International Journal Of Community Medicine And Public Health

Over-Reliance on frontline health workers in India

2026-10-01T01:35:04+00:00

The roles of the frontline health workers (auxiliary nurse midwives (ANMs) and Accredited Social Health Activists (ASHAs)) in Indian public health system has been invaluable. Originally aimed at delivering the maternal and child health services, their roles have been changing with the changing public health needs of the country. They primarily provide preventive, promotive and some administrative roles encompassing various health programs including communicable and non-communicable diseases. The health workers also document their activities and outcomes in both the register-based and mobile application-based formats. These reports are critical in monitoring and evaluating the programs and as a support to a careful decision making. However, the capacity of these health workers’ in balancing their abilities and workload is unfortunately one of the most often ignored aspect within the primary health care delivery. Additionally, their challenges are worsened with inadequate services of the essential training and supervision programs that are required for strengthening of skills and adequate execution of duties and responsibilities. Thus, to enhance efficient public health delivery, India must consider additional human resource allocation and task shifting options at the earliest.

Comparison of HPV vaccination strategies for pilot implementation in North India

2026-10-01T01:41:11+00:00

Cervical cancer remains a leading cause of cancer mortality among women in India. India’s 2024 interim budget prioritization of HPV vaccination for girls aged 9-14 years provided a pivotal opportunity for state-led pilots to inform national policy. This paper compares three vaccination strategies (Single-dose Gardasil; Two-dose Cervavac; and Single-dose Cervavac) within the planning for a school-based HPV vaccination pilot targeting 6,300 girls in North India. A comparative analysis of programmatic feasibility, estimated financial cost, and scientific evidence was undertaken. Strategy 1 (single-dose Gardasil) and Strategy 2 (two-dose Cervavac) had comparable financial outlays (~23 million INR), but Strategy 2 imposes a 64% higher human resource burden (2,120 vs. 1,288 man-hours). While Strategy 1 is supported by the strongest longitudinal efficacy data, Strategy 2 aligns with the national interest of indigenous vaccine with minimal cost per dose. We recommend an approach that leverages single-dose Gardasil vaccination until further trial data on single-dose Cervavac is available, to optimize the coverage and improve programmatic efficiency.

Treatment-resistant depression management in postpartum depression – a case report and literature review

2026-10-01T01:38:29+00:00

Postpartum depression (PPD) affects approximately 10-15% of women and can cause significant morbidity for mothers, infants, and families. When postpartum depression fails to respond to two adequate trials, it is called as treatment resistant postpartum depression (TRPPD). Treatment of TRPPD is challenging because of breastfeeding, limitation of medication and competing childcare responsibilities. We report the case of a 26-year-old female with a history of anxiety, ADHD, and depressive disorders who developed severe postpartum depression following her two pregnancies. Following her second delivery, she developed severe depressive symptoms within three weeks postpartum, with a PHQ-9 score of 28. Despite multiple sequential pharmacological regimens including desvenlafaxine with bupropion and subsequent dose adjustments, the patient showed only partial and transient improvement. Significant clinical response was achieved after addition of cariprazine along with intensive psychotherapy and structured psychosocial support, including enhanced caregiving assistance. Her PHQ-9 decreased to 5 three weeks after initiation of this regimen. Sustained remission was observed over long-term follow-up continuing to this day. This case demonstrates the complexity of TRPPD and the limitations of monotherapy. Early detection of treatment resistance is crucial in avoiding impaired infant bonding and long-term maternal dysfunction. A multimodal approach comprising psychotherapy, augmentation techniques, antidepressant optimization, and psychosocial support is needed for effective management and long-term remission. TRPPD is a difficult and underdiagnosed disorder that requires individualized, multidisciplinary care. In refractory circumstances, combination medication and targeted psychological therapies may improve effectiveness. More research is required to develop evidence-based treatment approaches and uniform diagnostic standards for TRPPD.

Role of steroids in a case of leptospirosis and dengue coinfection with acute respiratory distress syndrome

2026-10-01T01:42:23+00:00

Coinfection with leptospirosis and dengue complicated by acute respiratory distress syndrome (ARDS) is rare and potentially fatal. While steroids are generally contraindicated in dengue and their role in leptospirosis remains uncertain, management becomes challenging. This case highlights a situation where steroid therapy was beneficial. We describe a case of a 17-year-old male presenting with fever with chills, joint pain, abdominal pain and vomiting, hemoptysis and subsequent respiratory distress, diagnosed with concurrent leptospirosis and dengue. Despite the uncertain role of steroids in such a case of co-infections, methylprednisolone (MPS) was administered due to severe ARDS, yielding positive outcomes. This case underscores the complexity of managing coinfections and prompts reconsideration of treatment protocols. Literature review reveals conflicting evidence on steroid use in complicated cases as this one. The positive outcomes of administering steroids in this case highlight the need for further research to refine therapeutic approaches in managing complex coinfections. This case urges robust randomized controlled trials assessing corticosteroid efficacy in severe dengue shock syndrome and leptospirosis, given their potential to significantly improve patient outcomes.

Dapagliflozin induced balanitis in a patient with type two diabetes mellitus: a case report

2026-10-01T01:38:28+00:00

Dapagliflozin, an SGLT2 inhibitor used to control high blood sugar in patients having type II diabetes mellitus by blocking the SGLT2, present in the early proximal tubules of the kidney, thereby preventing glucose reabsorption into the blood and promoting excess glucose removal through urine causing glucosuria. Increased glucose concentration in urine in genitourinary tract creates a hostile environment for bacterial and fungal growth. Balanitis, condition where the glans penis is inflamed characterized by pain, redness, and swelling. This condition affects the male genitalia, most common causes being poor hygiene, accumulation of smegma beneath the foreskin, diabetes, and the use of SGLT2 inhibitors in diabetic patients. This is a case of 75-year-old male patient with the history with type 2 diabetes, hypertension, and triple vessel coronary artery disease, underwent successful off-pump CABG, following the surgery dapagliflozin 5 mg OD was advised for diabetes management. After 3 weeks of dapagliflozin 5 mg administration patient experienced frequent urination, swelling of the glans penis, painful micturition, and itching that persisted for more than a week. The urinalysis showed the presence of glucose in the urine despite having nearly normal blood sugar levels confirmed the presence of balanitis which was dapagliflozin induced. Dapagliflozin was immediately discontinued, and symptoms subsided. Naranjo scale was used for causality assessment, which produced a score of 7, indicating a probable adverse drug effect. This case highlights the necessity of early detection of symptoms, pre-treatment guidance, and rapidly stopping the medication to prevent complications in patients undergoing SGLT2 inhibitor therapy.

Duchenne muscular dystrophy in two siblings identified through the family adoption programme: a community-based case report from rural Punjab

2026-10-01T01:35:00+00:00

Duchenne muscular dystrophy (DMD) is a progressive X-linked disorder that is often recognised late in low-income rural settings. We report two brothers with DMD from a household in rural Ludhiana district, Punjab, encountered through the Family Adoption Programme (FAP), a longitudinal community attachment under the competency-based undergraduate curriculum. The younger brother had been genetically confirmed (hemizygous DMD c.5769delA, likely pathogenic) at a tertiary Centre of Excellence but his rehabilitation had lapsed; the elder brother, wheelchair-dependent since age eight, had never been evaluated because of cost. During a routine FAP home visit, his undiagnosed weakness was recognised, and both siblings were re-linked to structured rehabilitation. We use the household to examine what continuous family-level contact added to established neuromuscular care and where gaps in confirmatory testing, disease-specific therapy and linkage to the National Policy for Rare Diseases persisted. The report is offered as an implementation example, not a novel model of care.

An integrative orthobiologic approach to femoral head osteonecrosis: a case report

2026-10-01T01:33:07+00:00

Avascular necrosis (AVN), is a progressive disorder resulting from impaired blood supply to the femoral head leading to subchondral collapse and secondary osteoarthritis. Augmentation with percutaneous core decompression (PCD) with Hyperbaric oxygen therapy (HBOT) and curcumin/95 supplementation with structured rehabilitation would demonstrate benefits in AVN. 37-year-old man presented with eight-month history of right hip pain with difficulties (walking, squatting, stair and gait). MRI imaging confirmed AVN of right femoral head stage II B (Ficat-Arlet) and baseline patient presented Visual Analog Scale (VAS) 6/10, Oxford Hip Score (OHS)/33 with reduced muscle strength. The patient underwent PCD with bone marrow aspirate concentrate (BMAC) and high platelet-rich-plasma (PRP) followed by 15 sessions of HBOT, with strengthening of hip core and gait, with curcumin/95, 1000 mg daily for 60 days. At six months, the patient showed decrease in VAS score from 6/10 to 1/10, Oxford Hip Score increased from 33 to 43, Right hip flexion improved from 100° to 125° with mild pain, internal rotation from 10° to 30°, and extension from 15° to 20°. Hip muscle strength improved from grades 3-4/5 at baseline to 5/5 across assessed muscle groups. The antalgic gait and localized tenderness resolved, and functional mobility improved. This study advocates multimodal treatment strategy to arrive at functional status noted at six months with improvement in pain, hip mobility, muscle strength and gait. However, the contribution of individual treatment components cannot be determined from a single case, and longer-term controlled studies are required.

Determinants of confirmatory diagnosis of chronic hepatitis C among women of reproductive age: a surveillance-based analysis, 2018-2022

2026-10-01T01:37:38+00:00

Background: Women of reproductive age are disproportionately affected by chronic hepatitis C virus (HCV) infection, yet disparities in confirmatory diagnosis remain poorly understood. This study examined determinants of confirmed chronic HCV diagnosis among women aged 15-45 years in Maryland and assessed whether rural or urban residence influenced diagnostic confirmation.

Methods: This cross-sectional study used secondary surveillance data from the Maryland National Electronic Disease Surveillance System (NEDSS) for women aged 15-45 years with chronic HCV reported between 2018 and 2022. We used logistic regression to assess the association between residence and confirmed diagnosis, controlling for demographic characteristics and period of diagnosis.

Results: Among 2,197 women, 62.7% had a confirmed diagnosis and 37.3% were classified as probable cases. Bivariate analyses showed significant associations between diagnosis status and residence, age, and race. In unadjusted analysis, rural residents were more likely than urban residents to receive a confirmed diagnosis (OR=1.30, 95% CI: 1.09-1.54). After adjustment, residence was no longer significant (OR=1.07, 95% CI: 0.89-1.29). Women aged 26-35 years had higher odds of confirmed diagnosis than those aged 15-25 years (OR=1.32, 95% CI: 1.03-1.70). Compared with White women, Black women (OR=0.45, 95% CI: 0.35-0.58) and women of other racial backgrounds (OR=0.51, 95% CI: 0.26-0.99) had lower odds of confirmation.

Conclusions: Age and race were stronger determinants than residence, highlighting persistent disparities in completion of HCV diagnostic evaluation and the need for targeted confirmatory testing efforts.

Knowledge, attitudes, stigma and appropriate referral toward mental illness among secondary school teachers in Southwestern Nigeria: a mixed method study

2026-10-01T01:33:05+00:00

Background: Adolescent mental-health problems are important public-health and educational concerns. The ability of school teachers to respond appropriately to mental-health challenges may be affected by appropriate attitude, mental-health literacy, stigma, cultural and religious beliefs about mental illness. The study aimed to assess the knowledge, stigma and attitudes toward mental illness among secondary-school teachers.

Methods: The study employed a cross-sectional design involving mixed-methods of quantitative and qualitative approaches. A validated instrument; Community Attitudes towards Mental Illness (CAMI) scale divided into 4 priori subscales including: Authoritarianism, Benevolence, Social Restrictiveness and Community Mental Health Ideology and Sociodemographic Questionnaire were administered for 125 participants. Focus-group discussions (FGD) and key-informant interviews (KII) explored findings requiring deeper explanations. Data were analysed using SPSS version 20.

Results: The participants had a mean age of 42.05±8.99 years with female preponderance. Most had first degree in education with over 10years of teaching experience. Authoritarianism showed mixed but poor knowledge of mental health while the benevolence social restrictiveness and Community mental health ideology showed harsh reactions towards the mentally-ill. Key informant interview (KII) and focus group discussion (FGD) showed apparent knowledge-gap in description, causes and treatment modalities.

Conclusion: The study identified knowledge gaps as a key determinant of poor teacher mental-health literacy, stigma with poor referral intentions. Findings may inform teacher education, continuing professional development, school mental-health policies, anti-stigma programs and formal referral pathways between schools and mental-health services.

The presence of filarial worms in patients with elephantiasis in Benin

2026-10-01T01:41:12+00:00

Background: Lymphatic filariasis (LF) occurs in tropical and subtropical regions of the world with 40 million disabled. It is the second leading cause of disability in the world. LF is found in places with poor socio-economical conditions and large number of insects and other vectors that favor the transmission of infections. Clearly a disease of poverty. Ultrasound (USG) has been introduced for several years in the study of nematodes and lymphatic filariae in several countries. In Benin, detection was limited to the search for circulating antigen and this is the first study, carried out to study LF in Benin using USG. In LF, most of the severe disease patients have less circulating antigens, while USG allows detection and monitoring and also help clarifying the cause of the disease, still considered a curse.

Methods: We used a Mindray DP 8800 machine equipped with a Doppler mode and a multi-frequency linear probe (6.5 to 10.5 MHZ) to search for the presence of filarial worm in patient with elephantiasis. All affected parts, the axillary and inguinal regions were examined. The images obtained from a total of 107-patients were recorded, recovered, processed and analyzed.

Results: We found filarial dances (20.7%), lymphedema (26.2%), lymph nodes (30.7%), and worm pockets and necrotic pockets (7.8%) with more than one found in the same patient.

Conclusions: We conclude with the use of USG that LF is still present in the area of study and affects both sexes, with a male predominance.

Healthcare providers’ perceptions of the impact of electronic medical records on diabetes care at Nakuru county referral and teaching hospital, Nakuru county: an ordinal regression analysis of cadre and experience in Kenya

2026-10-01T01:42:23+00:00

Background: Electronic Medical Records (EMRs) are central to improving diabetes care, yet provider perceptions remain critical to their effective adoption, particularly in resource-limited settings. This study assessed healthcare providers’ perceptions of the impact of EMRs on diabetes care and examined the influence of professional cadre and experience in Kenya.

Methods: A cross-sectional study was conducted among 119 healthcare providers. Perceptions of EMR impact were measured using a Likert scale. Chi-square tests identified associations between socio-demographic variables and perception outcomes. Variables meeting inclusion criteria were entered into an ordinal logistic regression model to determine independent predictors. Model fit was assessed using likelihood ratio tests and Nagelkerke pseudo-R². Results: Overall, 86.5% of respondents reported positive perceptions of EMR impact on diabetes care (73.9% agree; 12.6% strongly agree). Chi-square analysis showed significant associations between perception and cadre (χ²=33.517, p<0.001), while gender, age and education were not significant. The ordinal regression model was statistically significant (χ²(5)=29.246, p<0.001) and explained 27% of variance. Nurses (OR=27.03, 95% CI: 6.27–116.51, p<0.001) and doctors (OR=19.61, 95% CI: 3.37–114.12, p=0.001) were significantly more likely to report positive perceptions compared to clinical officers. Although not statistically significant, shorter employment duration showed a consistent trend toward more favourable perceptions.

Conclusions: Healthcare providers in Kenya demonstrate overwhelmingly positive perceptions of EMRs in diabetes care, with cadre emerging as a key determinant. Tailored training and cadre-specific system optimization are recommended to enhance adoption and bridge experience-related gaps, supporting scalable EMR implementation in similar settings.

The registered footprint of health-professions education studies across the WHO International Clinical Trials Registry Platform: a cross-registry meta-research study

2026-10-01T01:39:12+00:00

Background: Trial and study registries are an underused meta-research lens on health-professions education (HPE), but keyword retrieval cannot reliably isolate learner-focused studies because education and training terms are dominated by patient-education and clinical-trial vocabulary. We mapped the registered HPE footprint across the WHO International Clinical Trials Registry Platform (ICTRP), testing whether classification rather than filtering recovers the learner-focused signal.

Methods: From a frozen ICTRP cross-registry export (10 June 2026), 16 narrow plus four broad education terms yielded 1,390 records after three-tier de-duplication. Because keyword precision was low (narrow-term interventional positive predictive value 0.182, 95% CI 0.130-0.248) and no term subset reached 0.85, we applied a four-value blind protocol to all 1,383 classifiable records, double-coding a random 200-record reliability sample.

Results: Classification identified 109 registered HPE studies (7.9%, 95% CI 6.6-9.4%): 60 interventional and 49 observational (HPE-versus-rest Cohen κ 0.906). The footprint was small and pandemic-concentrated: 97 of 109 (89%) were registered in 2020-2023, peaking in 2021, and 99 of 109 (90.8%) were COVID-themed, across 11 registries and 29 countries (India most represented). Of 60 trials, 36 (60%) were randomized (median planned enrolment 100). Prospective registration was documented for 51 of 108 (47.2%) and a results record for only 18 of 109 (16.5%).

Conclusions: Registries reveal a small, pandemic-era-concentrated HPE footprint that keyword search misses; recovering it requires manual, double-coded classification of the candidate net. Low retrievability and sparse registry-visible results signal opportunities to strengthen prospective registration and results posting. Because this is a retrieved rather than exhaustive footprint, the counts carry a recall caveat.

Uptake of medication use counseling among the patients receiving antibiotics from selected hospital pharmacies in Kiambu County, Kenya

2026-10-01T01:33:10+00:00

Background: Medication use counselling (MUC) is a critical component of patient care, particularly regarding antibiotic use. Despite its importance, studies indicate that over 50% of antibiotics are inappropriately consumed globally, largely due to inadequate counselling. The study aimed to determine the uptake of MUC among patients receiving antibiotics in selected hospital pharmacies in Kiambu County.

Methods: A cross-sectional study design was employed, utilizing structured questionnaires to gather data from 423 patients and key informant interviews among 12 pharmacy personnel across three hospitals. Statistical analysis was undertaken using the Statistical Package for Social Sciences version 24, with significance set at p<0.05.

Results: The findings revealed that MUC uptake varied significantly across facilities, with Kikuyu Hospital reporting the highest rate at 64%. Patients demonstrated high awareness of medication names (93.4%) and administration routes (95.5%), but knowledge regarding dosage strength (45.6%) and protocols for missed doses (37.8%) was notably low.

Conclusions: The overall uptake rate for MUC was found to be 64%, indicating a need for improvement in counselling practices.

Determinants and patterns of medication adherence among individuals with type 2 diabetes mellitus

2026-10-01T01:35:08+00:00

Background: Medication adherence is a key determinant in the effective management of type 2 diabetes mellitus (T2DM). Poor adherence contributes to inadequate glycemic control, increased complications, and higher healthcare costs. This study aimed to assess patterns of medication adherence and associated factors among patients with T2DM in Bangladesh.

Methods: A facility-based cross-sectional study was conducted among 412 adult patients with T2DM attending selected hospitals in Gazipur and Manikganj districts from September 2024 to March 2025. Participants were selected using simple random sampling. Data were collected through face-to-face interviews using a structured questionnaire, including the validated 8-item Morisky Medication Adherence Scale (MMAS-8). Descriptive statistics, Chi-square tests, and multivariable logistic regression analyses were performed using SPSS version 26.

