International Journal Of Community Medicine And Public Health

Outsourcing diagnostics in public hospitals: boon or bane! Insights from Punjab’s public-private partnerships experience

2026-02-01T03:16:43+00:00

The outsourcing of diagnostic services through public-private partnerships (PPPs) has emerged as a policy tool to address infrastructure and manpower gaps in India’s public health sector. Punjab’s Civil Hospital Mohali recently adopted this model, contracting a private provider to deliver advanced diagnostic services including MRI, CT, ultrasonography, and laboratory investigations. Drawing on data collected between December 2021 to February 2022, as part of the developing confident and critical thinkers case study writing program facilitated by the Mahatma Gandhi State Institute of Public Administration (MGSIPA) and the Chandler Institute of Governance (CIG), Singapore, this paper critically examines the outcomes of the PPP model. Early results suggest improved access, affordability, and efficiency. However, concerns related to equity, medical education, and sustainability have also surfaced. This commentary weighs the benefits and pitfalls of outsourcing diagnostics in public hospitals and highlights lessons for health policy and governance.

Antibiotic prescribing patterns at outpatient in Nanyuki Teaching and Referral Hospital, Laikipia County, Kenya

2026-01-20T02:06:50+00:00

Background: Antibiotics are the most commonly and often imprudently used therapeutics globally. The study of use of antibiotic is vital, as irrational use is a global public health threat. Very few studies are done on the out-patient prescribing patterns of antibiotic in Kenya. This study aimed to evaluate the antibiotic prescription patterns in the outpatient department in Nanyuki Teaching and Referral Hospital in Laikipia.

Methods: We adopted a point prevalence study using the out-patient global PPS tool. Important variables had data represented in frequency tables and graphs. Chi-square determined the association between categorical variables and t-test for continuous variables. Confidentiality of data will be maintained throughout the study and STATA was used for analysis.

Results: The point prevalence of antimicrobial use was (29.1%) patients who were receiving at least one antimicrobial agent at the time of the survey. Penicillins were the most commonly prescribed class (41.5%) followed by cephalosporins (21.6%). By age group, children had the highest proportion of prescriptions at 40.4%. Most common diagnostic indication was community acquired infection 89.5% that had least one antimicrobial while the highest infection is respiratory infections, at 26.3% of the cases, followed by gastrointestinal infections 19.8%. Cultures were rarely performed before initiating therapy, accounting for 1.8% only. Only 11.7%, of prescriptions were guided by existing local protocols.

Conclusions: This study recommends strengthening antimicrobial stewardship (AMS) committees to routinely review prescribing trends, alongside expanding diagnostic services as culture and sensitivity facilities to support evidence-based antibiotic use. Additionally, improve the utilization of guidelines in treatment.

Determinants associated with ST-elevation myocardial infarction

2026-02-01T03:16:24+00:00

Background: ST-elevation myocardial infarction (STEMI) is an acute coronary syndrome with a high fatality rate and is life-threatening. STEMI-related determinants for South Asian populations are significant to identify when preparing specific prevention strategies. STEMI-related determinants among a Bangladeshi population were the subject matter of this study.

Methods: A cross-sectional study was conducted at Sir Salimullah Medical College & Mitford Hospital, Dhaka, from June to December 2018. One hundred STEMI patients aged between 30-70 years who were purposively sampled and had ECG-confirmed ST-segment elevation were enrolled. Those with a previous cardiac event or chronic disease were excluded. Data collection was done through the collection of demographic data, cardiovascular risk factors, clinical measurements, and laboratory investigations. Independent determinants were determined using multivariate logistic regression analysis using SPSS v26.

Results: Mean age 52.5±13.1 years with male dominance (59%). Hypertension (HTN) was present in 63%, smoking in 47%, diabetes mellitus (DM) in 42%, and dyslipidemia in 22%. Age strata analysis revealed a significant association between age groups and the distribution of risk factors. Multivariate analysis revealed that age >50 years (AOR=2.85, p=0.008), male gender (AOR=1.74, p=0.001), HTN (AOR=3.25, p=0.004), DM (AOR=2.12, p=0.046), and smoking (AOR=2.50, p=0.012) were independent predictors for STEMI severity.

Conclusions: The traditional cardiovascular risk determinants remain the foremost predictors of STEMI among Bangladeshi populations. HTN was the strongest predictor, followed by DM and smoking. The findings emphasize the need for aggressive risk factor modification programs targeting modifiable determinants to reduce STEMI in Bangladesh.

Comparative study of patient’s satisfaction with quality of maternal and child healthcare services in primary healthcare centres in urban and rural communities in Ekiti State, Nigeria

2026-02-01T03:15:07+00:00

Background: Patients’ satisfaction is related to the extent to which general health care needs and condition specific needs are met. Evaluating the extent patients are satisfied is clinically relevant as satisfied patients are more likely to comply with medication and thus have a more positive health outcome. In sub-Saharan Africa, emphasis has been more on curative aspect of MCH as a result the indices for maternal and child mortality are relatively poor. This study aims to compare patients’ satisfaction with the quality of maternal and child healthcare services in primary health care facilities in rural and urban communities in Ekiti state.

Methods: A cross sectional survey with a multistage sampling technique was used. 366 rural women and 368 urban women utilizing MCH services in randomly selected PHC facilities were recruited by systematic random sampling. Data was collected using questionnaires and analyzed using SPSS version 26.0.

Results: This study found that 190 (51.6%) urban respondents received good quality ANC compared to 124 (33.9%) rural respondents. Similarly, 153 (41.6%) urban respondents received good quality delivery care compared to 71 (19.4%) rural respondents. In addition, 306 (83.2%) urban respondents received good quality immunization care compared to 267 (73%) rural respondents. Factors associated with patients’ satisfaction include reception by health staff with 35.8% rural mothers and 53.0% urban mothers satisfied. Also, 38.8% rural women were satisfied with the waiting time as against 26.9% urban mothers.

Conclusions: There was a high level of satisfaction amongst both rural and urban women with urban women having a higher percentage.

Knowledge and health facility–related determinants of men’s support for spousal cervical cancer screening: a mixed-methods study in a rural county of Southeastern Kenya

2026-02-01T03:12:45+00:00

Background: Globally, cervical cancer is the fourth leading cause of cancer deaths. In Kenya, it is ranked as the second cause of cancer-related deaths among females. Men’s knowledge of cervical cancer is essential in reducing cervical cancer burden. This study was conducted in Makueni County, Kenya, to establish knowledge and health facility-related determinants of men’s support for spousal cervical cancer screening in Kenya.

Methods: Quantitative and qualitative data were collected using structured questionnaires from married men aged 18–64 years attending three rural Health facilities in Makueni County, Kenya. Participants were recruited via simple random sampling from purposively selected hospitals. Quantitative data were analysed using descriptive and inferential methods, while qualitative data employed thematic coding. Key informant interviews with nurses heading Maternal and Child Health services provided qualitative insights. Ethical approval was obtained and participants consented.

Results: Male support for spousal cervical cancer screening was low, with 82% showing minimal involvement. Knowledge factors such as knowledge of cervical cancer signs or symptoms, causative agent, risk factors, prevention, screening frequency, and screening duration was strongly associated with male involvement (p<0.001). Awareness that men can transmit the causative agent to women also showed a significant relationship with involvement (p=0.019). The level of male support was significantly associated with service availability, presence of signage, and cost (p<0.005).

Conclusions: Male support for their spouses cervical cancer screening was low, calling for increased health education and awareness among men to boost support for cervical cancer screening initiatives. Health facilities should ensure continuous access to free services and promote their awareness.

Evaluation of cervical cancer awareness and preventive practices among nurses at Princess Christian Maternity Hospital, Sierra Leone

2026-02-01T03:14:58+00:00

Background: Cervical cancer remains a leading cause of preventable morbidity and mortality in sub-Saharan Africa, where organized screening and human papillomavirus (HPV) vaccination coverage are limited. Nurses are pivotal for counselling, triage, and referral within reproductive health services, yet their knowledge and personal engagement with screening strongly influence patient uptake. Empirical data from Sierra Leone especially from tertiary referral settings are scarce, hindering tailored capacity-building and service navigation interventions. Objectives were to assess nurses’ knowledge, awareness, and practices regarding cervical cancer, HPV, screening, and vaccination at a national referral hospital.

Methods: Cross-sectional survey at Princess Christian Maternity Hospital (PCMH), Freetown (25 November 2023 to 30 January 2024). Stratified sampling by cadre; n=117 (response rate 90% of the 130 minimum). Structured self-administered questionnaire with prespecified adequacy thresholds (causes ≥3/4; risk factors ≥5/8; symptoms ≥3/5; transmission ≥4/6; preventive practices ≥3/5). Descriptive statistics and χ²/Fisher’s exact tests (p<0.05).

Results: Only 35.9% identified HPV as the cause; adequacy was 48.7% for causes, 21.9% for symptoms, and 26.6% for risk factors. Knowledge differed by cadre (causes p=0.001; symptoms p=0.011), highest among BSc nurses and midwives, lowest among SECHN; no associations with age or experience. Awareness of screening was 47.9%; among the aware, correct timing “before sexual debut” was 14.3% and correct interval “every 3-5 years” 21.4%. Screening uptake in the past five years was 29.1%. Leading barriers were not knowing where to test (55.4%), perceived no need (20.5%), fear of procedure (14.5%), and fear of results (9.6%). Motivators were free services (44.1%) and provider advice (26.5%). Vaccine awareness was 32.5%; 97.4% of those aware would recommend it.

Conclusions: Nurses at PCMH, Freetown, showed suboptimal HPV-specific knowledge and low recent screening (29.1%), with significant cadre differences and navigation barriers. Targeted, cadre-specific training, clear service navigation aids, and provider-initiated, free/low-cost screening offers could rapidly improve nurses’ knowledge, uptake, and patient counselling.

Screen exposure and health behaviors in Saudi adults: cross-sectional associations with physical activity and BMI

2026-02-01T03:14:55+00:00

Background: Prolonged screen time in the modern digital society, including television viewing, smartphone use, computer use, and video gaming, has emerged as a significant public health concern. Excessive screen exposure may reduce physical activity levels and contribute to obesity. This study aimed to evaluate the association between screen time, physical activity, and obesity among adults living in Saudi Arabia.

Methods: A cross-sectional online survey was conducted using a 26-item questionnaire assessing screen time behaviors, physical activity (Godin–Shephard Leisure-Time Physical Activity Questionnaire), and sociodemographic characteristics. Associations were examined using chi-square tests, and multivariable logistic regression was used to identify independent predictors of prolonged weekday computer and smartphone use. Analyses were performed in SPSS version 29 with a two-sided significance level of p<0.05.

Results: A total of 1,282 participants completed the survey; 58% were female, and 57% were aged between 20 and 49 years. Overall, 36% of respondents were overweight, 27% were obese, and 64% were physically active. Screen time exceeding four hours per weekday was reported by 26% for television, 39% for computers, 7% for video games, and 67% for smartphones. Several demographic and socioeconomic factors were associated with increased computer and smartphone use. Smartphone use was significantly associated with insufficient physical activity or sedentary behavior, but not with overweight or obesity.

Conclusions: High levels of screen time were observed among adults in Saudi Arabia. While prolonged screen exposure was not associated with obesity, excessive screen time, particularly smartphone use, was significantly associated with lower physical activity levels. These findings highlight the need for public health strategies that promote physical activity and address excessive screen use among adults.

Integrated epidemiological surveillance in Chad: data from 2010 to 2024

2026-02-01T03:15:07+00:00

Background: Despite the adoption of the integrated disease surveillance and response strategy (IDSRS), Chad faces various health challenges, particularly regarding the detection and recording of events; case notification; data collection, processing and transmission; and response. The main of this study is to analyse the evolution and effectiveness of the integrated epidemiological surveillance system in Chad between 2010 and 2024.

Methods: This is a retrospective descriptive study. It considers the 6 priority diseases with epidemic potential under surveillance in Chad between 2010 and 2024. The main indicator for monitoring the epidemiological situation is the annual case fatality.

Results: Between 2010 and 2024 in Chad, meningitis mortality doubled from 6% to 12% despite a decline in cases, while measles (1.1% mortality before 2019) experienced a surge linked to COVID-19, which was quickly brought under control. There were four cholera outbreaks with fatality rates of 3% (2010-2011), 5.8% (2014), 6.4% (2017) and 4.1% (2019). Neonatal tetanus remained rare but highly fatal (approximately 30% mortality on average), and yellow fever had an average mortality rate of 2.7%. Malaria causes approximately 1,843 deaths each year out of more than 1.2 million suspected cases (mortality rate=0.15%).

Conclusions: To strengthen Chad's resilience to epidemiological threats, it is crucial to improve the integration and representativeness of real-time data, training, vaccination coverage, access to difficult areas, infrastructure, and intersectoral coordination, while regularly evaluating the integrated surveillance system.

Prevalence and sociodemographic risk factors of soil-transmitted helminth infections in pregnant women, Kisii County, Kenya

2026-02-01T03:15:12+00:00

Background: Soil-transmitted helminths (STH) are the most prevalent parasitic infections affecting humans worldwide. However, the levels of infection in pregnant women and the information on risk factors in Kisii County is not known. The aim of this study was to determine the prevalence of STH in pregnant women and the influence of sociodemographic factors.

Methods: A cross-sectional study of 384 pregnant women, selected through random sampling. A questionnaire was used to collect sociodemographic data. Faecal samples were examined microscopically with saline and formal-ether concentration techniques to identify helminth species. Data analysis involved proportions, logistic regression and Chi-square, with p<0.05 deemed significant.

Results: Results indicated that the prevalence of STH among pregnant women was 144 (37.5%) where A. lumbricoides was 94 (24.5%), Hookworm 21 (5.5%), S. stercolaris 5 (1.3%), T. trichiura 1 (0.3%) and E. vermicularis 1 (0.3%). Additionally, mixed infections were observed; A. lumbricoides and Hookworm 16 (4.2%), A. lumbricoides and T. trichiura 2 (0.5%), T. trichiura and E. vermicularis 1 (0.3%) and A. lumbricoides and E. vermicularis 1 (0.3%). Economic activity was significantly associated with STH infections (ꭕ2=63.485, p=0.01). Subsistence farming in particular was significantly associated with STH infections (ꭕ2=4.580, p=0.03The income levels had a significant association with STH infections (ꭕ2=16.833, p< 0.01). Lower levels of income were significantly associated with STH infections (ꭕ2=10.96, p<0.01).

Conclusions: STH infections are common in pregnant women at KTRH, especially subsistence farmers. Routine diagnosis, health education and treatment during antenatal care are critical. These findings could guide healthcare workers in eliminating STH infections in pregnancy.

