International Journal Of Community Medicine And Public Health

Diagnostic accuracy of the TimBre acoustic device for detecting pulmonary tuberculosis: a systematic review and meta-analysis

2026-04-30T14:33:37+00:00

Tuberculosis (TB) remains a major cause of infectious disease mortality worldwide, with India accounting for 26% of global cases. Conventional screening methods often miss asymptomatic or minimally symptomatic cases, highlighting the need for rapid, non-invasive detection tools. The TimBre acoustic system uses machine learning algorithms to analyze cough sounds for pulmonary TB (PTB) screening. A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines to evaluate TimBre’s diagnostic accuracy. Studies comparing TimBre with reference standards such as Xpert MTB/RIF, Xpert Ultra, TrueNat, or culture were identified from PubMed, Google Scholar, company sources, and grey literature. Pooled sensitivity and specificity were calculated using a random-effects model, and study quality was assessed with QUADAS-2. Three studies met inclusion criteria, encompassing populations from India, Vietnam, the Philippines, Uganda, and South Africa, with over 700,000 cough recordings analyzed. The pooled sensitivity was 71% (95% CI: 68-75%) and pooled specificity 76% (95% CI: 60-87%), with notable heterogeneity across studies. TimBre demonstrates moderate diagnostic performance as a rapid, low-cost, and non-invasive PTB screening tool. Its scalability and ease of deployment make it a promising triage solution for early TB detection, particularly in resource-limited settings. Larger multi-center validations and cost-effectiveness studies are warranted to guide programmatic integration.

Policy strictness, enforcement and public health effectiveness of tobacco control in India: integrating world health organization framework convention on tobacco control compliance and public perceptions

2026-04-30T14:32:18+00:00

The objective of this study is to examine the extent to which India's tobacco control policies have been implemented in practice and to analyse public perceptions of their effectiveness and alignment with WHO-FCTC provisions. A mixed-method design was adopted. A systematic review of national tobacco control policies was conducted to examine their alignment with selected world health organization framework convention on tobacco control (WHO-FCTC) provisions. Concurrently, a cross-sectional survey involving 95 participants was administered using the policy perception scale. The instrument measured policy strictness, enforcement rigidity, effectiveness of tobacco control initiatives, and policy alignment with international standards. Structural equation modelling (SEM) was performed to test hypothesized relationships among latent constructs and to determine predictors of perceived policy effectiveness. Our review of the policies showed that India is doing well with smoke free rules and warnings on packages but there are still problems with taxes and indirect promotion controls. When we asked people what they thought we found that they believe tougher policies lead to enforcement and good enforcement leads to better effectiveness of anti-tobacco initiatives, which in turn make people think the WHO-FCTC is being followed. For India to be successful in controlling tobacco use it needs to make sure the laws are enforced properly not just passed. India needs to make its enforcement stronger and fix the problems with how the laws are being implemented so that the laws can actually lead to better effectiveness of anti-tobacco initiatives.

Barriers to medication adherence in self-care management of systemic lupus erythematosus patients: a systematic review

2026-04-30T14:31:28+00:00

Aim of the study was to explore stakeholder viewpoints on factors impending compliance to medication among individuals with systemic lupus erythematosus (SLE). An extensive search of literature was carried out in PubMed, Embase, and Scopus databases extending from January 2000 to January 2026. The review encompassed all qualitative, peer-reviewed articles on obstacles to drug compliance, published in English language. Two individual reviewers evaluated study quality using the critical appraisal skills programme (CASP) qualitative checklist. Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) guidelines was used to synthesize the qualitative information. A total of eleven studies were selected. Prominent patient level barriers encompassed insufficient knowledge of the disease condition, risks of non-compliance, forgetfulness, inadequate social support, and suboptimal health teaching. Challenges associated to the healthcare resources, includes availability, cost, and suitability, which were noted in many articles. Proposed solution in reviewed articles to combat these included forming support networks, using electronic alerts, physical therapy, and specialized elderly care units at community health centres, along with cultural contextual approaches to patient support. Customized strategies focused on individual needs should be created to enhance management in SLE cases.

Factors associated with health care utilization among vulnerable households in Oshimili South LGA, Delta State, Nigeria

2026-04-30T14:31:05+00:00

Background: Vulnerable households in Nigeria face persistent barriers utilizing healthcare services, resulting in poor health outcomes. This study assessed the factors associated with healthcare utilization among vulnerable households in Oshimili South Local Government Area, Delta State, Nigeria.

Methods: The study employed a descriptive cross-sectional survey design. Using purposive and simple random sampling techniques, 349 vulnerable households were enrolled between April and July, 2024. Collected data was analyzed using IBM/SPSS version 25.

Results: The findings revealed that the majority of respondents were female (85.4%), while those aged 30–39 years constituted the largest age group (37.2%). The results showed that vulnerable households in Oshimili South LGA experience moderate health challenges, with nearly half (48.4%) falling sick 2–5 times and hypertension (25.2%) being the most common condition. While more than half (54.7%) rated their health as “fair” and 51.3% engaged in daily physical activity, access to medication remained a major concern, with 80.8% reporting occasional difficulties. In terms of healthcare services, most households (76.5%) had a facility in their community, but visits were irregular, with 74.2% attending only sometimes and quality of services were rated “poor” by over half (54.7%). General hospitals were the most used (32.7%) and the majority (58.2%) preferred public facilities,

Conclusions: The high prevalence of “Most Vulnerable” households, combined with socioeconomic, cultural and institutional barriers, underscores the need for deliberate interventions to enhance healthcare access and utilization. Targeted social protection programs should also be prioritized to mitigate the health risks faced by vulnerable populations.

Exploring the pathway from recognising symptoms to receiving a type 2 diagnosis among adults: a grounded theory study

2026-04-30T14:32:17+00:00

Background: The rising incidence of type 2 diabetes in Zimbabwe is linked to notable delays in diagnosis after symptoms emerge. Early detection, even before symptoms appear, is vital for clinical, social, and public health purposes. Although epidemiological data indicate an increase in cases, little is known about how patients perceive and respond to initial signs of diabetes. Gaining insight into this pre-diagnosis phase is essential for developing strategies to promote earlier detection and better engagement with healthcare services. This study examined the pathway from symptom recognition to a diagnosis of type 2 diabetes.

Methods: The study was guided by a constructivist grounded theory approach. Twenty-eight semi-structured interviews were conducted with individuals diagnosed with type 2 diabetes at selected community pharmacies in Harare.

Results: A theoretical category, ‘learning I have diabetes,’ emerged from the data analysis. ‘Learning I have diabetes’ is a non-linear process marked by interconnected milestones, such as recognizing symptoms, seeking information, health-seeking, experiencing negative emotions, denying the diagnosis, and ultimately accepting it. The theoretical category outlines the social processes, from recognizing bodily changes and investigating behaviours to diagnosing type 2 diabetes.

Conclusions: The process from recognising symptoms to receiving a type 2 diabetes diagnosis is intricate and not straightforward. It is influenced by psychological, socio-cultural, economic, and relational factors that affect health-seeking behaviours. This study indicates that culturally tailored awareness campaigns, enhanced primary care screening, and targeted information sharing can promote earlier diagnosis and help prevent diabetes-related complications.

Quality assessment of immunization clinics in Bondo sub-County, western Kenya: a descriptive study

2026-04-30T14:33:35+00:00

Background: Childhood vaccine coverage remains suboptimal in the second year of life. In Kenya, the fourth dose of the RTS,S/AS01 malaria vaccine stands at 34%. Demand and supply factors influence vaccine uptake but the quality-of-service delivery- a critical supply-side factor- remains underexplored. An immunization clinic quality assessment framework was developed to evaluate services in 29 health facilities in Bondo sub-County, Kenya.

Methods: The WHO pediatric quality of care framework was adapted and used to conduct a cross-sectional survey of 29 health facilities between April and May 2025. The framework included 33 measurable indicators categorized as provision of care, experience of care and availability of child friendly resources. Immunization clinics were scored 1 or 0 per indicator, with total scores expressed as percentages and categorized into three quality levels: “below average” (0-50%), “average” (51-79%), and “above average” (80-100%). A Mann-Whitney U test compared quality scores between level 2 and levels 3/4 health facilities.

Results: Of the 29 clinics, 58.6% were level 2, 34.5% level 3, and 6.9% level 4; 89.7% were government owned. Clinic scores ranged from 70% to 91%, with 52% classified as “average” and 48% as “above average.” Levels 3 and 4 facilities performed significantly better than level 2 (U=41.5, n₁=17, n₂=12, p=0.006). Key deficiencies included vaccine stockouts and absence of child-friendly spaces.

Conclusions: Vaccine stock-outs is the key challenge to delivering quality services. Improving immunization service quality requires increased government investment that ensures uninterrupted vaccine supply and enhancing clinic environments.

Perception toward school health and nursing service program among the students of Nuwakot District, Nepal

2026-04-30T14:32:30+00:00

Background: The school health and nursing service program is a public health initiative implemented by the government of Nepal to promote the physical, mental, and social well-being of school-aged children. Schools serve as an effective platform for delivering preventive, promotive, and basic primary health care services. Understanding students’ perceptions toward the program is essential for its effective implementation and sustainability.

Methods: A descriptive cross-sectional study was conducted among 201 students of grades nine and ten from three government schools in Nuwakot District. An enumerative sampling technique was used. Data were collected through a semi-structured, self-administered questionnaire based on a five-point Likert scale and analyzed using SPSS version 26. Descriptive statistics, including frequency and percentage, were used to summarize the findings.

Results: More than half of the respondents (57%) had a positive perception of the program. Preventive services were most appreciated (61%), followed by promotive services (38%), nutrition-related services (32%), and physical examinations (28%). About 80% of students reported increased awareness of communicable and non-communicable diseases and their prevention. Nearly all female students found the free distribution of menstrual pads helpful for maintaining menstrual hygiene. Students recommended adopting a need-based approach and improving the availability of health commodities at schools to strengthen the program.

Conclusions: The program is well accepted and has contributed to students’ well-being and academic performance. Strengthening preventive services and ensuring adequate resources could further enhance its effectiveness.

Hand-hygiene beliefs and practices of students in health-related departments of a university in Mogadishu, Somalia

2026-04-30T14:32:29+00:00

Background: This study aimed to investigate the relationship between hand hygiene beliefs and practices of university students studying in health-related departments in Mogadishu, Somalia. Evidence on hand washing knowledge, attitudes and practices among healthcare students in low- and middle-income countries is limited.

Methods: This study aimed to investigate the relationship between hand hygiene beliefs and practices of university students studying in health-related departments in Mogadishu, Somalia. Evidence on hand washing knowledge, attitudes and practices among healthcare students in low- and middle-income countries is limited.

Results: The mean age of the participants was 20.31±1.85 years and the majority were female (76.6%). The mean Hand Hygiene Beliefs Inventory (HHBI) score was 55.90±11.48, while the mean hand hygiene practices inventory (HHPI) score was 80.16±15.23. A moderate, statistically significant positive correlation was found between HHBI and HHPI scores (r=0.514, p<0.01). Students who reported adherence to hand hygiene practices had significantly higher belief and practice scores compared to those who did not (p<0.01). Regression analysis demonstrated that hand hygiene beliefs were a significant predictor of hand hygiene practices.