Results: Overall, 31.6% of participants demonstrated high adherence, 38.8% medium adherence, and 29.6% low adherence. Higher adherence was significantly associated with secondary or higher education (AOR: 2.14; 95% CI: 1.32-3.46), shorter duration of diabetes (<5 years) (AOR: 1.78; 95% CI: 1.10-2.89), good healthcare access (AOR: 2.67; 95% CI: 1.59-4.49), and living with family. Polypharmacy (AOR: 0.56; 95% CI: 0.34-0.91) and comorbidities (AOR: 0.63; 95% CI: 0.40-0.98) were negatively associated. Common barriers included forgetfulness (48.2%), financial constraints (33.5%), and lack of awareness (27.9%).

Conclusions: Medication adherence among patients with T2DM was moderate and influenced by multiple factors. Interventions focusing on patient education, improved healthcare access, and family support are essential to enhance adherence and improve outcomes in Bangladesh.

A cross-sectional study on influence of performance management system on employee productivity among healthcare managers in selected public hospitals in Kitui County, Kenya

2026-10-01T01:41:09+00:00

Background: Although the management of human resources is critical in providing high-quality and safe health care, many developing countries continue to face enormous challenges in health service delivery, including human resource management issues. Particularly, many health facilities around the world have limited human resources.

Methods: This research was carried in Kitui County for a period of 12 months between October 2022 and October 2023. An institutional-based cross-sectional research design was used. Purposive sampling was used to select public hospitals while stratified sampling was employed to obtain 310 study participants. Quantitative data was collected through open and closed ended questionnaires. Version 22.0 of SPSS software was used to statistically analyze the collected data. Chi-square was used to find the relationship between with a p value set at <.05. Binary logistic regression and Multivariate regression were also carried to determine the predictors of the research objectives.

Results: Overall productivity level was computed with 15 as a cut-off point for low and high productivity, and it was found that 185 (59.7%) of the respondents had low productivity. Majority of the respondents 136 (43.9%) disagreed that objective setting is important in PMS with 117 (37.6%) agreeing on the same. Majority of the employees 113 (36.5%) disagreed that PR identifies areas of improvement with 106 (34.2%) agreeing on the same.

Conclusion: On performance reviews and employee productivity among healthcare managers in selected public hospitals in Kitui County, the study concludes that performance reviews partly influence on employee productivity among healthcare managers in selected public hospitals in Kitui County.

Morbidity and socio-demographic profile of functionally impaired elderly and its impact on caregiver burden in Kerala

2026-09-20T03:44:20+00:00

Background: Aging populations increase the prevalence of functional impairment, leading to substantial dependence on informal caregivers and a high risk of caregiver burden. Understanding elderly characteristics and morbidity profiles, and how these influence caregiver burden, is vital. The objective of the study was to describe the socio-demographic characteristics and morbidity profile of functionally impaired elderly and examine associations with caregiver burden.

Methods: Community-based cross-sectional study among 250 functionally impaired elderly and their primary caregivers in Thrissur, Kerala. Socio-demographic and morbidity data (self-report and clinical assessment) for elderly, and Zarit burden interview scores for caregivers, were collected and analysed. Associations were tested using Chi-square or Fisher’s exact test.

Results: Out of the 250 elderly, more than half were females and widows. Mean age was 73 years. Common morbidities included visual impairment (52.3%), hypertension (35.2%), diabetes (34.8%), dementia (26%), and urinary incontinence (26%). A vast majority (91.2%) depended heavily on caregivers for their activities of daily living (ADLs) and instrumental activities of daily living (IADLs).64% of caregivers reported significant burden. Burden was significantly higher (p<0.05) among those caring for elderly with dementia, mental health issues, cancer, urinary incontinence, and those highly dependent for ADLs.

Conclusions: Elderly with cognitive, psychiatric, oncologic, or incontinence-related morbidities and those highly dependent in ADLs contribute notably to caregiver burden, highlighting a need for targeted support.

Interpreting India's below-replacement fertility: evidence from Sample Registration System and National Family Health Survey on tempo effects and age-structural change

2026-09-17T01:32:36+00:00

Background: Whether India's below-replacement period total fertility rate (TFR) reflects genuine quantum decline or partly reflects tempo distortion from delayed childbearing has not been systematically assessed using nationally representative data. Sample Registration System (SRS) 2023 reports a national TFR of 1.9 and National Family Health Survey-6 (NFHS-6) (2023-24) reports 2.0.

Methods: This study integrates three complementary approaches using SRS 2023, NFHS-5 (2019–21), and NFHS-6 (2023–24) data: age-specific fertility rate (ASFR) redistribution across age groups (2011–13 to 2021–23); retrospective period-specific fertility trends from NFHS-5 birth histories; and an illustrative application of the Bongaarts–Feeney tempo-adjustment framework.

Results: ASFR fell 63.1% among women aged 15–19 and 42.5% among those aged 20–24 between 2011–13 and 2021–23, while it rose 22.7–91.3% across the 30–49 age range; the modal fertility age shifted from 20–24 to 25–29 years. An illustrative Bongaarts–Feeney adjustment (annual r ≈0.0076) yields TFR≈1.91 for 2023, only modestly above the observed period TFR of 1.9. TFR has been stable between NFHS-5 (1.99) and NFHS-6 (2.0).

Conclusions: India's recent fertility decline is accompanied by substantial postponement of childbearing, with fertility shifting from younger to older age groups. Although the illustrative Bongaarts–Feeney adjustment suggests only a modest national tempo correction, period TFR should be interpreted alongside age-specific and cumulative fertility measures before being treated as definitive evidence of declining completed family size.

A cross-sectional study to find out the prevalence and determinants of obesity and hypertension among medical students in Mirzapur, Uttar Pradesh

2026-09-11T01:27:42+00:00

Background: Obesity is one of the major lifestyle disorders in India and its incidence is increasing during recent decades. Medical students are more prone for obesity, due to their sedentary lifestyle, lack of exercise, disordered eating habits due to lack of leisure time, increased stress and vast topics to learn. So, this study was done with the aim to estimate the prevalence of overweight and obesity among the Medical College students and also to assess the factors influencing it.

Methods: A cross-sectional study was conducted among second- and third-year medical students of Maa Vindhyawasini Autonomous State Medical College, Mirzapur, Uttar Pradesh. The study was conducted from August 2024 to September 2024 for two months. The total sample included 140 students. The information collected was entered in MS Excel, and analysis was done using SPSS version 2. The written informed Consent of the study participants was obtained. The ethical clearance was obtained from the institute, and confidentiality was maintained during the study.

Results: We found that 20% were overweight-at risk, 27.1% had grade 1 obesity and 2.8% had grade 2 obesity among medical students. 4.6% males and 9.3% females were underweight, 42.6% males and 50% females had normal BMI while 52.8% males and 40.7% females were overweight. Overweight was more prevalent in males.

Conclusions: The prevalence was found to be high among medical college students which were contributed by various factors. This can be reduced by modifying their diet, engaging in regular physical activity.

Rabies awareness and knowledge among adults in an urban Indian setting: evidence from Jaipur, India

2026-09-11T01:27:42+00:00

Background: Rabies is almost invariably fatal once symptoms appear yet preventable if post-exposure prophylaxis (PEP) is completed in time. National data show that almost half of those who begin a vaccine course in India do not complete it. Whether Jaipur residents possess the specific knowledge that governs treatment completion had not been assessed.

Methods: A cross-sectional survey used a bilingual questionnaire of ten factual knowledge items, administered online and face to face across Jaipur (September 2025 to February 2026). After exclusions, 349 adults were analysed.

Results: General awareness was high: 99.4% would attend a hospital after a bite and 89.1% knew rabies is preventable if treated in time. However, life-critical procedural knowledge was weak. Only 37.8% knew that rabies cannot be cured once symptoms appear, while 43.8% believed a hospital could still cure it, making the incorrect belief more prevalent than the correct one. Only 26.5% knew vaccine-induced protection is not immediate, 57.3% knew the full course requires four or five injections, and 42.1% knew that mammals other than dogs transmit the virus. Mean knowledge score was 6.07 of 10 (SD 1.87); 22.3% scored poorly. Scores were higher among those with a dog bite in the family or social circle (p=0.003).

Conclusions: High awareness coexists with critical gaps in the knowledge that determines survival: that rabies is incurable after symptom onset, that protection is not immediate, and that the course must be completed. Closing these gaps requires targeted communication at the point of post-exposure care, not broader awareness activity.

Preliminary psychometric testing of a novel cognitive decline risk screening tool for middle-aged adults of 40 to 60 years: a pilot study

2026-09-17T01:32:35+00:00

Background: The cognitive decline risk screening tool (CDRST) was developed using the modified Delphi technique for adults aged 40 to 60 years to identify cognitive decline risk. This pilot study assessed the tool's internal consistency and developed preliminary cut-off scores.

Methods: Community-dwelling adults aged 40 to 60 years who attended the outpatient clinic were included through convenience sampling. Analysis included descriptive statistics, Cronbach’s alpha, an inter-item correlation matrix with Spearman's rank correlation, and scale cutoff scores identified using the standard deviation method (Mean±SD).

Results: 103 individuals participated, with a mean age of 50.1±6.55 years. Cronbach's alpha was 0.81, and the inter-item correlation matrix ranged from -0.02 to 0.62, indicating low to moderate correlations. A cut-off score of ≥43.64 (≥Mean+1SD) was noted, with 14.56% as high risk.

Conclusions: The CDRST showed good reliability, with all items contributing to the tool's overall construct, and exploratory score cutoffs provided a preliminary risk-stratification framework.

Impact of parenting approaches on adolescents’ mental well-being: a cross-sectional study

2026-09-25T01:18:28+00:00

Background: Mental health disorder is a major public health problem across the world. It encompasses a wide range of disorders that are generally characterised by a combination of abnormal thoughts, perceptions, emotions, behaviours and relationships with others. Common mental disorders include depression, anxiety and stress. Recognizing the burden on families, particularly those affected by parental mental illness, highlights the need for family-focused interventions in India. Objectives were to study the prevalence of mental health disorders among adolescents (aged 13-16 years) in higher secondary schools and to determine the extent of parental involvement and association between adolescents’ mental health disorders and parental involvement.

Methods: A cross-sectional study was conducted from July to October 2025 (4 months) among higher secondary school students of class 8^th, 9^th and 10^th aged (13-16 years) from government schools of Raichur taluka. Four schools were selected from urban area of Raichur using lottery method and 310 participants were recruited using systematic random sampling. The questionnaire consisted of three parts: sociodemographic data, the parental authority questionnaire and depression, and the anxiety and stress scale (DASS-21).

Results: In our study, majority of the participants were having authoritative parenting style (40.49%), 35.69% of the participants were shown to have a permissive parenting style, 36.56% were having Authoritarian/ flexible parenting style.

Conclusions: In this study it was found that 36.56% of the parents of study subjects were authoritative. Significant association was found between permissive and authoritarian parenting styles with students having anxiety and stress.

Eye donation at a newly established eye bank of a government medical college of Eastern India: a three-year retrospective analysis of sources, retrieval logistics and tissue utilisation

2026-09-25T01:18:27+00:00

Background: Corneal blindness is a priority avoidable condition whose treatment depends entirely on donated tissue. We reported three years of donor tissue procurement at a newly established peripheral government eye bank in a densely populated, district of eastern India, examining the sources, geography and logistics of retrieval.

Methods: We retrospectively analysed all 320 eye donations received from the eye bank’s inception (8 April 2022) to 31 March 2025. Donations were classified by procurement source- external non-governmental organisation (NGO) eye retrieval centre (ERC), local NGO ERC or own hospital cornea retrieval programme (HCRP)- and by district of origin. Retrieval intervals were compared across sources by Kruskal-Wallis and Mann-Whitney tests, and utilisation derived by linking donors to keratoplasties performed.

Results: The 320 donors yielded 638 corneas. Despite continuous information-education-communication activity, local procurement remained minimal: only 74 donors (23.1%) came from the host district and 7 (2.2%) through the hospital’s own HCRP, while 245 (76.6%) were retrieved by a single external NGO ERC in a neighbouring district. Consequently 318 donors (99.4%) were Hindu, although the host district was Muslim-majority. Donors were elderly (mean 72.3±12.2 years; 87.2% aged ≥60 years). Mean death-to-enucleation was 3.71±1.56 hours, but transport differed markedly by source (4.31 versus 1.67 versus 0.90 hours; p<0.001), reaching 16 hours. Only 309 corneas (48.4%) were used for keratoplasty.

Conclusions: Local eye donation remained persistently low despite sustained awareness activity, obliging near-total dependence on an external retrieval centre in a neighbouring district. The resulting long transport times, with advanced donor age, define twin priorities of community-specific engagement and logistic strengthening.

Evolution of grip strength across transition between teenage and adulthood: a gender-based analysis

2026-09-20T03:44:19+00:00

Background: Hand grip strength is an important indicator of hand and overall muscular function and is influenced by factors such as age and sex. The transition from teenage to adulthood represents an important developmental period during which changes in grip strength may occur. The objective was to examine and compare the differences in hand grip strength between teenage and adult participants and to compare grip strength between males and females.

Methods: A cross-sectional comparative research design. was conducted among 220 healthy participants aged 17–25 years, including 97 males and 123 females. Participants were divided into teenage (17–19 years) and adult (20–25 years) groups. Grip strength was assessed for both the hands using a Jamar hand dynamometer under standardized testing conditions. The mean of three trials for each hand was used for analysis, and differences between group grip strength were statistically evaluated.

Results: Males demonstrated greater mean grip strength than females in both age groups for both hands. Adult males showed significantly greater grip strength than teenage males, with mean differences of 4.46 kg for the right hand and 3.0 kg for the left hand (p<0.001). In females, the differences between teenage and adult groups were not statistically significant.

Conclusions: Grip strength differed according to sex and age. Males demonstrating greater strength and a significant increase from teenage to adulthood. These findings highlight the importance of considering age- and sex-specific values during hand-strength assessment and rehabilitation planning.

Exploratory study of filariasis lymphatic in non-endemic area in Benin: the case of Atlantic department

2026-10-01T01:41:11+00:00

Background: Lymphatic filariasis (LF) is caused by a microfilaria, Wuchereria bancrofti, transmitted mainly by mosquitoes: female Anopheles and Culex quinquefasciatus. In Benin from 2000 to 2016, a program of LF elimination implemented. In 2019 southern departments of country reported non-endemic, however some LF disease cases are sometimes founded in hospitals of this area. The aim of this study was to determine whether there are still cases of LF in these regions, even though they have been declared non-endemic.

Methods: The study sample consisted of 107 subjects with elephantiasis of our area study (Atlantic department). All of them underwent to ultrasound exam at autonomous radiology center.

Results: Our 107 subjects included 61 male and 46 female subjects with the minimum and maximum age are respectively 4 and 80 years old. Table 1 shows also a little representation of subjects age group from 0 to 20 years old. The subjects in our sample consist mainly of fisherman (n=42) and fisherman (n=34) followed artisan (n=16), trader (n=5), student (n=3) and functionary (n=7). As the FL manifestations we noticed mainly about our subjects axillary and inguinal inflamed node, lymphedema, filariasis dancing sign (FDS) across all age group.

Conclusions: Although the conclusions of the literature which declared non-endemic some areas in Benin, our study still reveals the persistence of the cases of LF diseases.

Real-world utilization of topical heparin ointment for superficial venous thrombophlebitis in Indian clinical practice: a multicentre knowledge, attitude and practice survey

2026-10-01T01:33:14+00:00

Background: Superficial venous thrombophlebitis (SVT) is a frequent complication of peripheral intravenous (IV) cannulation, for which topical heparin ointment is widely used despite limited contemporary real-world data on clinician knowledge, attitude, and practice (KAP). This study examined the KAP of practicing clinicians regarding topical heparin ointment in SVT.

Methods: A cross-sectional observational survey of 362 clinicians routinely managing IV cannulation was conducted using an 11-item structured questionnaire. Items were a priori categorized into Knowledge (perceived SVT incidence and non-cannulation etiologies), Attitude (perceived effectiveness and tolerability, including pediatric use), and Practice (preferred treatment, timing, prophylactic use, duration, and use beyond SVT), with daily cannulation volume as a contextual exposure variable. Responses were summarized as frequencies, percentages, and 95% confidence intervals (CI).

Results: Among 362 clinicians, 74.5% performed 2–8 IV cannulations daily. For knowledge, 30.7% perceived that more than half of cannulated patients developed SVT, and 67.7% attributed non-cannulation SVT to vein injury, alone or with varicose veins. For attitude, symptom resolution and overall tolerability were rated excellent by 76.2% and 74.9%, respectively; pediatric tolerability was rated excellent or good by 97.5%. For practice, topical heparin ointment was preferred by 91.1% (alone or in combination), 85.1% (95% CI 81.4–88.8) had used it prophylactically, 62.7% prescribed it at or before cannulation, and a 7–10-day course was most common (50.6%).

Conclusion: Indian clinicians displayed a coherent KAP profile in which topical heparin ointment was overwhelmingly endorsed for prophylaxis and treatment of cannulation-related SVT, supporting its continued role in peripheral IV care pending patient-level outcome studies.

Dietary transition and its association with metabolic health trends among Khasi tribes in Shillong, Meghalaya: a cross-sectional study

2026-10-01T01:33:48+00:00

Background: Urbanisation and globalisation have rapidly altered the traditional dietary landscape of the indigenous Khasi tribe in Meghalaya, shifting preferences toward a Westernised diet. This dietary transition is increasingly linked to a rising incidence of metabolic disorders. This study assessed the transition in eating habits among Khasi adolescents, evaluating their perceptions of fast food and the broader regional burden of metabolic health issues.

Methods: A cross-sectional survey was conducted among 300 Khasi adolescents (150 boys, 150 girls) in the East Khasi Hills district, Meghalaya. A structured questionnaire gathered data on perceptions, preferences, and consumption frequencies regarding traditional versus non-traditional fast foods. Concurrently, retrospective clinical data from 2019 to 2022 were collected from regional hospitals, Primary Health Centres (PHCs), and Non-Communicable Disease (NCD) clinics to analyse the regional incidence of diabetes and hypertension.

Results: Dietary perceptions shifted significantly, with both genders agreeing that fast food tastes better than traditional cuisine. Males demonstrated a significantly higher preference for fast food over traditional meals compared to females (p< 0.05). Alarmingly, 40% of males and 49.33% of females perceived fast food as generally healthy, while 50.67% of adolescent girls believed there was no scientific evidence of its detrimental health effects. Clinical data over the 3 years (N = 75,673) revealed a substantial metabolic disease burden, with 4.04% of patients diagnosed with diabetes and 8.23% with hypertension.

Conclusions: Khasi adolescents exhibit a pronounced dietary shift from traditional whole foods toward commercial fast foods, driven by taste preferences and widespread health misconceptions. This dietary transition correlates with a high and rising regional incidence of diabetes and hypertension in the East Khasi Hills district, highlighting an urgent need for targeted school and community-based nutritional interventions.