Enhanced adherence counselling and viral load pattern amongst people living with HIV/AIDS in a Nigerian government hospital

2026-02-01T03:14:53+00:00

Background: Antiretroviral therapy (ART) remains the primary treatment for Human immunodeficiency virus (HIV) infection, aiming to reduce viral replication and mortality, but this requires lifelong adherence. To achieve viral load suppression (VLS) (below 1,000 copies/ml), the World Health Organization (WHO) recommends annual VL measurements and enhanced adherence counselling (EAC). Aim of the study was to determine the prevalence of VLS following EAC amongst the virally unsuppressed PLHIV at the Rivers State University Teaching Hospital (RSUTH) and factors influencing their virology outcomes.

Methods: A retrospective descriptive review of records of 330 virally unsuppressed PLHIV, aged 18 years and more, from September 2021–March 2023.

Sampling method: Random sampling method of those on three comprehensive sessions of monthly EAC. Ethical approval was obtained from the RSUTH ethical committee and an informed consent received from the ART management team. Data was collated and associations analysed with statistical significance set at p-value of<0.05.

Results: The prevalence of VLS after EAC3 (three sessions) was 70.9%. Highest preponderances were among females (51.5%), middle aged (73.3%), unemployed (71.1%), those on first line ART regimen (71.3%), CD4 count of <200 cells/mm³ and statistically significant levels (p-value<0.01) in those who had < five years ART (79.5%). There were also significant logistic regression scores (4.119, p=0.042 and 41.173, p=0.000, respectively) for VLS levels after EAC2 and EAC3.

Conclusions: Administration of at least three sessions of EAC with VL monitoring is helpful in achieving viral suppression in PLHWA.

Sociodemographic correlates of utilisation of basic emergency obstetrics and newborn care services in urban and rural Kaduna, Nigeria

2026-02-01T03:14:51+00:00

Background: Nigeria contributes significantly to global maternal mortality, with Kaduna State reporting 1,025 deaths per 100,000 live births. Basic emergency obstetric and newborn care (BEmONC) services can prevent 60% of these deaths, but utilisation between urban and rural areas remain poorly understood. This study compared the correlates of BEmONC services utilisation between urban and rural Kaduna.

Methods: A comparative cross-sectional study was conducted. Data were collected through interviews from 720 women (328 urban, 392 rural) who delivered within 36 months prior to the study. The assessment utilised WHO Emergency Obstetric Care indicators and data was analysed using IBM SPSS Statistics v26.

Results: In urban areas, women aged 15-24 years were more likely than those aged≥45 years to utilise BEmONC services, (aOR: 5.4; 95% CI: 1.1-25.6; p=0.033). Women with higher monthly household income earnings of ≥50,001 were more likely to utilise BEmONC services than those earning ≤₦10,000 (aOR: 7.4; 95% CI: 2.6-20.8, p=<0.001). While in rural areas, women who were married for ≥21 years were more likely than those married for ≤5 years to utilise BEmONC services (aOR: 10.9; 95% CI: 1.1-112.8; p=0.045). Women from households with monthly income of ≥₦50,000 (aOR: 7.0; 95% CI: 2.0-25.2; p=0.003) were more likely than those with income ≤₦10,000 to utilise BEmONC services.

Conclusions: Strengthening service delivery and addressing barriers to utilisation is crucial for improving maternal and newborn outcomes in Kaduna State.

Caregiver sociodemographic factors associated with adherence to zinc treatment of childhood diarrhoea, Kirinyaga county, Kenya

2026-02-01T03:14:28+00:00

Background: Zinc supplement is critical for managing childhood diarrhoea. However, adherence to zinc treatment remains low in low-resource settings. This study determined the association between zinc utilization for treatment of diarrhoea among children below five years old and caregivers’ sociodemographic factors in Kirinyaga County, central Kenya.

Methods: A cross-sectional study was conducted from February to March 2025, involving 223 caregivers and 25 healthcare workers across four hospitals.

Results: Only 20% (45/223) of children in this study received zinc treatment for the recommended period of 10–14 days. Low adherence to zinc treatment was associated with caregiver level of education and employment status (p<0.05). Lack of IMNCI training (96%; 24/25) among health workers was observed, despite most of them having access to the IMNCI guidelines.

Conclusions: Findings of this study underscore the need to sensitize caregivers on the benefits of zinc supplements in management of childhood diarrhea. These efforts should be complemented with periodic health worker training on guidelines that support effective management of childhood diarrhea in Kirinyaga County, particularly the IMNCI protocol.

Exploring the experiences and challenges in managing type 2 diabetes among adults in Harare, Zimbabwe – a grounded theory study

2026-02-01T03:14:44+00:00

Background: The global increase in type 2 diabetes is particularly pronounced in low-income countries such as those in Sub-Saharan Africa, where the consequences are more severe. Fragile healthcare systems, shortages of healthcare workers, and poor patient disease management aggravate this trend. Understanding patients' experiences and difficulties is essential for developing evidence-based, patient-centered interventions from their perspective. This study aims to explore the experiences and challenges faced by patients with type 2 diabetes who are receiving care at community pharmacies in Harare, Zimbabwe.

Method: Twenty-nine semi-structured interviews were conducted with individuals with type 2 diabetes who were recruited from community pharmacies using purposive and theoretical sampling. All interviews were audio-recorded and transcribed by the main researcher.

Results: The study highlighted three main themes reflecting participants’ experiences with managing type 2 diabetes: striving to adjust; receiving social support; and feeling a loss of self-identity. Participants also pointed out the difficulties of living with the condition, including facing financial constraints, encountering societal stigma, and enduring negative emotions. For many, these emotional and financial struggles deeply challenged their resolve to manage the disease.

Conclusion: Understanding the experiences and challenges faced by patients with type 2 diabetes from their perspective helps healthcare providers better grasp their needs, concerns, and fears. This understanding enables more person-centred support for self-management. Given that socioeconomic status greatly influences diabetes management, urgent policy changes are needed to lessen financial burdens, especially for low-income populations at greater risk as diabetes prevalence rises.

Scrub typhus at the local hyper-endemic area, central Vietnam: epidemiology, clinical presentations, and laboratory features at admission

2026-02-01T03:14:42+00:00

Background: The objective of this study was to deacribe the epidemiological characteristics, clinical and laboratory features at admission of scrub typhus at a local hyper-endemic area-Khanh Hoa province, central Vietnam.

Methods: From August 2018 to March 2020, a hospital-based active surveillance was applied to collect suspected adult scrub typhus cases from 9 public/district hospitals. A community survey was conducted to investigate epidemiological factors. PCR and ELISA IgM tests were applied to confirm cases. Using standardized questionnaires, trained health staffs gathered demographic, clinical and laboratory data, and assessed patients’ household conditions, personal behaviours/protective equipment, and vector exposure. Data was recorded using Open data kit (ODK) on Android devices and analysed with STATA version 15.

Results: Thirty-two confirmed cases were identified and analysed, with males accounting for 56.3%. Of these, 56.2% were farmers or worked in forests/mountain fields/garden. About 60% engaged in risky behaviours (urinating in the forest/near bushes/field; passing riverside; resting directly on household floor). About 96.9% lived in poor sanitation households and 60% always saw mice around their homes. Despite 72% worked in hazardous environment, only 34.4% used personal protective equipment. Common clinical symptoms beside fever included headache (84.4%), fatigue (75.0%), myalgia (68.8%), heart rate>90/min (50.0%), lymphadenopathy (34.4%). An eschar was found in 59.4%. Abnormal laboratory findings included neutrophils>70% (53.3%), lymphocytes<20% (65.6%), a neutrophils/lymphocytes ratio (<1 or >2) (60.0%), platelet<150,000/ml (56.3%), and AST/AL ≥40U/l (86.7%).

Conclusions: Comprehensive consideration of epidemiological features, clinical and laboratory examination is crucial for diagnosing scrub typhus upon admission. Clinicians in endemic areas need enhance their understanding of local scrub typhus.

Prevalence and antibiotic susceptibility profiles of bacteria isolated from out-patients presenting with septic wounds in Kajiado county, Kenya

2026-02-01T03:13:36+00:00

Background: The emergence of antibiotic resistance amongst bacteria colonizing wounds remains a serious global public health concern. There is a need for surveillance data on antimicrobial resistance, as this is critical in influencing policy on disease management.

Methods: The study utilized a cross-sectional study design to select 182 patients with septic wounds attending three level 3 hospitals within Kajiado County. Samples from abscesses, burns, surgical septic wounds, and lesions from patients were collected using sterile swabs, placed in transport media and transported to the lab in cold. The samples were subjected to standard bacteriological methods for isolation, characterization and identification of bacteria isolates. Antimicrobial susceptibility test was performed using the Kirby-Bauer method.

Results: The predominant bacteria isolated were Coagulase-negative Staphylococci (35.71%), S. aureus (31.69%) and E. faecalis (30.77%), P. mirabilis (19.78%), Pantoea species (14.84%) and A. viridans (12.09%). The S. aureus exhibited varied resistance to amoxicillin (20-91.9%) and ceftazidime (62.22-94.00%) but was highly susceptible to ciprofloxacin (82-97.30%) across different hospitals.

Conclusions: Staphylococcus spp. were the most prevalent bacteria isolated from patients in the study area and exhibited varying patterns of antibiotic resistance, with high resistance to amoxicillin and ceftazidime and high susceptibility to Ciprofloxacin. Further studies are needed to determine the factors associated with the occurrence of antibiotic resistance in bacteria in order to develop strategies to limit the emergence and spread of resistant pathogens.

Investigating healthcare waste management practices among healthcare workers at Samfya District Hospital of Luapula Province

2026-02-01T03:13:42+00:00

Background: Healthcare waste management is a critical component of infection prevention and control within health facilities, however, it still remains a global public health challenge. The purpose of this paper was to assess the healthcare waste management practices among health workers at Samfya District Hospital.

Methods: A descriptive cross-sectional study design and quantitative approach was employed. Simple random sampling was used, 65 healthcare workers participated in the study. Data was collected through structured questionnaire and analyzed using STATA version 14.2. Descriptive statistics were used to summarize socio-demographic characteristics and Healthcare waste management practices, while Fishers exact and chi square tests were applied to determine associations between variables. At 95% confidence Interval, a p value <0.05 was considered statistically significant.

Results: The study findings revealed that healthcare waste management practices were significantly associated with the presence of properly labelled waste bins (p<0.05, 95% CI), indicating that the availability and proper labelling of bins greatly influenced correct waste segregation and disposal. Furthermore, the profession of healthcare workers showed a statistically significant relationship with healthcare waste management practices (p<0.05, 95% CI), suggesting that knowledge and adherence to waste management protocols varied across professional categories.

Conclusions: The study concluded that while awareness of healthcare waste management practices among healthcare workers was high, actual compliance was influenced by structural factors such as the availability of properly labelled bins and professional background.

Population awareness of modifiable risk factors for coronary artery disease: a cross-sectional study in Islamabad, Pakistan

2026-02-01T03:13:03+00:00

Background: Coronary artery disease (CAD) is a leading global cause of morbidity and mortality, with rising prevalence and risk in developing countries like Pakistan. Despite the high burden, awareness of these risk factors remains limited in many populations. This study evaluates the knowledge and prevalence of modifiable CAD risk factors among adults in Islamabad and Rawalpindi. The findings aim to inform targeted public health strategies to reduce CAD-related morbidity and mortality.

Methods: A six-month cross-sectional study from May 2025 to October 2025 was conducted in Islamabad and Rawalpindi involving 322 adults including diagnosed CAD patients and at-risk individuals. Participants were recruited using non-random convenience sampling and completed an interview-based online questionnaire that assessed their knowledge of modifiable risk factors for cardiovascular disease. Data was analyzed with statistical package for the social sciences (SPSS) using Chi-square tests to explore associations. Ethical approval and informed consent were obtained with confidentiality maintained throughout the study.

Results: This study assessed awareness of modifiable risk factors for CAD among 322 adults in Pakistan, revealing that only 24.2% demonstrated good knowledge by identifying four or more key risk factors. Hypertension was the most recognized risk factor 51.6%, while awareness of smoking, diabetes, obesity, and high cholesterol ranged between 32% and 37%. Comparisons with regional and international studies highlight a significant knowledge gap in the Pakistani population.

Conclusions: This study reveals substantial gaps in public awareness of modifiable risk factors for coronary artery disease in Pakistan. Targeted educational interventions are urgently needed to improve knowledge, promote preventive measures and reduce disease burden.

Influence of food properties on hospital meal consumption among inpatients in level four public hospitals in Nairobi City County, Kenya

2026-02-01T03:13:31+00:00

Background: Adequate food intake among hospitalized patients is essential for recovery and nutritional well-being. Despite investments in hospital catering services in Kenya, low inpatient food consumption persists. Sensory and qualitative food properties strongly influence acceptance and eating behavior. This study examined the influence of food attributes taste, texture, aroma, temperature, variety, and presentation on meal consumption among inpatients in two level four public hospitals in Nairobi County.

Methods: A cross-sectional analytical study was conducted among 160 inpatients at Mbagathi and Mama Lucy Kibaki Hospitals using stratified random sampling. Data were collected through structured questionnaires and observation checklists. Quantitative data were analyzed using descriptive statistics, Pearson correlations, and multiple linear regression to assess associations between food properties and consumption levels.

Results: Food properties showed a non-significant yet theoretically meaningful influence on food consumption, explaining 4.2% of the variance (R²=0.042, p=0.117). Texture approached significance (p=0.094). Observational findings indicated that hospital meals, though nutritionally adequate, lacked sensory appeal due to monotony, suboptimal temperature, and limited variety factors linked to higher plate waste, particularly of vegetables.

Conclusions: Food properties are critical determinants of food consumption in public hospitals. Enhancing food variety, flavor, texture, temperature control and overall meal presentation can significantly improve intake and reduce plate waste. Hospital catering departments should incorporate sensory quality controls and patient-centered feedback mechanisms to guide meal planning.

The association between smartphone usage patterns, sleep quality, and academic performance among medical students in Punjab: a cross-sectional study

2026-02-01T03:16:29+00:00

Background: This study aimed to examine the prevalence of smartphone addiction and poor sleep quality among MBBS students in Punjab, Pakistan, and to investigate their associations with academic performance (CGPA%).

Methods: Between December 2024 and May 2025, a cross-sectional online survey was administered to 280 MBBS students at medical colleges in Punjab. Participants completed the Smartphone addiction scale-short version (SAS SV) to assess addictive smartphone behaviours and the Pittsburgh sleep quality index (PSQI) to evaluate sleep quality. Academic performance was self-reported as cumulative grade point average percentage (CGPA%). Associations were tested using chi-square, Mann-Whitney U, and chi-square test for trend as appropriate.