Conclusions: Although students demonstrated moderate levels of hand hygiene beliefs and practices, gaps remain that may compromise infection prevention efforts. As hand hygiene belief levels increased, practice levels also improved. These findings highlight the need for targeted educational interventions and multimodal strategies to strengthen hand hygiene beliefs and practices among healthcare-related university students, particularly in resource-limited settings.

Patterns of learning styles and study habits among undergraduate medical students of Green Life Medical College, Dhaka, Bangladesh

2026-04-30T14:32:23+00:00

Background: Learning styles and study habits are key determinants of medical students’ academic success, yet little is known about these factors among students in private medical colleges of Bangladesh.

Methods: A descriptive cross-sectional study was conducted among 237 MBBS students from July to September 2023 using a semi-structured, self-administered questionnaire. Data on sociodemographic factors, VARK learning styles, and study habits were analyzed using descriptive and inferential statistics.

Results: Visual learning style was predominant (56.5%), followed by auditory (39.7%) and kinesthetic (10.5%). Most students studied 3–5 hours daily and followed routine schedules mainly during examinations. Visual learners achieved significantly higher GPAs (4.72±0.31; p=0.021) than auditory or kinesthetic learners. Study environment and sleep quality also influenced performance (p<0.05). Students who studied in quiet settings, maintained adequate sleep, and used smartphones for academic purposes demonstrated better results. Logistic regression identified visual learning style (OR=1.84), ≥5 hours of daily study (OR=1.68), adequate sleep (OR=2.20), and academic phone use (OR=1.78) as significant predictors of high GPA.

Conclusions: Visual learning preference, structured study habits, sufficient sleep, and purposeful technology use contribute positively to academic performance. Incorporating multimodal teaching approaches and promoting healthy study routines may enhance learning outcomes and overall student well-being.

Knowledge and practice of complementary feeding among mothers of the children aged group 6-24 months

2026-04-30T14:32:22+00:00

Background: Complementary feeding, initiated at six months of age, is essential to meet the nutritional needs of infants beyond breast milk. Inappropriate complementary feeding practices contribute to malnutrition, increased morbidity, and poor growth outcomes among young children in Nepal. This study aimed to assess the knowledge and practices of complementary feeding among mothers of children aged 6–24 months in Mahalaxmi Municipality, Lalitpur, Nepal.

Methods: A descriptive cross-sectional study was conducted among 208 mothers attending Primary Health Care services. Participants were selected using a non-probability purposive sampling technique. Data were collected using a semi-structured questionnaire and analysed using SPSS software using descriptive statistics.

Results: The mean age of respondents was 27.10±6.30 years. Most mothers (69.2%) correctly defined complementary feeding, with family members (42.2%) and Female Community Health Volunteers (25.3%) as the main sources of information. Exclusive breastfeeding up to six months was practiced by 52.4% of mothers, while 23.1% introduced complementary feeding before six months. Homemade foods were provided by 83.1% of mothers, and 63.9% continued breastfeeding after initiating complementary feeding. Although hygiene practices were optimal, gaps were observed in feeding timing, food consistency, and feeding during child illness.

Conclusions: Despite relatively good knowledge, suboptimal complementary feeding practices persist. Strengthening maternal nutrition education through health workers and community-based interventions is essential to improve child nutrition outcomes.

Prevalence and biostatistical analysis of health facility related predictors of adherence to healthy timing and spacing of pregnancy among multiparous women in Wajir County, Kenya

2026-04-30T14:32:21+00:00

Background: Globally, healthy timing and spacing of pregnancy is important for reducing maternal and child health risks, yet adherence remains unpredictable. Sub-Saharan Africa faces high rates of short birth intervals due to inadequate contraception, cultural norms, and weak health systems. In Kenya, and especially Wajir County, poor adherence is driven by low contraceptive uptake, high fertility, and early pregnancies.

Methods: The study employed a cross-sectional descriptive-analytical design. It included multiparous women. A sample of 368 participants was selected using Fisher's formula via systematic sampling. Data were collected with structured questionnaires and analyzed using SPSS version 26.0.

Results: The results revealed that 56.5% of respondents adhered to heathy timing and spacing of pregnancy in Wajir County with 34.2 under age pregnancy, 15.8% abortion/miscarriage and 32.6% short inter-birth interval. The predictors of adherence based on health facility related factors were; time taken to reach nearest health facility offering family planning services (AOR=0.464, p=0.016), ever missed family planning services due to stock-out (AOR=3.902, p=0.001) and availability of contraceptive at health facilities (AOR=2.768, p=0.013) significantly influenced the adherence.

Conclusions: The study found that the health facility related factors that predicted the adherence were; time taken to reach nearest health facility offering family planning (AOR=0.464, p=0.016), ever missed family planning services due to stock-out (AOR=3.902, p=0.001) and availability of contraceptive at health facilities (AOR=2.768, p= 0.013).

Low back pain prevalence and risk factors among MBBS students in Lahore: a cross sectional study

2026-04-30T14:31:23+00:00

Background: Low back pain (LBP) is a leading cause of disability worldwide, yet little is known about its burden among Pakistani medical students. We aimed to estimate the prevalence of LBP in MBBS students at SIMS Lahore and identify associated factors.

Methods: In this cross‑sectional study (June–September 2021), a total of 1000 MBBS students were invited to participate in the survey with response rate of 93%. After IRB approval (IRB/2020/628/SIMS), participants completed an online survey including a modified Oswestry Disability Questionnaire (validated in a 30‑student pilot; Cronbach’s α=0.82). Statistical significance was set at p<0.05.

Results: Mean age was 20±2 years; 52.5% female. Overall LBP prevalence was 43% (342 minimal, 58 moderate disability) with 95% CI (39.8%–46.2%). Significant associations with LBP included gender (p=0.042), BMI (p=0.049), place of study (room vs. library; p=0.012), backpack use in clinical rotations (p=0.005), and family history (p<0.001). No association was observed for academic year, exercise habits, chair type, sitting posture, or study hours.

Conclusions: Nearly half of MBBS students report LBP, with identifiable risk factors amenable to early intervention—especially ergonomics education and backpack‑weight management. Future multicentre studies and multivariate analyses are needed to confirm these associations and explore causality.

Hypertension and obesity in adults: evidence from a cross-sectional study at a tertiary care hospital in Punjab

2026-04-05T05:43:49+00:00

Background: Hypertension and obesity are two of the most significant non-communicable diseases (NCDs) contributing to the global burden of morbidity and mortality. India is experiencing a rapid epidemiological transition with rising prevalence of lifestyle-related disorders. Punjab, known for its dietary patterns rich in fats and reduced physical activity levels, shows an even higher prevalence of both conditions compared to the national average. This study aims to investigate the burden of hypertension and obesity among adults at tertiary care hospital, Bathinda Punjab.

Methods: A cross-sectional research design was adopted to assess the burden of hypertension and obesity among 265 adults visiting the outpatient areas of tertiary care hospital, Bathinda, Punjab. Participants were recruited via consecutive sampling technique. Data collection relied on self-structured questionnaires and statistical analysis performed using statistical package for the social sciences (SPSS) version 23.

Results: The findings revealed a concerning high prevalence of hypertension, with 24.2% was in hypertension stage II followed by 22.6% were in pre-hypertension stage etc. It was also found that 36.9% of the participants were overweight and 18.9% of them were obese. The correlation of hypertension with obesity was found statistically significant (r=0.23 as p value<0.01 level of significance).

Conclusions: This study highlights the significant burden of hypertension and obesity in the study population, emphasizing the need for comprehensive management and prevention strategies. Targeted interventions and health literacy enhancement are crucial for improving hypertension outcomes. Early action can mitigate long-term complications.

Comparative assessment of knowledge, attitude and practice regarding tobacco and areca nut use among visually impaired and normally sighted individuals: a questionnaire study

2026-04-30T14:33:38+00:00

Background: Aim was to compare the knowledge, attitude, and practice (KAP) regarding tobacco and areca nut use among visually impaired (VI) and normally sighted (NS) individuals across three age groups.

Methods: A cross-sectional study was conducted among 90 participants (45 VI and 45 NS) divided into three age groups. A modified KAP questionnaire was used in Braille and print. Data were analyzed using SPSS; t-tests and ANOVA were applied.

Results: VI participants showed significantly lower KAP scores than NS individuals (Knowledge: 4.2 vs 6.9, attitude: 2.6 vs 5.3, practice: 1.8 vs 4.8; p<0.001). A gradual improvement with age was noted in both groups but VI scores remained consistently lower.

Conclusions: VI individuals have poorer awareness and practices regarding tobacco and areca nut use. Accessible health education tools like Braille and audio aids are essential for improving outcomes.

Mothers on the move: a mixed methods exploration of maternal and child healthcare access among migrant women in Bengaluru

2026-04-30T14:33:36+00:00

Background: Migrants in India face unique challenges in accessing maternal and child health (MCH) services. This study assessed the usage pattern and determinants of MCH services among migrant women in the Sarjapur PHC area of Bengaluru urban district, Karnataka.

Methods: A mixed-methods study was conducted between December 2023 and June 2024. Quantitative data was collected from 100 eligible migrant women using a semi-structured questionnaire. Adequate utilization was defined based on 8 indicators (ANC visits, IFA adherence, institutional delivery, PNC, immunization, family planning, Anganwadi enrolment, health worker contact); meeting ≥6 criteria was considered adequate. Statistical analysis was performed using chi-square and logistic regression. Qualitative data was gathered through 3 FGDs and 4 key informant interviews and analysed thematically.

Results: 74% of migrant women had adequate MCH utilization. Institutional delivery (90%) and immunization (88%) had the highest uptake, while IFA adherence (64%) and postnatal care (72%) lagged behind. Key predictors of adequate utilization included literacy (AOR 4.10, p=0.012), gainful employment (AOR 2.85, p=0.046), and South Indian origin (AOR 2.76, p=0.032). Qualitative findings highlighted the role of frontline workers, peer influence and familiarity with services as facilitators, while language barriers, time constraints and poor awareness were key barriers.

Conclusions: Despite relatively high overall utilization, migrant women, particularly those from north India, face systemic barriers. Targeted outreach, flexible service delivery and culturally sensitive strategies are needed to improve equity in MCH access.

Clinical profile, etiology and outcomes of meningoencephalitis in a tertiary care centre in Kerala

2026-04-30T14:33:34+00:00

Background: Meningoencephalitis remains a serious public-health issue in many low- and middle-income countries due to its potential for rapid neurological deterioration and preventable mortality. Limited diagnostic tools at peripheral hospitals often lead to delayed referral and empirical treatment. Understanding the regional etiology and identifying predictors of poor outcomes are essential for early case recognition, prioritisation of high-risk patients and strengthening surveillance and diagnostic pathways.

Methods: A prospective observational study was conducted among 129 patients (>13 years) admitted with meningoencephalitis to Government Medical College, Kozhikode from January 2019 to June 2020. Clinical features and CSF serological/molecular diagnostics were analysed. Patient outcomes at discharge were recorded and compared across etiological categories.

