with T2DM who were residing in urban field practice area of the Madras Medical College in Chennai. Participants were selected using consecutive sampling methods. After obtaining informed consent, data were collected using a semi-structured, pre-validated questionnaire based on the WHO ’s global physical activity questionnaire (GPAQ). Physical activity was quantified in MET-minute/week. Data analysis was performed using Epi Info, with Chi-square tests for associations (p<0.05).

Results: Among the 155 participants, 38.7%, 30.3%, and 31.0% had low, moderate, and high physical activity levels, respectively. Older age (>50 years), female sex, lower education, and unemployment were significantly associated with low activity, whereas employment and primary education were related to higher activity (p<0.05). The key barriers included physical discomfort (85.8%), unfavorable climate (82.6%), stray animals (78.1%), belief that exercise is unnecessary (73.5%), and lack of motivation (65.2%).

Conclusions: A substantial proportion of urban T2DM patients exhibit low physical activity influenced by sociodemographic factors and barriers. Future studies should examine the causal links, barriers, and effectiveness of interventions for physical activity, especially in high-risk groups.

Effectiveness of a video-assisted teaching programme on knowledge regarding first aid management among bus drivers: a quasi experimental study

2026-09-01T01:19:42+00:00

Background: Bus drivers are frequently the first responders to road traffic accidents and passenger medical emergencies, yet many lack adequate first aid knowledge. A video-assisted teaching programme (VATP) offers a learner-friendly method of improving this knowledge among adult learners with varied educational backgrounds. To assess knowledge regarding first aid management among bus drivers before and after a VATP, and to determine the association between pre-test knowledge and selected socio-demographic variables.

Methods: A quasi-experimental one-group pre-test post-test design was used. Thirty-five bus drivers from a selected college in Dehradun, Uttarakhand, were enrolled through purposive sampling. Knowledge was measured using a 28-item structured, expert-validated questionnaire (r=0.78) administered before and after a video-based teaching intervention. Data were analysed using descriptive statistics, the paired t-test, and the chi-square test.

Results: Mean knowledge score rose from 13.00 (SD=5.72) pre-test to 19.97 (SD=4.96) post-test, a gain of 6.97 points (t (34)=5.82, p<.001; Cohen's d = 0.98). Adequate knowledge rose from 17.14% to 68.57%, while inadequate knowledge fell from 28.57% to 2.85%. No significant association was found between pre-test knowledge and socio-demographic variables (all p>0.05).

Conclusion: VATP produced a statistically significant and practically meaningful improvement in first aid knowledge among bus drivers, independent of socio-demographic background, and is a feasible, scalable strategy for strengthening prehospital emergency response capacity among transport-sector workers.

Knowledge, attitude and practice towards general waste management among housewives: evidence from urban slums of Delhi

2026-09-01T01:19:40+00:00

Background: Waste that cannot be recycled and generated in households and factories or companies, also named as residual waste is called general waste. Materials such as non-recyclable plastic, polythene, kitchen wraps and packing papers are few examples of general waste. The process of collection, treatment, recycle and disposal of different waste materials is waste management. Household waste management can be effectively done if housewives have adequate knowledge, a positive attitude and adopt healthy practices.

Methods: A quantitative research approach was used for this study. The research was conducted in urban slum area, Aali Gaon of New Delhi among 100 using purposive sampling. The tools used were structured knowledge questionnaire, 5- point Likert attitude scale and structured practice checklist.

Results: The findings showed that 55% of housewives had average knowledge, 56% of housewives had unsatisfactory practice level, whereas in attitude score, 67% housewives had positive attitude level. A significant association was found knowledge and attitude with demographic variables.

Conclusions: Thus, there is a need for mass health education amongst the housewives by which knowledge and practice can be enhanced.

A comparative study on health risk behaviours among adolescent high school students of urban and rural areas of Raichur district, Karnataka

2026-09-01T01:19:40+00:00

Background: Objectives of the study were to compare the prevalence and pattern of health risk behaviours among adolescent high school students in urban and rural areas of Raichur district, and to assess associated socio-demographic factors influencing these behaviours.

Methods: A pre-tested WHO GSHS-based questionnaire was used in a school-based cross-sectional comparative study with 560 kids from August to October of 2025.

Results: The sociodemographic features of the two groups were comparable. Students from urban areas had greater levels of screen usage, poor eating habits, and physical inactivity. Students in rural areas were more physically active but also had higher absence and sleep deprivation rates. Overall, drug use was minimal, but in rural areas, it was marginally higher. There was a lot of academic stress in both groups.

Conclusions: Adolescent risk behaviors varied significantly across urban and rural areas, underscoring the need for focused, school-based interventions.

Medical jousting: ethical and legal considerations

2026-09-01T01:24:47+00:00

Medical jousting refers to making insulting or disparaging remarks about a fellow medical practitioner, usually in front of the patient or next of kin of the patient. These comments can be made intentionally or unintentionally. The results can be stressful for the patient and the medical professionals involved. Medical jousting produces various ethical and legal issues. To reduce instances of medical jousting, regulatory bodies of the medical profession should declare the act of jousting unethical and punishable with disciplinary action. Medical practitioners should think rationally before criticizing another medical practitioner and communicate with them directly to avoid any conflict.

Ebola virus disease and the 2026 FIFA World Cup mass gatherings: implications for global health security

2026-09-01T01:23:40+00:00

The 2026 Fédération Internationale de Football Association (FIFA) World Cup kicked off on June 11, 2026 in Mexico with the first opening match. It is unarguably the largest football event in the history of FIFA-organized tournaments, with three nations United States of America, Canada, and Mexico jointly hosting a 48-nation tournament featuring 104 matches. In contrast, previous tournaments, such as the 2022 event in Qatar, were limited to 32 participating countries and a single host nation. The number of participating countries from Africa was raised from five to nine with the epicentre of the current Ebola virus disease (EVD) outbreak, DR Congo (DRC) one of the participating countries having qualified through the intercontinental play off. Equally important is the fact that it is the longest running World Cup event lasting 39 days compared to 32 days previously.

One dose, one billion girls: the scientific and public health imperative of India’s single dose human Papillomavirus vaccination strategy

2026-09-01T01:29:12+00:00

Cervical cancer remains one of the leading causes of cancer mortality in women across low- and middle-income countries (LMICs). In India, an estimated 1,27,526 new cases and 79,906 deaths were recorded in 2022, accounting for approximately 19% of the global burden.¹ Every day, nearly 200 Indian women lose their lives to a disease that a vaccine can prevent. Against this backdrop, the phased introduction of the human Papillomavirus (HPV) vaccine under India's Universal Immunisation Programme (UIP), following the Union Budget announcement in February 2024 and sustained advocacy by the National Technical Advisory Group on Immunisation (NTAGI), represents a watershed moment in preventive oncology.

Healthy ageing in India: strengthening community-based senior care beyond longevity

2026-09-01T01:22:04+00:00

India is undergoing a profound demographic transition with a steady increase in the population aged 60 years and above. Declining fertility rates and improvements in life expectancy have reshaped the population structure, making older adults one of the fastest-growing demographic groups in the country.^1,2According to national projections, the ageing population is expected to continue expanding over the coming decades, creating substantial implications for healthcare systems, social protection mechanisms, and long-term care services. This demographic shift necessitates a transition from episodic, disease-centred healthcare toward integrated, person-centred approaches that preserve functional ability, independence, and overall wellbeing in later life.