Unseen battles: exploring the psychosocial challenges, coping mechanisms and resilience among caregivers of individuals with traumatic brain injury

2026-10-01T01:33:47+00:00

Background: Traumatic brain injury (TBI) affects not only patients, but also primary caregivers and family members, impairing their psychological well-being, social roles, and health. Caregivers frequently experience interpersonal conflict, role obstacles, and stress-related health issues.

Method: The study utilized a qualitative research approach, incorporating in-depth, semi-structured interviews to capture caregiver’s lived experiences. The study included eight caregivers of individuals with moderate to severe traumatic brain injury, selected using criterion-based purposive sampling. Caregivers were aged 18 years or above and had been providing care for a minimum of three months.

Results: The findings of the study revealed that caregivers of individuals with traumatic brain injury faced substantial emotional, social, and financial difficulties. Caregivers reported fear, anxiety, emotional exhaustion, identity disruption, and career strain during critical caregiving phase. Despite these difficulties, they demonstrated resilience through spirituality, family support, emotional commitment and motivation from recovery milestones.

Conclusion: Caregiving in traumatic brain injury involves substantial psychosocial burden alongside adaptive resilience. The findings emphasize the need for structured psychosocial, emotional, and financial support systems to reduce caregiver stress and enhance long-term well-being and sustainability.

Household e-waste awareness, disposal practices and socioeconomic factors in a semi-urban community of Kerala: a cross-sectional study

2026-10-01T01:34:08+00:00

Background: Electronic waste (e-waste) is a growing environmental and public health concern. This study assessed e-waste awareness, generation patterns, disposal practices, and socioeconomic factors among households in a semi-urban community of Kerala.

Methods: A cross-sectional study was conducted among 105 households in Cheroor ward, Thrissur district, Kerala. Data were collected through structured face-to-face interviews using a pre-tested questionnaire covering sociodemographic characteristics, e-waste generation, disposal practices, challenges, and awareness. Descriptive statistics, Pearson’s Chi-square tests, and binary logistic regression were used to examine associations and socioeconomic factors associated with general e-waste awareness.

Results: General awareness of e-waste was reported by 84.76% of households, while 78.10% were aware of its negative effects and 74.29% of its health effects. Awareness of e-waste management policies and regulations was lower (31.43%), and 48.57% had received information or education on e-waste management. Selling e-waste to scrap dealers was the most common disposal practice (80.95%), followed by storing e-waste at home (50.48%). Education was significantly associated with receipt of e-waste management information (χ²=8.497, df=2, p=0.014). In adjusted logistic regression, households with monthly incomes of ₹20,000–50,000 had higher odds of general e-waste awareness than those earning below ₹20,000 (OR=3.37, 95% CI: 1.28–9.24, p=0.015).

Conclusions: The findings indicate a gap between general e-waste awareness and use of formal disposal options. Improved household-level information and accessible formal collection facilities may support better e-waste management in semi-urban communities.

Prevalence and distribution of methicillin-resistant staphylococcal infections in a tertiary care hospital: a prospective observational study

2026-10-01T01:33:02+00:00

Background: Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MR-CONS) cause healthcare- and community-associated infection and spread rapidly within hospitals. Local surveillance guides empirical therapy and infection control. This study determined the prevalence, distribution, and outcome of MRSA and MR-CONS infections across areas of a tertiary care hospital.

Methods: A six-month prospective observational study was conducted at S.S. Institute of Medical Sciences and Research Centre, Davangere. Staphylococcal isolates from clinical specimens submitted from different hospital areas were identified by standard methods. Methicillin resistance was detected by cefoxitin disc diffusion per CLSI criteria; susceptibility was tested by the Kirby-Bauer method.

Results: Of 216 staphylococcal isolates, 80 (37.0%) were S. aureus and 136 (63.0%) were CONS. Fourteen isolates (17.5% of S. aureus) were MRSA, and 16 (11.8% of CONS) were MR-CONS, an overall rate of 13.9% (30/216). General wards and the outpatient department contributed the most isolates and highest MRSA/MR-CONS counts, while ICUs contributed few resistant isolates. Blood and pus/wound/tissue specimens yielded the largest share of resistant isolates. No isolate was vancomycin-resistant, and all patients recovered.

Conclusions: Methicillin resistance was relatively low overall, suggesting effective infection control, particularly in critical care areas. The disproportionate burden of resistant isolates in general wards and the OPD highlights the need to strengthen infection control outside ICUs and investigate risk factors for community- and ward-acquired MRSA.

Evaluation of training effectiveness and patient referral patterns in palliative care by ASHAs and ANMs in Jodhpur

2026-10-01T01:34:07+00:00

Background: Access to palliative care is still limited in India with Rajasthan and this is accompanied by a lack of awareness and trained personnel. Frontline workers like ASHAs and ANMs can help to improve early identification and referral of patients in need of palliative care. To assess effectiveness of palliative care training of ASHAs and ANMs and its effect on the pattern of referrals to patients in Jodhpur.

Methods: A quasi-experimental study was carried out in selected 21 Urban Primary Health Centres in the period from before (Sept-2024 to Jun-2025). The participants went through a two-day structured training programme. Knowledge was evaluated by a validated 18-item questionnaire in pre- and post-tests and referrals were followed for 6 months. Data were analysed with paired t-test and descriptive statistics.

Results: Significant improvement of knowledge scores was noted post training (P<0.05) with similar improvement among ASHAs and ANMs. A total of patients were identified and referred with a steady increase in referrals over time. Field exposure through home visits increased use of referral activity.

Conclusions: Structured training has been effective in improving knowledge and referral practices. Integrating trained frontline workers with supportive supervision and referral systems in community-based palliative care in resource limited settings.

Application of the 5C model in understanding adult vaccine hesitancy among medical students: a cross-sectional study

2026-10-01T01:34:07+00:00

Background: Adult vaccination is an important component of preventive health care, but vaccine hesitancy can limit uptake even when vaccines are available. Medical students represent future health professionals and may influence vaccination decisions in the community. The 5C model provides a multidimensional framework encompassing confidence, complacency, constraints, calculation, and collective responsibility.

Methods: A cross-sectional study was conducted among undergraduate medical students in a tertiary-care teaching institution, Puducherry. A total of 386 medical students from first year through internship were included. Data were collected using a self-administered, pre-tested structured questionnaire containing sociodemographic variables and assessment of adult vaccine hesitancy and the five dimensions of the 5C model. Data were analyzed using IBM SPSS. Categorical variables were expressed as frequency and percentage, and associations were assessed using Pearson's chi-square test. Pearson's correlation coefficient was used to assess correlations between the five 5C dimensions.

Results: Among 386 participants, 216 (56.0%) were classified as vaccine hesitant and 170 (44.0%) as non-hesitant. Age and religion were not significantly associated with vaccine hesitancy (p=0.851 and p=0.495, respectively). Significant associations were observed with gender (p<0.001) and year of study (p<0.001). The five 5C dimensions demonstrated statistically significant positive correlations with one another. Correlation coefficients ranged from 0.581 between calculation and collective responsibility to 0.699 between confidence and calculation (all p<0.001).

Conclusions: Adult vaccine hesitancy was prevalent among the medical students studied. Gender and year of study were significantly associated with hesitancy, while the five psychological antecedents measured by the 5C model demonstrated significant interrelationships.

Surgical site infection prevention bundle: changes in staff nurses’ practices and SSI outcomes

2026-10-01T01:33:46+00:00

Background: Surgical site infection (SSI) remains an important postoperative problem, and prevention depends on consistent care. This study examined changes in nurses’ observed SSI-prevention practice and in-hospital SSI occurrence after a structured bundle intervention.

Methods: A pre-post interventional study was conducted from November 2025 to April 2026 in General Surgery and Orthopaedic Surgery wards of a tertiary hospital in Kolkata. Seventy-six nurses were observed before and after intervention using a 10-item checklist. Patient surveillance included 386 patients before and 470 after intervention. The bundle combined teaching, demonstration, bedside reinforcement, observation and feedback. Practice scores were compared using the Wilcoxon signed-rank test and SSI proportions using Pearson’s chi-square test. Risk estimates and multivariable logistic regression were calculated.

Results: Mean practice score increased from 5.21±1.36 to 6.78±2.96; median score increased from 5 to 8, and good practice from 2.6% to 53.9% (Z=-4.01, p<0.001; r=0.46). SSI decreased from 20.21% (78/386) to 14.89% (70/470) (χ²=4.185, p=0.041). RR was 0.74 (95% CI 0.55-0.99) and ARR 5.32 percentage points (95% CI 0.17-10.45). Adjusted odds were lower after intervention (AOR=0.70, 95% CI 0.489-0.999; p=0.0495).

Conclusions: The bundle was followed by better observed nursing practice and lower in-hospital SSI occurrence. The adjusted result was close to the 0.05 threshold; the absence of a concurrent control group and post-discharge surveillance limits causal interpretation.

Knowledge, attitude and awareness of tuberculosis among caregivers in Mullana, Ambala, India

2026-10-01T01:42:00+00:00

Background: Caregivers play a vital role in supporting tuberculosis (TB) patients through treatment adherence, emotional support, and access to care, yet their knowledge, attitude, and awareness (KAB) regarding TB remain understudied. This study assessed the KAB of caregivers of TB patients admitted to the TB and Chest Ward at MMIMSR, Mullana, Ambala, Haryana, India, and examined relationships between KAB domains and selected sociodemographic variables.

Methods: A quantitative, cross-sectional study was conducted among 100 caregivers of TB patients admitted to the TB and chest ward at MMIMSR during November 2023, recruited using convenience sampling. Data were collected through a validated, self-administered questionnaire assessing sociodemographic characteristics and structured knowledge, attitude, and awareness domains. Descriptive statistics summarized the findings, and correlation analysis examined relationships between KAB domains and sociodemographic variables, with p<0.05 considered significant.

Results: Slightly more than half of caregivers (53%) had average knowledge of TB, 45% had good knowledge, and 2% had poor knowledge. Attitudes were largely positive, with 85% rated good, and awareness was high, with 90% rated high. Significant positive correlations were found between knowledge and attitude, attitude and awareness, and knowledge and awareness. No significant association emerged between sociodemographic factors and knowledge, although attending a health education program was significantly associated with higher awareness.

Conclusions: Caregivers demonstrated average knowledge, positive attitudes, and high awareness of TB. Persistent knowledge gaps indicate a need for targeted educational interventions, particularly for caregivers who have not attended health education programs, to strengthen overall KAB and support TB management and control efforts.

Prospective evaluation of quality of life among patients with type 2 diabetes mellitus residing in urban slums of Bengaluru

2026-10-01T01:41:59+00:00

Background: Type 2 diabetes mellitus (T2DM) is one of the most prevalent non-communicable diseases globally and poses a significant public health challenge, particularly in developing countries like India. The chronic nature of the disease, along with its complications and long-term treatment requirements, can substantially affect patients’ quality of life (QoL).

Methods: A community-based prospective observational study was conducted among 390 adults with type 2 diabetes mellitus residing in selected urban slums of Bengaluru from February 2025 to January 2026. Participants were selected using simple random sampling. Quality of life was assessed using the WHOQOL-BREF questionnaire. Data were analyzed using SPSS version 26. Descriptive statistics and inferential tests such as chi-square test were applied, with p<0.05 considered statistically significant.

Results: The mean age of participants was 52.3±10.8 years. The physical health domain had the lowest mean QoL score (54.3±11.6), while the social relationships domain showed the highest score (60.2±12.4). Overall, 56.9% of participants had poor quality of life. Significant associations with poor QoL were observed for age >50 years (OR=1.85), female gender (OR=1.84), diabetes duration >5 years (OR=2.27), presence of complications (OR=2.79), and lower socioeconomic status (OR=4.16) (p<0.05).

Conclusions: More than half of the diabetic patients living in urban slums had poor quality of life. Older age, female gender, longer disease duration, diabetic complications, and low socioeconomic status were key determinants of reduced QoL.

Assessing the knowledge, attitudes and practices of ASHA workers towards the Ayushman Bhava Initiative in Western Gujarat: a mixed-methods study

2026-10-01T01:41:13+00:00

Background: The Ayushman Bhav initiative, launched by India's government, represents a pioneering approach to holistic healthcare delivery. This study evaluated the knowledge, attitudes, and practices (KAP) of Accredited Social Health Activists (ASHAs) regarding this initiative in Western Gujarat.

Methods: A mixed-methods study engaged 170 ASHA workers through structured questionnaires and 12 focus group discussions (8 participants each). The questionnaire assessed socio-demographic characteristics and KAP dimensions; logistic regression examined associations between socio-demographic factors and knowledge levels. Qualitative data underwent thematic analysis.

Results: Fifty-seven percent of ASHAs accurately understood the initiative's core aim, though specific knowledge gaps persisted; 51.2% had overall good knowledge. Attitudes were generally favourable, with 95.3% believing the initiative could improve patient care and 97% valuing communication. Self-reported practice was high across all domains, including information-sharing (95%) and active listening (84.7%). Higher education (AOR 3.79, 95% CI 1.49-9.63 for graduates), longer work experience, and higher income were significantly associated with good knowledge. Qualitative analysis identified three themes: Transformative potential versus implementation Reality, reflecting ASHAs' view of the initiative as paradigm-shifting despite ground-level challenges; structural tensions, highlighting resource-responsibility mismatches and knowledge-practice gaps; and evolution of Professional Identity, describing ASHAs' shift from health workers to community advocates.

Conclusions: The study reveals moderate knowledge, strongly positive attitudes, and high self-reported practice among ASHAs. These findings support targeted capacity-building, community engagement strategies, and policy interventions to bridge knowledge gaps and strengthen implementation of Ayushman Bhava through ASHAs.

A cross-sectional study on knowledge, attitude and practice of biomedical waste management among nursing officers in Government General Hospital, Mahabubabad

2026-10-01T01:42:24+00:00

Background: Biomedical waste management (BMWM) is an important component of hospital infection control, occupational safety and environmental protection. Nursing officers play a key role in segregation and safe disposal of biomedical waste. Aim was to assess the knowledge, attitude and practice regarding BMWM among nursing officers in Government General Hospital, Mahabubabad.

Methods: A cross-sectional study was conducted over 15 days among 100 nursing officers selected by simple random sampling. Data were collected using a self-administered structured questionnaire comprising 10 knowledge, 5 attitude and 6 practice questions. Knowledge was categorized as low (0-6), moderate (7-8) and high (9-10); attitude as favourable or unfavourable; and practice as good or poor. Data were summarized using descriptive statistics.

Results: High knowledge was observed in 84% of participants, moderate knowledge in 15% and low knowledge in 1%. A favourable attitude was observed in 93.4%, while 85.1% demonstrated good practice. Only 51% reported ensuring that biomedical waste containers were not overfilled.

Conclusions: The study demonstrated high knowledge, a favourable attitude and generally good BMWM practice among nursing officers, with specific practice gaps that can be addressed through periodic training and monitoring.

Menstrual hygiene practices and awareness among hosteller and non-hosteller college students: a comparative analysis

2026-10-01T01:41:13+00:00

Background: Menstrual hygiene management is an important component of reproductive health among adolescent and women. The present study aimed to assess and compare menstrual hygiene practices, awareness, disposal methods and challenges faced by hosteller and non-hosteller female students.

Methods: A comparative cross-sectional descriptive study design was adopted for the study, which was conducted among female students of Women’s College, Jharsuguda. A total of 100 respondents, comprising 50 hostellers and 50 non-hostellers aged between 17 to 20 years, were selected using a simple random sampling technique. Data were collected through a structured questionnaire covering socio-demographic details, menstrual practices, hygiene behaviours, disposal methods and awareness levels. The data were analyzed using descriptive and inferential statistical methods, including the Chi-square test to determine associations between variables.

Results: The results revealed that most respondents used sanitary pads and maintained basic hygiene practices. However, hosteller students experienced greater difficulties in accessing menstrual hygiene products and disposal facilities compared to non-hostellers. Awareness regarding menstrual hygiene was moderate in both groups. The Chi-square analysis showed a statistically significant association between residence (hosteller and non-hosteller) and access to disposal facilities as well as frequency of changing sanitary products p<0.05, while other variables were found to be non-significant.

Conclusions: It is concluded that there is a need to improve knowledge regarding menstrual hygiene, strengthen infrastructural facilities, enhance awareness programs and develop better institutional support systems for adolescent girls.

Assessment of compliance of smoke-form and smokeless tobacco product packages with COTPA packaging and labelling amendment rules, 2024

2026-10-01T01:41:10+00:00

Background: Pictorial health warnings (PHWs) on tobacco packages are a proven tobacco control tool. India mandates that PHWs cover 85% of the principal display area under COTPA, as updated by the December 2024 amendment rules. Evidence on manufacturer-level compliance as assessed at the point of retail sale remains limited. We assessed compliance of smoke-form and smokeless tobacco product packages at retail outlets in Mumbai with the December 2024 COTPA amendment rules and compared compliance between categories.

Methods: A cross-sectional observational study was conducted in Mumbai from September to November 2025. Packages were collected from diverse retail settings by purposive sampling with saturation. A validated structured checklist based on the December 2024 amendment rules was used. Descriptive statistics and Fisher’s exact test were applied.

Results: 48 packages (30 smoke-form, 18 smokeless) were assessed. Only 27 (56.3%) displayed PHWs in accordance with December 2024 regulations, 15 (31.3%) carried outdated warnings, and 6 (12.5%) had no PHW. Among packages with current PHWs (n=27), smokeless products showed poorer compliance than smoke-form on warning size (0% versus 95.0%, p<0.001), ‘not for minors’ message (28.6% versus 95.0%, p=0.001), and pictorial quality (0% versus 100%, p<0.001). Misleading descriptors were more prevalent on smokeless products (57.1% versus 10.0%, p=0.024).

Conclusions: Compliance with COTPA packaging and labelling regulations remains inadequate at the retail level, with smokeless tobacco sector showing the greatest deficiencies. Urgent enforcement action, regular retail-level monitoring, and sector-specific regulatory attention are essential to translate packaging mandates into effective tobacco control outcomes.

Exploring mental well-being and resilience factors among medical resident doctors in a tertiary care institute in Mumbai

2026-10-01T01:41:08+00:00

Background: Resident doctors face significant professional pressures, shifting research focus toward positive mental health and resilience. This study utilizes the Warwick-Edinburgh mental well-being scale (WEMWBS) to assess psychological health, examining its relationship with resilience and demographic factors. By identifying protective coping mechanisms within a community medicine framework, the findings aim to support resident welfare and enhance patient care quality.

Methods: This cross-sectional observational study, conducted from December 2024 to March 2025, included 135 Resident Medical Officers from 18 departments in Mumbai using proportional stratified random sampling. Data were collected through Google Forms using WEMWBS and BRS tools, after IRB approval, and analysed using statistical package for the social sciences (SPSS) version 25 with appropriate statistical tests.

Results: Among 135 residents (66.7% female), the mean mental well-being score was 45.04±11.03, with 28.9% reporting very low well-being. The mean resilience score was 19.23±3.43, where 72.6% displayed normal to high resilience. While gender and training year showed no significant associations, specialization significantly influenced both well-being (p=0.014) and resilience (p<0.001). Participants worked an average of 69.29 hours weekly, reporting a mean stress score of 5.87. Social support from friends and family (66.7%) was the most prevalent coping strategy.