Results: Among 129 patients, 56% were male and 61% were aged <40 years. Common symptoms were fever (96%), headache (86%), vomiting (64%), altered sensorium (53%) and seizures (34%). Etiology was identified in 39.5%, with viral meningoencephalitis most common; HSV-1 was the leading viral agent. ICU care was required in 24.8% and ventilatory support in 7%. Overall, 83.7% recovered completely, 6.2% had sequelae and 10.1% died. Mortality was highest in tuberculous and fungal meningitis. Seizures, low GCS and delayed presentation were associated with poor outcomes.

Conclusions: Viral meningoencephalitis was the leading etiology, while tuberculous and fungal infections contributed disproportionately to mortality. Improved access to molecular diagnostics and early recognition of high-risk clinical indicators could reduce preventable deaths. Strengthening surveillance and referral pathways is essential to improving neurological outcomes in the community.

Stitching through strain: a cross-sectional study on distribution and determinants of chronic musculoskeletal and ocular discomfort in rural Zari embroidery workers of West Bengal, India

2026-04-30T14:33:33+00:00

Background: Zari embroidery supports many artisans but poses health risks, including musculoskeletal-disorders and ocular discomfort due to repetitive work. Workers experience chronic pain and eye strain, yet these health challenges receive limited attention. This study investigates the factors contributing to these health issues among zari workers in rural West Bengal, India.

Methods: This cross-sectional community-based study was conducted among 330 embroidery workers from March 2023 to January 2024. Cluster sampling selected 30 villages, followed by random selection of 11 participants per village. Data collection involved structured interviews and necessary instruments. Univariate and multivariable logistic regression identified the determinants of chronic musculoskeletal and ocular discomfort.

Results: Out of 330 participants, 271 (82.1%) reported chronic musculoskeletal discomfort, with low back pain (69.7%) and neck pain (57.5%) being the most common sites. Key modifiable determinants of chronic musculoskeletal discomfort included psychological stress (aOR=1.03, p<0.001), longer work duration (uOR=2.68, p=0.02), and extended working hours (aOR=8.04, p<0.001) whereas, for chronic ocular discomfort, reported by 189 (57.2%) participants, where long work duration (uOR=2.32, p=0.01), working at a stretch (aOR=2.20, p=0.02), and night-time work (aOR=4.20, p=0.01) revealed as major determinants.

Conclusions: The study reveals a high prevalence of musculoskeletal and ocular discomfort among zari workers highlighting the urgent need for improved occupational health policies and ergonomic interventions.

Knowledge and attitude of youth of India towards cardio pulmonary resuscitation: a cross-sectional study

2026-04-30T14:33:32+00:00

Background: Sudden cardiac arrest is a major global cause of mortality, with out-of-hospital cardiac arrest (OHCA) accounting for nearly 10% of all deaths. Early Cardiopulmonary Resuscitation (CPR) and defibrillation can significantly improve survival, yet bystander CPR rates remain low, especially in India. Existing research largely focuses on healthcare professionals. Given India’s predominantly young demographic, evaluating CPR knowledge in this group is crucial.

Methods: A cross-sectional survey was conducted among 583 young adults (18–35 years) from urban India. Participants were recruited through snowball sampling; those with medical backgrounds or involved in roles such as military, lifeguards and flight attendants were excluded. A validated 24-item questionnaire (CVI=0.8) assessed demographics, CPR knowledge and attitudes. Data were analyzed using descriptive statistics in Microsoft Excel.

Results: Of 583 individuals included in the analysis, only 101 participants had previously received CPR training. Knowledge levels were low: 73% could not identify the correct chain of survival. Only 28% had heard of the AED. In contrast, attitudes of the youth towards CPR were positive: 87% were willing to assist an unconscious victim, 94% believed CPR should be taught to the general population and 95% supported CPR training in schools and colleges.

Conclusions: A strong willingness to help exists among youth, but major gaps in CPR and AED knowledge might limit effective bystander response. Implementing practical, skill-based CPR education in schools and colleges is essential to strengthen youth competence and improve survival in cardiac emergencies.

Objective structural clinical examination: a superior assessment tool for community medicine

2026-04-30T14:33:30+00:00

Background: Traditional assessments in community medicine usually emphasize on theoretical understanding, with a limited capacity to evaluate practical competencies. The objective structured clinical examination (OSCE) has been widely recognized for its structured, skill-based assessment in various clinical disciplines, though its implementation in Community Medicine remains very limited. To assess the effectiveness of OSCE in evaluating undergraduate competencies in Community Medicine subject and to compare its outcomes with the traditional viva assessments and explore the student perceptions regarding its utility.

Methods: An educational interventional study was conducted on 156 MBBS students from the two MBBS batches. Participants were assessed by both traditional viva and a six-station OSCE method. The Performance scores were recorded using standardized checklists. Feedback was gathered by structured questionnaire. Paired t-test was applied for the comparative analysis and internal reliability of OSCE was assessed using Cronbach’s alpha.

Results: It was seen that the students achieved significantly higher scores in OSCE (mean 13.41±6.14) as compared in the traditional viva (mean 9.09±3.89, p<0.001). The highest performance was observed in the 24-hour dietary recall station, whereas the lowest in ORS preparation. Student feedback indicated high levels of acceptance, perceived relevance and confidence gained from OSCE. Internal consistency was strong as Cronbach’s α=0.86.

Conclusions: OSCE was found to be a reliable and effective assessment tool in Community Medicine subject, offering improved objectivity, skill evaluation and student engagement.

Knowledge and perception about One Health among young doctors in north India: an observational study

2026-04-30T14:32:31+00:00

Background: One Health is a novel concept and is need of hour to improve human health. It is a collective, multi-sectoral and trans-disciplinary phenomenon. The interplay of relationships among people, animals, and the environment is ever-changing and evolving. Not one discipline or sector of society has enough knowledge and resources to prevent the emergence or resurgence of diseases in today’s globalized world; hence, inter-sectoral collaboration is the need of the hour. This study was conducted in order to assess knowledge regarding one health among medical students.

Methods: A descriptive cross-sectional study was conducted using a pre-tested, structured questionnaire, administered via social media platforms. The participants included medical students, medical graduates undergoing internship, post-graduate students and young resident doctors.

Results: Only one-third of the participants (n=300) responded in the affirmative when asked whether they knew about one health. A majority of the participants (73%) believed that one health is the domain of veterinarians. Only 44% of the participants were actively involved in one health at the time of the study, while 63% of the participants showed a willingness to get involved in the one health approach.

Conclusions: Dissemination of correct and complete information about one health would go a long way in bridging the gap between the two professions of medicine and veterinary science, and provide us with an able and willing workforce ready to commit to and work for the one health approach.

A descriptive study to assess the knowledge, attitude and practice regarding heart smart diet among hypertensive patients from selected rural community in central part of India

2026-04-30T14:32:29+00:00

Background: Cardiovascular diseases (CVDs) are the leading cause of death globally, with hypertension as a major contributor. Dietary modification plays a vital role in controlling hypertension and preventing related complications. Assessing the knowledge, attitude, and practice (KAP) regarding a heart-smart diet among hypertensive patients in rural areas helps identify gaps and guide effective health interventions.

Methods: A descriptive, quantitative study was conducted among 114 hypertensive patients from a selected rural community in central India using purposive sampling. Data were collected from 20 January to 2 February 2025 using a structured questionnaire covering KAP toward a heart-smart diet. Descriptive and inferential statistics, including chi-square tests, were used to analyze associations between demographic variables and KAP scores.

Results: Of 114 participants, 45.6% had average knowledge and 43.0% had poor knowledge. Regarding attitude, 45.6% were neutral, and for practice, 57.9% needed improvement.

Conclusions: A clear gap exists between KAP related to heart-smart diet among hypertensive patients. Although some awareness and a positive outlook were observed, poor dietary practices persist, increasing the risk of complications. Urgent, context-specific health education, counseling, and community-based interventions are essential to improve dietary adherence and reduce the burden of hypertension in rural populations.

Process evaluation of recruitment and retention strategies in a cohort study: qualitative insights from a rural site in Telangana, India

2026-04-30T14:32:28+00:00

Background: Longitudinal cohort studies are important for generating evidence on disease patterns, risk factors, and outcomes, informing public health policies and interventions. However, participant recruitment and long-term retention pose significant challenges, particularly in rural and resource-limited settings. Maintaining participant engagement over extended periods is essential to ensure data validity in such studies. Effective recruitment and retention strategies, tailored to the study design, population characteristics, and setting are therefore crucial. At our site, a robust recruitment and retention plan contributed to a high retention rate of 99.6%.

Methods: This study presents a qualitative process evaluation from a rural site in Telangana, which was part of a multicentric cohort study designed to estimate the incidence of acute febrile illnesses, including dengue, over 12 months. In-depth interviews and focus group discussions were conducted with 20 stakeholders, including program personnel, field staff, community health workers, and participants. A manual thematic analysis was performed based on the transcribed interviews.

Results: The study identified key facilitators for recruitment and retention, including strong community engagement, support from CHVs and village leaders, cultural sensitivity, flexibility in follow-ups, and a participant-centered approach. Major challenges included participant fatigue, seasonal migration, reluctance to provide blood samples during illness, limited incentives, and increased documentation burden. Strategies like addressing broader health needs, medical camps, and capacity-building trainings enhanced trust and engagement.

Conclusions: The findings from this study offer valuable insights into context-specific strategies that can inform the design and implementation of future cohort studies in similar rural environments, thereby ensuring high retention and data quality with minimal attrition.

Enhancing COVID-19 analysis using adaptive robust geographically weighted regression: a global perspective

2026-04-30T14:32:27+00:00

Background: Understanding the global spread and impact of COVID-19 requires analytical approaches that capture spatial heterogeneity and data irregularities. Traditional regression methods often fail to address issues such as outliers and heteroscedasticity, limiting their effectiveness in modeling pandemic data.

Methods: This was an ecological and spatial analytical study using secondary global COVID-19 data. This study employs an adaptive robust geographically weighted regression (AR-GWR) model integrated with the γ-divergence technique to enhance robustness against outliers and non-constant variance. Unlike classical regression and standard geographically weighted regression (GWR), the AR-GWR model incorporates adaptive bandwidth selection, enabling automatic optimization of spatial smoothness and robustness parameters. This improves localized parameter estimation and predictive performance.

Results: The findings reveal substantial spatial variation in COVID-19 outcomes across countries. Nations with advanced healthcare systems, such as South Korea and France, report higher case numbers despite high human development index (HDI) scores. In contrast, Sub-Saharan African countries exhibit relatively lower case and mortality rates, potentially due to demographic and geographic factors. The AR-GWR model identifies healthcare infrastructure and preexisting health conditions as significant determinants of COVID-19 mortality, while demographic factors primarily influence infection rates. Compared to traditional models, AR-GWR demonstrates superior predictive accuracy and better handling of spatial non-stationarity.

Conclusions: The study highlighted the effectiveness of advanced spatial regression techniques, particularly AR-GWR with adaptive bandwidth selection, in modelling complex pandemic data. By accounting for spatial heterogeneity and data irregularities, the model provides more reliable insights into global health patterns. These findings can support improved pandemic preparedness and informed public health decision-making.