Results: Fifty one percent of students met criteria for smartphone addiction, with mean SAS SV scores of 32.15±12.13 for males and 31.33±12.31 for females (p=0.76), indicating no significant gender difference. Eighty percent of participants exhibited poor sleep quality (mean PSQI 7.43±3.33). There was a significant association between smartphone addiction and poor sleep quality (p=0.027). Smartphone addiction was also modestly associated with lower CGPA% (U=8535.5, p=0.026, r=0.13).

Conclusions: High rates of smartphone addiction and poor sleep quality were observed among MBBS students, and these factors were significantly correlated. Smartphone addiction was also modestly linked to academic performance. These findings underscore the need for institutional interventions to target smartphone overuse and improve sleep hygiene to safeguard students’ health and grades.

Evaluating community needs and the effect of community-based intervention in preventing dengue and chikungunya in urban hotspots of Jammu city: a mixed-method study

2026-01-17T02:41:13+00:00

Background: Vector-borne diseases (VBDs) remain a major public health concern in India especially with its diverse climate patterns and densely populated urban environments. Understanding community needs and gaps in awareness is crucial for designing interventions that are acceptable and effective. This study aims to evaluate community needs and assess the impact of community-based preventive strategies to reduce the disease burden in urban hotspots of Jammu region.

Methods: The study was conducted over a period of two months in four selected areas. This study adopted a mixed-methods research design to obtain a comprehensive understanding of VBDs among the community, with a specific focus on Dengue and Chikungunya.

Results: A total of 682 participants were assessed for the knowledge, attitude and practices. Most participants correctly identified mosquito transmission and key symptoms, though gaps existed regarding breeding sites and resting habits. A significant proportion overestimated the effectiveness of fogging alone. Government facilities were the preferred choice for treatment, though home remedies were still practiced. Focus group discussions with sanitary workers and Malaria workers highlighted strong community resistance, poor risk perception, and non-cooperation as major barriers to dengue control. Operational challenges included manpower shortages, salary disparities, and inadequate protective equipment, leading to demotivation and health risks. The findings point to behavioural and infrastructure-related constraints affecting effective vector control.

Conclusions: The study demonstrates good awareness but inconsistent preventive practices for dengue and chikungunya, influenced by misconceptions and low risk perception. Community resistance, socio-economic constraints, and operational challenges faced by frontline workers limit effective control.

Prevalence and determinants of refractive error among school children in two Southern districts of Karnataka

2026-01-10T10:57:37+00:00

Background: Refractive error (RE) is a major cause of visual impairment in schoolchildren, affecting learning and long-term eye health. Its prevalence varies across India, with limited data from southern Karnataka. This study assessed RE prevalence and determinants among children aged 6-16 years.

Methods: A school-based cross-sectional study was conducted from July to October 2025 among 1,070 students selected through cluster sampling using probability proportionate to size (PPS). Within each school, participants were chosen by simple random sampling. Data were collected using a structured proforma capturing sociodemographic, familial, clinical, and behavioural factors. Visual acuity was assessed using a standardized Snellen chart protocol. Statistical analysis included descriptive measures and Chi-square tests to determine associations between RE and selected variables.

Results: The prevalence of RE was 8.2%. Age and educational grade showed significant associations (p=0.005), with older children presenting higher impairment. Significant determinants included history of eye infection (p=0.027), family history of glasses (p=0.024), and screen exposure (p=0.014), with RE rising from 6.2% in low screen-time groups to 16.7% in high-exposure groups. Gender, parental education, family type, and history of eye injury were not significantly associated.

Conclusions: RE remains a notable concern among schoolchildren in southern Karnataka. Findings highlight the role of biological and behavioural determinants, underscoring the importance of strengthened school-based screening and early preventive interventions.

Knowledge, attitude and related practices about chronic pain conditions and pain clinic among undergraduate students in a medical college

2026-01-23T03:29:32+00:00

Background: Objectives were to evaluate the knowledge, attitude, and related practices about chronic pain conditions and pain clinics among undergraduate medical students in a medical college.

Methods: This cross-sectional, questionnaire-based study was conducted among 226 final-year undergraduate students and interns at Heritage Institute of Medical Sciences, Varanasi. Data were collected through a Google Form questionnaire designed to assess basic knowledge, attitudes, and practices related to chronic pain and pain clinic awareness. Descriptive statistics were applied to analyze the responses.

Results: Most participants correctly defined chronic pain (88.9%) and a pain clinic (87.6%), though only 37.6% identified a validated pain assessment scale. Arthritis was the most commonly identified chronic pain condition. Despite 127 students or family members reporting chronic pain, only 11 had ever consulted a pain clinic. The mean Likert score for perception of pain physicians’ competence was 3.82, while agreement on including chronic pain education in the medical curriculum scored 4.09, indicating a strongly positive attitude.

Conclusions: Although conceptual awareness of chronic pain and pain clinics was high among participants, significant gaps were found in applied knowledge and exposure to multidisciplinary pain care. The findings underscore the need for integrating structured pain management education and clinical exposure into undergraduate medical training in India.

Impact of social media among women in a rural community, South Kerala, India – a community based cross sectional study

2026-02-01T03:16:39+00:00

Background: Social media has emerged as an influential virtual space revolutionizing the digital world across diverse settings. It enables women to bypass traditional, cultural and mobility barriers, it also potential risks such as cyber bullying and addiction. This study explored the impact of social media among rural women.

Methods: A cross sectional study was conducted among 289 women in a rural community in Thiruvananthapuram, Kerala using a pre designed, pretested interviewer administered questionnaire. Data analysis was done using SPSS. Variables were expressed in mean and percentages. Association between socio demographic variables with cyber bullying was analyzed and p value <0.05 was considered statistically significant.

Results: Median age was 31 years, demographic analysis showed 62.3% were graduates, 85.8% were married and 70.2% belonging to low socioeconomic strata. 83.8% of women had a special preference to the social media site Facebook. 55.7% believed that social media has boosted their self-concept but nearly 75% reported deception. 87% felt that children and spouses have been sidelined due to excessive usage consequently decreased productivity. Most women reacted by deleting their accounts. There was a strong association between low socioeconomic and poor educational statuses and chance of having a negative impact.

Conclusions: The digital revolution has enhanced access to information and self-development; however, its negative effects, particularly on family life and risk such as addiction and bullying needs greater attention to promote balanced and safe social media use.

A longitudinal follow-up study on sustained behavioural change and compliance post BMW management training among healthcare workers

2026-02-01T03:16:34+00:00

Background: While training interventions on bio-medical waste (BMW) management have shown immediate improvements in knowledge and practices among healthcare workers, there is limited evidence on the sustainability of such outcomes. This study follows up with the same cohort from the 2022 intervention at three hospitals in Rajasthan to assess long-term behavioural retention and operational compliance six months post-training.

Methods: This observational follow-up study included 124 of the original 156 participants. A structured survey and observational audit were conducted to measure retention of knowledge and adherence to BMW segregation protocols, PPE usage, and reporting mechanisms for needle-stick injuries. Spot-checks and supervisor feedback were also recorded.

Results: The average knowledge score declined slightly from 16.4 (post-training) to 14.8 after six months but remained significantly higher than the pre-training baseline (9.2, p<0.001). Sustained compliance was observed in 85% for colour-coded segregation, 89% for PPE use, and 82% for hand hygiene. Reporting of needle-stick injuries, however, dropped from 89% to 63%. Class 4 and housekeeping staff showed the most retained improvement, suggesting lasting value in training lower-cadre employees.

Conclusions: While slight declines were observed, most key behaviours related to BMW management remained significantly better than baseline. This underscores the value of refresher modules and continuous monitoring to sustain impact. Structured interventions, when coupled with audits and reinforcement, can yield lasting operational changes even in low-resource hospital settings.

Effectiveness of Terminalia chebula on halitosis among 18-25 years old adults: a randomized controlled trial

2026-02-01T03:15:21+00:00

Background: Halitosis, commonly known as bad breath, is a dental condition characterized by an unpleasant and offensive odour from the oral cavity. Pathological halitosis is mainly caused by Gram-negative bacteria in the oral cavity that produce volatile sulphur compounds (VSC). Chlorhexidine mouthwash has been used for decades; however, it remains contraindicated due to its side effects. On the other hand, the anti-bacterial properties of plant-derived compounds are well documented. The study aims to assess the effectiveness of Terminalia chebula as an oral rinse against VSC in halitosis patients.

Methods: The study sample was selected from patients attending the regular outpatient Department of Public Health Dentistry, Karpaga Vinayaga Institute of Dental Sciences and consisting of 30 adults (both males and females) ranging between 18-25 years of age. The sample was selected from people who present with halitosis. The subjects were randomly divided into groups A and B with 15 adults in each group. Group A was assigned to Terminalia chebula mouthwash and group B to chlorhexidine mouthwash.

Results: The study demonstrated a significant reduction in halitosis scores and oral hygiene index (OHI) scores post-intervention in both groups, with group A showing a greater improvement. Statistically significant differences were observed between the groups after the intervention for halitosis and OHI scores, while no significant differences were noted at baseline.

Conclusions: Terminalia chebula can suitably be used as an oral rinse for halitosis and does not have any side effects such as erosion and staining.

Study of determinants and predictive risk of cardiovascular disease among adult males in Aligarh: a cross-sectional study

2026-02-01T03:15:17+00:00

Background: Non-communicable diseases (NCDs) result from genetic, physiological, environmental and behavioural factors in combination. NCDs kill around 41 million people a year, equivalent to three-quarters of deaths worldwide. QRISK is a well-established cardiovascular disease (CVD) risk score, in use across the NHS since 2009, which is designed to identify people at high risk of developing CVD who need to be recalled and assessed in more detail to reduce their risk of developing CVD.

Methods: This was a cross-sectional study conducted under the department of community medicine in rural and urban health training centre of JNMC AMU, Aligarh, India, during 2019 to 2020 with a sample size of 204.

Results: A total of 204 males in the age group of 25 to 84 years were study participants. Among all, 32.8% participants were physically active, 52.0% participants were current smokers, 27.0% participants were overweight, and 5.4% were found to be obese. The prevalence of raised blood sugar was 21.1% and raised blood pressure in 23% participants. According to the QRISK2 score developed in 2017, participants at high risk (≥20%) were 26.5%.

Conclusions: Cardiovascular disease risk factors, smoking, lack of physical activity, diabetes, raised blood pressure, overweight and obesity by BMI, and abdominal obesity and also 10-year cardiovascular risk are higher than the studies conducted for these risk factors in India. Health education, early diagnosis should be imparted to the general population.

Problematic binge-watching and its impact on mental health status among students in Puducherry: a cross-sectional study

2026-02-01T03:15:14+00:00

Background: Binge-watching, or watching numerous episodes of a TV show back-to-back in one sitting, has been very popular in the last few years, especially among young people and students. Although it can be leisure, compulsive binge-watching can affect mental health. Objectives were to evaluate the prevalence of problematic binge-watching among college students in Puducherry and its association with students’ mental health status, which includes anxiety, depression, and stress levels.

Methods: A Cross-sectional study among 360 students with 18-25 years in Puducherry was conducted using simple random sampling for a period of three months. Data were collected using a structured questionnaire that included sociodemographic details, questions related to binge-watching behavior, and three mental health scales patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and perceived stress scale (PSS-10). The chi-square test was used for determining independence. A p<0.05 was considered statistically significant.

Results: Out of 360, 53.3% were aged 18-20 years, and 51.6% were female. The majority belonged to urban (85.8%), and 56.1% were from the lower socioeconomic class. 63.6% of students binge-watched, predominantly on smartphones (71.6%). Even though age, gender, and socioeconomic status had no significant relationship with binge-watching, urban participants had a high association (p<0.001). Consistent associations were found between binge-watching and anxiety (p<0.001) and depression (p=0.008), but stress was not significantly related (p=0.764).

Conclusions: This research highlights the psychosocial dangers of overusing screen-based entertainment in young adults, emphasizing the need for targeted counseling and awareness programs to encourage good watching habits and maintain student mental health.

Assessment of menstrual health product knowledge and education among medical professionals: a cross-sectional study

2026-02-01T03:15:11+00:00

Background: Menstrual health education is an essential component of reproductive health training for medical professionals; however, it remains inadequately addressed in medical curricula. This study aimed to assess the knowledge and awareness of menstrual health products and sources of education among medical professionals in India.

Methods: A cross-sectional study was conducted using an online, questionnaire-based survey among medical students and postgraduate trainees across India from March 2024 to August 2024. The questionnaire assessed demographic details, knowledge and awareness of menstrual health products, sources of education, and perceived barriers to menstrual health education. Data were analysed using SPSS version 22. Descriptive statistics were used to summarize the findings.

Results: A total of 136 participants completed the survey, of whom 93 (68.4%) were females and 43 (31.6%) were males. Formal menstrual hygiene education was reported by 97(71.3%) participants, most commonly received during school education (55.1%). Overall knowledge was self-rated as high (score 7-10) by 98(72%) participants. Awareness was highest for sanitary pads (95.6%), followed by menstrual cups (69.9%) and tampons (62.5%), while awareness of reusable cloth pads (55.1%) and period panties (44.1%) was lower. Only 66 (48.5%) participants reported full awareness of proper usage and disposal methods. The major barriers identified were lack of a formal curriculum (51.5%) and social taboos related to menstruation (47.8%).

Conclusions: Despite high perceived knowledge among medical professionals, significant gaps and barriers in menstrual health education persist. Strengthening formal curricular training and addressing stigma are essential to improve menstrual health competence among future healthcare providers.

Knowledge on rabies transmission, immunisation and wound management among medical undergraduate students at a medical institute in North India

2026-02-01T03:15:02+00:00

Background: Medical undergraduates, as future frontline healthcare providers, are instrumental in early detection, risk stratification, and management of rabies exposures. Evaluating their knowledge particularly regarding rabies transmission routes, WHO exposure categories, wound care, and post-exposure prophylaxis is vital for guiding educational interventions and enhancing clinical competencies in rabies prevention and control at both institutional and public health levels.

Methods: A cross-sectional study was conducted among 240 medical undergraduate students from King George’s Medical University in Lucknow from May 2025 to July 2025. A pre-tested, semi-structured, self-administered questionnaire was sent as a Google form to all the participants via WhatsApp messaging app. All the participants responded to the questionnaire. Hence, the final analysis comprised of these 240 respondents.

Results: While medical undergraduates have strong knowledge of rabies causation, reservoirs, wound washing, and avoidance of harmful practices, there are misconceptions in understanding of categorizing the exposure, risk-based management, and intradermal vaccination protocols.

Conclusions: The findings suggest the importance of enhancing clinical scenario-based teaching and incorporating updated guidelines into medical curriculum to bridge these knowledge gaps.