Conclusions: Among 135 Mumbai residents, average mental well-being (mean 45.04) and high resilience were reported. Specialization significantly influenced outcomes, favoring pre/paraclinical roles. Social support remains a key protective factor, highlighting the importance of institutional resilience-building initiatives.

Prevalence and determinants of social media addiction and social anxiety among medical undergraduates: a cross-sectional study from Dakshina Kannada

2026-10-01T01:41:58+00:00

Background: Social media is an important part of communication among young adults, but excessive use may be associated with poor mental health outcomes, including social anxiety. This study assessed the burden of social media addiction and social anxiety among undergraduate medical students and examined their association with selected demographic factors.

Methods: A cross-sectional study was conducted among 261 undergraduate medical students aged 17 years and above using convenience sampling. Data were collected using a pre-tested questionnaire that included a Social Media addiction scale and a social anxiety scale. Descriptive statistics, chi-square tests and logistic regression were used for analysis.

Results: High social media addiction was observed in 48.3% of participants, while 6.5% had very high addiction. Severe social anxiety was reported by 37.9% and extreme social anxiety by 31.0%. Age was not significantly associated with either social media addiction or social anxiety. Gender was significantly associated with social anxiety, with males showing higher odds of severe or extreme anxiety (odds ratio 4.636; 95% confidence interval 1.680–12.794).

Conclusions: The study shows a substantial burden of social media addiction and social anxiety among medical undergraduates. Early screening, digital well-being initiatives and gender-sensitive mental health support may help address these concerns.

Assessment of the prevalence of anemia and its association with nutritional anthropometric variables and dietary intakes among fishermen at coastal area, India

2026-10-01T01:41:08+00:00

Background: Anemia is associated with poor physical performance due to promotes exhaustion and a lack of muscular oxygen, resulting in reduced muscular strength, quality, and performance. Various characteristics including ethnicity, sex, age, sociodemographic profile, eating pattern, physical and mental health, environment and genetics are correlated with anemia. Aim of our study is to explore the prevalence of anemia with difference BMI categories along with comparison of nutrients intake between anemic and non-anemic subjects in our study group in the area of coastline of Purba Medinipur district, India.

Methods: A cross-sectional study was carried out from September 2023 to December 2023 in the coastline of Purba (East) Medinipur district, West Bengal. In the study, 410 fishermen and 205 non-fishermen were included. Following standard procedure haemoglobin (Hb) estimation and anthropometric variables were measured. Diet survey was conducted by standard 24 hours recall method. Collected data was analyzed statistically using Student’s t-test, Chi-square test and bivariate logistic regression analysis.

Results: Prevalence of anemia were more likely to non-fishermen compared to fishermen. It is also noted that obesity indicators are significantly higher in non-anemic participants. Participants who have been classified as overweight or obese take more nutrients and have a lower risk of anemia.

Conclusions: The present study illustrates the prevalence of anemia among fishermen and fishermen with higher BMI are less likely to have anemia. This study exposes an inverse relationship between anemia and overweight/obesity to the fishermen in the maritime of Purba (East) Medinipur district. Poor nutritional status and unhealthy dietary practices are significant causes of anemia.

Assessment of knowledge, attitudes and practices regarding disposal of unused and expired medicines among the general public in Bathinda district, Punjab

2026-10-01T01:41:07+00:00

Background: Improper disposal of unused and expired medicines has become an important public health and environmental concern. Lack of awareness regarding safe medication disposal practices may lead to environmental pollution, drug resistance, and adverse health outcomes. The present study aimed to assess the knowledge, attitude, and consumer practices regarding disposal of unused and expired medicines among the general public in Bathinda district, Punjab.

Methods: A community-based cross-sectional observational study was conducted among 152 participants aged above 18 years in Bhucho-kalan, Bhucho-khurd, and Bhucho-mandi areas of Bathinda district. Data were collected using a structured questionnaire through face-to-face interviews after obtaining informed consent. Statistical analysis was performed using Microsoft Excel and IBM SPSS version 22.0. Chi-square test was applied and p<0.05 was considered statistically significant.

Results: Majority of participants (61.2%) reported the availability of expired medicines at home. About 53.3% participants understood expiry of medicines as loss of shelf life, treatment failure, and production of toxins. Most respondents disposed medicines in household trash (59.2%) and only a few returned medicines to pharmacies (5.3%). Significant association was observed between checking expiry dates and demographic factors such as age, education, and occupation status (p<0.05).

Conclusions: Although the public showed awareness regarding environmental hazards associated with improper disposal of medicines, inappropriate disposal practices were still common. Awareness programs, written instructions, and drug take-back initiatives are required to improve safe disposal practices among the general population.

A study to assess the effectiveness of PTP on knowledge regarding ragging and anti-ragging measures among the adolescents

2026-10-01T01:37:47+00:00

Background: Ragging is a serious issue in educational institutions that negatively affects the physical and psychological well-being of students. The present study aimed to assess the effectiveness of a planned teaching programme on knowledge regarding ragging and anti-ragging measures among adolescents in selected schools and junior colleges.

Methods: A quantitative research approach with a one-group pre-test post-test design was adopted. The study was conducted among 120 students from 10th, 11th, and 12th standards of a selected school. A structured questionnaire was used to assess the knowledge of participants before and after the intervention.

Results: The findings revealed that in the pre-test, 50% of participants had poor knowledge, which significantly reduced to 19.16% in the post-test. The proportion of participants with good knowledge increased from 21.66% to 47.50% after the teaching programme. Statistical analysis indicated no significant association between pre-test knowledge and demographic variables such as age, education, and gender.

Conclusion: The study concluded that the planned teaching programme was effective in improving knowledge regarding ragging and anti-ragging measures among adolescents. Hence, similar educational interventions should be implemented to promote awareness and prevent ragging in educational institutions.

A cross-sectional study of womens’ knowledge and reported practices on reproductive, maternal and child health in rural area of North-Eastern India

2026-10-01T01:37:46+00:00

Background: Women’s knowledge and health-seeking practices are crucial determinants of reproductive, maternal, and child health outcomes. Information from rural communities of North-Eastern India remains limited. The study aims to assess women’s knowledge and reported practices regarding reproductive, maternal, and child health and to determine the influence of sociodemographic factors on overall health knowledge.

Methods: A community-based cross-sectional study was conducted among 300 women selected from the rural field practice area of a tertiary care teaching hospital in Assam. Data were collected using a pretested interview schedule covering maternal and child health knowledge, preventive practices, and treatment-seeking behaviour. Health knowledge scores were generated based on correct responses. Univariate analysis was performed to summarize data, followed by multiple linear regression to identify factors associated with health knowledge.

Results: Knowledge regarding diarrhoea prevention and management was poor; 52.3% had never heard of oral rehydration solution and only 20.7% recognized vaccination as a preventive measure against measles. Although 95% of women had received antenatal care, only 45.2% initiated breastfeeding within one hour of birth. Full immunization coverage was 65.7%. More than half (54.1%) sought initial treatment from ASHAs/ANMs. Higher educational attainment and increasing age were significantly associated with better health knowledge (P<0.05).

Conclusions: Significant gaps exist in maternal and child health knowledge and practices among rural women. Educational status and age are important determinants of health knowledge, highlighting the need for targeted community-based health education interventions.

Knowledge, attitude and awareness regarding the protection of children from sexual offences act among medical and paramedical personnel: a cross-sectional questionnaire study

2026-10-01T01:37:44+00:00

Background: The Protection of Children from Sexual Offences (POCSO) Act, 2012 mandates reporting of child sexual abuse and places important legal responsibilities on healthcare professionals. Adequate knowledge and awareness of the Act are essential for effective implementation and child protection. This study aimed to assess the knowledge, attitude, and awareness regarding the POCSO Act among medical and paramedical personnel.

Methods: A cross-sectional questionnaire-based study was conducted among 408 participants, including undergraduate students, postgraduate trainees, doctors, and allied healthcare professionals. A structured 20-item questionnaire assessing knowledge, attitude, and awareness regarding the POCSO Act was administered electronically. Data were analyzed using descriptive statistics and one-way analysis of variance (ANOVA).

Results: Participants demonstrated moderate levels of knowledge and awareness regarding the POCSO Act. The mean knowledge score was 6.25±1.68, the mean attitude score was 3.03±1.01, and the mean awareness score was 5.28±1.42. Significant differences in knowledge scores were observed among professional categories (p=0.003), whereas attitude and awareness scores did not differ significantly. Deficiencies were noted in specific legal provisions, reporting obligations, and procedural aspects of the Act.

Conclusions: Medical and paramedical personnel demonstrated moderate knowledge and awareness and generally positive attitudes towards the POCSO Act. Structured medico-legal training, continuing medical education programmes, and integration of child protection laws into healthcare curricula are necessary to strengthen compliance with reporting obligations and improve management of child sexual abuse cases.

Beyond BMI: association of body roundness, abdominal volume, conicity and body shape indices with insulin resistance and metabolic risk in urban Indian adolescents and adults

2026-10-01T01:37:43+00:00

Background: Body roundness index (BRI), Abdominal volume index (AVI), Conicity index (CI), and a body shape index (ABSI) have been proposed as improved predictors of adiposity and metabolic risk. This study evaluated gender differences, age-related trends, diagnostic performance and associations of these indices with adiposity and metabolic parameters.

Methods: A cross-sectional analysis was conducted among 1,998 apparently healthy Indian adolescents and adults (620 males and 1,378 females;16–55 years) from the Mumbai Metropolitan Region. Anthropometric measurements, body composition, and biochemical parameters were assessed. BRI, AVI, CI, and ABSI were calculated. Gender differences were compared using independent t-tests, age-related trends across quintiles, receiver operating characteristic analysis assessed diagnostic accuracy, and Pearson's correlation examined associations with metabolic parameters.

Results: Adiposity indices increased significantly with age, whereas muscle mass declined (p<0.001). Females had higher BMI, waist-to-height ratio, body fat percentage, and BRI, while males had higher waist circumference, waist-to-hip ratio, visceral fat, muscle mass, AVI, CI, and ABSI (all p<0.01). BRI showed the highest accuracy for identifying obesity (AUC=0.953) and central obesity (AUC=1.000), followed by AVI. Both BRI and AVI correlated with adiposity measures, fasting glucose, fasting insulin, HbA1c, and HOMA-IR (all p<0.001). AVI was independently associated with HOMA-IR and fasting insulin, whereas BRI was associated with the fasting glucose-to-insulin ratio.

Conclusion: BRI and AVI are reliable, low-cost markers of adiposity and early metabolic dysfunction. BRI showed superior diagnostic accuracy for obesity, whereas AVI demonstrated stronger associations with insulin resistance, supporting their use in early cardiometabolic risk screening among apparently healthy Indian populations.

Sociodemographic, behavioural and cardiometabolic correlates of severe locomotive syndrome among older adults attending an urban health training centre in Maharashtra: a facility based cross-sectional study

2026-10-01T01:37:42+00:00

Background: Severe Locomotive Syndrome (severe LS) is an emerging public health concern that affects functional independence among older adults. Evidence on its sociodemographic, behavioural, and cardiometabolic correlates in India remains limited. This study aimed to identify correlates of severe LS among older adults attending an urban health training centre in Maharashtra.

Methods: A facility-based cross-sectional study was conducted among 264 adults aged ≥60 years. Sociodemographic, behavioural, and cardiometabolic data were collected using a structured questionnaire. LS was assessed using the Stand-Up Test, Two-Step Test, and the 25-item Geriatric Locomotive Function Scale (GLFS-25). Participants were categorised as non-severe LS (LS-1/LS-2) or severe LS (LS-3). Associations were examined using Pearson's chi-square test and the Mann–Whitney U test. Multivariable logistic regression and dose–response trend analyses were performed, and model performance was evaluated.

Results: The median age of participants was 70 years (IQR: 66–74), and 57.6% were female. Severe LS was observed in 55.3% of participants. Independent correlates of severe LS included age ≥70 years, female gender, non-graduate educational status, history of falls, smoking, central obesity, and hyperlipidaemia. The odds of severe LS increased significantly with the number of cardiometabolic disorders (score test for trend, p<0.001). The model demonstrated good fit (Hosmer–Lemeshow p=0.238) and good discriminatory ability (AUC=0.89).

Conclusions: Severe LS affected more than half of the study participants and was significantly associated with advancing age and several modifiable risk factors. These findings highlight the need for early screening and targeted interventions to promote healthy ageing among urban older adults.

Influence of social media on health-related decision making among caregivers attending an outpatient department in a tertiary care hospital, Bengaluru

2026-10-01T01:37:41+00:00

Background: Social media has emerged as an influential source of health information, shaping public perceptions and behaviours. While it enhances awareness, it also risks disseminating misinformation, potentially affecting health related decisions and trust in healthcare providers. This study was conducted to determine the influence of social media on health-related decisions among adults.

Methods: A hospital-based cross-sectional descriptive study was conducted among 130 caregivers aged ≥18 years attending OPD’s. A purposive sampling method was used to recruit participants. Data were collected through a pretested semi-structured questionnaire various aspects of social media use and its impact on healthcare decision-making. Data were analyzed using MS Excel.

Results: Most participants actively used WhatsApp (82%), YouTube (76%) and Facebook (68%) for health-related information. Social media significantly influenced doctor selection (58%) and lifestyle modifications (64%) among users. Notably, 64 participants (49%) reported encountering misleading or incorrect health information. Trust in online health content varied significantly across age and education levels, with younger and more educated individuals showing higher reliance on social media for medical guidance.

Conclusion: Social media substantially influences health-related decision-making among caregivers, particularly regarding lifestyle and healthcare provider choices. The study highlights the urgent need to improve digital health literacy, ensure content authenticity, and create awareness about credible online health sources.

Comparative hematological parameters at admission in Kyasanur forest disease: a single centre study in Goa

2026-10-01T01:37:40+00:00

Background: Kyasanur forest disease (KFD) is a tick-borne viral hemorrhagic fever endemic to southern India. This study describes the clinical profile and hematological parameters of confirmed KFD cases in a tertiary care center in Goa.

Methods: A retrospective observational study was conducted at Goa Medical College, from June 2016 to June 2017. Medical records of adult patients with reverse transcription polymerase chain reaction (RT-PCR)-confirmed KFD were reviewed. Demographic data, clinical features, and laboratory parameters were analyzed descriptively. Patients with incomplete medical records or non-confirmed diagnoses were excluded.

Results: A total of 57 patients were enrolled, with female predominance 36 (63.2%) and a mean age of 41.6±15.7 years. Fever was universal, with gastrointestinal and myalgia symptoms. Bleeding occurred in 10 (17.5%), and neurological involvement developed in 30% by day 5–6. Leucopenia was documented in 52 (91.2%), neutropenia in 48 (84.2%), and thrombocytopenia in 40 (70.2%). Transaminitis was observed in 51 (90.2%), while hyperbilirubinemia and renal dysfunction were rare. Most patients recovered by day 7; one death occurred due to pneumonia-related complications.

Conclusion: KFD is characterized by early cytopenias and hepatic involvement following a predictable temporal pattern. Early diagnosis and phase-specific monitoring are essential to optimize outcomes.

Utilization of adolescent health services: is there a need for digitalization?

2026-10-01T01:37:39+00:00

Background: Adolescents have unique healthcare needs, yet utilization of adolescent-friendly health services remains low due to individual, sociocultural, and health-system barriers. Digital health interventions may enhance accessibility and engagement with healthcare services. This study assessed the utilization of adolescent health services, factors influencing utilization, and the perceived need for digitalization of these services.

Methods: A concurrent mixed-methods study was conducted among 100 adolescents aged 10–19 years residing in selected Urban Primary Health Centre areas of Visakhapatnam district. Participants were selected through simple random sampling. Quantitative data were collected using a face-validated semi-structured questionnaire and analysed using SPSS version 25. Descriptive statistics and Chi-square test were applied. Qualitative data were obtained through in-depth interviews and focus group discussions with adolescents, parents, and healthcare providers and analysed thematically.

Results: Good awareness of adolescent health services was observed among 53% of participants, whereas only 14% reported good utilization. Awareness was significantly associated with female gender (p=0.02) and higher educational status (p=0.048). Utilization was significantly associated with socioeconomic status (p=0.038) and preference for government healthcare providers (p<0.001). Facilitators included school-based sensitization, parental encouragement, and support from frontline health workers. Qualitative findings identified gaps in awareness, stigma, long waiting times, and preference for private healthcare services as barriers to utilization. Participants perceived digitalization as beneficial for improving privacy, accessibility, health information dissemination, and appointment scheduling.

Conclusions: A substantial awareness utilization gap exists among adolescents. Strengthening adolescent-friendly services and integrating digital health solutions may improve healthcare utilization among adolescents.

Profile of children presenting with speech delay without any specific diagnosis

2026-10-01T01:37:39+00:00

Background: Speech delay, characterized by a child’s failure to develop age-appropriate language skills, is a major concern in paediatric healthcare. Speech delay can be attributed to underlying conditions such as hearing impairment, neurological disorders, or genetic syndromes. While, a considerable proportion of cases remain without a clear aetiology. Psychological deprivation, inadequate stimulation, seizure disorders, intellectual disability, and excessive screen time may predispose children to speech delay. The repercussions of speech delay, including poor academic achievement, social anxiety, and stress, may negatively impact a child’s future.

Methods: A record-based cross-sectional study was conducted among children who attended therapy at the Regional Early Intervention Centre (REIC), Medical College, Kottayam. With the assistance of a speech therapist employed at the centre, a semi-structured proforma based on the receptive-expressive emergent language scale (REELS) was prepared. Data were entered into Microsoft Excel and analysed using IBM SPSS version 20.0.

Results: The mean age of the study participants was 4.06±2.14 years. The majority of children (39.3%) belonged to 3-5-year age group and were males (75.3%). Speech delay alone was the presenting complaint in 73.5% of children. Speech delay was observed in 77% of children with excessive screen time and in 87.5% of children with feeding problems, with these associations being statistically significant (p<0.05).

Conclusions: Speech delay without any specific diagnosis was observed in 63% of children. A statistically significant association was found between speech delay and a history of feeding problems and excessive screen time.

Quality of life and its determinants among pulmonary tuberculosis and multidrug-resistant tuberculosis patients receiving DOTS therapy in Lucknow District, Uttar Pradesh: a cross-sectional study

2026-10-01T01:37:38+00:00

Background: Tuberculosis (TB) remains a major public health challenge, and multidrug-resistant TB (MDR-TB) may impose an additional physical, psychological, and social burden. Quality of life (QoL) assessment provides information beyond conventional treatment outcomes. Objectives were to assess QoL among pulmonary tuberculosis (PTB) and MDR-TB patients and identify determinants of QoL in Lucknow district, Uttar Pradesh.

Methods: A cross-sectional analytical study was conducted among 214 TB patients receiving treatment through urban DOTS centres in Lucknow district from 1 September 2017 to 31 August 2018. Systematic random sampling was used; a target of five patients was interviewed each day, and every 10^th registered patient was selected. If the selected patient did not fulfil the inclusion criteria, the next registered patient was included. Of the 214 participants, 157 had PTB and 57 had MDR-TB. Data were collected using a pretested structured questionnaire, and QoL was assessed using the medical outcomes study short form-36 (SF-36). Multiple linear regression was used to identify predictors of QoL.