Out of pocket expenditure on hypertension and diabetes mellitus among people residing in the rural field practice area of a medical college: a community based cross-sectional study

2026-04-30T14:32:27+00:00

Background: Out-of-pocket expenditure (OOPE) on health care especially with non-communicable diseases forces households into poverty. The study was conducted with the aim of understanding the out-of-pocket health expenditure and their coping mechanisms in patients suffering from hypertension and diabetes mellitus in the rural field practice area.

Methods: A community-based cross-sectional study was conducted among 230 study participants suffering from hypertension or diabetes mellitus or both in the rural field practice area of Andhra Medical College, Visakhapatnam.

Results: The total mean OOPE among hypertensives was ₹ 501.69, among diabetics it was ₹ 1522.27, and among both hypertensives and diabetics, it was ₹1352.93. Age<50 years, being literate, belonging to upper-middle and lower-middle socioeconomic status, being married, suffering from diabetes mellitus and receiving treatment from a private hospital were associated with the presence of OOPE.

Conclusions: The current study highlights the rising economic burden of hypertension and diabetes mellitus. There is a significant impact of OOPE on household finances. Many households resort to coping mechanisms such as family members providing the money, borrowing money, selling assets or spending from savings or pension.

Prevalence of depression and anxiety in the elderly patients admitted in Regional Geriatric Centre, Gauhati Medical College and Hospital, Guwahati

2026-04-30T14:32:26+00:00

Background: Mental health issues among the elderly are frequently under-recognized and untreated, particularly in developing countries. Depression and anxiety are common psychiatric morbidities in geriatric populations and are often associated with socio-demographic factors. This study was conducted to assess the prevalence of depression and anxiety among elderly patients admitted to a tertiary care geriatric center and to examine their socio-demographic correlates.

Methods: This cross-sectional hospital-based study was conducted at the Regional Geriatric Centre, Gauhati Medical College and Hospital, from August 2016 to July 2017. Eighty-five patients aged 60 years and above who fulfilled the inclusion criteria were evaluated. Socio-demographic data were collected using a semi-structured proforma. Psychiatric diagnoses were made using the International Classification of Diseases, 10^th Revision (ICD-10) diagnostic criteria.

Results: Out of 85 elderly patients assessed, 40 (47.1%) were diagnosed with psychiatric illness. Depression was present in 16 patients (40%) and anxiety disorders in 5 patients (12.5%). Depression was more common among females, widows, unemployed individuals, and those from rural backgrounds. Anxiety disorders were more frequently observed in males, individuals aged 70-79 years, and those living in joint families. Psychiatric comorbidity was observed in five patients with depression.

Conclusions: Depression and anxiety are highly prevalent among hospitalized elderly patients and show significant associations with socio-demographic factors. Early identification and appropriate intervention are essential to improve mental health outcomes in the geriatric population. Community awareness and integration of mental health services into geriatric care are strongly recommended.

Effectiveness of a multidimensional health awareness programme on NCDs and communicable diseases, vaccination and environmental hazards: a community-based study in the Indian Sundarbans

2026-04-30T14:32:26+00:00

Background: A health awareness program is an essential tool for determining health outcomes, especially in rural communities like the Sundarban area, where access to healthcare and services is limited. The study aimed to assess the effectiveness of a health awareness program on knowledge regarding communicable and non-communicable diseases, vaccination, and environmental hazards among villagers in the Mathurapur area of Sundarban.

Methods: This study employed a pre-experimental research design, specifically the one-group pre-test and post-test design. Data were collected from 100 randomly selected participants using structured questionnaires and analysed via SPSS (version 27) software.

Results: Results showed a significant improvement in post-test knowledge scores as p<0.001 in the paired t-test. The study reflects that 76% of participants had poor knowledge regarding communicable diseases and NCDs, vaccination, environmental hazards in pre-test whereas changing in knowledge, 83% attained good knowledge in post-test.

Conclusions: The majority of respondents moved from poor knowledge to good knowledge regarding communicable diseases and NCDs, vaccination, environmental hazards in the post-test, from pre-test. The study showed that the elderly group, female participants, higher educational level, higher income level, and employment correlate with higher knowledge, whereas it is necessary to focus more on students, lower income levels, lower literacy individuals, and males to empower them about the importance of health awareness programs.

Effectiveness of school-based health education through student Arogyadoots for vector-borne disease prevention in rural Maharashtra: a pre-post interventional study

2026-04-30T14:33:31+00:00

Background: Vector-borne diseases (VBDs) continue to place a heavy burden on rural India, and conventional control efforts have produced only limited gains. School-based peer education through student ‘Arogyadoots’ (messengers of good health) may offer a practical way to reach rural households. Objective was to assess changes in knowledge, attitudes and practices (KAP) regarding VBD prevention among trained student Arogyadoots and the rural families they educated.

Methods: A pre-post interventional study was carried out in Ghorad village, Seloo Block, Wardha district, Maharashtra, between January 2023 and March 2025. Ninety-seven students from classes VIII-X received a two-month (60-hour) training module on VBDs and then delivered household health education to 970 families over six months. KAP was measured at baseline, immediately after the intervention, and three months later.

Results: Mean knowledge scores rose from 46.12% to 77.62% among students (d=2.84, p<0.001) and from 32.20% to 68.34% among families (d=2.67, p<0.001). Attitude and practice scores improved similarly in both groups. At three-month follow-up, more than 94.9% of the gains were retained. All 970 households were reached, 97% of students completed the programme, and protocol fidelity was 94.6%.

Conclusions: Trained school students can function as effective, low-cost health communicators for VBD prevention in resource-limited rural settings. Larger controlled trials with longer follow-up and objective outcome measures are needed before wider adoption.

Addressing the increasing incidence of allergic diseases in young working individuals and their effective management with sublingual immunotherapy in Mumbai

2026-04-30T14:32:24+00:00

Background: Allergic diseases are on an increase in office workers and students, as a result of climate change and environmental exposure. Our objective here was to define the role of the skin prick test in identifying common inhalant allergens in allergic rhinitis patients and selecting the allergens for optimum sublingual immunotherapy.

Methods: 773 patients were tested in Mumbai from November 2018 to December 2023 by skin prick test. Sublingual Immunotherapy was initiated in 301 patients. Pre and post-therapy SNOT22 symptom score was noted for 3-6 months in a subset of 50 patients.

Results: It was found that 52% were in the age group 20-40 with almost equal male /female ratio, 95% primarily had allergic rhinitis, house dust mite allergy 84%, pollen allergies were the next most common, 63% each being Prosopis and Amaranthus. 40% opted for sublingual immunotherapy, from which a subset of 50 patients, 35 %, showed significant improvement verified by statistical analysis in the first 6 months.

Conclusions: It was found that 52% were in the age group 20-40 with almost equal male /female ratio, 95% primarily had allergic rhinitis, house dust mite allergy 84%, pollen allergies were the next most common, 63% each being Prosopis and Amaranthus. 40% opted for sublingual immunotherapy, from which a subset of 50 patients, 35%, showed significant improvement verified by statistical analysis in the first 6 months.

Prevalence of sleep disorders and their association with poor academic performance among medical students of Punjab, Pakistan: a cross-sectional study

2026-04-30T14:31:19+00:00

Background: Medical students face heavy workloads, overnight duties, and high stress, which can impair sleep and academic performance. Objectives were to assess the prevalence of sleep disorders among medical students in Punjab, Pakistan, and their association with academic performance.

Methods: From January to June 2025, MBBS students at ~16 medical colleges in Punjab were invited to complete the English SLEEP-50 questionnaire (pilot-tested on 30 students). Of ~500 invitees, 345 (69%) participated. Demographics, BMI, sleep patterns, and annual academic percentage were self-reported. Sleep duration was classified as short (<6 hours), normal (6-8 hours), or long (>8 hours). Academic performance was grouped as below average (50-69%), excellent (70-85%), or outstanding (>85%). Chi-square tests and binary logistic regression- adjusting for all the variables in the model- were used to identify factors independently associated with poor performance (<70%).

Results: Mean age was 21.85±3.1 years; 30% female; mean BMI 22.3±3.6 kg/m². Seventy-five percent screened positive for at least one sleep disorder: narcolepsy (62%), restless legs syndrome (29%), and insomnia (18%). Adjusted analysis showed obesity (OR=13.16; 95% CI 3.08-55.56; p<0.001), insomnia (OR=5.24; 95% CI 2.19-12.50; p<0.001), narcolepsy (OR=5.00; 95% CI 1.93-12.99; p=0.001), and male gender (OR=4.20; 95% CI 1.63-10.84; p=0.003) as significant factors.

Conclusions: Sleep disorders are common among Punjab’s medical students. Obesity, insomnia, narcolepsy, and male gender were independently associated with poor academic performance. Early screening and targeted interventions are needed to improve student well-being and achievement.

Physical activity profile of children, men and women from urban low middle income families

2026-04-30T14:32:24+00:00

Background: Globally there had been a progressive reduction in moderate physical activity. Despite intensive behavioural change interventions, physical inactivity remains a major public health problem in all countries.

Methods: A study was taken up in urban low-middle income families to obtain information on time spent and intensity of physical activity in different domains using 24-hour physical activity recall. Problems faced by persons trying to improve activity and their suggestions on how cope with existing constraints were ascertained.

Results: Children spent 7-8 hours in school; men spent 8-9 working and women spent over 6 hours in household chores. All the family members spent 12-14 hours in sedentary activities. Nearly 80% of women in 19-49 years of age, had adequate physical activity (600 or more MET min/week); over 80% of men and nearly 2/3^rd of the children was sedentary. Less than 20% of women and 10% of men beyond 50 years had adequate physical activity. Sedentary persons were unable to increase moderate physical activity by brisk walk because the roads were uneven, crowded and slippery. They did not have the space at home to undertake exercises.

Conclusions: There is an urgent need to find out feasible methods to increase moderate physical activity within the existing constraints, so that sustained improvement in moderate physical activity can be achieved.

Public awareness regarding antimicrobial resistance in a hilly area of Garhwal Uttarakhand: a cross-sectional community-based study

2026-04-30T14:32:23+00:00

Background: Rising resistance for antimicrobials is a significant health concern globally. India is one of the countries with high prevalence of infectious diseases and misuse of antibiotics associated with it, contributing to emergence of drug-resistant organisms. Awareness among people is therefore important to prevent antimicrobial resistance.

Methods: This cross sectional, community-based study assessed public awareness about antimicrobial resistance with 24 close ended questions scaled on three-point Likert scale as agree, disagree and not sure, divided in five parts including basic knowledge regarding antimicrobials, purchase of antimicrobials, duration of antimicrobial course, spread of antimicrobial resistance, and misuse of antimicrobials. Overall, 17 questions were positively scored as 0,1 and 2 for disagree, not sure and agree respectively, and reverse scoring was done for 7 questions. Data was analysed using SPSS v.27.

Results: Sixty three percent study participants have good awareness about antimicrobial resistance and awareness level is significantly associated with age group, education level of the participants, occupation and not with gender.

Conclusions: Findings reveal that even basic knowledge was poor among one fifth participants in study. Poor awareness about purchase, duration of course and spread of antimicrobial resistance, found in nearly half of study participants.