Healthcare professionals' acquaintance with climate change in India: impact on health, adaptation and mitigation strategies

2026-02-01T03:15:00+00:00

Background: Climate change is one of the most pressing global public health threats of the 21^st century, affecting human health through increased respiratory and vector-borne diseases, food and water insecurity, extreme weather events and mental health challenges. Vulnerable populations, including children, the elderly, and those in low-resource settings, are disproportionately affected. India is particularly vulnerable due to existing health and social inequities, underscoring the need for a climate-literate health workforce. This study aimed to assess awareness among healthcare professionals regarding the health impacts of climate change and to examine their understanding of mitigation and adaptation strategies.

Methods: An exploratory cross-sectional survey was conducted using convenience sampling among doctors, nurses, and paramedical professionals working across India. Data were collected online via a structured questionnaire covering climate dynamics, health impacts and vulnerability. Ethical approval and informed consent were obtained. A total of 1009 participants responded between October 2024 to April 2025.

Results: Most participants were nurses (89.4%), females (68.3%) and aged 26- 30 years. Nearly all respondents (98.2%) reported experiencing climate change in their localities. The mean knowledge score was moderate (10.0 ± 2.65 out of 24), with doctors scoring highest. Significant gaps were identified in understanding mitigation and adaptation concepts.

Conclusions: Despite great concern about climate change, healthcare professionals demonstrated limited conceptual clarity and engagement, highlighting an attitude-action gap and the need for strengthened climate-health education and training.

Urbanization, lifestyle change, and the growing burden of non-communicable diseases in India: evidence from a community-based study in Hyderabad

2026-02-01T03:14:49+00:00

Background: Non-communicable diseases (NCDs) are an escalating public health concern in India’s rapidly urbanizing regions, with cities like Hyderabad experiencing significant increases in disease burden linked to lifestyle and socioeconomic changes.

Methods: A community-based, cross-sectional study was conducted using systematic random sampling to recruit adults aged 20 and above in urban Hyderabad. Data were collected with the WHO STEPS questionnaire, direct anthropometric measurements, blood pressure monitoring, and biochemical screening for glucose and lipid profiles.

Results: The study found high prevalence rates of hypertension (up to 50% in the elderly), diabetes (25–26% in the elderly), and obesity (44% in the elderly, 37% in adults), with a greater impact on women than men. Behavioral risk factors, including sedentary lifestyle, tobacco use, poor dietary diversity, and excess salt intake, were widespread, and nearly half of hypertensive and many diabetic individuals were unaware of their diagnoses.

Conclusion: These findings underscore the critical need for strengthened surveillance, targeted screening, and coordinated preventive interventions to address the rising NCD epidemic in urban India.

Prevalence and determinants of hypertension among men and women in Maharashtra: an analysis of NFHS-5 data 2019-2021

2026-02-01T03:14:38+00:00

Background: Hypertension is a major underlying factor in India’s rising non-communicable disease burden and poses a significant public health challenge. This study investigated the prevalence and identifies key determinants among men and women in Maharashtra.

Methods: This cross-sectional study used data from the National Family Health Survey (NFHS-5, 2019-2021). Statistical analysis was conducted using SPSS for descriptive statistics and logistic regression, we explored associations between hypertension and comprehensive set of factors including demographic attributes (age, gender, marital status, education), socioeconomic status (wealth index quintiles, religion, caste/tribe), geographic (urban/rural residence, region), health (diabetes status), and lifestyle (tobacco use, alcohol consumption).

Results: Our results showed that hypertension occurs significantly more often with age and is generally higher in women. Wealthier individuals in urban settings exhibit a higher prevalence, with some regional differences across the state. A strong correlation was found between diabetes and hypertension, and lifestyle habits such as tobacco and alcohol use were significantly associated with elevated blood pressure.

Conclusions: Hypertension in Maharashtra is influenced by complex mix of factors, such as age, socioeconomic status, geography, and modifiable risk behaviours, to a significant extent. High prevalence, especially in women and wealthier populations, coupled with the diabetes link and far-reaching lifestyle impacts, underscores an urgent public health priority. These findings highlight focused public health initiatives and awareness programs, lifestyle intervention, and better healthcare access in Maharashtra to manage and prevent hypertension, a growing non-communicable disease burden.

Clinico epidemiological profile and trends of breast cancer over a decade: a study from UT of J&K, India

2026-02-01T03:14:35+00:00

Background: Breast cancer remains one of the leading causes of malignancy related deaths in women. Understanding the burden of disease and its epidemiology including risk factors are fundamental to public health preventive measures. The study explored the clinic-epidemiological profile and trends of breast cancer in Jammu province of UT of J&K, India.

Methods: Hospital Based Cancer Registry (HBCR) has been in operation since 2014 in Government Medical College Jammu. The data from 2014-2024 was collected as per socio demographic variables, district wise residence and detailed information about clinical profile of the patients. The data was represented as frequency and proportions while trends were reflected using line diagram.

Results: Almost one-third of the patients (30.3%) were in the 45-54 years age group. Similar proportion of the patients was found to be in premenopausal age group. 91% of the patients were married and 63.11% of the total were illiterate. District wise distribution of the patients revealed that almost half (51.60%) of the total belonged to Jammu district. Majority (94.8%) has infiltrating ductal carcinoma on histopathology. At the time of presentation 41.36% were in Stage-II of the disease.

Conclusion: The trends of breast cancer reveal that disease has a steady path with peaks in 2018 and 2019. One third of patients in pre-menopausal age group is a cause of concern. Authors recommend continuous health education regarding warning signals of breast cancer and it’s early screening so that these patients can be diagnosed and treated at an earlier stage.

A pre-experimental study to assess the effectiveness of Buerger Allen exercise to improve lower extremity perfusion among patients with diabetes mellitus type 2 admitted to selected hospitals, Jalandhar, Punjab

2026-02-01T03:14:33+00:00

Background: God consider good health one of his greatest gifts. A healthy individual may live a healthy and prosperous life, but many people in the current world cannot owe heart disease, neurological diseases, orthopaedic injuries, and metabolic illnesses, the greatest of which is diabetes. The World Health Organization defines diabetes as a chronic metabolic illness that damages the blood vessels, eyes, kidneys, and nerves due to high blood glucose levels.

Methods: This study employed a quantitative research approach with a pre-experimental design (one group pre-test post-test) to evaluate the impact of Buerger Allen Exercise (BAE) on lower extremity perfusion in 60 patients with type 2 diabetes mellitus from selected hospitals. Data collection utilized the Modified Ankle Brachial Index and a self-structured lower extremity perfusion scale.

Results: Pre-test mean lower extremity perfusion scores using the Modified Ankle Brachial Index were 1.73 (±0.54) for the right limb and 1.70 (±0.497) for the left limb. Post-test scores significantly improved to 0.53 (±0.72) for the right limb and 0.50 (±0.70) for the left limb, with‘t’ values of 13.59 and 14.69, respectively (p<0.05). Similarly, pre-test scores using the self-structured scale were 14.28 (±3.44) for the right leg and 14.08 (±2.71) for the left leg, improving to 6.88 (±3.26) and 6.98 (±3.01) post-test, with 't' values of 16.36 and 15.86, respectively (p<0.05).

Conclusions: The study concludes that Buerger Allen Exercise significantly improves lower extremity perfusion in patients with type 2 diabetes mellitus.

Contraceptive awareness, patterns of use, and unmet contraceptive needs among pregnant women attending antenatal clinics in a tertiary care facility

2026-02-01T03:13:41+00:00

Background: The term unmet need for family planning is a central metric in reproductive health, guiding advocacy, policy formation, programme implementation, and monitoring of health outcomes globally. This study evaluated awareness, perceptions, and usage of contraceptive methods among pregnant women.

Methods: A descriptive cross‑sectional study was undertaken among 384 third‑trimester antenatal attendees at a tertiary care hospital. Data were obtained using a pre‑validated questionnaire and analysed using SPSS v20 and Epi Info.

Results: While 94.3% knew of at least one contraceptive method and 76% endorsed use to delay or avoid pregnancy, only 25.3% had ever practised contraception. The most frequently used methods reported were condoms (55%) and oral contraceptive pills (26%).

Conclusions: Contraceptive knowledge and use were significantly associated with age over 20 years, higher education, employment, and better socioeconomic status (SES).

Assessment of knowledge, attitudes, and practices regarding premarital genotype counselling and testing for sickle cell disease among African international students at universities in Gujarat state, India

2026-02-01T03:13:39+00:00

Background: Sickle Cell Disease (SCD) is a common inherited blood disorder, especially in sub-Saharan Africa, where over 300,000 infants are born with SCD each year, with 75% of these cases occurring in Africa. This study aimed to evaluate the knowledge, attitudes, and practices regarding premarital genetic counselling and testing for SCD among African international students in Gujarat State, India.

Methods: A cross-sectional descriptive design was adopted, involving a sample of 99 students who were selected through convenience sampling. Data were collected through questionnaires. Analysis was performed using IBM SPSS version 20.

Results: Most respondents (92.9%) were aware of SCD, with 66.7% citing media (TV, radio, internet) as their source of information. About 69.6% recognized genetic mutation or inheritance as a cause. A significant majority (72.7%) agreed that SCD can be diagnosed through blood tests, and 78.8% believed that couples with AS genotypes should avoid marriage. However, 61.6% had not undergone genotype testing, and the same proportion lacked education or counselling about SCD.

Conclusions: Although awareness of SCD is high, many participants do not know their genotype and have not received sufficient information or counselling regarding the disease.

From awareness to action: e-waste handling practices among medical students in Puducherry

2026-02-01T03:13:33+00:00

Background: Given the global concern over e-waste, which means discarded electrical or electronic devices, it makes sense that many families would be interested in recycling their old appliances. Today, India is one of the largest producers, but we still have a huge gap in safe recycling and disposal. This study aimed to evaluate the awareness and practices of e-waste management among medical students in Pondicherry with changing national policies and global trends.

Methods: A cross-sectional study was carried out for three months, among the students from the second year to final year (n=401) of two randomly selected medical colleges in Pondicherry. Data regarding awareness and practice were collected by a pre-designed semi-structured questionnaire, and data were analyzed using Microsoft EXCEL and Epi Info.

Results: The study defined the respondents of our findings as being 85.8% aware of the term “e-waste” and 91.0% acknowledging the e-waste’s environmental hazards. In addition, only 12.2% had ever heard of the Indian laws concerning e-waste protection and its management. Less than 10% of the respondents reported always setting aside e-waste for recycling. Males were better informed of the amount of waste and what could be separated, such as guidelines classification, while females better acknowledged the consequences associated.

Conclusions: University students’ knowledge of medical schools on e-waste policy is limited, and safe disposal practice may not reflect their awareness of the risk. Medical school inquiry-triggered education, directly connected to formal recycling systems, could bridge the gap between perceived risk and action.

Polycystic ovary syndrome awareness: insights from female medical students in Telangana

2026-02-01T03:13:26+00:00

Background: Polycystic ovary syndrome (PCOS) affects millions of young women worldwide, yet awareness remains suboptimal even in medical trainees. This study explored the knowledge, attitudes, and practices (KAP) regarding PCOS among 320 female medical students in Telangana, India, a group particularly vulnerable due to academic stress, irregular lifestyles, and limited personal health prioritization.

Methods: A validated, web-based cross-sectional survey was conducted among undergraduate and postgraduate female medical students aged 18–30 years. KAP scores were categorized as low (<37), moderate (38–45), or high (>45) using visual binning. Associations with age, menstrual regularity, BMI, stress levels, and PCOS diagnosis were analyzed using chi-square tests and independent t-tests.

Results: Most participants (63.1%) showed moderate KAP, 24.1% low, and only 12.8% high. Higher KAP was significantly associated with older age (p=0.016), menstrual irregularity (p=0.029), and previous PCOS diagnosis (p<0.001). Students diagnosed with PCOS reported significantly higher stress levels (mean 3.30 versus 2.99, p=0.007). BMI was significantly linked to PCOS diagnosis (p=0.015).

Conclusions: Moderate levels of PCOS awareness have been recorded with personal diagnosis being the strongest driver of knowledge. The elevated stress among affected students highlights the emotional burden of the condition. These findings emphasize the need for structured PCOS education, early screening, and psychosocial support within medical curricula to empower future physicians to better care for themselves and their patients.

Effect of supervised exercise therapy program on the pain, disability, lumbar spine mobility and back muscle endurance in chronic non specific low-back pain patients: a quasi-experimental design

2026-02-01T03:13:23+00:00

Background: Chronic non-specific low back pain (CNSLBP) is a prevalent musculoskeletal disorder that leads to pain, functional limitation, and reduced spinal mobility. Exercise therapy is widely recommended; however, the effectiveness of supervised exercise interventions requires further evaluation. This study aimed to determine the effect of supervised exercise therapy on pain, disability, lumbar spine mobility, and back extensor muscle endurance in patients with CNSLBP.

Methods: A quasi-experimental study was conducted on participants diagnosed with chronic non-specific low back pain. All participants underwent a 12-week supervised exercise therapy program that consisted of motor control exercises, strengthening, and stretching exercises. Outcome measures included pain intensity using the visual analogue scale (VAS), disability using the Oswestry disability index (ODI), spinal mobility using Schober’s flexion and extension tests, and back extensor endurance using the Sorenson test. Pre- and post-intervention values were statistically analyzed, with significance set at p<0.05.

Results: Significant reductions were found in mean pain scores (VAS: 56.73 to 31.22, p<0.001) and disability levels (ODI: 24.33 to 12.72, p<0.001). There were notable improvements in back extensor endurance (Sorenson test: 28.68 to 51.27 seconds, p<0.001) and lumbar spine mobility in both flexion (Schober’s flexion: 4.79 to 6.0 cm, p<0.001) and extension (2.8 to 3.8 cm, p<0.001).

Conclusion: Twelve weeks of supervised exercise therapy produced significant improvements in pain reduction, functional ability, lumbar spine mobility, and back extensor endurance among individuals with chronic non-specific low back pain. These findings support the incorporation of supervised exercise programs as an effective therapeutic approach for managing CNSLBP.

Assessment of agrochemical exposure in farmers through urinary residue analysis: a cross-sectional survey

2026-02-01T03:13:12+00:00

Background: The usage of pesticides has become widespread in agricultural sector to meet the rising demand for food production, especially in developing countries like India. Exposure to pesticides and lack of adequate protective measure leads to various health effects among agricultural workers. The study aims to evaluate pesticide exposure by analysing urine samples from farmers in Mysuru district of Karnataka.

Methods: A community-based cross-sectional study was conducted from November 2024 to January 2025 among 100 agricultural workers selected from three primary health centres (PHCs) (Suttur, Hadinaru and Kadakola). Data were gathered through a structured questionnaire, and urine samples were analyzed for the presence of pesticide residues. The statistical analysis involved both descriptive statistics and logistic regression.