Results: PTB patients had higher overall QoL scores than MDR-TB patients (42.7±18.8 versus 34.6±17.8). Significant differences were observed in physical functioning, role physical, bodily pain, general health, vitality, and social functioning. Poor social relationships were the strongest predictor of reduced QoL among PTB patients, whereas dissatisfaction with DOTS centre services was the strongest predictor among MDR-TB patients.

Conclusions: TB substantially impairs QoL, with a greater burden among MDR-TB patients. Psychosocial support, stigma reduction, patient-centred DOTS services, and improved patient-provider interactions should be integrated into TB care.

Epidemiological insights into scrub typhus in Goa

2026-10-01T01:38:29+00:00

Background: Scrub typhus is an acute, mite-borne, febrile illness, caused by Orientia tsutsugamushi (“noxious” or “dangerous mite”). It is an under-recognized rickettsial re-emerging infection with increasing public health relevance in India. Despite advances in diagnostics, regional epidemiological data remain sparse. Emerging epidemiological evidence indicates its occurrence in Goa, and potential to be a major challenge to public health owing to less developed preparedness.

Methods: Hospital-based retrospective observational descriptive analysis of line-listed data of confirmed scrub typhus cases reported from Goa Medical college and hospital (tertiary care hospital), between 1st April 2024 and 31st March 2025. Temporal, spatial, and demographic analyses were performed using descriptive epidemiology and geospatial mapping

Results: A total of 827 confirmed cases were documented with positivity of 29.38%. Males (65.6%) were disproportionately affected compared to females (34.4%). The highest burden occurred among adults aged 18-60 years. Seasonal peaks were observed during the monsoon months (July–September). Geospatial mapping revealed clusters in Tiswadi and Marmugao block.

Conclusions: Scrub typhus is a re-emerging vector-borne infection in Goa, India with distinct seasonal and demographic patterns. Strengthened surveillance, clinician awareness, and integration of scrub typhus diagnostics into routine fever panel is warranted.

Colour vision deficiency and driving: impact on safety, performance and everyday challenges

2026-10-01T01:37:36+00:00

Background: This study aimed to assess the impact of colour vision deficiency (CVD) on driving performance, challenges and related factors among licensed male drivers.

Methods: This prospective observational study recruited drivers with normal and colour vision deficiency. Initial screening used the Ishihara plates, followed by AO-HRR plates to confirm the type of congenital CVD, and the Farnsworth Lantern signal test to assess signal perception. Drivers with best-corrected visual acuity less than 6/12 or acquired CVD were excluded. Detailed eye examinations and occupational/driving histories were also collected.

Results: The study included 63 male drivers: 30 with normal colour vision (mean age 41.1±6.6 years) and 33 with congenital CVD (mean age 38.7±8.9 years). Drivers with CVD were eight times more likely to experience difficulties compared to the normal vision group (OR: 7.80, 95% CI: 2.22-27.39, p=0.001), and nearly five times more likely to report difficulties under adverse conditions such as rain, fog, bright sunlight, (OR: 4.79, 95% CI: 1.36-16.87, p=0.015). No statistically significant association was found between CVD and road traffic accidents (RTA) in current study (p=0.07). However, CVD did affect the driving performance and self-reported difficulties.

Conclusions: No statistically significant association was found between CVD and RTA in current study; however, it significantly affects driving performance, with protans experiencing delayed signal recognition and deutans experiencing more colour confusions, especially under adverse weather conditions when secondary cues were absent.

Neck circumference and wrist circumference as a screening tool for obesity in early adolescents: a cross-sectional study

2026-10-01T01:37:35+00:00

Background: Obesity in adolescents is a growing public health problem. Neck circumference (NC) and wrist circumference (WrC) were suggested as simple and cheap alternatives for obesity screening. The objective of this study was to determine the prevalence of obesity and the utility of NC and WrC in rural adolescent.

Methods: A community based cross-sectional study was conducted among 318 rural adolescents aged 11-14 years. Anthropometric measurements of height, body weight, NC and WrC were performed using standard procedures. Obesity was defined as BMI-for-age Z score (BAZ). Pearson correlation and receiver operating characteristic (ROC) curve analysis was done.

Results: Prevalence of obesity was 4.1% (13/318). NC showed statistically significant negative correlation with BAZ (r=-0.180, p=0.001) while WrC showed a stronger negative correlation with BAZ (r=-0.390, p<0.001). The ROC analysis showed acceptable diagnostic performance for NC (AUC=0.707, 95% CI: 0.549-0.865) and good diagnostic performance for WrC (AUC=0.832, 95% CI: 0.748-0.917). The optimal cutoff values were 29.25 cm for NC and 16.25 cm for WrC.

Conclusions: Both NC and WrC were able to identify obesity in rural adolescents, with WrC performing better in diagnosis than NC. WrC could be a simple and feasible anthropometric marker for screening of obesity in community settings. These findings need to be confirmed in further studies.

Impact of social media on the psychological well-being of adolescents and young adults in Delhi

2026-10-01T01:37:35+00:00

Background: Social media has become an integral part of the daily life of adolescents and young adults. With access to smartphones and social media beginning at younger ages, there are concerns regarding their potential impact on psychological well-being and cognitive functioning. However, evidence from an urban Indian setting remains limited. This study aimed to assess the distribution of psychological distress and examine its association with smartphone use, social media engagement, and cognitive failure among individuals aged 15-25 years in Delhi.

Methods: A cross-sectional study was conducted among 50 participants selected through purposive sampling. Digital media behaviour was assessed using a semi-structured proforma, while cognitive failure and psychological distress were evaluated using standardised and validated questionnaires. Oral and informed written consent were obtained before data collection.

Results: Anxiety was the most common form of psychological distress. Two-thirds of participants reported extreme anxiety. Both early smartphone ownership (<16 years) and early social media adoption (<15 years) showed statistically significant association with higher psychological distress across all domains (p<0.01-0.001). Those who reported more than five hours of daily usage on social media were more in an extreme psychological distress state. Higher cognitive failure was significantly associated with severe psychological distress, while greater social media usage correlated with increased cognitive impairment.

Conclusions: These findings highlighted the importance of age-appropriate digital media practices and effective screen time regulation to protect the psychological well-being of youth.

Impact of food and nutrition literacy on knowledge, attitude and practices among adults with hypertension in Jalgaon, Maharashtra

2026-10-01T01:35:55+00:00

Background: Hypertension affects 28-30% of Indian adults, yet fewer than 9% achieve adequate blood pressure control. Low-socioeconomic-status (SES) adults face barriers including limited food and nutrition literacy, food insecurity, poor dietary practices. This study evaluated the impact of a six-week food and nutrition literacy intervention on knowledge, attitude, practice (KAP) outcomes and clinical parameters among low-SES adults with hypertension in Jalgaon, Maharashtra.

Methods: A pre-post intervention study was conducted among 80 low-SES adults with hypertension attending the OPD of a multispecialty hospital in Jalgaon. Six educational sessions were delivered over five weeks using a Hindi flipbook, illustrated posters, and locally relevant recipe cards, reinforced through WhatsApp reminders. KAP was assessed using knowledge and attitude questionnaires, a food frequency questionnaire, and healthy habits practice scale. SBP, DBP, and body weight were measured at baseline and post-intervention. Appropriate statistical tests were applied.

Results: Significant improvements were observed in knowledge (median 11.0 to 13.0, p<0.001), attitude (46.5 to 47.5, p<0.001), and multiple dietary practice indicators. Significant reductions occurred in SBP (144.5 to 140.5 mmHg), DBP (85.0 to 83.5 mmHg), and body weight (74.0 to 73.0 kg; all p<0.001).

Conclusions: A structured, culturally adapted food and nutrition literacy intervention significantly improved KAP and clinical outcomes among low-SES hypertensive adults. This feasible, low-cost model may be replicated in hypertension management programmes.

Energy drink consumption patterns and perceived benefits and health risks among MBBS students: a cross-sectional study

2026-10-01T01:35:09+00:00

Background: Energy drink consumption has increased among young adults, particularly medical students, due to academic stress, prolonged study hours, and the perceived need for enhanced alertness. This study assessed the prevalence, consumption patterns, associated factors, and perceived benefits and health risks of energy drink use among MBBS students.

Methods: A cross-sectional analytical study was conducted among 120 MBBS students at a private medical college in Kanpur, Uttar Pradesh, using a structured, self-administered questionnaire. Data regarding socio-demographic characteristics, consumption patterns, motivations, awareness of health risks, and self-reported adverse effects were collected. Associations were assessed using the Chi-square test, with p<0.05 considered statistically significant.

Results: Overall, 47.5% of students reported consuming energy drinks, with 69.2% of consumers reporting rare use. The commonest motivations were boosting energy and improving concentration, while Red Bull and Sting were the preferred brands. Although 75.0% were aware of potential health risks and 85.0% considered long-term consumption harmful, awareness was not significantly associated with consumption (p=0.2986). Palpitations (16.7%) and gastrointestinal symptoms (9.2%) were the most frequently reported adverse effects. Consumption was significantly associated with male gender (p<0.0001) and year of study (p=0.0417).

Conclusion: Energy drink consumption was common despite substantial awareness of health risks. Targeted health education, stress management, and promotion of healthier alternatives may help reduce consumption among medical students.

Survey on the role of physiotherapy in alcohol addiction recovery programme: a practitioner’s perspective

2026-10-01T01:36:22+00:00

Background: Alcohol use disorder (AUD) is a chronic condition characterized by a compulsive pattern of alcohol consumption that adversely affects physical, psychological, and social well-being. Physiotherapy has increasingly been recognized as a supportive intervention that may facilitate physical rehabilitation and improve mental health during recovery. Although conventional treatment primarily involves medical, psychological, and behavioural therapies, the contribution of physiotherapy to alcohol addiction recovery remains underexplored.

Methods: A cross-sectional observational study was conducted among physiotherapists practising in and around Pune, Maharashtra, India. The study consisted of two phases: questionnaire development and questionnaire validation. A total of 273 physiotherapists participated. Content validity of the questionnaire was assessed using a five-point Likert scale, and the content validity index (CVI) was calculated.

Results: The questionnaire demonstrated satisfactory content validity, with an average scale-level content validity index (S-CVI/Ave) of 0.85 and a universal agreement index (S-CVI/UA) of 0.10. Most respondents (95.1%) agreed that physiotherapy plays a significant role in alcohol addiction recovery programmes by improving physical health, emotional well-being, treatment adherence, and overall recovery outcomes.

Conclusions: The findings suggest that physiotherapy is perceived as an important supportive component of alcohol addiction recovery programmes. Greater integration of physiotherapy into multidisciplinary addiction rehabilitation may enhance patient outcomes and quality of life.

Patterns and predictors of hearing help-seeking behaviour among older adults with hearing loss in a South Indian cohort

2026-10-01T01:35:54+00:00

Background: Hearing loss is highly prevalent among older adults and is associated with communication difficulties, social isolation, depression, and reduced quality of life. Despite these consequences, many individuals delay seeking professional hearing healthcare and hearing-aid adoption for several years. Hence, the study aimed to characterize the extent of help-seeking delay (HSD) among older adults with sensorineural hearing loss in this cohort and to investigate the demographic and audiological factors associated with HSD.

Methods: A retrospective, quantitative design was employed using a structured self-report form. The study included 250 participants aged ≥55 years, representing diverse demographic and audiological characteristics.

Results: On average, participants delayed 3.5 years from the onset of self-reported hearing difficulties before undergoing a hearing test. Help seeking interval was significantly associated with participants’ age, with younger individuals in the cohort seeking help earlier compared to older counterparts. Socio-economic, rural residence, and hearing loss were significant predictors of delay, while gender and literacy were not. Help seeking interval was independently associated with increasing age and below-poverty-line income, but not with audiological severity or other demographic after adjustment.

Conclusions: Despite perceiving hearing difficulties, many older adults in India delay seeking audiological care. The mean pure-tone average at first assessment corresponded to moderately-severe degree of hearing loss, suggesting that help-seeking occurs only when impairment becomes substantial. At this stage, individuals begin considering for hearing help; however, age and financial constraints remain a barrier to timely seek-help.

Burden of cardiovascular disease risk factors among PLHIV individuals in Davanagere: a cross-sectional study

2026-10-01T01:35:09+00:00

Background: The HIV and Acquired Immunodeficiency Syndrome (AIDS) pandemic has significantly contributed to mortality rates in many countries over the past three decades. The risk of acquiring NCDs has increased with usage of ART among HIV people.

Methods: A cross-sectional study was done among 150 PLHIV registered in the ART centres of the teaching hospitals of Davanagere. Study subjects were selected randomly and were interviewed and examined to identify CVD risk factors like NCDs, lifestyle factors, duration of ART and CD4 count. Univariant analysis was done to determine association between NCD and risk factors.

Results: Among 150 PLHIV individuals, CVD risk factors prevalence was highest (75%) in diet, followed by female’s waist-to-hip ratio (55%), hypertension (7.3%) and diabetes (5%) among PLHIV. Risk factors like diet, physical activity, anthropometric measures showed significant association (p value-0.00001 which is <0.05) in developing NCDs. Chi-square test showed significant association (p value-0.0024 which is <0.05) among risk factors like diet, BMI, W/H ratio whereas the HIV factors like ART duration, CD4 count and viral load didn’t show any significant association(p>0.05).

Conclusions: CVD risk factors prevalence like poor diet and obesity was more, despite CVD prevalence being low among PLHIV. Adequate counselling on diet and physical activity can help improve their quality of life and reduce morbidity and mortality due to CVD with continuous ART.

A community based cross-sectional study on psychosocial status among elderly population of rural field practice area of a tertiary health care centre of Maharashtra

2026-10-01T01:35:54+00:00

Background: Psychological and social factors form an integral part in the health and wellbeing of elderly. The elderly who will constitute 10% of the Indian population by 2025 face problems such as deteriorating healthcare status, loneliness, and economic constraints among others. All these factors together may affect the psychosocial status of the elderly and their health‑seeking behaviour. With this background, the current study tried to evaluate the psychosocial status among elderly patients.

Methods: The present community based cross-sectional study was carried out among 200 men and women of aged above 60 in rural healthcare centre of a tertiary health centre of Maharashtra. A semi‑structured interview schedule was administered by a trained medical professional after taking informed consent over a period 6 months from January to June 2023.

Results: Depression was found significantly higher in age group above 75 years (66.7%), Of which majority are female (57.9%). The proportion of Hindu suffering from depression was 55.5% as compared to other religions. The depression was found significantly higher among elderly population those who are illiterate and having education below secondary level and of lower socioeconomic status.

Conclusions: In present study, elderly above 75 years, female gender, illiteracy and low SES were found significant factor for poor psychological status. Depression was higher among those elderly population whose advise was not honored and whose living arrangement was alone.

Association of emotional factors with dietary behaviors and body weight status among college students: a cross-sectional study

2026-10-01T01:35:52+00:00

Background: Transitions of college life often lead to changes in eating habits, psychological well-being, and body weight, which can have an impact on young adults' nutritional status and general health. The purpose of this study was to examine the relationship between eating attitudes, emotional appetite, and Body Mass Index (BMI) among college students.

Methods: A cross-sectional study including 356 college students aged 15 to 30 years was carried out at SRM Institute of Science and Technology in Chennai, India. Eating attitudes were measured with the Eating Attitudes Test (EAT-26), and emotional appetite was measured with the Emotional Appetite Questionnaire (EMAQ). The Body Mass Index (BMI) was computed using basic anthropometric measurements. Statistical analyses were used to examine the relationships between eating habits, emotional appetite, and BMI.

Results: The majority of individuals (64.9%) had healthy eating attitudes, while 32.3% had poor eating behaviors. A statistically significant relationship was found between eating attitudes and BMI (p=0.034), with normal-weight participants more likely to report good eating habits. Emotional appetite patterns showed that negative emotions were often connected with lower appetite and positive emotions with increased food intake. However, there was no statistically significant relationship between emotional appetite and BMI.

Conclusions: Healthy eating attitudes were substantially connected with normal BMI among college students, whereas emotional appetite had no effect on BMI despite impacting eating habits. These findings emphasize the need to combine nutrition education and mental health measures to encourage good eating habits and improve college students' overall well-being.

Morbidity profile and healthcare utilization among beneficiaries of Swasthya Rakshan programme siddha medical camps in rural area: a retrospective observational study

2026-10-01T01:35:06+00:00

Background: Community outreach medical camps play an important role in improving access to healthcare services in rural and underserved populations. Siddha medical camps conducted under the Swasthya Rakshan Program aim to extend traditional healthcare services and promote awareness of the Siddha system of medicine. The present study evaluated the beneficiary profile and morbidity pattern of patients attending Siddha medical camps conducted between 2022 and 2025.

Methods: A Retrospective observational study was conducted based on the Siddha medical camps organized by Siddha Medical Plants Garden and Research Centre, Mettur, between December 2022 and March 2025. Basic demographic and clinical data of beneficiaries were recorded during consultation. Patients were categorized based on gender, age group and type of visit (new or follow-up). Disease distribution was analysed system-wise according to Siddha clinical classification. Descriptive statistics and chi-square tests were used to assess differences in demographic characteristics.

Results: A total of 1,405 beneficiaries attended the Siddha medical camps, including 659 (46.9%) new cases and 746 (53.1%) follow-up cases. Of these, 893 (63.6%) were adults and 512 (36.4%) were children. Among adults, females greatly outnumbered males (68.1% vs. 31.9%; χ²=116.8, p<0.001), while the gender ratio among children was similar. The most common morbidities were musculoskeletal disorders, followed by respiratory, skin and gastrointestinal issues.

Conclusions: Siddha medical camps serve as an effective community outreach strategy for delivering traditional healthcare services. The findings highlight the importance of strengthening such programs to improve accessibility and promote integrative healthcare in rural communities.

Effectiveness of sexual and reproductive health training program on knowledge and coping strategies of women with mental illness: a true experimental study

2026-10-01T01:35:05+00:00

Background: Women with mental illnesses (WMI) experience significant problems with their reproductive health and feel uncomfortable discussing sexual functioning with medical professionals. Therefore, the study aims to investigate the efficacy of the sexual and reproductive health (SRH) training program on knowledge and coping strategies among WMI.

Methods: The study employed a true experimental design with a pretest-posttest control group. Individuals with SRH problems were selected using a simple random sampling technique from a random table for the experimental (n=65) and control (n=65) groups. The experimental group received the SRH training program, which included three interactive sessions using different teaching methodologies. While the control group received Information Education and Communication (IEC) material on SRH. A knowledge questionnaire about SRH and a Coping Checklist were used to gather data. SPSS version 22 for Windows was used to analyze the data.

Results: The study demonstrated the effectiveness of the SRH training program, as evidenced by differences in knowledge and coping strategy scores between experimental and control groups following the post-test (p<0.05). In the experimental group, a substantial positive correlation was found at the p<0.05 level between knowledge and problem-solving, distraction-negative, acceptance/redefinition, religion/faith, and denial/blame coping strategies.

Conclusion: The present study findings concluded that WMI benefit from the SRH training program in terms of improving their knowledge and coping mechanisms regarding the appropriate use of contraception, prevention of Sexually Transmitted Infections, sufficient information on sexual health, and appropriate referral services for sexual violence.