Visual acuity profile of school-going children: a descriptive cross-sectional study

2026-04-30T14:32:21+00:00

Background: Visual acuity is a critical component of a child’s visual function and is essential for learning and overall development. Unrecognized reduction in visual acuity during school years can adversely affect academic performance and quality of life. School-based vision screening offers an effective opportunity for early identification of reduced visual acuity, particularly in urban settings where visual demands are high. In this context, the present study aimed to assess the visual acuity status of school-going children aged 6-16 years and to document the eye-wise distribution of visual acuity categories in urban schools of Mysuru.

Methods: A cross-sectional study was conducted over one month among 422 children aged 6-16 years selected using probability proportionate to size sampling. Visual acuity was assessed using a standardized Snellen chart. Sociodemographic details and family history of spectacle use were recorded. Data were analyzed using descriptive statistics.

Results: Normal visual acuity (6/6) was observed in 81.5% of right eyes and 82.7% of left eyes. Reduced visual acuity of 6/12 or worse was observed in a smaller proportion, with higher frequencies noted among older age groups. Visual acuity of 6/18 or worse was more common in children aged 11-16 years. Gender-wise distributions of visual acuity were comparable between boys and girls.

Conclusions: A substantial proportion of school-going children exhibited reduced visual acuity detectable through routine screening. The findings highlight the importance of regular school-based visual acuity assessment to facilitate early identification and timely intervention for visual impairment.

Knowledge, attitudes and practices regarding maternal nutrition in pregnant women in an urban population: an observational cross-sectional study

2026-04-30T14:32:20+00:00

Background: Pregnancy entails profound physiological as well as psychological shifts that elevate nutritional requirements. Hence, optimal intake during pregnancy and lactation is essential to optimize maternal health and fetal development. There are various factors like mother’s nutritional reserves, dietary intake, and others that significantly influence maternal and perinatal outcomes. Therefore, assessing women’s awareness and behavior regarding nutrition becomes important. Knowledge, attitude and practice studies are useful tools in assessing the nutritional awareness of pregnant women as well as identifying gaps in understanding and guiding effective interventions accordingly.

Methods: A cross-sectional descriptive hospital-based study was carried from April to June 2025. This study consisted of a multiple-choice questionnaire testing the knowledge, attitude and practice of 585 pregnant females visiting the obstetrics department outpatient services at a tertiary care hospital in Mumbai.

Results: We considered factors like parity and education that may affect the knowledge, attitude and practice assessment of the nutrition in pregnant women. The participants demonstrated comparatively limited knowledge about nutrition during pregnancy (mean score: 4.42). However, their attitude showed a positive response (mean score: 4.356) and the practice score exceeded their knowledge score (mean score: 4.52).

Conclusions: In our study, we found some loopholes in the people’s knowledge, attitude and practices of nutrition in pregnancy which highlights lack of awareness and correct knowledge amongst the people about the same.

Prevalence of hypertension and its risk factors in a rural village of district Raigad in Maharashtra: a community-based cross-sectional study

2026-04-30T14:32:19+00:00

Background: Hypertension is a leading modifiable risk factor for cardiovascular morbidity and mortality globally. Rural areas of India are increasingly experiencing a rising burden due to epidemiological transition, lifestyle changes and population ageing. Reliable district-level data are essential to guide targeted public health interventions under national non-communicable disease control programs.

Methods: A community-based cross-sectional study was conducted from December 2022 to July 2023 among 302 adults aged ≥30 years in Poyanje and Poyanje-wadi villages, Raigad district, Maharashtra. Participants were selected by random household sampling. Blood pressure was measured using a validated digital sphygmomanometer and the average reading was recorded. Socio-demographic, anthropometric and lifestyle-related risk factors were assessed using a structured questionnaire. Bivariate analysis used the Chi-square test and multivariate logistic regression identified independent predictors of hypertension.

Results: The prevalence of hypertension was 29.8% (95% CI: 24.6–35.0). Among participants, 19.5% were newly diagnosed and 10.3% were known cases. Prevalence increased significantly with age (p=0.003). Independent predictors included age 45–59 years (AOR 2.25), age ≥60 years (AOR 7.11), very high waist circumference (AOR 3.16) and smoking (AOR 3.83).

Conclusions: Nearly one-third of adults in this rural population were hypertensive, with many newly diagnosed. Advancing age, central obesity, clustering of NCD risk factors and smoking were significant determinants. Strengthening community-based screening, early detection and lifestyle modification strategies should be prioritized.

Knowledge, attitudes and practices on climate change among study participants in India

2026-04-30T14:32:18+00:00

Background: Climate change is a global challenge with significant implications for ecosystems and health. Understanding the knowledge, attitudes, and practices (KAP) of communities is essential for designing effective mitigation and adaptation strategies. In India, where vulnerability to climate change is high, assessing public perception and response is particularly important.

Methods: A cross-sectional study was conducted among 159 participants from both rural and urban areas. Data were collected using a pre-tested, semi-structured questionnaire covering knowledge, attitudes, and practices related to climate change. Responses were analyzed using descriptive statistics, and results were expressed as frequencies and percentages.

Results: The study included 159 participants, predominantly aged 15-24 years (96.9%) and female (59.7%), with most residing in urban areas (81.1%). Over half (58.5%) had good knowledge of climate change, but only 36.1% demonstrated moderate practices. Major perceived causes included deforestation (87.4%) and vehicle emissions (83.6%). Most participants viewed climate change as a shared responsibility (69.2%) and believed it currently poses health risks (79.9%). Commonly perceived disease risks were respiratory infections (83.6%), allergies (81.8%), and skin cancers (81.1%). Overall, awareness was high, but practical engagement in climate change mitigation remained limited.

Conclusions: The study highlighted a high level of awareness and concern regarding climate change among participants, alongside positive attitudes toward mitigation. However, discrepancies between knowledge, attitudes, and practices were evident. Strengthening climate change education, promoting community-based initiatives, and enhancing institutional support are crucial to translating awareness into sustainable collective action.

HIV/AIDS prevention among high-risk group and bridge population: awareness, perception and practices in five states of India

2026-04-30T14:31:28+00:00

Background: India has one of the highest burdens of HIV in the world with heterosexual transmission accounting for the majority of HIV infections. Bridge population and high-risk group population are most vulnerable to infection and preventing transmission among these groups is the cornerstone to HIV/AIDS elimination.

Methods: A cross-sectional study was undertaken to assess the knowledge, perception and practices regarding HIV/AIDS and its prevention among female sex workers (high-risk group) and long-distance truckers and migrants (bridge population) in five states in India.

Results: A total of 366 individuals (98 female sex workers, 146 long distance truckers and 122 migrants) participated in the study. There was considerable misconception among study participants regarding HIV transmission, with 27.3% (95% CI 22.8%-31.9%), 30.6% (95% CI 25.9%-35.3%), 22.4% (95% CI 18.1%-26.7%) and 26.2% (95% CI 21.7%-30.7%) participants responding that HIV is transmitted through sharing meals, room, clothes and toilet facilities with an infected person, respectively. Consistent condom use was practiced by 67.3% (95% CI 58.1%-76.6%) female sex workers, 30.2% (95% CI 22.7%-37.6%) truckers and 30.3% (95% CI 22.2%-38.5%) migrants. Only 54.1% (95% CI 46.0%-62.2%) truckers were willing to get tested for HIV on a regular basis as opposed to 80.6% (95% CI 72.8%-88.4%) female sex workers and 70.5% (95% CI 62.4%-78.6%) migrants.

Conclusions: Our study highlights a need for awareness generation regarding HIV transmission among high-risk groups and bridge populations which is necessary to achieve targets of HIV/AIDS elimination in India.

A cross-sectional study on nutritional assessment of under-five children of brick kiln workers in a rural area of West Bengal

2026-04-30T14:31:27+00:00

Background: Undernutrition among under-five children remains a major public health concern in India, particularly among marginalized populations such as brick-kiln workers. These families often live in vulnerable conditions with poor access to healthcare, nutrition, and sanitation, placing children at high risk of underweight, stunting, and wasting. This study aimed to assess the nutritional status among under-five children of brick-kiln workers in a rural area of West Bengal and to identify factors associated with these conditions.

Methods: A community-based cross-sectional study was conducted among 220 under-five children residing in brick kilns of a rural block in West Bengal. Data were collected using a pretested structured questionnaire. Nutritional status was assessed following WHO guidelines. Multivariable logistic regression was used to identify factors associated with undernutrition.

Results: Among the 220 children studied, 35.6% were underweight 41.2% stunted, and 24.3% wasted. Severe acute malnutrition (SAM) as per MUAC was present in 5.6% of children. Significant factors associated with underweight included female gender (AOR = 1.9, 95% CI: 1.08-3.45) and lower maternal education (AOR = 1.65, 95% CI: 1.43-3.21). Stunting was significantly associated with increasing child age (AOR = 1.09, 95% CI: 1.06-1.13) and low maternal education (AOR = 2.1, 95% CI: 1.6-4.1).

Conclusions: The prevalence of undernutrition in children of brick-kiln workers was high. Female gender, low maternal education, age, and poverty were major determinants. Targeted, inclusive, and community-based interventions are urgently needed to address nutritional needs of this vulnerable population.

Maternal literacy and regional disparities as independent determinants of child malnutrition in India: an empirical analysis using NFHS-5

2026-04-30T14:31:26+00:00

Background: Child malnutrition remains a critical public health challenge in India. Despite modest improvements between NFHS-4 and NFHS-5, 35.5% of children under five are stunted, 19.3% wasted, and 32.1% underweight. This study aimed to analyze interstate differences in child malnutrition and examine the relationship between maternal education and nutritional outcomes using NFHS-5 data.

Methods: A cross-sectional, quantitative design was employed. State-level prevalence data from 28 Indian states and union territories were analyzed using one‑way ANOVA to test for regional variation in stunting, wasting, and underweight. Pearson’s correlation was used to assess the association between maternal years of schooling and mean Z‑scores for height‑for‑age, weight‑for‑height, and weight‑for‑age.

Results: ANOVA revealed significant regional variation for wasting (F=6.393, p=0.001) and underweight (F=8.525, p<0.001), while stunting variation was marginal (p=0.061). Maternal education showed a very strong positive correlation with height‑for‑age (r=0.95, p=0.003) and weight‑for‑age (r=0.93, p=0.006), and a strong correlation with weight‑for‑height (r=0.84, p=0.034). All correlations were statistically significant.

Conclusions: Both geographical region and maternal education are independent determinants of child malnutrition in India. Regional disparities, especially in wasting and underweight, call for location‑specific interventions. The strong, graded association between maternal education and improved nutritional outcomes underscores the need for continued investment in female education as a long‑term malnutrition reduction strategy.

Prevalence of gastroesophageal reflux disease and its associated factors among professional college students in North Kerala

2026-04-30T14:31:25+00:00

Background: Gastroesophageal reflux disease (GERD) is a condition wherein reflux of gastric contents produces troublesome symptoms and complications, significantly impacting quality of life. The objective is to determine the prevalence of gastroesophageal reflux disease and its associated factors among professional college students in North Kerala. To assess its symptom severity.

Methods: A cross-sectional study was conducted among 320 professional college students aged ≥18 years in North Kerala during a period of one year using stratified multistage random sampling. Data were collected through a semi-structured self-administered questionnaire. GERD was assessed using the validated Frequency Scale for the Symptoms of GERD, with a score >8 considered diagnostic. Data were analysed using SPSS. Appropriate statistical tests were applied; p< 0.05 was considered significant.