Results: In the sample of 100 participants, pesticide residues were identified in 21% of the urine samples. Carbendazim and tricyclazole were detected most frequently (7% each). Unsafe practices regarding pesticide handling were prevalent, only 34% reported using personal protective equipment (PPE), and 53% stored pesticides in fields. Although pesticide usage was widespread, the low detection rates might be related to inconsistent exposure. Chronic health issues such as hypertension (14%) and diabetes (12%) were common among participants.

Conclusions: The findings show the internal exposure of agrochemicals among farmers and inadequate use of PPE. It is essential to enhance educational outreach, conduct regular health monitoring, and implement regulatory measures to protect the health of farming communities by incorporating occupational health into primary care and enhancing training on safe pesticide usage, PPE, and hygiene.

Utilization, perception, and challenges of using social media in dental public health activities among public health dentists of India: a pilot study

2026-02-01T03:13:06+00:00

Background: Social media has transformed public health dentistry by providing accessible tools to enhance community engagement and oral health outcomes. This study is aimed to assess utilization, perception and challenges of social media in dental public health activities among public health dentists of India.

Methods: A cross-sectional pilot questionnaire survey was conducted in April, 2025. A self-designed, pre-tested 26-items questionnaire consisting of 10 close-ended questions for utilization, and 16 items based on Likert-scale (10 for perception and 6 for challenges). The questionnaire was formulated with Google Forms and distributed to public health dentists via email and personal online communication. Responses were noted in proportions.

Results: Total 48 public health dentists have participated. The mean age was 39.69±6.89 years having male predominance (n=31, 64.58%). The 25 (52.08%) participants use social media for 1-2 hours daily. The 31 (64.58%) respondents believed that social media helps in spreading oral health awareness, and 35 (72.92%) supported its use for tobacco cessation. While, 38 (79.17%) advocated for government regulations to prevent misinformation. All participants acknowledged presence of inaccurate oral health content on social media. 32 (66.67%) participants agreed about ethical concerns of social media in dentistry and 28 (58.33%) refrained from using social media professionally due to fear of online trolling.

Conclusions: While social media is increasingly recognized as a valuable tool in dental public health, its effective utilization is hindered by several challenges.

Beyond biomedical care: the role of psychosocial support in improving birth outcomes in rural Uttar Pradesh

2026-02-01T03:12:52+00:00

Background: Maternal health encompasses multiple dimensions, including nutritional status, antenatal care (ANC), and psychosocial well-being, all of which significantly influence pregnancy outcomes. While ANC coverage has improved however, Neonatal mortality remains a major concern. Prematurity and low birth weight account for 35% of neonatal deaths, hence it is pertinent to explore the reasons beyond medical care.

Methods: This observational case–control study was conducted in Raebareli district, Uttar Pradesh. A total of 425 women were enrolled, including 212 cases who delivered low birth weight (<2500 g) babies and control group comprised 213 women without LBWs babies.

Results: In the bivariate analysis, a highly significant association was observed between the number of ANC check-ups received and adverse birth outcomes such as low birth weight and preterm birth (χ²=162.50, p=4.26 × 10⁻³⁴). Even after excluding women had four or more ANC visits, the psychosocial factors continued to show strong associations with adverse pregnancy outcomes. Women who reported low family support had 3.41 times higher odds of delivering a low-birth-weight or preterm newborn (OR=3.41, 95% CI: 1.91–6.12). Similarly, partner support emerged as another significant psychosocial determinant (OR=2.86, 95% CI: 1.57–5.23; p=0.0006).

Conclusions: This study demonstrates that psychosocial factors play an independent and equally critical role in determining birth outcomes.

A study on knowledge, attitude, and practices related to brucellosis among small-scale dairy farmers in a rural area of Belagavi, Karnataka

2026-02-01T03:13:01+00:00

Background: Brucellosis remains a significant zoonotic disease affecting livestock productivity and human health in India. Despite the high burden in Karnataka, little is known about farmers’ knowledge, attitudes, and practices (KAP) in rural Belagavi. This study aimed to assess KAP related to brucellosis among small-scale dairy farmers to identify behavioural gaps influencing disease transmission.

Methods: A community-based cross-sectional study was conducted among 188 small-scale dairy farmers in rural Belagavi. Data were collected using a pre-tested structured questionnaire covering socio-demographic characteristics and KAP components. Descriptive statistics were used to summarise responses, and associations were assessed using Chi-square or Fisher’s exact tests.

Results: Awareness of brucellosis was limited, with 53.2% having never heard of the disease and 52.4% demonstrating poor knowledge scores. Most participants were unaware of zoonotic transmission (84.6%) or human symptoms (76.1%). Despite these gaps, attitudes were predominantly positive, with all participants scoring within the favourable range. Several risky practices were identified: 93.6% sold unpasteurized milk, protective measures during handling of aborted materials were minimal, and only 6.9% reported adopting any preventive or vaccination-related precautions. Although 96.8% sought veterinary care for sick animals, most relied on family advice for general animal health decisions.

Conclusions: Farmers exhibited substantial knowledge gaps and unsafe practices despite positive attitudes toward disease prevention. Strengthening community-based education, improving awareness of zoonotic risks, and promoting safe livestock-handling behaviours are essential for effective brucellosis control in this high-risk population.

Predictors of elective and emergency caesarean deliveries in India: evidence from large scale survey

2026-02-01T03:12:59+00:00

Background: Emergency and elective C-sections are essential for strengthening obstetric care, particularly in low- and middle-income countries like India. This study aims to (i) estimate the prevalence of emergency and elective C-section deliveries in India, and (ii) examine sociodemographic and clinical factors associated with these two types of procedures.

Methods: Data were drawn from 230,870 individual births that occurred in the five years preceding the survey, using National Family Health Survey (NFHS-V) data. C-section deliveries were categorized into emergency and elective based on reported indications. Descriptive statistics, bivariate analysis, and multivariable logistic regression were used to assess associated factors.

Results: The overall C-section rate was 21.6%, of which 14.2% were emergency and 7.4% elective procedures. Multivariable logistic regression indicated that private facility deliveries were strongly associated with higher odds of overall (AOR=4.17), elective (AOR=2.94), and emergency (AOR=3.08) C-sections compared to public facilities. Rural residence reduced C-section likelihood, while wealthier women, especially the richest, had higher odds. Maternal age, education, and media exposure increased odds across all types. Multiple pregnancies substantially raised C-section risk, whereas higher birth order lowered it. Larger birth size increased emergency C-section likelihood. Regional variation was notable, with southern India showing the highest odds. ANC visits increased overall C-section risk but had limited impact on elective or emergency C-sections.

Conclusions: Addressing regional inequities, improving obstetric care readiness, and reducing unnecessary elective C-sections are critical for improving maternal and neonatal health outcomes.

Assessment of knowledge and indicators of drinking water, sanitation, and hygiene practices from rural and urban schools of Belagavi, Karnataka: a cross-sectional study

2026-02-01T03:12:47+00:00

Background: Adequate water, sanitation, and hygiene (WASH) in schools is essential for preventing communicable diseases and promoting health. However, gaps often persist between students’ knowledge and the availability of WASH infrastructure. This study aimed to assess WASH-related knowledge among school children and to evaluate school-level WASH indicators in rural and urban schools of Belagavi district, Karnataka.

Methods: A cross-sectional study was conducted from March 2023 to May 2024 among 422 students from grades VI-VIII across 40 schools (25 rural, 15 urban). Students’ WASH knowledge was assessed using a pre-tested questionnaire, while school WASH indicators were evaluated using standardised facility assessment tools. Data were analysed using descriptive statistics and chi-square tests.

Results: Overall, 51.2% of students demonstrated good WASH knowledge. Awareness that unsafe water affects health was reported by 68.2%, and 99.5% recognised the disease risk of not washing hands. All schools had drinking water and handwashing facilities; however, consistent year-round water availability was reported by only 50% of rural and 37.5% of urban schools. Soap was absent at handwashing points in over 90% of schools. Rural schools more frequently had pit latrines and fewer usable toilets, while toilet cleanliness was reported in 55% of rural and 37.5% of urban schools.

Conclusions: Moderate WASH knowledge among students coexists with substantial infrastructural gaps, particularly the lack of soap, inadequate sanitation facilities, and inconsistent water availability. Strengthening school WASH infrastructure and maintenance is critical to translate knowledge into effective hygiene practices.

Caregiver burden in autism spectrum disorder among low-income countries: a systematic review

2026-01-14T03:04:10+00:00

This review aims to examine the challenges faced by caregivers of children with autism spectrum disorders (ASD) in low-income countries (LICs), highlighting the financial, healthcare, and psychological burdens. The study seeks to explore how these challenges affect caregivers' well-being and identify potential solutions to alleviate their burden. A comprehensive literature review was conducted using peer-reviewed articles and studies focusing on caregiver burden in ASD within LICs. Data was collected from academic databases like ProQuest, PubMed, Embase, Science Direct including all the studies on financial constraints, healthcare access, cultural perceptions, and caregiver quality of life (QoL). Caregivers of children with ASD in LICs face significant challenges due to financial instability, inadequate healthcare infrastructure, and social stigma. This review examines the financial, healthcare, and psychological stressors affecting caregivers in LICs through a comprehensive literature analysis. Thirteen studies met the inclusion criteria and were synthesized in this systematic review. The reasons for the increase in the caregiver burden in LICs can be broadly divided into 3 groups: the role of the ASD severity and comorbidities, the caregiver related factors and other factors like the financial aspects of the caregivers. These studies indicate that primary caregivers, often mothers, experience heightened fatigue, poor mental and physical health, marital strain, and economic hardship, exacerbated by limited access to specialized support. Compared to other developmental disorders, ASD presents a greater burden on families in LICs, where resources are scarce. Research highlights a direct correlation between ASD severity and caregiver stress, underscoring the urgent need for targeted policies, improved healthcare services, and community-based support programs to mitigate caregiver burden and enhance QoL.

A systematic review of anticoagulants evaluating efficacy and safety in thromboembolic disease

2026-01-28T14:11:19+00:00

Venous thromboembolism (VTE) is a major global source of morbidity and mortality. Oral anticoagulants have become a safer and more effective alternative to conventional anticoagulants, such as heparin and warfarin, which have been the cornerstone of treatment. They have shown comparable efficacy with fewer significant bleeding episodes. This study investigated the efficacy and safety of oral anticoagulants in comparison with other conventional anticoagulant therapies in patients with venous thromboembolism. A systematic review was conducted where data were obtained from PubMed, Scopus, Google Scholar, and Clinicaltrials.gov, covering the period from January 2020 to July 2025. Study selection was conducted in accordance with PRISMA guidelines and illustrated using a PRISMA flowchart. Eligible studies included randomized clinical trials, cohort studies, and observational studies that compared direct oral anticoagulants (DOACs) with conventional or other anticoagulant therapies. Data extraction was performed independently by two reviewers (EA), who identified relevant studies and extracted information on study characteristics, outcomes, and efficacy from the included articles. It was found that VTE is effectively managed with prolonged anticoagulation therapy. Research indicates that a minimum duration of three to six months of oral anticoagulant use significantly reduces the risk of recurrent VTE and is associated with fewer major bleeding events. Among the available options, a 20 mg dose of rivaroxaban has been shown to offer the highest efficacy. In contrast, monotherapy with agents such as vitamin K antagonists, aspirin, or warfarin is generally less effective, whereas combination therapy with oral anticoagulants provides improved outcomes. It is concluded that for patients with venous thromboembolism, direct oral anticoagulants are a safer and more efficient therapeutic option than vitamin K antagonists and traditional anticoagulation treatments.

Significant increase in necrotizing fasciitis in the post-COVID era: a systematic review

2026-02-01T03:12:41+00:00

Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening soft tissue infection associated with high morbidity and mortality. The COVID-19 pandemic has significantly altered healthcare delivery and patient health profiles, potentially influencing the incidence and clinical characteristics of NF. To systematically review and analyze the reported literature on necrotizing fasciitis in the post-COVID era, with a focus on incidence, risk factors, clinical presentation, outcomes, and possible links with COVID-19 infection or its sequelae. A systematic review was conducted in accordance with the PRISMA guidelines. Major databases (PubMed, Scopus, Web of Science, and Google Scholar) were searched for studies published between January 2020 and July 2025 that reported cases or series of necrotizing fasciitis in the post-COVID period. Data regarding demographics, comorbidities, COVID-19 status, clinical features, management, and outcomes were extracted and analyzed. The review identified a notable increase in reported cases of necrotizing fasciitis in the post-COVID era, particularly among patients with a history of COVID-19 infection, diabetes mellitus, obesity, or immunosuppression. Delayed hospital presentations, atypical clinical manifestations, and higher rates of severe complications were frequently observed. Mortality remained significant despite aggressive surgical and medical management, with some studies attributing poorer outcomes to post-COVID immune dysregulation and healthcare system delays. Necrotizing fasciitis appears to have increased in frequency and severity in the post-COVID era, with COVID-19–related comorbidities and immune alterations serving as potential contributing factors. Early recognition, timely surgical intervention, and heightened clinical suspicion in post-COVID patients are crucial to improving outcomes. Further large-scale studies are needed to clarify the causal relationship and guide preventive strategies.

Long-term maintenance protocols for overdenture attachments

2026-01-08T02:23:19+00:00

Overdentures provide better stability, retention, and patient comfort compared to conventional complete dentures, representing a significant advancement in removable prosthodontics. Their effectiveness is strongly influenced by the type of support, whether tooth-supported or implant-supported, as well as the chosen attachment system, including ball-bar-clip locators, telescopic mechanisms, and magnetic mechanisms. Mandibular implant overdentures in particular demonstrate high clinical predictability and remain the standard of care for patients with severe ridge resorption. This review evaluates the performance of overdentures by examining implant survival, mechanical and biological complication patterns, functional outcomes, and patient satisfaction. According to available data, implant overdentures greatly improve oral health-related quality of life while increasing bite force and masticatory efficiency. Long-term success requires taking into account attachment-specific maintenance requirements, such as the wear of bar components or the periodic replacement of nylon inserts in locator systems. To achieve similar results, maxillary overdentures may need extra implants or changes to the palatal design. The review also covers emerging trends influencing overdenture therapy in the future, clinical implications, and maintenance procedures. Clinicians can choose the best attachment systems to predict maintenance needs and enhance long-term treatment outcomes for edentulous patients by having a thorough understanding of these factors.