Effect of yoga on lung function tests and mental health among medical students: a longitudinal before-after study

2026-10-01T01:35:05+00:00

Background: Medical students often experience high levels of academic stress, sedentary lifestyle, and irregular routines, all of which can adversely impact both physical and mental health. Yoga, that integrates asanas, pranayama, and meditation, has gained increasing attention in modern health research for its potential holistic benefits. This study aims to evaluate the effect of a structured yoga intervention on lung function tests and mental health among undergraduate medical students.

Methods: A longitudinal pre-post interventional study conducted among medical students who are willing to participate in a 12-week yoga training program, while those with severe respiratory diseases and current smokers excluded. Baseline assessments included pulmonary function tests and mental health evaluation using the Perceived Stress Scale (PSS-10). Participants underwent a structured yoga intervention for an above said period. Post-intervention assessments were performed using the same standardized instruments. Pre- and post-intervention values were compared using appropriate statistical tests, with a p-value <0.05 considered statistically significant.

Results: Mean age of the study participants was 20.3±1.7. Following intervention, the Yoga participants showed significant improvement in pulmonary function parameters, including FEV1, FVC and FEV1/FVC. Mean PSS-10 scores showed a significant reduction, indicating improved mental well-being.

Conclusions: Regular yoga practice was associated with significant improvements in lung function and mental health among medical students. Incorporating yoga into medical education may serve as an effective, low-cost strategy for promoting physical and psychological well-being.

Mental health awareness and literacy among health university students in Southern Karnataka

2026-10-01T01:35:04+00:00

Background: Mental health awareness and literacy among university students are increasingly important as enrolment in higher education rises. Health university students represent the future healthcare workforce, making their understanding of mental health a critical indicator.

Methods: A cross-sectional study was conducted from January to June 2023 among first- and second-year students of the JSS Medical, Dental and Pharmacy Colleges, JSS Academy of Higher Education and Research, Mysuru. Universal sampling was adopted: all 828 eligible students were invited, and 348 (42.0%) completed the survey. Data were collected through a Google Form containing a socio-demographic proforma, a self-designed 17-item Mental Health Awareness Scale (MHAS) (Cronbach’s α=0.78) and the 35-item Mental Health Literacy Scale (MHLS). Scores were categorised as low or high using the overall mean, and associations were tested using the chi-square test.

Results: Of the 348 participants, 57.5% were female and 56.0% were aged 17-19 years; Pharmacy students formed the largest group (44.8%). Medical students had the highest mean mental health awareness (68.76±6.84) and literacy (118.19±13.12) scores. Age, gender and course of study were significantly associated with both mental health awareness and literacy (p<0.05); older students and male students more often had high scores, and Pharmacy students had the lowest proportion with high scores.

Conclusions: Overall mental health awareness and literacy among health university students were satisfactory, but important gaps persist, particularly among younger students, indicating the need for structured mental health education early in health professional curricula.

Social stigma among tuberculosis patients attending an urban health training centre in central India: a cross-sectional study

2026-10-01T01:35:03+00:00

Background: Tuberculosis (TB) in India contributes a large share of the global burden. Beyond physical illness, patients often face emotional strain, discrimination and unfavourable community attitudes that hinder care-seeking and adherence. Knowing how common stigma is and what drives it, is important for TB control.

Methods: This cross-sectional study was conducted at an urban health training centre of a tertiary care teaching hospital in Central India between November 2025 and April 2026. Eighty diagnosed TB patients aged ≥18 years were recruited by convenience sampling. Data were collected using a semi-structured questionnaire and the Van Rie TB Stigma Scale. Statistical analysis used: Associations were examined using the Chi-square test or Fisher’s exact test where expected cell counts were small, with statistical significance set at p<0.05.

Results: Males predominated (48 vs 32); the commonest age group was 18–30 years. Pulmonary TB was present in 56 patients and extrapulmonary TB in 24. On the stigma scale, 18 (22.5%) had low, 38 (47.5%) moderate and 24 (30.0%) high stigma, thus 77.5% experienced moderate-to-high stigma. Stigma was significantly associated with socio-economic status (p=0.017) but not education (p=0.59) or occupation (p=0.68).

Conclusions: A sizeable proportion of TB patients experienced moderate-to-high social stigma, a notable psychosocial burden in TB care. Community awareness, patient counselling and supportive training for health workers may help reduce stigma and improve treatment outcomes.

Investigating rahu (North lunar node) placement in the sixth house of the natal horoscope with special reference to irritable bowel syndrome: an exploratory case control study

2026-10-01T01:35:02+00:00

Background: Irritable bowel syndrome (IBS) is a common, multifactorial disorder of gut-brain interaction. In Jyotisha (Vedic astrology), the sixth house (Shashtha Bhava) is traditionally linked to disease, and placement of Rahu (North Lunar Node) in this house is hypothesised to influence disease susceptibility. This exploratory case-control study evaluated whether Rahu's placement in the sixth house is significantly associated with Rome IV-confirmed IBS.

Methods: This case-control study was conducted in an institutional outpatient department from December 2025 to March 2026, enrolling 176 participants (88 Rome IV-confirmed IBS cases and 88 healthy controls). Natal horoscopes were generated using validated AstroSage software from documented birth details and independently verified by a qualified astrologer for presence of Rahu in the sixth house. Association with IBS status was analysed using the Pearson chi-square test, and OR with 95% CI was calculated by the Woolf (logit) method.

Results: Rahu was identified in the sixth house in 76.1% of cases compared with 15.9% of controls (χ²=64.25, df = 1, p<0.001; exact p=1.10 × 10⁻¹⁵), yielding an OR of 16.86 (95% CI: 7.94–35.80). Sex distribution did not differ significantly between groups (p=0.543).

Conclusions: A statistically significant, strong association was found between Rahu's placement in the sixth house and Rome IV-confirmed IBS, lending preliminary support to the Graha Chikitsa hypothesis. As an exploratory observational study, this cannot be interpreted as causal; multicentre validation adjusting for biological, dietary, and psychosocial confounders is warranted before clinical application.

Impact of health education on menstrual hygiene practices among school-going adolescent girls in an urban area of Lucknow: a quasi-experimental study

2026-10-01T01:34:59+00:00

Background: The issue of menstrual hygiene is inefficiently accepted and has not received appropriate consideration. Numerous studies have confirmed that scientific health education can bring about an affirmative change in knowledge and practice among adolescent girls concerning menstrual hygiene management.

Methods: A quasi-experimental study was conducted among 473 adolescent girls in schools offering classes from 9th to 12th standards. Multistage stratified random sampling technique was applied to select adolescent girl students. After completion of data collection all girls were given health education talk on menstrual health and hygiene practices with help of Flipbook provided by Menstrual Hygiene Management Scheme under National Rural Health Mission. A pamphlet prepared in vernacular language (Hindi) from this flipbook was given to each girl. After 3 months effect of health education talk was assessed by post-test questionnaire.

Results: The hygienic practices of adolescent girls during menstruation before and after health education intervention were compared. Notable improvements include increased use of sanitary pads (65.1% to 75.6%), higher frequency of changing absorbents daily (>2 times: 40.4% to 52%), and better hand washing with soap and water (42.1% to 55.8%) was observed. The proportion of participants with good practice scores increased significantly from 35.3% to 61.3% after the intervention (p < 0.001).

Conclusions: This study provides comprehensive insights into menstrual hygiene among adolescent girls, highlighting the effectiveness of a health educational intervention in improving knowledge and practices surrounding menstruation.

Maternal mortality trend in Goa: a record-based study

2026-10-01T01:34:58+00:00

Background: Maternal mortality reflects unequal access to quality health services across the world. Despite a consistent decline in deaths, disparities between states could hinder our progress towards Sustainable Developmental Goals. Maternal Death Reviews were introduced nationwide to address causative aspects of maternal deaths and take corrective actions. This study was devised to assess the maternal mortality trend over a 10-year period and to determine cause-specific distribution of mortality across Goa.

Methods: A retrospective study was conducted using Facility reviews and Verbal Audit forms of reported maternal deaths from 2016 to 2025. All 125 reports were analysed for sociodemographic data, antenatal factors and cause of death using SPSS v.14. Results were presented as frequency, percentages, figures and graphs.

Results: Out of 125 deaths, 103 (82.4%) were indigenous. Among these, 24 (23.3%) were graduates, 44 (42.7%) were above poverty line, 12 (11.6%) conceived with in-vitro fertilization and 82 (79.6%) were from rural Goa. Ten (7.7%) mothers died without antenatal care and 61 (59.2%) died postnatally. Haemorrhage (22.3%), hypertension (21.4%), other infective causes (17.5%) and cardiovascular causes (15.5%) caused the most indigenous deaths; these were primarily concentrated among <35 years old (67%), South Goa (56.3%), Goa Medical College (74.8%) and in 2018 (16.5%).

Conclusions: Though Goa provides commendable obstetric care, equipping all healthcare levels equally to handle any obstetric case before it becomes a tragedy needs prioritizing. Continuing MDSR with responsibility rather than blame, robust counselling of expectant mothers especially at IVF centres and a prompt referral system could help.

Diet and WASH practices in the double burden of stunting and thinness among tribal adolescents in Madhya Pradesh, India

2026-10-01T01:34:57+00:00

Background: Undernutrition is a major public health concern among adolescents, disrupting normal growth and development with long-term health consequences. However, evidence on the nutritional status of tribal adolescents remains limited. This study aimed to assess the prevalence of undernutrition (stunting and thinness) and its associated risk factors among Gond tribal adolescents in Madhya Pradesh, India.

Methods: A community-based cross-sectional study was conducted among 500 Gond tribal adolescents. Data on sociodemographic characteristics, water, sanitation, and hygiene (WASH) practices, and dietary diversity were collected using a structured questionnaire. Height and weight measurements were obtained to assess stunting (height-for-age) and thinness (BMI-for-age) according to WHO standards. Binary and multivariable logistic regression analyses were performed to identify factors associated with undernutrition.

Results: The prevalence of stunting, thinness, and their coexistence was 32.6%, 31.8%, and 13.2%, respectively. In bivariate analyses, age, sex, family type, personal hygiene index, and dietary diversity were significantly associated with undernutrition. After adjustment, females had higher odds of stunting, whereas males had higher odds of thinness. Early adolescents were more likely to experience thinness and the coexistence of stunting and thinness than late adolescents. Poor personal hygiene was independently associated with all three outcomes, while low dietary diversity remained a significant predictor of stunting.

Conclusions: Undernutrition is highly prevalent among Gond tribal adolescents. Poor personal hygiene and low dietary diversity, together with sociodemographic factors, contribute significantly to undernutrition. Community-based interventions focusing on nutrition education, dietary diversification, improved hygiene practices, and regular nutritional screening are essential to improve the nutritional health of tribal adolescents.

Perception of hypertension among the rural inhabitants of a district in Assam: a qualitative study

2026-10-01T01:33:15+00:00

Background: With the current epidemiological transition, India faces triple burden of disease and hypertension has emerged as a major problem. Effective prevention and control strategies need adequate knowledge regarding the perception and understanding of hypertension from a layman’s viewpoint. The qualitative study aimed to understand the layman’s perceptions and the basis of it.

Methods: Five focus group discussions (FGD) were conducted among rural inhabitants of Assam with grounded theory approach and social constructivist paradigm. Data mining with thematic and content analysis was done.

Results: Hypertension was perceived to be a serious problem in the community. The people were not clear regarding the symptoms. Faulty diet, household and work-related stress and environmental change were considered as major predisposing factors for hypertension. They perceived their lack of knowledge and so was the importance of awareness campaigns and regular screening in the community. Slight variations in perception of hypertension among man and woman was seen. Men perceived physical inactivity as the major issue while women perceived household stress as the leading cause for hypertension.

Conclusions: Hypertension is a serious problem in the community. The community lacks understanding of the symptoms of hypertension. Awareness regarding the problem is there but the treatment seeking behavior is lacking. There was a felt need of awareness campaigns and regular screening. This will help in filling the dearth of knowledge on hypertension in the community leading to effective prevention and control.

Non-communicable disease risk factors: a cross-sectional study among the adult population of rural Patna, India

2026-10-01T01:33:13+00:00

Background: Non-communicable diseases (NCDs) are a leading cause of morbidity and mortality worldwide, primarily driven by cardiovascular diseases, diabetes, cancers and chronic respiratory conditions. This study aimed to assess the prevalence of NCD risk factors among adults in a rural area of Patna, Bihar.

Methods: A community-based cross-sectional study was conducted over two months (April–May 2024) among adults aged 18 years and above using convenience sampling. Data were collected using a modified WHO STEPS tool through face-to-face interviews, along with physical and biochemical measurements. Descriptive and inferential statistics, including chi-square tests, were applied for analysis.

Results: Among 211 participants (mean age: 47.05±16.63 years), tobacco use (31% smoking, 36.8% smokeless) and alcohol consumption (42.5%) were markedly higher among males, while inadequate fruit and vegetable intake was common in both sexes; physical activity was higher in males (64.4%) than females (53.2%). Hypertension was observed in 21.8% of males and 17.7% of females. Overweight was more prevalent in males (37.9%), whereas obesity was slightly higher in females (22.6%). Despite this, central obesity was notably high, affecting 85.1% of males and 76.6% of females, indicating increased metabolic risk even among individuals with normal or mildly elevated BMI. Overall, 74.88% of participants had three or more NCD risk factors, indicating a clustering of NCDs, with no significant association across socio-demographic variables.

Conclusions: A high burden of clustered NCD risk factors across all groups highlights the need for population-wide prevention and early screening strategies.

Solid waste management: a case study of a slum area within the UHTC field practice area

2026-10-01T01:33:12+00:00

Background: Rapid urbanization and population growth have led to a substantial increase in municipal solid waste (MSW) generation, posing significant environmental and public health challenges, particularly in developing countries. Evaluating community awareness and practices related to household waste management is crucial for devising effective interventions.

Methods: A community-based cross-sectional study was performed in a slum area. Data were gathered via a door-to-door survey employing a standardized questionnaire amongst 482 households. We got information about socio-demographic characteristics, household waste generated, segregation practices, disposal methods, municipal waste collection.

Results: Most households generated common domestic waste, including kitchen waste, vegetable waste, paper, and plastic. (99.4%) people knew that throwing away trash in the wrong way hurts the environment. About 54.4% of families threw away their trash in trash cans, and 5.4% in open areas near their homes. 37.6% of homes said that municipal services picked up their trash every day, while 20.5% said that it was picked up at random times. Only 36.3% of those who answered were happy with the current system for picking up trash in the city.

Conclusions: To improve sustainable household waste management in urban slum areas, it is important to strengthen the infrastructure for municipal trash management, make sure that waste is picked up on a regular basis, encourage source-level segregation, and get more people involved.

Comparative analysis of regression models in predicting Intimate partner violence: a gender specific analysis using NFHS-5 data

2026-10-01T01:33:11+00:00

Background: Existing regression models for determining intimate partner violence (IPV) against women include characteristics of women and men individually but evidence lacking on couple characteristics and best fit models. We aimed to compare regression models in predicting IPV using characteristics of women and her partner separately and as a dyad.

Methods: We used couple data from National Family Health Survey-5 containing data from both women and her partner. IPV considered as positive response for any of the questions on domestic violence. Multiple logistic regression models were built separately for characteristics of women and men and couple characteristics. Best fit models identified through r-squared value and AIC and BIC statistics.

Results: We included 46445 couple data for final analysis. R-squared value for models including female characteristics were similar to models with couple characteristics and higher than the models with male characteristics. Odds Ratio were also higher for women characteristics compared to their counterparts’ characteristics. Family history of IPV among women, women’s attitude towards wife beating and controlling behavior of partner were associated with higher IPV.

Conclusions: Individual characteristics of women in a couple alone can be an effective determinant of IPV than the traditional view of power relations between men and women in household.

Perception and practices on menstrual hygiene among urban adolescent girls: a cross-sectional study

2026-10-01T01:33:10+00:00

Background: Adolescence is a period of transition from childhood to adulthood. It is a unique stage of human development and an important time for laying the foundation. The World Health Organization defines adolescents as "young people between the ages of 10 and 19 years, a transition period from childhood to adult life”. This study aimed to assess the perception of menstrual hygiene among adolescent girls. To find out the prevailing practices of menstrual hygiene among adolescent girls in the field practice area of UHTC, VIMSAR, Burla. To assess other factors associated with menstrual hygiene practices.

Methods: This study was conducted as a community-based cross-sectional study. This study was conducted from September 2022 to July 2024. The study was designed and planned in the Department of Community Medicine, VIMSAR, Burla, Sambalpur, Odisha, India. VIMSAR is one of the oldest Medical Colleges in the state of Odisha.

Results: Mean age of menarche was 12.5±1.22 years. Around 33% were aware of menstruation before menarche, and mothers were the main source of information. Around 58% were aware of the subsidy on sanitary napkins. All of the participants used sanitary napkins. Around 60% girls changed menstrual materials 4-6 hourly. The majority of the participant were disposing of their materials by burning or burying, or throwing in a dustbin. Good menstrual hygiene management was followed by only 27.7% of the participants.

Conclusions: Even though sanitary pad users were high, unhygienic practices were noticed, so more emphasis needs to be given on awareness of menstrual hygiene practices among adolescent girls.

Self-care practices among type 2 diabetes patients of urban community of coastal city of Uttara Kannada, Karnataka

2026-10-01T01:33:08+00:00

Background: Diabetes mellitus requires sustained self-management, including appropriate medication use, dietary regulation, physical activity, glucose monitoring, and engagement with healthcare providers. This study assessed self-care practices among patients with type 2 diabetes mellitus using the diabetes self-management questionnaire-revised (DSMQ-R).

Methods: A community-based cross-sectional study was conducted among 189 patients with type 2 diabetes mellitus registered at the Urban Primary Health Centre, Baithkol, Karwar, Karnataka, from July to December 2025. Participants were selected from the non-communicable disease register. Data were collected after informed consent using the DSMQ-R and analyzed using descriptive statistics, the chi-square test, correlation analysis, and multiple linear regression in SPSS version 27.0.

Results: Of the 189 participants, 93.7% were aged >40 years and 63.0% were male. Nearly half (47.1%) had diabetes for 1–5 years, and 27.0% were receiving insulin. Overall, 57.6% demonstrated moderate self-care adherence, 23.2% fair adherence, 14.3% good adherence, and 4.7% poor adherence. Diabetes duration was significantly associated with overall self-care practice scores (χ²=15.854, p=0.045). Overall self-care scores showed significant positive correlations with eating behaviour, medication-taking, glucose monitoring, cooperation with the diabetes care team, and insulin management (all p<0.001). In regression analysis, eating behaviour was the strongest positive predictor (β=0.357, p<0.001).

Conclusion: Most participants demonstrated moderate self-care practices, but important gaps remained in glucose monitoring and insulin management. Structured self-care education and DSMQ-R-based counselling at the primary healthcare level may strengthen diabetes self-management.