Results: The mean age was 20.85 ± 1.83 years with equal gender distribution. The prevalence of GERD was 38% (121), higher among medical students (24.6%) than engineering students (13.4%). Mild, moderate, and severe symptoms were observed in 20.4%, 13.1%, and 4.4% respectively. Significant association were found between GERD and medical stream, hostel stay, co-morbidities, family history, stress, regular medication and analgesic use, unhealthy dietary habits life frequent hotel meals and aerated drinks. Physical activity showed a protective effect.

Conclusions: GERD prevalence was 38% among professional college students, particularly higher among medical students. Lifestyle factors, stress, and certain medical conditions were significantly associated, while physical activity was protective. Promoting healthy diet, regular exercise, and stress management may reduce risk.

Prevalence of visual impairment among school children in Burla, Odisha: a cross-sectional study

2026-04-30T14:31:21+00:00

Background: According to WHO, approximately 19 million children and adolescents 5-15 years of age suffer from visual impairment. Priority should be given to effective methods of vision screening in children and correction as early as possible.

Methods: The study was conducted as a cross-sectional study among 340 school students in Burla, in the age group of 10–15 years. A child with a presenting maximum vision ≤6/12 Snellen equivalent in the better eye is considered visually impaired. Details of near work and outdoor activities were collected from their parents by administering a pretested questionnaire. Data was analyzed using EPI Info software version 7.

Results: The overall prevalence of visual impairment (vision ≤6/12) among the study participants was 11.8% (95% confidence interval = 8.8% to 15.6%). Participants who spend more hours reading/writing and on a digital screen have a higher prevalence.

Conclusions: The study highlights the high prevalence of undetected visual impairment in school children and the importance of early detection, treatment, and compliance with using corrective spectacles, which halts the further progression of low vision.

Effect of topical magnesium sulphate dressing on thrombophlebitis among patients with intravenous cannulation: a quasi-experimental study

2026-04-30T14:31:20+00:00

Background: Thrombophlebitis is a common complication of intravenous (IV) cannulation, characterized by pain, redness, swelling, induration, and warmth along the vein. It increases patient discomfort, prolongs hospital stay, and may lead to serious complications if untreated. Topical magnesium sulphate has anti-inflammatory and osmotic properties that may help reduce local inflammation. This study aimed to evaluate the effectiveness of topical magnesium sulphate dressing on thrombophlebitis among hospitalized patients.

Methods: A quasi-experimental one group pretest–posttest design was adopted in a tertiary care hospital. Patients diagnosed with thrombophlebitis were recruited using purposive sampling and divided equally into experimental and control groups. A structured thrombophlebitis assessment scale was used to measure severity (pain, redness, swelling, induration, warmth). The experimental group received topical magnesium sulphate dressing, while the control group received routine hospital care. Data were analyzed using descriptive and inferential statistics including paired and unpaired tests and chi-square test.

Results: The experimental group demonstrated a statistically significant reduction in mean thrombophlebitis scores after intervention compared to pretest scores (p<0.05). Posttest comparison between groups showed a significant difference favoring the experimental group. Selected demographic variables showed significant association with severity.

Conclusions: Topical magnesium sulphate dressing was effective in reducing thrombophlebitis severity. It can be recommended as a simple, cost-effective nursing intervention in clinical settings.

Empowering street food vendors on nutrition and healthy cooking practices in Urban Bengaluru: a mixed-methods evaluation of a community-based intervention

2026-04-30T14:31:13+00:00

Background: Street food vendors are central to India’s urban food environment, providing affordable meals to millions. However, limited nutrition awareness and unsafe cooking practices among vendors contribute to poor dietary quality and increased risk of non-communicable diseases (NCDs). This study assessed the effectiveness of a structured nutrition and healthy cooking training program among street food vendors in Bengaluru, India.

Methods: A structured training program focusing on oil reuse, salt reduction and alternatives, balanced nutrition and NCD prevention was delivered through interactive, local-language sessions using pictorial tools and practical demonstrations. A community-based, mixed-methods study was conducted among 500 vendors across seven urban locations in Bengaluru. A sequential explanatory design combined quantitative pre- and post-intervention surveys with qualitative focus group discussions (FGDs) and field observations to assess knowledge gain, retention and practice adoption.

Results: The awareness of recommended daily salt intake (≤5 g/day) increased by 37% and knowledge of recommended oil intake (3–4 teaspoons/day) improved by 40%, post-intervention, Awareness of health risks associated with repeated oil reuse increased by 16–17%. Knowledge of healthier ingredient choices improved, with a 32% increase in recognition of wheat flour as a healthier alternative to refined flour. Approximately 80–85% of participants retained core training messages related to oil use, salt reduction and healthy cooking practices.

Conclusions: The training effectively improved nutrition knowledge and awareness among street food vendors. However, sustained behavior change will require periodic refresher trainings, economic and structural support and visible recognition mechanisms to reinforce healthy practices.

Perceived stress among undergraduate medical students: are academic factors responsible?

2026-04-30T14:31:12+00:00

Background: Stress is body’s response to physical, mental or emotional pressure. Stress is an inevitable part of our fast‑paced life. Stress has been identified as an important indicator of the overall health. If we talk about students, generally, stressors are derived from academia load, classroom environment, faculty interaction, illness, and emotional concerns outside of the classroom. This might affect their academic performance, health and also make them consider suicide. Hence in order to raise concern, this is our small attempt towards our college students to assess their stress level and to deal further accordingly.

Methods: A cross-sectional study conducted in a medical college at Muzaffarpur, Bihar. Methods like Simple random sampling and systematic random sampling used for sampling purpose and sample size was calculated using formulae n=Z²PQ/D².

Results: The present study finding suggested prevalence of mild stress among 11 (2.6%) moderate stress in 50 (12%) and severe stress in 356 (85.4%). Academic burden was found to be a reason.

Conclusions: Health education activities to be conducted among undergraduates on how to cope with the stress related to academics. Activities (like yoga) should be conducted to encourage students on releasing stress.

Coverage gaps in child health screening under Rashtriya Bal Swasthya Karyakram: a Tanahashi framework analysis using national and state-level data from India

2026-04-30T14:31:12+00:00

Background: Childhood conditions, including congenital anomalies and developmental delays, are significant contributors to morbidity in India. To address these challenges, the Rashtriya Bal Swasthya Karyakram (RBSK) was initiated under the national health mission for the early detection and management of health issues through widespread screenings of children aged 0 to 18 years. However, limited evidence exists regarding the program's overall effectiveness. This study aims to assess coverage gaps in the implementation of RBSK using the Tanahashi model and to evaluate key program indicators at both national and state levels.

Methods: We conducted a secondary data analysis based on reports from the ministry of health and family welfare, the national health mission, and parliamentary records. Program indicators were mapped according to the Tanahashi coverage stages: availability, accessibility, contact coverage, detection, and care, with a particular focus on Andhra Pradesh.

Results: Between 2014 and 2024, approximately 160.84 crore screenings were performed under RBSK, achieving coverage of nearly 60% of the target population. The detection rate stood at 7.4%, revealing that 11.90 crore children were identified with health issues; however, only 5.64 crore (47.4%) received further care, indicating a significant treatment gap. Furthermore, there were 430 district early intervention centres (DEICs) across approximately 53.75% of districts. In Andhra Pradesh, while screening trends were observed, data regarding referrals and treatments were insufficient.

Conclusions: Although RBSK has realized considerable screening coverage, substantial gaps persist in service availability and effective care delivery. It is essential to strengthen referral pathways and enhance diagnostic and treatment capacities to ensure that children identified through screenings receive timely and appropriate care.

Trends in self-reported diabetes prevalence and management: insights from NFHS-4 to NFHS-5

2026-04-30T14:31:10+00:00

Background: Diabetes mellitus is a rapidly increasing non-communicable disease in India, driven by demographic and epidemiological transitions. Understanding changes in prevalence and treatment-seeking behaviour across population is crucial for successful public health planning. This study aimed to assess trends in self-reported diabetes prevalence and treatment-seeking behaviour among men and women in India and to examine socio-demographic variations using data from NFHS-4 (2015-16) and NFHS-5 (2019-21).

Methods: This study utilized nationally representative data from NFHS-4 and NFHS-5. The analysis included men aged 15-54 years and women aged 15-49 years. Outcome variables were self-reported diabetes and treatment-seeking behaviour. Sociodemographic characteristics included age, gender, education, marital status, religion, caste/tribe, and wealth index. Descriptive comparative analysis was performed to identify trends across the surveys.

Results: The prevalence of self-reported diabetes increased from 1.7% to 2.1% among men and from 1.7% to 1.9% among women between NFHS-4 and NFHS-5. Treatment-seeking behaviour showed a slight decline. Higher prevalence was consistently associated with increasing age, urban residence, and higher wealth status. Individuals aged 35-49 years exhibited the highest burden. Socioeconomic gradients were evident, with wealthier groups showing higher prevalence and better treatment uptake. Women demonstrated higher treatment-seeking behaviour than men across most categories. However, disparities persisted among lower socioeconomic and marginalized groups, particularly in treatment access.

Conclusions: Diabetes prevalence in India has increased over time, with notable socio-demographic inequalities in both disease burden and treatment-seeking behaviour. Strengthening early screening, improving awareness, and ensuring equitable access to diabetes care especially among disadvantaged populations are critical to addressing the growing burden.

Knowledge, attitude and practice among first year MBBS and nursing/paramedical students of GMC Anantnag regarding tetanus vaccination: a cross-sectional study

2026-04-30T14:31:08+00:00

Background: Tetanus is a life-threatening, yet vaccine-preventable disease that continues to contribute in morbidity and mortality, especially in low- and middle-income countries. Despite the availability of an effective vaccine, and inclusion of booster doses at 10 and 16 years under the UIP, gaps in awareness and vaccination practices persist. Objective of the study was to assess the knowledge, attitude and practice (KAP) regarding tetanus vaccination among first-year MBBS and nursing/paramedical students of Government Medical College (GMC), Anantnag.

Methods: A cross-sectional analytical study was conducted among 235 first-year MBBS and nursing/paramedical students at GMC Anantnag from June to July 2025. Data was collected using a structured, self-administered questionnaire assessing KAP related to tetanus vaccination. Data was analyzed using descriptive and inferential statistics.

Results: The overall mean KAP score was 47.7%, with knowledge (42.5%) and practice (43.0%) scores being suboptimal despite a relatively higher attitude score (63.0%). Female participants demonstrated marginally higher knowledge and attitude scores, whereas males had significantly higher practice scores (p=0.02). No significant gender difference was observed in overall KAP scores.

Conclusions: The study revealed inadequate knowledge and practices regarding tetanus vaccination with slightly better attitude scores among first-year students. Strengthening school-based and adolescent health programs, along with routine verification of immunization status during primary care visits, can help improve booster coverage and prevent gaps in protection against tetanus.

Assessment of emotional intelligence among medical students in Hyderabad: a cross-sectional study

2026-04-30T14:31:07+00:00

Background: Emotional intelligence (EI) refers to the ability to recognize, understand, manage, and use emotions effectively in oneself and others. In the context of medical education, EI is increasingly recognized as a core competency alongside clinical knowledge and technical skills. It is integral to the formation of compassionate, adaptable, and competent healthcare professionals. In this framework, EI is conceptualized not solely as a personality attribute but as a modifiable and teachable construct that facilitates the acquisition of core competencies such as professionalism, effective interpersonal communication, and patient-centred care.