The relationship between chronic kidney disease and soft tissue inflammation in the oral cavity

2026-01-10T10:57:36+00:00

Chronic kidney disease (CKD) is a systemic condition marked by progressive loss of renal function, often accompanied by complications beyond the kidneys. Among these, oral soft tissue inflammation remains under-recognized despite its growing clinical relevance. Individuals with CKD frequently experience gingivitis, periodontitis, oral mucosal lesions, and xerostomia, all of which may exacerbate systemic inflammation. The bidirectional relationship between renal dysfunction and oral disease is mediated through immune suppression, accumulation of uremic toxins, and microbial dysbiosis. Neutrophil impairment, altered cytokine profiles, and changes in salivary composition contribute to a compromised oral environment, allowing chronic inflammation to persist in soft tissues. The inflammatory burden from oral tissues may influence CKD progression by elevating systemic markers such as interleukin-6 and C-reactive protein. Moreover, patients with advanced CKD or those receiving dialysis often report nutritional challenges due to oral discomfort, which further complicates disease management. Periodontal pathogens and their byproducts may enter systemic circulation, potentially aggravating endothelial dysfunction and cardiovascular risks associated with renal impairment. Despite these associations, oral health is seldom integrated into CKD care protocols. Preventive strategies involving routine screening, patient education, and interdisciplinary collaboration are essential for early detection and intervention. Coordinated care models involving nephrologists and dental professionals can facilitate timely treatment and reduce systemic complications. Enhancing awareness of the oral-systemic link and prioritizing oral health within CKD management may improve long-term outcomes and quality of life for affected individuals.

Discoloration patterns in dental restorations linked to common beverages and spices

2026-01-10T10:57:35+00:00

Discoloration of dental restorations remains a major concern in aesthetic dentistry, driven largely by the interaction between restorative materials and commonly consumed staining agents such as beverages and spices. The degree and permanence of staining depend on several variables including the chemical structure of chromogens, the composition and surface characteristics of restorative materials, and patient-related factors such as oral hygiene and dietary habits. Resin-based composites are particularly vulnerable to color change due to their hydrophilic resin matrix and capacity for pigment absorption, especially when exposed to substances like coffee, red wine, and turmeric. In contrast, ceramics display better color stability, though they can still stain when surface glaze is compromised. Glass ionomer cements, frequently used in non-load bearing areas, demonstrate the highest susceptibility due to their porous structure and water sorption. The mechanism of discoloration involves both surface adsorption and deeper absorption, influenced by the acidity, temperature, and duration of exposure to staining agents. Surface treatments, including polishing and glazing, significantly affect the resistance of restorations to external pigmentation. Clinical management focuses on minimizing aesthetic deterioration through material selection, polishing techniques, dietary counseling, and regular maintenance. While polishing can address superficial stains, intrinsic discoloration often requires restoration replacement. Bleaching therapies pose additional challenges, as restorative materials do not respond predictably to whitening agents, potentially creating shade mismatches. Understanding the dynamics of staining allows for more informed clinical decisions and improved patient outcomes. Ongoing research continues to explore advanced materials with enhanced stain resistance and surface durability, aiming to reduce the frequency of aesthetic failures and extend restoration longevity in pigment-rich oral environments.

Assessment of the San Francisco syncope rule in detecting high-risk cardiac and neurological causes of syncope

2026-01-23T03:29:28+00:00

Syncope is a common clinical presentation in emergency departments (ED), often posing significant diagnostic challenges due to its broad differential and the potential for life-threatening underlying causes. Accurate risk stratification is essential to differentiate patients requiring urgent intervention from those who can be safely discharged. The San Francisco syncope rule (SFSR) was developed to aid clinicians in identifying patients at risk of short-term serious outcomes. Despite its widespread adoption, evidence regarding its reliability and predictive accuracy remains mixed. External validation studies have reported variable sensitivity and specificity, with some highlighting its failure to detect neurologic or subtle cardiac causes of syncope. Comparative analysis with other stratification tools such as the OESIL score, ROSE rule, and EGSYS score reveals key differences in design and clinical utility. Each model offers unique strengths but also exhibits important limitations when applied across heterogeneous patient populations. Inconsistent definitions of serious outcomes and variable study methodologies have contributed to difficulty in standardizing syncope assessment across settings. Additionally, neurologic causes are frequently underrepresented in many tools, reducing their diagnostic reach. Biomarkers and imaging have been proposed as adjuncts but are limited by access, cost, and timing. Recent interest has turned to machine learning models capable of integrating broader clinical variables to generate personalized risk profiles. Although early results are encouraging, such approaches require rigorous external validation before widespread clinical use. Overall, existing models offer useful guidance but are not definitive. Risk stratification in syncope should remain a dynamic process informed by evidence-based tools, clinician experience, and ongoing research into more adaptable, data-rich strategies capable of addressing the complexity of syncope presentations in modern emergency care.

Role of proprioceptive training in the prevention of recurrent ankle sprains

2026-01-27T15:55:31+00:00

Recurrent ankle sprains are a common consequence of initial ligamentous injuries, often leading to chronic ankle instability and long-term functional limitations. A key factor contributing to recurrence is the disruption of proprioceptive feedback mechanisms, which impair neuromuscular control and compromises joint stability. Proprioceptive training has gained prominence as a targeted intervention aiming to restore sensorimotor function and reduce the likelihood of repeated injury. Unlike traditional rehabilitation, which emphasizes muscle strength and range of motion, proprioceptive protocols focus on reestablishing the body's awareness of joint position and improving reactive control during movement. These programs often include balance exercises, dynamic stabilization drills, and controlled perturbation challenges that stimulate the afferent pathways and retrain neuromuscular responses. Evidence supports the effectiveness of proprioceptive interventions in enhancing postural control, refining muscle activation patterns, and lowering reinjury rates across various populations, including athletes and recreational participants. Comparative studies reveal superior outcomes in tasks requiring dynamic balance and rapid directional change when proprioceptive components are included in rehabilitation. Long-term follow-up suggests that the benefits of these programs can be maintained, particularly when exercises are integrated into regular routines and supported by consistent adherence strategies. Factors influencing compliance include program design, supervision, motivation, and accessibility. Remote monitoring tools and personalized feedback have shown promise in improving engagement and retention. Collectively, the findings emphasize the critical role of neuromuscular retraining in comprehensive ankle rehabilitation. Addressing proprioceptive deficits not only enhances physical function but also provides a protective mechanism against future injury. As research continues to refine the understanding of proprioceptive mechanisms and optimize intervention strategies, the integration of sensorimotor training into standard care protocols represents a vital step toward reducing the long-term burden of recurrent ankle sprains.

Prevalence and management of persistent cough in children post-viral infection

2026-01-27T15:55:31+00:00

Persistent cough in children following viral respiratory infections is a common presentation in clinical practice, often causing concern among caregivers and prompting repeated healthcare visits. While acute viral illnesses typically resolve within two to three weeks, a subset of children experience prolonged cough that persists beyond this period, sometimes lasting up to eight weeks. The pathophysiology involves a combination of heightened cough reflex sensitivity, lingering airway inflammation, and potential involvement of coexisting conditions such as asthma or protracted bacterial bronchitis. Identifying the underlying cause can be challenging due to overlapping symptoms, variability in caregiver reporting, and the limited availability of pediatric-specific diagnostic tools. Prevalence rates vary significantly across regions, with higher incidences observed in low-resource settings where environmental exposures, overcrowding, and delayed access to care are more common. Differences in viral pathogens also influence outcomes, with viruses such as respiratory syncytial virus, rhinovirus, and adenovirus more likely to be associated with prolonged symptoms. Diagnosis relies heavily on clinical judgment, as cough characteristics and duration alone are often insufficient to distinguish between post-viral cough and more chronic respiratory conditions. Management strategies are inconsistent, with frequent reliance on medications lacking strong evidence of efficacy in pediatric populations. Antitussives, inhaled corticosteroids, and antibiotics are often prescribed without clear indications, contributing to unnecessary treatment and potential harm. Non-pharmacologic approaches, including caregiver reassurance and environmental modifications, are commonly recommended but remain under-researched. Overall, the variability in clinical practice highlights the need for more robust pediatric-focused studies and clearer guidelines to support appropriate diagnosis and treatment. Addressing these gaps is essential to improve patient outcomes, reduce unnecessary interventions, and alleviate the burden on families and healthcare systems.

Outcomes of immediate reduction versus delayed management in shoulder dislocation

2026-01-27T15:55:30+00:00

Shoulder dislocations are among the most frequently encountered joint injuries in emergency and orthopedic care, with anterior dislocations accounting for the majority of cases. The timing of reduction following dislocation plays a critical role in influencing short-term outcomes, procedural success, and long-term joint stability. Early reduction is often associated with decreased pain, improved ease of reduction, and lower sedation requirements. Delayed reduction, particularly beyond several hours post-injury, may increase the likelihood of reduction failure, nerve injury, or the need for operative intervention. Studies have shown that recurrence rates are higher in younger patients, especially when treatment is delayed or conservative methods are used without close follow-up. Functional recovery, including return to sport or daily activity, is significantly affected by the management approach and timing of reduction. Structural injuries such as Bankart lesions, Hill-Sachs defects, and rotator cuff tears further complicate outcomes and are more common in delayed or recurrent cases. The presence of risk factors like hyperlaxity, previous subluxations, and improper immobilization also contribute to instability. Imaging strategies, early rehabilitation protocols, and patient education are essential to support recovery and prevent re-dislocation. Variability in emergency department protocols, clinician experience, and resource availability can influence treatment timing and outcomes. Understanding how early versus delayed intervention shapes both immediate and extended recovery allows for more effective decision-making in both acute and follow-up care.

Post-mastectomy pain syndrome: mechanisms, prevention, and management strategies

2026-01-27T15:55:29+00:00

Post-mastectomy pain syndrome (PMPS) affects a significant proportion of breast cancer survivors and represents a challenging consequence of surgical treatment. It is primarily characterized by chronic neuropathic pain in the chest wall, axilla, or upper arm that persists beyond the expected healing period. The underlying mechanisms involve a combination of peripheral nerve injury, central sensitization, inflammatory processes, and maladaptive neuroplasticity. Surgical disruption of nerves such as the intercostobrachial and thoracodorsal plays a critical initiating role, while changes within the central nervous system sustain and amplify the pain experience over time. Preventive strategies span the entire surgical timeline. Preoperative psychological screening and education can reduce risk by addressing anxiety and pain sensitivity. Intraoperative nerve-sparing techniques and regional anesthesia such as paravertebral or pectoral nerve blocks help to blunt nociceptive signaling. Postoperative care focuses on controlling acute pain, early mobilization, and maintaining functions to limit the transition to chronic pain. Despite these interventions, a subset of patients continues to experience persistent symptoms that interfere with daily activities and quality of life. Therapeutic management is often multidisciplinary, incorporating pharmacologic agents like tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and gabapentinoids, along with physical therapy and psychological interventions. The variability in patient response remains a clinical hurdle. Newer approaches such as neuromodulation, ketamine infusions, and noninvasive brain stimulation are being explored for refractory cases. Persistent gaps in early identification, consistent treatment pathways, and personalized care models continue to limit progress. Addressing PMPS requires a comprehensive understanding of its biological and psychosocial components, along with strategies that evolve alongside advances in surgical and pain science. Effective care hinges on early intervention, tailored treatment, and improved integration across specialties involved in breast cancer recovery.

Effectiveness of lifestyle interventions in preventing progression from prediabetes to diabetes

2026-01-27T15:55:29+00:00

Prediabetes, a state of intermediate hyperglycemia, significantly increases the risk of developing type 2 diabetes mellitus and associated complications. With global prevalence on the rise, early intervention is critical to reduce the long-term health and economic burden of diabetes. Lifestyle modification remains the most effective non-pharmacological approach for preventing the progression from prediabetes to diabetes. Interventions focusing on dietary changes, increased physical activity, and weight reduction have demonstrated substantial improvements in glycemic control, particularly in structured and intensive programs. Clinical trials such as the Diabetes Prevention Program and the Finnish Diabetes Prevention Study have shown that lifestyle interventions can reduce diabetes incidence by more than 50 percent among high-risk individuals. Despite strong evidence, real-world implementation reveals challenges in long-term adherence and program scalability. Multiple factors influence outcomes, including individual motivation, cultural relevance, socioeconomic constraints, and healthcare access. Programs tailored to the needs and preferences of specific populations show better retention and engagement. Digital tools and community-based approaches have expanded accessibility, although technological barriers and variability in engagement persist. Sustained impact often relies on ongoing support and integration with primary care and public health systems. From a public health perspective, creating environments that support healthy behaviors is essential for sustaining lifestyle changes. Policy measures that improve food access, promote physical activity, and encourage preventive care can reinforce individual-level efforts. Cost-effectiveness analyses support investment in lifestyle programs, particularly when targeted at high-risk groups. Long-term sustainability depends on aligning intervention design with both personal and structural determinants of health. While lifestyle change is often viewed as an individual responsibility, its success is shaped by systems and environments that either support or hinder behavior over time. Addressing these broader influences remains key to reducing the global burden of diabetes through prevention.

Relationship between circadian disruption and mood instability in shift workers

2026-01-27T15:55:28+00:00

Shift work has become a structural necessity in modern economies, yet its impact on mental health remains a growing concern. Circadian disruption, a core consequence of working non-standard hours, has been consistently linked to mood instability. This misalignment between internal biological rhythms and externally imposed work schedules affects key physiological systems involved in emotional regulation, including sleep-wake cycles, hormonal rhythms, and neurotransmitter activity. Disturbed sleep architecture, altered cortisol patterns, and impaired serotonergic function all contribute to heightened vulnerability to mood disorders such as depression, anxiety, and emotional lability among shift workers. The relationship between circadian misalignment and mood is not uniform across individuals. Genetic predispositions, diurnal preference, social environment, and occupational conditions play a substantial role in modulating emotional outcomes. Evening chronotypes may adapt more efficiently to night shifts, while certain polymorphisms in circadian genes increase sensitivity to rhythm disruption. Social support and perceived control over work schedules further influence psychological resilience in these populations. Clinical interventions targeting circadian health have shown efficacy in improving emotional outcomes. Light therapy, melatonin, and behavioral strategies such as cognitive behavioral therapy for insomnia have demonstrated benefits in regulating both sleep and mood. Preventive measures, including forward-rotating shift schedules, extended recovery periods, and fatigue risk management systems, also contribute to mitigating psychological harm. Addressing mood instability in shift workers requires a multidimensional approach that considers biological rhythms, individual risk modifiers, and systemic workplace design.