Effect of paschimottanasan versus foam roller on hamstring flexibility in physiotherapy college students: a comparative study

2026-10-01T01:33:08+00:00

Background: Reduced hamstring extensibility is frequently observed in young adults and may be influenced by prolonged sitting and low physical activity. Paschimottanasana and foam rolling are commonly used to address flexibility limitations, but their relative effects in physiotherapy students have not been directly compared often.

Methods: Sixty physiotherapy students aged 18-25 years with hamstring tightness on the YMCA Sit-and-Reach Test participated in this comparative interventional study. Purposive sampling was used, followed by chit-based allocation to Paschimottanasana (n=30) or foam roller self-myofascial release (n=30). Both groups trained three times weekly for four weeks. Flexibility was measured before and after the intervention. Paired t-tests assessed within-group change and an independent t-test compared post-intervention scores. Statistical significance was set at p<0.05.

Results: Sit-and-Reach scores increased from 22.86±2.08 cm to 25.16±1.90 cm after Paschimottanasana (t=5.51, p<0.001), and from 23.16±1.74 cm to 24.16±1.44 cm after foam rolling (t=3.61, p=0.001). The post-intervention comparison was also significant (t=2.29, p=0.025).

Conclusions: Both approaches improved hamstring flexibility, with a significantly larger improvement following Paschimottanasana. The posture may therefore provide a practical, low-cost flexibility option for healthy young adults.

Prevalence of cyber victimization, knowledge of cybercrime and its psychological impact among nursing students in New Delhi: a descriptive study

2026-10-01T01:33:48+00:00

Background: The rapid advancement of communication technology has transformed connectivity through smartphones and social media, but has also expanded avenues for online harassment, making cybervictimization a public health concern. Nursing students are particularly vulnerable due to frequent online exposure and academic demands. This study aimed to assess prevalence and knowledge of cybercrime and evaluate psychological impact of cybervictimization among nursing students in New Delhi.

Methods: A quantitative descriptive cross-sectional survey was conducted at selected nursing colleges of New Delhi from June 2024 to December 2024. A total of 701 nursing students were selected using total enumeration sampling technique. Data were collected using structured knowledge questionnaire, standardized Cybervictimization Scale (CYBVICS 2019), and Depression, Anxiety, and Stress Scale-21 (DASS-21). Data were analyzed using descriptive statistics and chi-square test.

Results: Out of 701 nursing students, 565 (80.60%) demonstrated good knowledge, 121 (17.26%) average, and 15 (2.14%) poor knowledge regarding cybercrime. Cybervictimization was present in 491 (70.05%) students, with 151 (21.54%) mild, 149 (21.25%) moderate, and 191 (27.24%) severe victimization. Among 475 victimized participants, 286 (60.21%) had depression, 279 (58.73%) anxiety, and 55 (11.57%) stress. Significant associations were observed between cybervictimization and depression, anxiety and stress at p<0.05.

Conclusions: Although most students possess good knowledge, prevalence of cybervictimization remains high and significantly associated with psychological outcomes, emphasizing need for institutional cyber safety programs and psychological support.

Burden of non-communicable diseases, occupational stress and quality of life among police personnel in Telangana, India: findings from a cross-sectional study

2026-10-01T01:33:04+00:00

Background: Police personnel work under demanding conditions characterised by long duty hours, irregular shifts, exposure to traumatic events, and high occupational stress. These factors may contribute to unhealthy lifestyle behaviours and increase the risk of non-communicable diseases (NCDs), adversely affecting their overall health and quality of life. This study aimed to assess the prevalence of major NCDs and identify associated lifestyle, occupational, and psychosocial risk factors among police personnel in Telangana, India.

Methods: A cross-sectional baseline survey was conducted among 1,172 police personnel in Siddipet district, Telangana, from March to May 2022. Information on socio-demographic characteristics, lifestyle practices, occupational stress, and quality of life was collected using validated questionnaires, Anthropometric measurements, blood pressure, and laboratory investigations.

Results: The majority of participants (89.3%) were men, with a mean age of 38±9.7 years. Nearly 25% of them were physically inactive. 43.3% of employees had high levels of operational stress. Of the individuals, 22.3% had hypertension, 19.7% had diabetes, and 58.0% were overweight or obese. A larger burden of NCDs was substantially correlated with older age, male gender, alcohol intake, tobacco use, and physical inactivity. Higher levels of organisational and operational stress were reported by female employees. Nearly half of the participants reported having a higher overall quality of life despite these difficulties.

Conclusions: Police personnel in Telangana face a considerable burden of NCDs and occupational stress. Strengthening workplace health promotion, regular screening, physical activity programs, and stress-management interventions may help reduce disease risk and improve overall well-being and quality of life.

Association between digestive function and sleep outcomes: a systematic review protocol

2026-10-01T01:36:37+00:00

Background: Digestive disturbances and sleep disorders frequently coexist and are increasingly recognized to share interconnected circadian, metabolic, inflammatory, and neuroendocrine pathways. The gut–sleep axis has emerged as a framework describing bidirectional interactions between gastrointestinal physiology, gut microbiota, and sleep regulation. Ayurveda presents a parallel systems-based perspective through the concepts of Agni (digestive capacity) and Nidra (sleep), emphasizing that impaired digestion and accumulation of Ama may contribute to disturbed sleep and systemic imbalance. This systematic review aims to synthesize available evidence evaluating the relationship between digestive function and sleep outcomes and to explore the underlying physiological and mechanistic pathways linking these processes.

Methods: Human clinical and observational studies will form the primary evidence base, while experimental and animal studies investigating digestive–sleep mechanisms will be considered separately to support mechanistic interpretation and will not be included in quantitative synthesis. Literature searches will be conducted across MEDLINE, Embase, CENTRAL, Scopus, Web of Science, the AYUSH Research Portal, and Google Scholar, with citation tracking and screening of Ayurvedic postgraduate and doctoral dissertations, for studies published up to October 2025. Methodological quality will be independently assessed by two reviewers using the RoB-2 and ROBINS-I tools. Findings will primarily be synthesized narratively, with meta-analysis undertaken only if methodological and outcome homogeneity permit; heterogeneity will be assessed using the I² statistic and certainty of evidence evaluated using the GRADE approach.

Conclusions: This review is expected to provide an integrative understanding of digestive–sleep interactions and inform future research and evidence-based clinical strategies.

Trial registration: PROSPERO CRD420251178526.

Data, methodological and referencing concerns in a cross-sectional study of oral health among preschool children attending Anganwadi centers

2026-10-01T01:35:08+00:00

The cross-sectional study by Pullagurla et al, published in the International Journal of Community Medicine and Public Health, examined oral health status, dietary habits and parental perception among 202 preschool children attending Anganwadi centers in Vikarabad district. The topic is genuinely important: dental caries remains the most prevalent chronic disease of early childhood and data from rural Integrated Child Development Services settings are scarce. However, a close reading of the tables, methods and reference list reveals several internal inconsistencies that should be corrected before the findings inform practice or policy.

Clinical performance and patient outcomes of artificial intelligence assisted shade matching in aesthetic restorations: a systematic review

2026-10-01T01:35:07+00:00

Shade selection for tooth restoration is a crucial step in achieving patient satisfaction in aesthetic dentistry. The practitioner should know the aspects of color, as well as the illumination of the object, the teeth and their surroundings and the observer himself. Given the highly subjective nature of the process, conventional shade guides were developed, along with modernized shade-taking devices, to achieve excellent color-matched restorations. Nevertheless, determining the correct shade of the restoration remains a significant challenge in routine dental practice. Artificial intelligence (AI) has emerged as a promising tool to improve the efficiency of shade matching. However, the clinical impact of its implementation and the limitations it poses remain inadequately explored. We conducted a systematic review, searching PubMed, ScienceDirect and Cochrane Library for studies. Eligible studies reported outcomes on AI performance compared with traditional triage methods. Risk of bias was assessed. The included studies (n=11) demonstrated AI’s potential to reduce triage time, improve accuracy and enhance decision support. However, limitations included under-triage risks, variable accuracy and predominance of single-center studies. In addition to implementation challenges, including workflow integration barriers and clinician acceptance. The use of AI models in esthetic dentistry improved accuracy in shade selection and restoration color prediction compared with conventional visual methods. Nevertheless, given the variability in results and the predominance of laboratory-based and single-center validation studies, large-scale clinical validation studies and standardized outcome reporting are required to synthesize evidence on long-term impact, patient-related esthetic outcomes and ethical considerations regarding the routine use of AI models.

Comparative clinical effectiveness of thrombolytic agents streptokinase versus alteplase versus tenecteplase in the management of ST-segment elevation myocardial infarction: a systematic review and meta-analysis

2026-10-01T01:41:14+00:00

ST-segment elevation myocardial infarction (STEMI) remains a leading cause of mortality worldwide, particularly in LMICs where access to primary percutaneous coronary intervention is limited. Thrombolytic therapy continues to be the cornerstone of reperfusion in such settings. This study aimed to assess the clinical effectiveness of fibrinolytic agents Streptokinase (SK), Alteplase (tPA), and Tenecteplase (TNK) in management of STEMI. This SRMA was conducted in accordance with the PRISMA guidelines. A literature search was performed across PubMed, Web of Science, and Embase using predefined keywords. Two independent reviewers screened titles, abstracts, and full texts. Data were extracted in predetermined way and assessed for quality using appropriate critical appraisal tools. Meta-analyses were performed using a random-effects model to compare the clinical outcomes. Total of 12 studies were selected out of 1280, 158 duplicates and 1048 studies were removed based on title and abstract screening, 59 studies were excluded on full text screening. Of all 9 evaluated vessel reperfusion based on TIMI grades, 8 evaluated 30-day mortality, 6 studies reported major bleeding events, 5 reported minor bleeding and 7 reported MACE. Meta-analysis showed significant improvement in reperfusion with fibrinolytic therapy (62.80%; 95% CI: 53.98–71.62%). TNK demonstrated higher reperfusion success and lower 30-day mortality (3.46%; 95% CI: 0.00- 7.85) compared to SK (5.15%; 95% CI 2.27- 8.04%). TNK exhibited the lowest bleeding risk (0.92; 95% CI: 0.03- 1.80%) and favourable MACE outcomes (11.04%, 95% CI: 3.44-18.64). Fibrin-specific thrombolytic i.e. TNK, demonstrate superior efficacy and safety in the management of STEMI.

Occupational burnout, perceived stress and psychological well-being among healthcare workers: a PRISMA-guided systematic review

2026-10-01T01:33:49+00:00

Healthcare workers face elevated occupational demands that place them at risk of burnout, chronic perceived stress, and diminished psychological well-being. Objectives were to systematically identify, screen, and synthesize peer-reviewed literature on the conceptualization, prevalence, antecedents, interrelationships, and mitigation of occupational burnout, perceived stress, and psychological well-being among healthcare workers, following PRISMA 2020 reporting principles. A structured, multi-query search was conducted across academic and biomedical search-engine-indexed sources (covering PubMed/PMC, Scopus-indexed journals, JAMA, BMC, MDPI, Frontiers, and ScienceDirect), supplemented by backward citation searching. Records were screened against pre-specified eligibility criteria (PICOS) by a single reviewer; a PRISMA-style flow diagram documents identification, screening, eligibility, and inclusion. Of 96 records identified, 43 met eligibility criteria and were included: 8 foundational theoretical/instrument sources, 15 systematic reviews or meta-analyses, and 20 primary empirical studies spanning nurses, physicians, and allied health professionals across more than a dozen countries, including India. Reported burnout prevalence ranged from approximately 11% to over 80% depending on profession, instrument, and pandemic period. Emotional exhaustion was the burnout dimension most consistently associated with anxiety, depression, and reduced psychological well-being, while personal accomplishment and organizational resources functioned as protective factors. The evidence base confirms substantial, heterogeneous psychological risk among healthcare workers and points to combined individual- and organizational-level intervention as the most defensible path forward. Limitations of the review's search and screening approach are discussed.

Antibiotic prescription patterns and barriers to rational antibiotic use in low and middle income countries: a scoping review

2026-09-17T01:32:37+00:00

Antibiotics are central to reducing infection related mortality. However, misuse has fueled a global antimicrobial resistance (AMR) crisis with the greatest impact in low- and middle-income countries (LMICs), where healthcare systems are often under-resourced. The World Health Organization (WHO) and International Network for Rational Use of Drugs (INRUD) indicators, along with the WHO Access, Watch, and Reserve (AWaRe) classification, provide benchmarks for antibiotic use. This scoping review aimed at examining antibiotic prescription patterns as well as identifying barriers to appropriate prescribing in LMICs. A scoping review was conducted following PRISMA-ScR guidelines. PubMed and Scopus were searched for English language studies published between 2015 and July 2025. Eligible studies reported on prescription patterns using WHO/INRUD indicators, the WHO AWaRe classification, or barriers to appropriate antibiotic prescription. Data were charted and synthesized using descriptive statistics and content analysis. Forty-four (44) studies from twenty (20) LMICs were included in the scoping review. Antibiotic prescribing rates often exceeded the WHO optimal range of 20–26.8%, reaching as high as 94.9% in Sierra Leone. In 78.6% (11/14) of the studies reporting AWaRe classification, the WHO target of ≥60% prescription of access antibiotics was not met, while watch category antibiotics accounted for disproportionately high prescribing levels (>70%) in some countries. The key barriers to appropriate prescription identified in this review included poor prescriber knowledge and attitude, and inadequate access to diagnostics, treatment guidelines, and antibiotics. Antibiotic prescribing in LMICs is frequently suboptimal, with excessive reliance on broad-spectrum antibiotics from the watch category as a result of widespread system and prescriber-level barriers that influence appropriate antibiotic prescription. Strengthening diagnostics while ensuring reliable access to antibiotics, increasing access to updated guidelines, and engaging prescribers and communities through tailored stewardship programs are essential to improve antibiotic prescriptions in LMICs.

Insecticide resistance in Anopheles mosquitoes: mechanisms, epidemiological impact and implications for malaria control in Sub-Saharan Africa

2026-10-01T01:42:01+00:00

Malaria remains among the most formidable public health challenges confronting Sub-Saharan Africa, with the region bearing 94% of the estimated 265 million global cases recorded in 2024. The emergence and proliferation of insecticide resistance in Anopheles mosquitoes threatens to reverse decades of hard-won progress in malaria control. Kenya's experience exemplifies this crisis, with malaria cases surging 27% from 3.3 million in 2023 to 4.2 million in 2024, a trend partly attributable to intensifying resistance patterns. This review synthesizes contemporary evidence on insecticide resistance mechanisms operating in Anopheles vectors throughout Sub-Saharan Africa, examining the epidemiological context of malaria transmission, the diversity of vector species, and the multifaceted nature of resistance including target-site modifications, metabolic detoxification, cuticular alterations, and newly identified sequestration mechanisms. Current surveillance indicates that 90% of malaria-endemic nations report resistance to at least one insecticide class, while 32% demonstrate resistance across all four major insecticide classes. Documentation of intense pyrethroid resistance exceeding ten-fold diagnostic concentrations in Uganda, coupled with sporozoite infection rates reaching 20.41% in resistant populations, underscores the operational significance of this phenomenon. Environmental contaminants originating from agricultural pesticides and extractive industries constitute additional resistance drivers that operate independently of public health interventions. This review identifies critical knowledge deficiencies in resistance characterization at subnational scales and emphasizes the imperative for integrated resistance management frameworks incorporating molecular surveillance networks, genomic technologies, and evidence-informed insecticide deployment strategies. Comprehending the intricate relationships between resistance mechanisms and epidemiological outcomes proves essential for maintaining the effectiveness of existing vector control approaches and guiding the strategic deployment of next-generation interventions across malaria-endemic regions.

From research to discovery: developing scholarly research competence in health professions education

2026-10-01T01:33:01+00:00

This evidence-informed narrative review examines how research engagement in health-professions education can develop into continuing scholarly participation, from research experience and publication to scholarly discovery, connection with subsequent scholarship and interpretation of research indicators. Literature addressing research engagement, thesis-to-publication experiences, scientific communication, scholarly discoverability, bibliometrics, research indicators and responsible research assessment was identified through targeted searches of PubMed/MEDLINE and scholarly databases, supplemented by citation tracking and guidance from scholarly organisations. Evidence was synthesised narratively to develop an educational perspective. Research engagement can support skills and scholarly interests among health-professions learners. Evidence from medical education illustrates the transition from student research projects and theses to publications. Publication creates a formal scholarly record, while identifiers, metadata and indexing support discovery and connection with related scholarship. Bibliometric indicators describe selected dimensions of scholarly activity, and their interpretation depends on the indicator, unit of analysis, source, time period, field and purpose. Building on existing scholarship on bibliometric and scholarly metrics literacy, we adapt the concept for health-professions education as a practical educational competency: the ability to understand commonly encountered scholarly indicators, recognise what they describe, identify their source and context, and interpret them appropriately. This definition is an educational synthesis rather than a claim of a universally standardised competency framework. Research education can extend beyond conducting a study to communicating research, participating in the scholarly record, understanding scholarly connections and interpreting research indicators responsibly. The pathway—RESEARCH → PUBLISH → DISCOVER → CONNECT → UNDERSTAND → GROW—frames research as a continuing scholarly journey.

Sleep quality in children with autism spectrum disorder: a narrative review

2026-10-01T01:41:59+00:00

Sleep disturbances are among the most frequently reported yet inadequately addressed comorbidities in children with autism spectrum disorder (ASD). Affecting an estimated 50–80% of this population, sleep problems in ASD are multifactorial in origin and disproportionately severe compared to typically developing peers. Their consequences extend beyond the affected child to encompass family functioning, caregiver mental health, and child's neurodevelopmental trajectory. A systematic narrative review was conducted using PubMed, Scopus, Embase, and Google Scholar databases. Articles published between 2000 and 2024 were screened using the terms 'autism spectrum disorder,' 'sleep disturbances,' 'sleep quality,' 'children,' 'melatonin,' and 'behavioural sleep interventions.' Original research articles, systematic reviews, meta-analyses, and evidence-based clinical guidelines were included. Grey literature and single case reports were excluded. The reviewed literature consistently identifies sleep-onset insomnia, frequent nocturnal awakenings, irregular sleep-wake cycles, and reduced total sleep duration as the predominant sleep phenotypes in ASD. Aberrant melatonin synthesis, sensory processing atypicality’s, co-occurring psychiatric conditions, and genetic factors collectively underpin these disturbances. The Children's Sleep Habits Questionnaire (CSHQ) and actigraphy remain the most validated assessment tools. Behavioural interventions, particularly parent-delivered sleep education programmes, demonstrate moderate-to-high efficacy. Melatonin supplementation shows consistent short-term benefit, though long-term safety data in paediatric ASD populations remain limited. Sleep disturbances in children with ASD are prevalent, clinically significant, and amenable to evidence-based intervention. Routine sleep screening should be integrated into the community medicine framework for neurodevelopmental disorders. Longitudinal research in low- and middle-income countries, including India, remains a critical gap.