Methods: A cross-sectional study was conducted for a period of one month among 301 undergraduate medical students at ESIC Medical College and Hospital using a semi structured validated questionnaire containing socio-demographic details and questions on EI test. The questionnaire was administered to the students through Google form. The questionnaire consists of two parts: sociodemographic details and the Schutte self-report EI test (SSEIT). Data was entered in Microsoft excel. Descriptive statistics and Inferential statistics were applied using SPSS version 21. P<0.05 was considered statistically significant.

Results The mean age of the participants was 20.10±1.70. Out of 301 medical students participated in the research, 123 (40.9%) were males and 178 were females (59.10%). The 52.2% of participants had good EI score, 46.2% had average EI score, 1.6% had poor EI.

Conclusions: Strengthening EI among medical students is not merely an added advantage but a fundamental necessity for effective medical practice and improved patient outcomes.

A rare adverse effect of aripiprazole: hiccups and dose-dependent tolerance

2026-04-25T01:22:05+00:00

Hiccups result from sudden, irregular contraction of the diaphragm and intercostal muscles, leading to immediate closure of the larynx. Aripiprazole, a third-generation antipsychotic, functions as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors while antagonizing serotonin 5-HT2A receptors. Hiccup is a rarely reported side effect of aripiprazole. Research indicates that neurotransmitters, especially dopamine, serotonin, and GABAergic transmission are likely central to hiccup development, though specific mechanisms remain unclear. Here we present a 52-year-old male patient with a long-standing psychosis, who developed hiccups after initiation of aripiprazole. A 52-year-old male patient with a long-standing psychotic disorder, characterized by delusions of misidentification, social withdrawal, and impaired self-care. Shortly after initiation of aripiprazole, the patient developed persistent hiccups that continued overnight, prompting hospitalization. Symptomatic treatment with chlorpromazine and metoclopramide resulted in the resolution of hiccups. Aripiprazole was discontinued, and brexpiprazole was initiated. Despite its pharmacological similarity to aripiprazole, brexpiprazole was well tolerated and did not induce hiccups. Interestingly, hiccups did not recur after we re-challenged with aripiprazole starting from ultra-low doses and titrated slowly. With this case report, we concluded that aripiprazole may induce hiccups, particularly during treatment initiation. This effect may be related to its dopaminergic agonism at D2 receptors at low doses, while brexpiprazole’s lower agonistic activity at D2 receptors may explain the absence of hiccups. Our case suggests that when aripiprazole is initiated at ultra-low doses and titrated slowly, hiccups may not recur, and discontinuation or switching to an alternative antipsychotic may not be necessary.

A case report on Aspergillus fumigatus causing pulmonary aspergillosis in an immunocompromised patient presenting as chronic obstructive pulmonary disease and pulmonary tuberculosis

2026-04-30T14:33:30+00:00

Pulmonary aspergillosis (PA) is a complicated fungal infection caused by aspergillus species, predominantly affecting immunocompromised individuals. This case highlights the diagnostic complexities as it often mimics other respiratory diseases like tuberculosis (TB) and chronic obstructive pulmonary disease (COPD) and in a patient with advanced HIV. Case presentation: A 48-year-old male with HIV (on third-line antiretroviral therapy, CD4 count 150 cells/μL) presented with a one-week history of cough, wheezing, shortness of breath, and fatigue. Initial management for COPD and bacterial infection provided minimal relief. Extensive diagnostic workup, revealed elevated Aspergillus-specific IgG antibodies (122 U/ml) and IgE levels (67.60 KUA/l). High-resolution computed tomography (HRCT) of the chest revealed bilateral bronchiectasis, suggestive of fungal infection, confirming PA. Conclusion: This case underscores the importance of considering opportunistic fungal infections like PA in immunocompromised patients with non-resolving respiratory symptoms, even when classic radiological signs are absent or overlap with other pulmonary conditions.

A case of Guillain-Barré syndrome in a 24-year-old man

2026-04-30T14:32:30+00:00

Guillain-Barré syndrome (GBS) is an acute, immune-mediated neurological disorder that affects approximately 1.2 to 2.3 individuals per 100,000 population annually, with notable regional and seasonal variations. In recent years, an increase in reported cases in certain regions of India has highlighted its emerging public health significance. GBS is characterized by rapid onset of muscle weakness and can progress to severe paralysis if not promptly managed. Early diagnosis and timely therapeutic interventions, such as immunotherapy and supportive care, are essential to improve patient outcomes and reduce the risk of long-term disability. This case report describes a 24-year-old male diagnosed with severe motor axonal polyneuropathy, a variant of GBS associated with more aggressive progression. Following a thorough clinical evaluation and diagnostic investigations, the patient was initiated on plasmapheresis. Currently, his condition is stable, with no further neurological deterioration, indicating a positive response to treatment and ongoing medical management.

Hutchinson–Gilford progeria syndrome in a 2-year-11-month-old female child: a clinico-genetic case report from Assam, India

2026-04-30T14:32:25+00:00

Hutchinson–Gilford Progeria Syndrome (HGPS) is a rare genetic disorder characterized by premature aging beginning in early infancy. It is caused by de novo pathogenic variants in the LMNA gene. We report a case of a 2-year-11-month-old female child from Nagaon district of Assam who presented with failure to thrive and progressive craniofacial and somatic changes. Clinical features were classical for Progeria, with preserved cognitive and social development. Whole Exome Sequencing confirmed a pathogenic heterozygous variant in exon 11 of the LMNA gene, consistent with Hutchinson–Gilford Progeria Syndrome. This report highlights early clinical recognition, genetic confirmation, and the psychosocial impact on caregivers, emphasizing the role of counseling and multidisciplinary care.

Ambition versus reality: will the 2026-2027 union budget transform India's health care?

2026-04-30T14:31:09+00:00

I am examining the Union Budget for 2026-27, which has gained attention for its significant fiscal commitments to improve India’s healthcare system. While the budget allocations are promising, the crucial question remains whether they will lead to real improvements in accessibility, service quality, and affordability for citizens. The budget allocated ₹1,06,530.42 crore to the Ministry of Health and Family Welfare, marking a 10% increase from the revised estimates of 2025-26. Over the past 12 years, health expenditures have risen by over 194%, reflecting a strong commitment to enhancing healthcare infrastructure and expanding public health services.

Program and policy evaluations of oral health initiatives: a scoping review protocol

2026-04-30T14:31:24+00:00

Background: Oral health has historically received limited policy attention, and India’s National Oral Health Programme (NOHP) has not undergone a formal evaluation. This scoping review aims to systematically map global evidence on program and policy evaluations of oral health initiatives to inform future evaluation strategies, adoption of best practice approaches, and policy development in India.

Methods: This review will follow the Joanna Briggs Institute (JBI) 2020 methodology and PRISMA-ScR (Preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews) guidelines. A comprehensive search will be conducted in Scopus, Embase (via Ovid), and PubMed, supplemented by hand-searching and citation tracking. Screening will follow a two-step process based on the Population-Concept-Context (PCC) framework. Two independent reviewers will conduct screening, with discrepancies resolved through discussion or consultation with a third reviewer. Data will be extracted into a structured Excel sheet, with quantitative data summarized descriptively and qualitative data synthesized narratively. The review will identify and map and summarise the existing evaluation frameworks, methodologies, outcome measures, strengths, and gaps in oral health program and policy evaluations globally. It will also highlight best practice strategies that could be adapted for India’s NOHP.

Conclusions: Findings will guide policymakers and program planners in developing robust evaluation strategies, adopting global best practices, and integrating oral health into broader health systems, ultimately improving population-level oral health outcomes and reducing inequalities.

Deciphering spinal muscular atrophy through pedigree and molecular genetic analysis

2026-04-30T14:31:25+00:00

Spinal muscular atrophy (SMA) is a severe autosomal recessive neuromuscular disorder characterized by degeneration of anterior horn cells of the spinal cord, leading to progressive muscle weakness and atrophy. It is primarily caused by mutation or deletion in the survival motor neuron-1 gene SMN1 gene on chromosome 5q13.2, resulting in reduced levels of SMN protein, while the SMN2 gene provides only partial compensation. The present study investigated the inheritance pattern and molecular characteristics of SMA in ten clinically diagnosed cases. Clinical histories were collected through patient, family and physician interactions and pedigree charts were constructed to assess inheritance patterns. Molecular diagnosis was performed using genomic DNA analysis, multiplex ligation-dependent probe amplification (MLPA), automated DNA sequencing and multiplex PCR to detect SMN1 gene deletions. The findings revealed that most patients exhibited deletions in exon regions of the SMN1 gene, with six cases showing homozygous deletion of exon 7, two cases showing deletion of both exons 7 and 8 and two cases showing homozygous deletion of exon 7 along with heterozygous deletion of exon 8. Additionally, two patients demonstrated overlapping clinical features of SMA and Duchenne muscular dystrophy (DMD). Pedigree analysis confirmed an autosomal recessive inheritance pattern, with affected individuals born to phenotypically normal carrier parents. The study highlights that homozygous deletion of exon 7 of the SMN1 gene is the most common molecular cause of SMA and emphasizes the importance of molecular genetic testing for accurate diagnosis, carrier detection, prenatal screening and effective genetic counseling.

Holding on through crisis: mothers’ experiences in the neonatal intensive care unit

2026-04-30T14:32:20+00:00

Motherhood is often seen as a transformative and fulfilling journey; however, this experience is profoundly disrupted when infants are admitted to a neonatal intensive care unit (NICU), leading to fear, uncertainty, and emotional distress. The sudden physical separation, exposure to complex medical care, and disruption of expected caregiving roles challenge mothers’ emotional well-being, coping mechanisms, and developing maternal identity. This study explored the lived experiences of mothers with infants in the NICU, focusing on the meanings they attach to these experiences. Eight mothers with infants admitted to a government hospital’s NICU in Southwestern Mindanao shared their experiences. Findings revealed four interconnected themes. First, mothers experienced embodied struggle and transformative resilience, marked by physical exhaustion and emotional strain while gradually developing coping strategies. Second, they navigated issues of safety, control, and emotional security within the NICU environment. Third, supportive relationships and guidance from healthcare providers and family members emerged as essential in helping mothers understand and manage their situation. Finally, relational support served as a lifeline that sustained mothers throughout the hospitalization period. The study concludes that although NICU experiences are highly challenging, they also foster resilience, self-growth, and adaptive coping among mothers. A structured and supportive environment, along with strong relational connections, plays a crucial role in promoting maternal well-being and caregiving capacity. These findings highlight the importance of family-centered care, consistent emotional support, and responsive communication in improving maternal experiences during neonatal hospitalization.