Clinical reassessment of denture fit and tissue tolerance in aging edentulous patients

2026-01-27T15:55:27+00:00

Tooth loss in the elderly remains a widespread concern, with complete edentulism significantly impacting oral function, comfort, and overall quality of life. As individuals age, ongoing anatomical and physiological changes in the oral cavity influence the performance of removable prostheses. Progressive alveolar bone resorption, soft tissue atrophy, and reduced neuromuscular coordination contribute to compromised denture retention and stability. In many cases, patients continue to wear their dentures for extended periods without reassessment, leading to tissue trauma, discomfort, and oral lesions. These problems are often exacerbated by age-related systemic health conditions, such as diabetes and dry mouth, which reduce the tissue’s capacity to adapt to mechanical pressure. Biological responses to long-term denture use vary significantly among patients, depending on factors like immune response, mucosal health, and hygiene practices. Tissue tolerance decreases when dentures are ill-fitting, unbalanced, or worn beyond their functional lifespan. Inflammatory conditions such as denture stomatitis and epulis fissuratum frequently emerge due to microbial colonization and sustained mucosal pressure. Clinicians must pay close attention to subtle tissue reactions and identify changes early to prevent chronic complications. Effective reassessment requires a comprehensive clinical approach that includes visual inspection, pressure distribution analysis, evaluation of occlusal function, and patient feedback. Corrective interventions may involve relining, occlusal adjustments, or complete prosthesis replacement. In complex cases, especially where tissue damage is advanced or retention cannot be restored by conventional means, implant-supported solutions may be explored. Continuous monitoring and patient-specific care are essential to ensure denture performance aligns with evolving anatomical and physiological conditions in the elderly. A proactive, structured reassessment strategy enhances comfort, protects soft tissues, and supports functional adaptation over time.

Mechanisms and management of treatment-resistant depression in clinical psychiatry

2026-01-28T14:11:22+00:00

Treatment-resistant depression (TRD) is a severe and persistent form of major depressive disorder characterized by inadequate response to at least two antidepressant treatments of adequate dose and duration. It affects a substantial proportion of patients and is associated with chronic symptoms, functional impairment, and elevated suicide risk. The underlying mechanisms are multifaceted, involving disrupted neurocircuitry, impaired neuroplasticity, neuroinflammation, and dysregulation of the hypothalamic-pituitary-adrenal axis. Structural and functional brain imaging studies have identified consistent abnormalities in the prefrontal-limbic networks, particularly in regions such as the subgenual anterior cingulate cortex and dorsolateral prefrontal cortex. Inflammatory markers including interleukin-6 and C-reactive protein are frequently elevated in TRD populations, linking immune system activation to poor antidepressant response. Diagnosis of TRD is complicated by the absence of universal criteria, variability in clinical assessment, and confounding psychiatric or medical comorbidities. Misclassification is common due to incomplete treatment histories and inconsistent use of structured diagnostic tools. Recent advances in treatment include glutamatergic agents such as esketamine, non-invasive neuromodulation techniques like theta burst stimulation, and the emergence of digital monitoring tools to guide personalized care. Psychedelic-assisted therapy is also gaining clinical interest, supported by preliminary evidence of rapid and sustained antidepressant effects. As research progresses, there is increasing emphasis on integrating biomarkers, neuroimaging, and functional outcomes into future diagnostic and therapeutic frameworks.

Subclinical hypothyroidism and its clinical relevance in routine practice

2026-01-28T14:11:21+00:00

Subclinical hypothyroidism is defined by elevated serum thyroid-stimulating hormone levels with normal circulating free thyroxine and is commonly identified through routine blood tests. Although patients are often asymptomatic, the condition has been associated with a range of systemic effects, including cardiovascular dysfunction, lipid abnormalities, cognitive changes, and subtle metabolic disturbances. These associations have raised concerns about potential long-term consequences, especially in populations with pre-existing risk factors. The diagnosis remains challenging due to inter-individual variation in TSH levels, age-related shifts in reference ranges, and the nonspecific nature of presenting symptoms. Interpretation of thyroid function tests must consider these variables to avoid overdiagnosis or unnecessary treatment. Evidence on whether levothyroxine therapy improves clinical outcomes in subclinical hypothyroidism remains mixed. While some studies suggest benefits in symptom relief, lipid profile improvement, or cardiovascular risk reduction, others show limited or no benefit, particularly in older adults. Treatment is more strongly supported in patients with TSH levels above 10 mIU/l, pregnant women, or those planning conception. In contrast, younger asymptomatic individuals with mild TSH elevations are often monitored without pharmacological intervention. Management strategies must balance potential benefits with the risk of overtreatment, including iatrogenic hyperthyroidism and its associated complications. Individualized care, guided by symptom profile, risk factors, and patient preferences, is increasingly recognized as the most appropriate approach. Clinical guidelines continue to evolve as more data emerge from randomized trials and longitudinal studies. Despite progress, significant gaps remain in understanding the natural history and optimal management of subclinical hypothyroidism. Future research focused on biomarkers of progression, patient-reported outcomes, and age-specific thresholds may help address these uncertainties and improve clinical decision-making.

Bacterial regrowth following various surgical scrubbing methods in prolonged surgeries

2026-01-28T14:11:21+00:00

Bacterial regrowth beneath surgical gloves during prolonged operations remains a critical challenge in infection prevention. While surgical scrubbing methods effectively reduce microbial load at the start of procedures, the persistence and reappearance of skin flora over time can compromise the sterile field, especially during glove changes or unnoticed micro-perforations. The type of antiseptic agent, its residual activity, and the duration of the procedure influence how rapidly bacteria recolonize the hands. Alcohol-based hand rubs offer rapid initial reduction but may lack prolonged antimicrobial activity, while chlorhexidine and povidone-iodine formulations exhibit longer-lasting effects due to their ability to bind to the skin. Environmental conditions under gloves such as moisture, heat, and friction further contribute to microbial resurgence. The skin's natural characteristics, including the presence of deep-seated resident flora and the integrity of the skin barrier, also shape the rate of regrowth. Studies indicate that even with strict adherence to antisepsis protocols, bacterial levels under gloves can approach pre-scrub levels after several hours of wear. This risk is heightened in long surgeries where intraoperative interventions are limited. Infection control strategies must evolve to include time-based glove changes, selection of antiseptics with sustained activity, and intraoperative hygiene protocols when necessary. Institutional policies often overlook regrowth dynamics, focusing solely on preoperative practices. A more dynamic model that accounts for intraoperative changes and incorporates evidence-based antiseptic selection can reduce the risk of surgical site contamination. Understanding the multifactorial nature of bacterial regrowth and addressing it through procedural, environmental, and product-based adjustments is essential for maintaining surgical sterility in extended operations.

Cutaneous vascular response and its role in the efficacy of laser-based aesthetic procedures

2026-01-28T14:11:20+00:00

Laser-based aesthetic procedures rely heavily on the interaction between laser energy and the skin’s vascular system. The effectiveness of these treatments often depends on the ability to precisely target and modulate blood vessels without damaging surrounding tissue. Key to this process is selective photothermolysis, where laser wavelengths are absorbed by hemoglobin, leading to controlled thermal injury and vessel coagulation. The biological response that follows includes inflammatory signaling, thrombosis, and subsequent vascular remodeling, all of which contribute to clinical improvements in conditions like telangiectasia, port-wine stains, and facial erythema. The extent of vascular response is shaped by numerous variables such as vessel size, blood flow rate, depth, and the optical properties of the skin. Laser parameters including wavelength, pulse duration, and fluence must be carefully matched to these vessel characteristics to ensure effective treatment. In patients with darker skin tones, melanin competes with hemoglobin for light absorption, raising the risk of pigmentation issues. Protective measures like epidermal cooling and longer wavelengths help reduce adverse effects while maintaining efficacy. Treatment outcomes are also influenced by anatomical location, pre-existing vascular conditions, and patient-specific healing responses. Technological advancements, including dynamic cooling, pulse stacking, and multispectral lasers, have improved precision and safety. Monitoring vascular behavior during treatment allows for real-time adjustments, making procedures more adaptable to individual needs. Together, a deeper understanding of vascular mechanisms and improved device control continues to expand the potential of laser-based aesthetics, offering more consistent and personalized results across a wide range of skin types and vascular presentations.

Nanotechnology in contemporary dentistry: a comprehensive review of current clinical applications, bioactive materials, and future perspectives

2026-02-01T03:12:34+00:00

This review explores the transformative shift in dentistry from biopassive materials to bioactive nanotechnology, addressing critical challenges such as polymerization shrinkage, secondary caries, and mechanical failure. Through a systematic search of PubMed, Scopus, Cochrane, and Google Scholar (2015–2026), the study evaluates the mechanisms and clinical efficacy of bioactive glass (BAG), nanohydroxyapatite (nHA), and calcium-phosphate scaffolds. Findings indicate that these nanomaterials outperform traditional composites by enabling deep biomimetic remineralization, providing Power of Hydrogen (pH)-responsive ion release, and reducing polymerization stress by up to 37% through advanced fillers like nanoclay. In clinical practice, nanotechnology enhances the polishability and wear resistance of restoratives, optimizes osseointegration via nanofeatured implant surfaces, and improves endodontic sealing through nanoparticle-enhanced sealers. The review concludes that the integration of smart stimuli-responsive systems, Artificial Intelligence (AI), and three-dimensional (3D) bioprinting is transitioning the field from prosthetic replacement to full biological tooth regeneration, establishing nanotechnology as the cornerstone of personalized, regenerative oral healthcare.

Molecular epidemiology and genomic surveillance of human pegivirus: current insights and future directions

2026-02-01T03:14:46+00:00

Human pegivirus (HPgV), formerly termed GB virus C (GBV-C), is a widely circulating, non-pathogenic RNA virus within the Flaviviridae family. Although highly prevalent globally, HPgV remains insufficiently characterized despite growing evidence of its immunomodulatory effects, particularly among individuals co-infected with HIV or HCV. Improved understanding of its genetic diversity, transmission patterns, and evolutionary dynamics is crucial to elucidate its potential biomedical relevance. The contemporary evidence on the molecular epidemiology and genomic surveillance of HPgV, emphasizing research gaps, geographic disparities, and priorities for future study. A systematic peer-reviewed literature and publicly available genomic repositories such as GenBank and GISAID was conducted for studies published between 1995 and 2025 using terms including “HPgV,” “GBV-C,” “molecular epidemiology,” “genomic surveillance,” and “genotype distribution.” Extracted data were classified by region, genotype, and study design to evaluate trends in prevalence, genetic variability, sequencing coverage, and the strength of surveillance systems. The review reveals substantial global genetic diversity, comprising at least seven recognized genotypes with distinct regional distributions. Despite diversity, HPgV remains underrepresented in genomic studies, particularly in low- and middle-income countries. Limitations include scarce full-genome sequencing, inconsistent genotype classification, and limited integration into global pathogen surveillance platforms. While co-infection with HIV and HCV poses analytical challenges, it also offers opportunities to investigate HPgV-associated immune modulation. Although clinically benign, HPgV’s widespread distribution and possible immunological influence highlight the need for enhanced genomic monitoring, standardized nomenclature, and expanded sequencing capacity. Coordinated global efforts are essential to strengthen HPgV surveillance and advance understanding of its evolutionary behavior and public health implications.

Concept of epidemiology – a detailed review

2026-02-01T03:15:22+00:00

Epidemiology may typically be demonstrated as a branch of science; which has undergone multifaceted changes through the long span of time. It has contributed immensely to the human society to raise widespread community awareness. It has also played a significant role in imparting knowledge about health, citing relation to various infectious diseases. Therefore; in relation to the incessant evolution, it is thoroughly important to understand the ‘concept’ of ‘epidemiology’; as to analyse chiefly the numerous risk factors; responsible for the different infectious diseases; thereby ushering in a better; disease-free; healthy tomorrow for the mankind.

A systematic approach to the development and validation process of a research tool: an overview

2026-02-01T03:15:04+00:00

Research tool development and validation process is enigmatic and opaque due to the diverse range of techniques it requires. As a result, the main goal of this article is to provide an overview of the research tool development process as simply as possible in order to support the development of new, valid, and reliable research tools, as well as improvement of existing ones. We accomplish this work by presenting all of the required steps in the right sequence to develop a research tool. In light of our search, we suggest five phases of tool development and validation, each with its own sub-steps. The first step involves preparing the preliminary draft, which includes conceptualizing the construct, evaluating current practices, conducting focus group discussions, and creating the item pool. The second phase includes the tool draft's validation with internal and external review, as well as the tool's pre-testing. Phase three includes field testing of the finalized tool draft, sampling planning, and data collection. The fourth phase includes the analysis of research tool data with item analysis, exploratory factor analysis, internal consistency, and test-retest reliability. The fifth phase is all about scale interpretation using percentiles, standard scores, norms, and cut-off points. Additionally, we briefly discussed the key best practices indicated in each step. This review will help both scientists and practitioners to understand all the steps and methodologies of research tool development and validation.

Climate change and health distress

2026-02-01T03:13:38+00:00

Climate change represents a significant health threat to human populations, particularly affecting impoverished and low-income nations, making it a global health concern in the 21st century. An extensive literature search was performed from June to September 2025, utilizing databases like PubMed, Scopus, Web of Science, and Google Scholar. The search strategy included pertinent keywords and MeSH terms such as “climate change,” “global warming,” “health effects,” “non-communicable diseases,” “infectious diseases,” “mental health,” and “vulnerable populations,” combined with Boolean operators (AND, OR). This narrative review explores the various health impacts of climate change on different organ systems, including both direct and indirect effects and their consequences. Increased temperatures, extreme weather events, altered precipitation patterns, and heightened air pollution are linked to numerous health issues, such as cardiovascular diseases, neurological disorders, kidney ailments, and respiratory problems. The detrimental effects of heat stress, dehydration, and air pollution elevate the risk of heart attacks, arrhythmias, strokes, and neurodegenerative conditions. Prolonged exposure to air pollution is associated with cognitive decline, anxiety, and depression. Tackling these intricate challenges necessitates coordinated multisectoral efforts that focus on climate resilience, strengthening health systems, and implementing equity-centred adaptation strategies.

The importance of modern technology advancements in the development of classical Panchakarma instruments

2026-02-01T03:13:17+00:00

The ultimate substitute of Ayurvedic treatment is Panchakarma, a specific bio-purificatory and rejuvenating method that involves five grand operations, namely Vamana, Virechana, Basti, Nasya and Raktamokshana. The success of these classical procedures is not based on the skill of the physician and drugs only but also on the accuracy of the instruments (Yantras and Upakaranas) used and the design of the instruments. Historically Panchakarma instruments were made by hand out of natural products, e.g. clay, wood, brass, or animal parts based on the theory named Sukha-Upayoga (easy to use), Kshamata (efficient) and Sthirata (long-lasting) in the writings of Charaka Samhita and Sushruta Samhita. But in the face of the renewed Ayurveda worldwide, the shortcomings of traditional equipment, e.g. the absence of standardization, variation of temperature, hygiene issues, and the reliance on human skill, have aroused the requirement of technology. Background: This review seeks to assess the relevance of the modern technological development on the design, standardisation, and clinical adjustments of classical Panchakarma instruments and in particular, their safety, accuracy, reliability and universal usability. Panchakarma instruments have been undergoing a transformation process that is progressive, which has been achieved by incorporating both engineering and biomedical technology. Added to innovations in the area. Moreover, standardization, documentation of research and global acceptance has become easier due to the introduction of Ayur informatics, sensor-based monitoring, and data-driven SOPs.