A scoping review of the evidence linking metabolic dysfunction-associated steatotic liver disease and hearing loss: mapping the liver-ear axis

2026-10-01T01:38:46+00:00

Fatty liver disease, currently termed metabolic dysfunction–associated steatotic liver disease (MASLD), is increasingly recognised as a systemic metabolic disorder with potential extrahepatic manifestations. However, the association between MASLD and hearing loss has not been systematically evaluated. We conducted a scoping review to evaluate the association between fatty liver disease and hearing impairment. Our review adhered to the PRISMA-ScR checklist and searched using keywords in four databases (PubMed, EMBASE, Scopus, and Cochrane). Studies assessing the association between MASLD and hearing outcomes were included. Risk of bias assessment was conducted using the Newcastle-Ottawa Scale and Joanna Briggs Institute checklist. Of 415 records identified, two studies involving 210,939 participants, including 192,467 individuals with fatty liver disease, met the inclusion criteria. Both studies demonstrated high methodological quality. Fatty liver disease was assessed using fatty liver index-based steatosis definitions, while hearing outcomes were evaluated using pure tone audiometry and validated ICD-based diagnoses of sudden sensorineural hearing loss. In both studies, individuals with fatty liver disease had a higher proportion of hearing impairment. Current evidence suggests a possible association between fatty liver disease and hearing impairment, supporting the concept of a metabolic–auditory link. Nevertheless, the evidence base remains limited, and further longitudinal studies using standardized MASLD definitions and objective hearing assessments are required to clarify causality and clinical implications.

National viral hepatitis control program in India: current status and SWOT analysis

2026-10-01T01:38:30+00:00

Viral hepatitis is a public health problem in India. The National Viral Hepatitis Control Program (NVHCP) launched in 2018 paved a way in India’s journey towards universal health coverage but gaps remain in diagnostics, peripheral capacity, vaccine supply, and pediatric treatment access. This review maps the history of the program in India, its current status, gaps, and opportunities toward the 2030 elimination goals. For the purpose of this review, a comprehensive search of literature was conducted examining technical and operational guidelines, management protocols, policy documents, and review articles to understand India's journey towards viral hepatitis control. The program demonstrates multiple strengths including strong government commitment, comprehensive national guidelines, free diagnosis and treatment services, robust preventive strategies, and trained master trainers. However, several weaknesses exist as well like insufficient diagnostic infrastructure, limited molecular testing capacity, inadequate trained manpower at peripheral centers, erratic hepatitis B vaccine supply, vertical transmission prevention gaps, and no free treatment provision for children. The opportunities outlined include newer WHO guidelines extending treatment to children and adolescents, point-of-care diagnostic facilities, public-private partnerships, one-stop centers, dried blood spot testing, treat-all approaches, and establishing an adult immunization program. Major threats foreseen are competing national health programs diverting resources, dropout from diagnosis-treatment cascade, public and healthcare worker stigma, and limited private practitioner participation in the program. Although NVHCP has a robust framework aligned with global strategies, addressing gaps in awareness, logistics, and peripheral-level manpower through equity-focused innovation is essential to achieve 2030 elimination targets and advance universal health coverage.

Nomophobia in the digital age: prevalence, psychological and behavioral determinants and public health implications: a narrative review

2026-10-01T01:38:45+00:00

Nomophobia, defined as the fear of being without access to a mobile phone. Despite not being formally classified in the in the DSM-5 or ICD-11, nomophobia has emerged as increasing research attention in recent era. This narrative review aimed to synthesis evidence on the prevalence, associated factors and underlying mechanisms of nomophobia. A comprehensive search of electronic databases, including PubMed, Google Scholar and PubMed Central, was conducted for studies published between 2008 and 2025. The final search was conducted in February 2026.Eligible observational study designs, including cohort, longitudinal, ecological, case-control and cross-sectional studies published in English. The search identified 324 records across databases, including 72 from PubMed, 54 from Google Scholar and 198 from PubMed Central. Following the screening and eligibility assessment, 36 studies were included in the final synthesis. Most studies reported moderate to severe levels of nomophobia, with particularly high prevalence among medical and university students. Consistent associations were observed between nomophobia and anxiety, depression, stress, fear of missing out (FoMO), poor sleep quality, excessive screen time and problematic social media use. Younger age, frequent smartphone checking, prolonged daily smartphone uses and digital dependency behaviors emerged as predictors of nomophobia. Nomophobia represents a significant and emerging public health issue with implications for mental health and daily functioning. Addressing this condition requires targeted interventions focusing on digital well-being, emotional regulation and responsible smartphone use, alongside the development of standardized measurement approaches for improved comparability across studies.

Effectiveness of micronutrient powder intervention in reducing anemia among children under six years of age: a rapid review

2026-10-01T01:37:46+00:00

Anemia is a major public health problem among the children under six years of age. Iron deficiency is the primary cause, while deficiencies in vitamin A, folic acid, and zinc also contributes. Childhood anemia impairs the cognitive and physical development and increases the susceptibility to infections. Micronutrient powders (MNPs) are widely used as home fortifiers to reduce anemia prevalence. This rapid review consolidated the evidence from observational and interventional studies on MNP use and anemia prevalence in children under six. PubMed and Cochrane were searched for the English full-text studies conducted in Asia. Eligible designs included the randomized controlled trials, cohort, case-control, and cross-sectional studies. Data extraction followed PICO based criteria, with 12 studies meeting inclusion. MNP use consistently improved the hemoglobin levels and reduced anemia prevalence, particularly with iron inclusive formulations and high adherence. Improvements were also noted in the micronutrient status. Although effect sizes varied, supplementation generally raised hemoglobin concentrations. Program delivery structure and adherence were critical determinants of the success. MNPs significantly improve the hemoglobin concentrations and also reduce the anemia prevalence, especially among children under two years or those with moderate baseline anemia. Adherence (≥75%) was a vital factor, with compliant studies showing substantially better outcomes. Active involvement of the community health workers in distributing MNPs and educating caregivers enhanced the program success. Targeting interventions to the vulnerable populations such as anemic or at-risk children (6–24 months) may achieve greater impact than universal administration.

A review-based socio-economic framework for studying school-age malnutrition among government school children in Ranchi district, Jharkhand

2026-10-01T01:37:45+00:00

School-age malnutrition remains under-recognised in nutrition research and public-health planning, particularly in socio-economically vulnerable districts where children depend on government schools and public services. Ranchi district, Jharkhand, is a relevant setting because it includes rural, peri-urban and urban populations, a sizeable tribal presence and dependence on public schooling and nutrition support. This review-based paper develops a socio-economic and demographic framework for studying malnutrition among government schoolchildren aged 6–12 years in Ranchi district. It draws on primary-data studies from India and other developing regions to identify determinants repeatedly associated with school-age malnutrition. The reviewed evidence indicates that nutritional outcomes are shaped by household poverty, parental education, family size, gender, caste, tribe, ethnicity, dietary diversity, sanitation, morbidity and school environment. The proposed framework links distal determinants such as socio-economic status, household demography and social-group background with proximate pathways such as diet quality, water, sanitation and hygiene, recent illness and school-based support. It also outlines a practical field methodology based on multistage sampling, anthropometry, child and parent schedules, school-level information and descriptive analysis. School-age malnutrition in Ranchi should be studied not only as an anthropometric condition but also as a public-health and social-development issue. A school-centred, household-sensitive and district-level framework can support future field enquiry, nutrition monitoring and targeted public-health responses.

Disability-inclusive disaster management in India integrating healthcare, the National Building Code and Indian Public Health Standards: a narrative review

2026-10-01T01:37:43+00:00

India’s disaster management framework, established under the Disaster Management Act of 2005, addresses hazards like floods, cyclones, earthquakes, heatwaves, landslides, and heavy rain. However, the 26.8 million people with disabilities in India 2.21% of the population per the 2011 Census, with global estimates suggesting up to 15-24.9% face disproportionate risks, including mortality rates up to four times higher than others. Despite increased healthcare spending (from 1.2% of GDP in 2014-15 to 2.1% in 2022-23) and programs like Ayushman Bharat and Niramaya Health Insurance, many healthcare facilities and disaster shelters remain inaccessible for persons with disabilities. The National Building Code (NBC) of 2016 and Indian Public Health Standards (IPHS) of 2022 set standards for accessible infrastructure and emergency preparedness, yet compliance is inconsistent. This narrative review explores how integrating healthcare, building codes, and public health standards can foster a disability-inclusive disaster management system. It highlights barriers, such as inaccessible shelters, limited disaster management training for persons with disabilities, and attitudinal challenges, and suggests solutions like retrofitting facilities, developing Information, Education, and Communication (IEC) materials/Standard Operating Procedures (SOPs), and boosting community involvement to ensure equitable safety.

Prevalence and determinants of anaemia among women of reproductive age in India: a narrative review

2026-10-01T01:37:37+00:00

Anaemia is India’s most prevalent nutritional disorder among women of reproductive age (15-49 years), affecting their physical, social, and mental well-being. This narrative review synthesizes evidence on the prevalence of anaemia and its determinants, including dietary, economic, and cultural factors, as well as education, gender disparities, early marriage, and limited access to health services. Understanding these factors can help identify high-risk subgroups and guide targeted interventions. A review of studies published between 2015 and 2026 was conducted using PubMed, Google Scholar and publicly accessible National Family Health Survey (NFHS) and World Health Organization (WHO) reports. Included studies were observational, cross-sectional, community-based, or secondary data analysis. NFHS data showed that anaemia prevalence among women increased from 53% (NFHS‑4, 2015-2016) to 57% (NFHS‑5, 2019-2021), with higher rates in aspirational districts which rose from 58.7% (NFHS-4) to 61.1% (NFHS-5). Across all the covered studies, prevalence was predominant among rural women and socially disadvantaged groups, and were associated with inadequate dietary intake, low socioeconomic status, limited education, gender disparities, and cultural practices. Interventions reported to reduce anaemia included iron-folic acid supplementation, government health programs, nutrition education, and community-based initiatives. Anaemia persist as a major public health concern in India. Strengthening existing programs, including Anaemia Mukt Bharat, promoting nutrition education, and improving access to health services are essential to reduce anaemia.

Polypharmacy and medication-related harm in people with disabilities: a narrative review of prevalence, mechanisms and research gaps

2026-10-01T01:35:53+00:00

People with disabilities (PWDs) experience a disproportionately high burden of multimorbidity and long-term medication use, increasing their risk of polypharmacy and medication-related harm. This narrative review synthesised evidence on the prevalence and patterns of polypharmacy, mechanisms contributing to medication-related harm, deprescribing practices, medication optimisation strategies, and research gaps among individuals with disabilities. In accordance with the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines, searches of PubMed, Scopus, Google Scholar, and grey literature were conducted to identify studies published in English from January 2010 to May 2026. Eligible studies included individuals with recognised disabilities and reported outcomes related to polypharmacy, inappropriate prescribing, adverse drug events, medication-related harm, pharmacokinetic changes, or deprescribing. Due to heterogeneity in populations, disability types, and reported outcomes, findings were synthesised narratively. Evidence indicated a high prevalence of polypharmacy among individuals with intellectual and developmental disabilities, spinal cord injury, cerebral palsy, and multiple sclerosis, with substantial medication burdens occurring earlier than in the general population. Psychotropic polypharmacy was particularly prevalent among individuals with intellectual and developmental disabilities. Medication-related harm was influenced by polypharmacy, disability-specific pharmacokinetic alterations, communication barriers, medication errors, fragmented healthcare delivery, and limited continuity of care. Multidisciplinary medication reviews, structured deprescribing, and person-centred medication optimisation showed promise, although evidence remains limited, particularly in low- and middle-income countries. Strengthening medication assessment, deprescribing, accessible communication, caregiver support, and evidence-based prescribing is essential to improve medication safety and promote equitable, person-centred care for people with disabilities.

Role of dentists in supporting the WHO MPOWER tobacco control strategy: a review

2026-10-01T01:35:51+00:00

Tobacco use continues to pose a significant global public health challenge and is linked to numerous oral diseases, such as periodontal disease, delayed wound healing, oral potentially malignant disorders, and oral cancer. Dentists are uniquely positioned to promote tobacco cessation within routine clinical practice. This review evaluates the role of dentists in supporting the World Health Organization (WHO) MPOWER tobacco control strategy and summarizes current evidence on tobacco cessation interventions in dental settings. Articles published between 2009 and 2025 were identified through searches in PubMed, ScienceDirect, Google Scholar, ResearchGate, and BMC Public Health using keywords related to dentists, tobacco cessation, MPOWER, oral health, tobacco use, dental professionals, and WHO strategies. Thirty articles meeting the eligibility criteria were included, and their findings were synthesized according to the six components of the WHO MPOWER strategy. The literature indicates that dentists generally have sufficient knowledge of the harmful effects of tobacco and maintain positive attitudes toward tobacco cessation counseling. Nevertheless, implementation of cessation interventions remains inconsistent due to inadequate training, limited consultation time, lack of institutional support, insufficient referral systems, and, in some contexts, tobacco use among dental professionals. Dentists can make a substantial contribution to tobacco control by incorporating evidence-based tobacco cessation interventions into routine dental practice. Enhancing undergraduate education, continuing professional training, institutional support, and integration of dental services with national tobacco control programs may further strengthen their contribution to the WHO MPOWER strategy.

From ashes to numbers: the Punjab partition of 1947 as a historical social determinant of health evidence from NFHS-4, NFHS-5 and NFHS-6 (2015–2024)

2026-10-01T01:35:00+00:00

Punjab National Family Health Survey (NFHS) profile presents a paradox that contemporary health systems analysis cannot resolve. A state that leads north India in institutional delivery rates (94.3%, NFHS-5, highest in the region) and records one of its lowest infant mortality rates (approximately 14 per 1,000 live births, NFHS-5) simultaneously records child anemia at 71.1% (NFHS-5, exceeding the national figure of 67.1%), overweight or obesity in women aged 15 - 49 years at over 41% (among India five highest states), a caesarean section rate of 38.5% (far above WHO 10-15% optimal threshold), and a sex ratio at birth of only 904 girls per 1,000 boys. This review undertakes a descriptive secondary analysis of Punjab's health profile across NFHS-4 (2015 - 16), NFHS-5 (2019 - 21), and NFHS-6 (2023 - 24), integrating NFHS-6 national comparator data released in May 2026. It argues that this paradox cannot be explained by contemporary policy variables alone. The Green Revolution agricultural model itself, the product of refugee economic reconstruction after the Partition of 1947, created a dietary monoculture that underlies the present burden of anaemia. Partition-derived intergenerational trauma contributes to the chronic stress physiology measurable in community health indicators. The cultural devaluation of women entrenched during Partition's systematic gendered violence persists in a skewed sex ratio. The opioid epidemic is geographically concentrated in historically displaced border districts. Punjab NFHS data, read against its specific Partition history, establishes a case for recognizing the 1947 catastrophe as a historical social determinant of health with implications for community medicine practice and public health policy in Punjab and its diaspora.

Transforming nursing practice across the lifespan integrating community health, mental health, child health, midwifery and medical surgical nursing: a comprehensive review

2026-10-01T01:33:09+00:00

Nursing practice has undergone substantial transformation in response to evolving healthcare needs, demographic transitions, technological innovations and the increasing complexity of patient care across the lifespan. This comprehensive review synthesizes current evidence on the integration of community health nursing, mental health nursing, child health nursing, midwifery and medical-surgical nursing to highlight their collective contribution to person-centered, evidence-based healthcare. Literature published between 2020 and 2026 was identified through searches of PubMed, Scopus, Web of Science, CINAHL, Embase, Cochrane Library and Google Scholar using Medical Subject Headings (MeSH) and relevant keywords. Evidence from clinical guidelines, systematic reviews, randomized controlled trials, cohort studies, qualitative studies and policy reports was narratively synthesized. The findings demonstrate that integrated nursing practice enhances health promotion, disease prevention, early diagnosis, chronic disease management, maternal and neonatal care, child health outcomes, mental health services, acute care, rehabilitation and continuity of care. Nurse-led interventions, interdisciplinary collaboration and the adoption of digital health technologies including telehealth, electronic health records, remote patient monitoring and artificial intelligence consistently improved patient safety, healthcare accessibility, clinical decision-making and quality of care. Despite these advances, challenges related to workforce shortages, healthcare inequities, digital competency, and resource limitations remain significant barriers. Strengthening nursing leadership, evidence-based practice, advanced education, implementation research and technology integration is essential to sustain future healthcare transformation. Integrating nursing specialties across the continuum of care provides a robust framework for improving patient, family and population health outcomes while supporting resilient, equitable and sustainable healthcare systems.

FibroScan as a recommended modality for diagnosis of non-alcoholic fatty liver disease at the district level: a SWOT analysis

2026-10-01T01:33:06+00:00

Non-Alcoholic Fatty Liver Disease (NAFLD), increasingly known as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), is the most common chronic liver condition both globally and in India. FibroScan (vibration-controlled transient elastography; VCTE) provides a non-invasive, rapid, and reproducible alternative to liver biopsy by simultaneously measuring hepatic steatosis through the Controlled Attenuation Parameter (CAP) and liver fibrosis via Liver Stiffness Measurement (LSM). This review article assesses the feasibility and implications of implementing FibroScan in district-level health facilities in India using a structured SWOT (strengths, weaknesses, opportunities, and threats/challenges) analysis. The key strengths of FibroScan include its proven diagnostic accuracy, patient acceptability, and alignment with national non-communicable disease priorities. However, its weaknesses encompass costs, operator dependence, and reduced accuracy in obese patients. Many challenges are faced in the implementation of FibroScan at the district level, including the lack of infrastructure, trained personnel and health care financing. But FibroScan also offers the possibility of earlier case detection, fewer liver biopsies, better public health surveillance, and better preventive lifestyle outreach. Strategic policy integration within the Ayushman Bharat framework and the development of models for public-private partnerships could be very useful in facilitating its decentralized adoption.

A transforming emergency care in Tamil Nadu: a narrative review of the Innuyir Kappom Thittam - Nammai Kakkum 48 Scheme

2026-10-01T01:33:05+00:00

In 1956, the WHO Advisory Group defined accidents as unpremeditated events resulting in recognizable damage. Road traffic injuries (RTIs) remain a global public health challenge, with 1.19 million deaths reported in 2021, equating to 15 deaths per 100,000 population. RTIs are now the leading cause of death among individuals aged 5-29 years. In India, estimates of road traffic accidents (RTAs) largely rely on indirect reporting systems such as the National Crime Records Bureau (NCRB) and the Ministry of Road Transport and Highways (MoRTH). According to NCRB 2022, Tamil Nadu recorded 17,884 fatalities, with Chennai reporting the highest number of RTAs among metropolitan cities. Reducing road traffic deaths is critical to achieving Sustainable Development Goal (SDG) 3.6, which aims to halve global traffic deaths and injuries by 2030. Recognizing the burden of RTAs and associated financial strain, the Government of Tamil Nadu launched the “Innuyir Kappom Thittam: Nammai Kakkum - 48” scheme on December 18, 2021. This initiative ensures cashless trauma care during the first 48 hours, golden period covering 81 treatment modalities up to ₹1 lakh per individual under the Chief Minister’s Comprehensive Health Insurance Scheme. Between December 2021 and March 2023, 1,53,091 victims benefited, with ₹135.01 crore spent. By January 2024, 2,09,561 individuals had received treatment. The scheme continues under assurance mode and justified to raise the ceiling to ₹2 lakhs. High utilization and strong public‑private collaboration mark IK:NK‑48; independent evaluations could establish scalable, equitable trauma care models globally.