Developing and validating the coping intervention program on burden and wellbeing of family members of chronic mentally ill patients

2026-04-30T14:32:17+00:00

Suffering psychological distress and shouldering burdens while caring for a mentally ill relative affects not only the caregiver’s quality of life and health, but due to the increasing demands and responsibilities, there is an increasing concern about their ability to manage or cope up. Coping Intervention Program was formulated for family members who are giving care to the mentally ill people, after the thorough literature review, feedback from mental health expert and caregivers (during validation process), and a pilot study (for feasibility and preliminary effectiveness). Throughout, the focus was on simplicity, feasibility, and applicability across single settings (inpatient) and modalities (face-to-face/direct intervention). After much review Coping Intervention program took about 6 months to develop. The primary caregivers assessed the clarity, comprehension, and usefulness of the intervention. The final components included introductory interaction, audio-visual content, booklet, and clarification session. Lived problem solving session was used and educational session on effective coping strategies was adopted through audio visual content, psychoeducational approaches through booklet and audio-visual content, and practice sessions on mindfulness-based therapy and progressive muscle relaxation therapy through audio instructions. Pilot testing of Coping Intervention program suggested its feasibility in administration. Coping Intervention program was developed and validated through an interactive process, keeping cultural contextuality in mind. The investigators were planning to test its efficacy in a robustly designed study.

Utilization of primary healthcare services in Nasarawa state, Nigeria: addressing structural and sociocultural barriers

2026-04-30T14:33:35+00:00

Primary healthcare (PHC) forms the backbone of Nigeria’s health system, particularly in rural states like Nasarawa. Despite increased policy focus and infrastructure development, utilization of PHC services remains low, contributing to persistent maternal and child health challenges. Barriers such as cultural norms, inadequate manpower, and weak infrastructure continue to undermine effective service uptake. This study employed a narrative review methodology to synthesize over 30 peer-reviewed publications, national health reports, and global policy documents from 2019 to 2024. The Andersen Behavioural Model of Health Services use was applied as a conceptual framework to categorize factors influencing PHC utilization into predisposing, enabling, and need-based components. Findings reveal that cultural beliefs, gender dynamics, poor health literacy, poverty and limited community engagement significantly hinder service utilization, even when facilities are geographically accessible. Structural issues, including the chronic shortage of healthcare workers, drug stock-outs, and poor facility infrastructure, further limit PHC effectiveness. Only 30-45% of residents in Nasarawa utilize PHC services regularly. While policy reforms such as the Basic Health Care Provision Fund (BHCPF) have yielded some gains, implementation bottlenecks, underfunding, and weak accountability mechanisms persist. Improving PHC utilization in Nasarawa State requires an integrated, equity-focused approach that goes beyond infrastructure provision. Addressing both demand- and supply-side barriers is essential to enhance service uptake and public trust. Key policy recommendations include increased domestic health funding, targeted recruitment and retention of PHC staff, culturally adapted health education campaigns, and strengthened community participation in health governance. Operationalizing these interventions within a behavioural framework offers a path toward achieving universal health coverage and improving population health outcomes in underserved regions of Nigeria.

Nanotechnology in dentistry: mechanisms, clinical applications and translational status

2026-04-30T14:31:07+00:00

Nanomaterials in dentistry comprise a diverse group of material platforms rather than a single therapeutic category. This structured narrative review examined the principal nanomaterial classes used in dentistry, including calcium phosphate and nano-hydroxyapatite systems, bioactive glass and ion-releasing nanoparticles, metallic nanoparticles, metal-oxide nanoparticles, polymeric nanoparticles and nanogels, carbon-based nanomaterials, and hybrid multifunctional systems. A literature search of PubMed, Scopus, and Web of Science, and evidence was analyzed comparatively according to material class, mechanism of action, dental indications, and current evidence maturity across preventive-pediatric, prosthodontic, orthodontic, endodontic, periodontal, and implant-related applications. Overall, the findings suggest that nanomaterials used in dentistry do not represent a single level of clinical maturity. Mineral-based systems, particularly calcium phosphate and nano-hydroxyapatite, show the strongest clinically anchored evidence, especially for caries prevention in selected settings and dentin hypersensitivity relief, whereas evidence for white spot lesion improvement remains less robust and often short-term. By contrast, many antimicrobial, multifunctional, and implant-related nanomaterials remain supported mainly by laboratory or early translational data, with performance that is highly dependent on formulation, durability, and the balance between function and material stability. Future progress will depend on comparative studies that assess performance, durability, and long-term patient-relevant outcomes.

Traditional wisdom, modern solutions: millets as medicine for India’s tribal communities

2026-04-30T14:33:33+00:00

Millets, which are small-grained crops, are deeply rooted in Indian agriculture and food systems since ancient times. Despite their numerous health benefits, these nutritious grains have faced a significant downfall in agricultural land coverage in recent years and have been overshadowed by the popularity of crops like wheat and rice, especially after India’s Green Revolution. Interestingly, for many tribal communities across the country, millets remain not only a regular dietary item but also a symbol of their cultural identity and traditions. Tribes constitute approximately 8.6% of India's population and contribute significantly to the nation's ethnic/cultural diversity. As per UNICEF data, over 40% of under-five year tribal children are experiencing stunted growth and 16% of them are profoundly stunted owing to undernutrition. Millets, often termed 'Nutri-cereals' due to their superior nutritional profile, can be an important staple food for addressing nutritional deficiencies prevailing among tribal communities. In this review, we have compiled a comprehensive literature on the dietary benefits of millets, their pharmacological properties and their integration in tribal culture, and livelihood. Additionally, we have covered the significance of millets in the sustainable development of agriculture and the circular economy of farmers.

Bridging Ayurveda and biochemistry: a scoping review of Agni and metabolism

2026-04-30T14:31:29+00:00

Agni is described in Ayurveda as the fundamental principle governing digestion, metabolism, tissue transformation, and vitality. Thirteen types of Agni: Jatharagni, seven Dhatvagni, and five Bhutagni are considered essential for physiological balance. However, their mechanisms remain largely conceptual, with limited systematic correlation to contemporary metabolic science, restricting broader scientific interpretation. A scoping review was conducted following Arksey and O’Malley framework and PRISMA-ScR guidelines. A structured search was performed across PubMed, Web of Science, Google Scholar, DHARA, Ayush Research Portal, and ARD. Studies published between January 2010 and December 2024 were screened. Twenty-four eligible research studies were included for final analysis. Data extraction was performed using JBI SUMARI tool. The included studies demonstrated functional parallels between Jatharagni and digestive enzyme activity, gastric secretions, and enteric regulation. Dhatvagni showed correlation with tissue-level metabolic processes, endocrine modulation, and cellular respiration parameters including thyroid function, lipid profile, glucose metabolism, and mitochondrial activity. Bhutagni was interpreted in relation to hepatic biotransformation, cytochrome P450 pathways, detoxification processes, and immune-metabolic responses. However, objective quantification tools for Agni assessment remain insufficient. The review identifies emerging integrative interpretations between Ayurvedic Agni and modern metabolic science. While conceptual correlations are evident, further structured clinical and molecular research is required for measurable validation.

India’s healthcare paradox: would the domestic doctor shortage result in failure of journey towards universal health coverage?

2026-04-30T14:31:26+00:00

Doctor vacancies in rural India, particularly in Primary and Community Health Centres (PHCs & CHCs), represent a critical challenge to the healthcare system and threaten progress toward the Sustainable Development Goals (SDGs), especially SDG 3 (Good Health and Well-being) and SDG 8 (Decent Work and Economic Growth). These centres form the backbone of rural healthcare, serving nearly 64 percent of India’s population. However, persistent shortages of medical personnel undermine access to quality care in rural areas. As per 2023, rural CHCs face a shortfall of over 17,551 specialists, including 4,499 physicians. These gaps limit comprehensive service delivery, particularly in emergency care, maternal health, and the management of non-communicable diseases. Contributing factors include underfunding, inadequate infrastructure, poor working conditions, and difficult recruiting and retaining of doctors. This study examines how doctor shortages in rural centres threaten India’s progress toward Universal Health Coverage (UHC) and related SDG targets. Using recent workforce data and policy analysis, it explores the scale of vacancies, their impact on healthcare delivery and workforce conditions, and broader economic and equity implications. Inadequate staffing undermines UHC, increases morbidity and mortality among vulnerable populations, and exacerbates rural–urban health disparities, directly impeding SDG 3. From an SDG 8 perspective, these shortages reflect unstable employment and missed decent work opportunities in public health sector, constraining economic productivity. Addressing these vacancies through comprehensive workforce reforms, improved working conditions, and sustained incentives along with proper implementation is essential for strengthening rural healthcare, advancing health equity, and supporting India’s broader health and development goals.

The role of nurses in advancing organ donation: a review paper

2026-04-30T14:31:11+00:00

Organ transplantation is an effective treatment for patients suffering from end-stage organ failure caused by diseases, accidents, or congenital conditions. However, the success of transplantation largely depends on the availability of donated organs. Despite medical advancements and improved survival rates after transplantation, the demand for organs continues to exceed supply. In India, the organ donation rate remains extremely low compared to many developed countries, resulting in a large number of preventable deaths each year. Limited awareness, cultural beliefs, and misconceptions about organ donation contribute to this shortage. Healthcare professionals, particularly nurses, play a crucial role in promoting organ pledging and increasing organ donation. Through patient and family education, identification of potential donors, counselling, and coordination of the donation process, nurses can significantly influence decisions regarding organ donation. Literature also suggests that training and awareness programs for healthcare workers can improve knowledge, attitudes, and participation in organ donation activities, thereby helping to bridge the gap between organ demand and availability.

Role of artificial intelligence in health sector: review of literature

2026-04-30T14:31:10+00:00

Artificial Intelligence will play a significant role in various health sectors in near future. AI technologies like machine learning, deep learning, natural language processing and robotics help to analyse large and complex datasets. This analysis leads to early disease detection, personalised treatment and predictive risk assessment. AI supports public health efforts by predicting outbreak, monitoring health parameters and allocating resources. Despite its benefits and challenges, integrating AI into healthcare system remains crucial. This paper explores Evolution of AI in healthcare, the technologies involved, its benefits, challenges and ethical considerations and future prospects.

Artificial intelligence in rural healthcare in India: applications, challenges and a strategic implementation framework

2026-04-30T14:31:06+00:00

India’s healthcare system is marked by a paradox wherein innovative medicine technologies exist alongside significant accessibility issues in rural areas where the majority (more than 66%) of its citizens live. As much as 80% of specialist positions at community and primary health centres in rural India are vacant, contributing to diagnostic inefficiencies and placing an emphasis on chronic disease prevalence. The purpose of this paper is to examine the role of artificial intelligence (AI) in enhancing healthcare services in rural India based on literature reviews from 2015 to 2025. The integration of machine learning algorithms and computer vision has enormous potential to bypass geographical and personnel limitations. Potential use cases involve tele-radiology services powered by AI for detecting tuberculosis and stroke, edge AI technologies that can perform offline diagnostics, decision support systems in telemedicine, and epidemic predictions. However, widespread adoption faces multiple socio-digital and structural challenges, including the lack of independent studies performed in rural settings, insufficient basic infrastructure (e.g., power supply and internet connectivity), and the potential of creating biased algorithms when training is primarily performed using historical data unrelated to local conditions. For optimal utilization of AI, a phased approach focusing on augmenting the intelligence of medical professionals is crucial. The government should concentrate on developing digital public infrastructure, engaging public-private partnerships, and creating context-specific, offline-ready solutions.