Bacterial endocarditis and dental infections in the post-COVID-19 era: a review of current concepts

2026-02-01T03:13:10+00:00

The COVID-19 pandemic has profoundly impacted global healthcare, leading to shifts in the epidemiology, diagnosis, and management of various infectious diseases. Infective endocarditis (IE), a severe and life-threatening infection of the endocardial surface of the heart, has seen a resurgence in recent years, with oral streptococci remaining a predominant causative agent. This review explores the evolving relationship between dental infections, oral health, and the risk of IE in the post-COVID-19 landscape. We examine the pathophysiological mechanisms linking dental bacteremia to endocardial colonization, emphasizing the role of endothelial damage induced by SARS-CoV-2 as a potential novel risk factor. The pandemic led to significant disruptions in routine dental care, resulting in an accumulation of untreated dental disease and a cohort of patients with advanced oral infections. Concurrently, altered immune responses and the pro-thrombotic, pro-inflammatory state associated with COVID-19 may create a more susceptible environment for bacterial adhesion and vegetation formation. This article synthesizes current evidence on these interactions, discusses updates in antibiotic prophylaxis guidelines, and highlights the critical importance of restoring access to dental care and reinforcing collaborative efforts between cardiologists, infectious disease specialists, and dentists in the post-pandemic period.

Overview of solar radiation exposure to the human health particularly to the eye: a review article facts and figures till today

2026-02-01T03:12:50+00:00

Exposure to solar radiation (SR) induces photochemical and thermal damage to ocular tissues, primarily via ultraviolet radiation (UVR), affecting outdoor workers and recreational users globally. Short-term effects include photokeratitis (corneal inflammation, akin to "snow blindness") and photoretinitis, while chronic exposure leads to cataracts, pterygium, corneal degeneration, and eyelid cancers. High-altitude and snowy areas intensify UVR by up to 85% reflection from fresh snow, exacerbating risks for unprotected eyes in both children and adults. This review synthesizes evidence from epidemiological studies, clinical case series, and photobiology research up to 2025, including world health organization (WHO) global burden estimates and occupational exposure data. Key sources encompass PubMed/PMC articles on UVR mechanisms (e. g., Bunsen-Roscoe reciprocity law for cumulative damage) and field measurements of ultraviolet (UV) reflectance in elevated/snowy terrains. Analysis focuses on human health impacts, prioritizing eye-specific outcomes via qualitative synthesis without meta-analysis. Acute UVR exposure causes painful photokeratitis and conjunctivitis, with snow reflection increasing retinal stress and erythropsia (temporary red vision). Chronic effects show outdoor workers with 4-fold higher pterygium odds and substantial cataract burden (e.g., 529,242 DALYs globally per WHO). Skin and immune impacts include immunosuppression and higher skin cancer rates, with solar retinopathy from direct gazing causing permanent macular damage; 100% UV-protective sunglasses mitigate nearly all risks. SR endangers eyes and skin profoundly in reflective environments, urging optometrists and ophthalmologists to recommend 100% UVA/UVB-blocking sunglasses for patients visiting high altitudes or snowy areas. Prioritizing protection prevents acute injuries and chronic diseases, promoting public health education on evidence-based eyewear selection.

Comparative outcomes of free flap versus local flap reconstruction in post-traumatic lower limb defects following orthopaedic fixation: a meta-analysis

2026-01-20T02:06:50+00:00

Post-traumatic lower limb defects following orthopedic fixation present significant reconstructive challenges, and the choice between free flap and local flap reconstruction remains critical for limb salvage, functional recovery, and complication prevention. This study systematically evaluated and compared the outcomes of free flap versus local flap reconstruction in the management of post-traumatic lower limb soft-tissue defects after orthopedic fixation. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library for studies published up to October 2025, including randomized controlled trials, cohort studies, and case series that directly compared free and local flap techniques in adult patients. Data were extracted on flap survival, infection and complication rates, time to bone union, functional outcomes, and the need for re-operation. Twenty-seven studies met the inclusion criteria, demonstrating that free flaps were more reliable for large or complex defects and were associated with lower rates of deep infection and flap failure in high-risk wounds, while local flaps offered shorter operative times and reduced donor-site morbidity but showed higher rates of partial necrosis and limited effectiveness in extensive defects. Functional outcomes and time to fracture union were generally comparable between the two techniques; however, free flaps provided superior results in cases with compromised soft-tissue envelopes. Both free and local flaps are effective reconstructive options following lower limb trauma with orthopedic fixation, with free flaps being preferable for large or highrisk defects and local flaps remaining suitable for smaller, less complex wounds, emphasizing that defect size, vascular status, and patient-specific factors should guide individualized reconstructive decision-making.

Exploring the burden and associated risk factors of antenatal depression: a systematic review and meta-analysis

2026-01-23T03:29:43+00:00

Antenatal depression (AND) is a critical public health issue affecting a significant number of pregnant women worldwide, particularly in low- and middle-income countries. This review synthesizes findings from 40 studies, primarily observational research and randomized controlled trials, published between January 2011 and December 2024, sourced from academic databases including Google Scholar and PubMed. The objective is to explore regional variations in the burden of AND and identify associated risk factors. The evidence reveals that risk factors for AND can be grouped into five categories: family and community dynamics, violence and abuse, obstetric factors, psychological issues, and socio-demographic conditions. Among these, inadequate social support and poor partner relationships consistently emerged as strong predictors. Exposure to violence, especially domestic abuse, significantly increased the risk. Obstetric factors such as unintended pregnancies, high gravidity, and past miscarriages were also linked to higher AND prevalence. In addition, psychological history, including prior episodes of depression or anxiety, played a central role in increasing vulnerability. Socio-demographic elements such as marital status and financial hardship further shaped the risk landscape. These findings emphasize the need for culturally sensitive interventions that strengthen social support networks, address intimate partner violence, and expand access to targeted maternal mental health care.

Clinical outcomes of integrated psychiatric and homoeopathic management in acute substance withdrawal: a case series

2026-02-01T03:14:31+00:00

Substance withdrawal is characterized by a cluster of symptoms and physiological changes that occur on reduction or cessation of prolonged or heavy substance use. The clinical features depend on the substance, dosage, and usage pattern, with alcohol, cannabis, and tobacco being among the most commonly implicated. Symptoms can range from mild discomfort to severe, life-threatening conditions. Standard management includes detoxification, medication-assisted therapy, and supportive care. Integrating psychiatry care with homoeopathy with may enhance outcomes by alleviating withdrawal symptoms, reducing stress, and supporting emotional balance, thereby improving recovery and reducing relapse risk. This case series aims to explore the Integration of standard care with homoeopathy to enhance treatment outcomes through individualized patient-centred intervention. Three young individuals with histories of alcohol, tobacco, and cannabis use presented to the psychiatry outpatient department of the national homoeopathy research institute, Kottayam, and were diagnosed with substance withdrawal as per ICD-10 criteria. Homoeopathic medicines, including Nux vomica and Staphysagria, were prescribed. In cases where the response was inadequate in some of the withdrawal symptoms, mild sedatives and antipsychotics (Lorazepam and olanzapine) were administered concurrently under psychiatric supervision and later tapered. This integrated approach resulted in noticeable relief from withdrawal symptoms within a few days and a sustained reduction in substance dependence over the following months. Treatment response, assessed using standard withdrawal scales for alcohol, cannabis, and tobacco, showed significant score reductions. While homoeopathy holds potential in managing acute substance withdrawal, the unpredictable nature of withdrawal progression makes Integration with psychiatric care a safer and more effective approach.

Clinico epidemiological investigation of an outbreak of food poisoning in a girl’s hostel of an educational institute

2026-02-01T03:16:22+00:00

Food poisoning results from ingestion of contaminated food or beverages, commonly presenting as gastroenteritis. Prompt epidemiological investigation is essential for source identification and prevention. In February 2025, following a farewell celebration at a girl’s hostel of an educational institution in India, multiple students developed acute gastroenteritis. The event was catered for by an external vendor, and all affected individuals were female students. Objective was to determine the magnitude, source, and causative agent of the outbreak, and to identify contributing environmental and epidemiological factors. A retrospective cohort study was conducted. All symptomatic individuals were included as cases. Data on symptoms, exposure history, and food consumption was collected via interview and medical record review. Attack rate (AR), relative risk (RR), and attributable risk (AR%) were calculated for each food item. Seventeen of 160 students (AR 10.6%) developed symptoms within 8-24 hours post-exposure. Diarrhoea occurred in all cases, vomiting in 66%, abdominal pain in 76.4%, and fever in 11.8%. Gol Gappa (AR=9.95%) and rice (AR=6.79%) were most strongly associated with illness. Based on symptomatology and incubation period, Salmonella typhimurium was the most probable causative agent; microbiological confirmation was not possible due to lack of food samples. A small-scale outbreak of food poisoning was linked to consumption of Gol Gappa and rice, likely contaminated due to improper handling and storage. Strengthened food hygiene practices and timely outbreak investigations are crucial to prevent recurrence.

An unusual case report of chlorpheniramine-induced severe thrombocytopenia

2026-02-01T03:16:36+00:00

A rare but fatal illness is drug-induced thrombocytopenia (DITP). Severe thrombocytopenia is not frequently linked to antihistamines, especially first-generation H1 blockers like chlorpheniramine. We describe a rare instance of a 31-year-old man who used chlorpheniramine for rhinitis and thereafter got severe thrombocytopenia (platelet count=0×10⁹/L). The patient had subcutaneous petechiae, bilateral conjunctival hemorrhage, and bleeding gums. Other causes were ruled out by laboratory tests, such as bone marrow analysis and peripheral blood smears. After receiving intravenous immunoglobulin (IVIG) and corticosteroids, the patient's platelet counts gradually recovered. This instance emphasizes how crucial it is to identify DITP as a side effect of chlorpheniramine so that early diagnosis and treatment may be carried out.

Exploring the role of social work in perinatal mental health: a case study of postpartum depression intervention in Belize

2026-02-01T03:15:10+00:00

Social workers play a vital role in addressing the mental health and social needs of perinatal women, often as key members of multidisciplinary teams. Postpartum depression (PPD) affects 10–20% of new mothers globally, posing risks to maternal well-being and infant development. Despite their importance, limited literature reviews the specific interventions social workers provide in PPD care. This study assesses the effectiveness of social work interventions for a first-time mother in Belize. This single-case intervention study employed a mixed-methods approach. MG, a 31-year-old first-time mother diagnosed with PPD, received eight biweekly online psychoeducational sessions (2–3 hours each) delivered by a licensed social worker between February and June 2025. Quantitative data were collected using the Edinburgh Postnatal Depression Scale (EPDS) and the Multidimensional Scale of Perceived Social Support (MSPSS) at baseline and post-intervention. Qualitative data were gathered through journaling and semi-structured interviews. Informed consent and confidentiality were maintained. MG’s EPDS score dropped from 15 to 2 post-intervention, an 87% reduction, moving from clinically significant to subclinical symptoms. MSPSS scores for family and significant others remained high (6), reflecting stable informal support. Qualitative findings showed improved emotional regulation, coping, and maternal confidence. Symptom reduction appears primarily linked to formal support via social work intervention. This study highlights the pivotal role of social workers in supporting women with PPD. Findings suggest that brief, low-cost, remotely delivered psychoeducational interventions can significantly improve maternal emotional health. Future research should explore scalability and integration into routine perinatal care in resource-limited settings.

Body dysmorphic disorder by proxy: a case report and literature review

2026-02-01T03:13:15+00:00

Body dysmorphic disorder (BDD) is a distressing and/or impairing preoccupation with a perceived defect in physical appearance which is minimal or unnoticeable to others. It affects approximately 1.6% to 2.4% of the general population. According to DSM-5, BDD is characterized by significant distress and repetitive behaviour. It is sometimes associated with anxiety, obsessive-compulsive disorder (OCD), depression or impaired functioning. BDD by proxy (BDDBP), an overlooked variant, involves obsessive concern with another individual’s appearance rather than one’s own. It leads to assurance seeking and attempts to correct the flaws. A 23-year-old man presented with anxiety and depressive symptoms due to his concern regarding his wife's protruding chin. The patient's preoccupation began early in the relationship and intensified over the period. The wife’s refusal to pursue corrective measures caused marked distress, anxiety and thoughts of divorce. He underwent a mental status examination and psychiatric evaluation for further analysis. Body dysmorphic disorder (BDD) and body dysmorphic disorder by proxy (BDDBP) are serious but often overlooked mental health issues that can lead to significant emotional distress and impairment in daily life. These disorders can strain relationships, cause obsessive behaviors and severely affect quality of life. Effective treatment usually includes cognitive-behavioral therapy (CBT) and SSRIs, along with education and lifestyle changes.

Central giant cell granuloma presenting as a multilocular radiolucency in the mandibular canine–premolar region: a pediatric case report

2026-02-01T03:12:57+00:00

Central giant cell granuloma is a benign but locally invasive intraosseous lesion most commonly affecting the mandible in children and young adults. This report describes a 14-year-old female who presented with a firm, non-tender bluish swelling in the mandibular canine–premolar region. Radiographic examination revealed a well-defined multilocular radiolucent lesion with cortical expansion and divergence of adjacent teeth. Laboratory investigations showed normal calcium and parathyroid hormone levels, excluding hyperparathyroidism. Histopathological examination revealed multinucleated giant cells within a fibroblastic stroma, confirming the diagnosis of giant cell granuloma. The lesion was managed successfully with conservative surgical curettage and extraction of associated teeth. Overall, this case represents some aggressive behavior of central giant cell granuloma in a young female patient, demonstrating classic clinical, radiographic, and histopathological characteristics, and emphasizes the importance of systematic evaluation and surgical management.

Dental management under general anesthesia in a pediatric patient with Netherton syndrome: a case report

2026-02-01T03:12:39+00:00

Netherton syndrome (NS) is a rare genodermatosis with autosomal recessive inheritance caused by mutations in the serine peptidase inhibitor Kazal type 5 (SPINK5) gene, characterized by the triad of ichthyosiform erythroderma, hair shaft abnormality, and atopic diathesis. A 5-year-old Saudi boy diagnosed with NS is reported. He presented with many food allergies, mild lymphopenia, trichorrhexis invaginata, eczema-like lesions, elevated immunoglobulin E (IgE), and exfoliative erythroderma at birth. Several carious teeth and widespread non-plaque-induced gingival inflammation were among the intraoral findings. Following preoperative multidisciplinary clearance, full dental rehabilitation under general anesthesia was carried out. Prophylactics, composite restorations, stainless steel crowns, and extractions of non-restorable teeth were included as part of the treatment. The patient's recovery from the procedure went smoothly, and both oral comfort and function improved. In conclusion, this case highlights the critical role of multidisciplinary collaboration in the safe delivery of dental rehabilitation under general anesthesia for patients with NS.