International Journal Of Community Medicine And Public Health

Barriers, enablers and perceived benefits of mental health services among workers in primary healthcare facilities in Rivers State: a qualitative approach

Pearl Iyaye Daibi Abereton — 2026-06-30

For effective provision of mental healthcare services (MHS), resource availability is key. This study explored the enablers and barriers affecting the provision of primary MHS in primary healthcare (PHC) facilities in Rivers State. A qualitative study was conducted among 12 PHC workers in Rivers State, Nigeria, using topic-guided in-depth and key informant interviews. Ethical considerations were ensured and thematic content analysis was used to analyze and code data into subthemes. Enabling factors included the availability of workers, and having workers who were willing to provide these services. Barriers included unavailability of trained staff, poor mental health awareness, unavailability of medications. The provision of MHS faces barriers that can potentially limit the quality and effectiveness of services provided at the PHC level. Establishing and implementing a strategic framework to address the identified challenges and improving overall government support towards MHS provision were recommended.

Health care providers’ perspectives about modern contraceptive use among eligible couples in a tribal area of Palghar district, Maharashtra: a qualitative study

Milind M. Rasal — 2026-06-30

The exploration of healthcare providers’ perspectives, attitudes, and practices towards modern contraceptives is essential to address the unmet need for the use of modern contraceptive methods. The present qualitative study involved in-depth interviews (IDIs) with participants, conducted using a semi-structured questionnaire. The study was conducted in the subcentres of Ashagad PHC, Palghar District, Maharashtra, India. 17 health care workers (3 CHOs, 5 ANMs, and 9 ASHAs) participated in the study. Participants were selected by the purposive sampling method. Data were analysed using deductive thematic analysis. The findings showed that condoms and oral contraceptive pills were the most commonly preferred contraceptives by eligible couples. Intrauterine contraceptive devices (IUCD) and injectables were less opted for due to fear of side effects & misconception that it affects fertility. The healthcare workers perceived difficulties while promoting contraceptives, which included illiteracy, influence of community members and quacks, use of jungle herbs as contraceptives, and fear about contraceptives among eligible couples. The health care workers also enumerated facilitating factors at the community level, such as street plays, counselling sessions at community level camps, use of effective IEC materials at Ashram schools. Fostering sustained behaviour change in community members appropriate to local needs and using a culturally sensitive approach will greatly enhance acceptance of family planning services among eligible couples in the tribal area.

A systematic review and meta-analysis of therapeutic strategies for postoperative abdominal wound infection

Osman Suliman — 2026-06-30

Postoperative abdominal wound infections remain a major cause of morbidity, prolonged hospitalization, and increased healthcare costs worldwide. Despite advances in surgical techniques and infection prevention, controversy persists regarding optimal management strategies, leading to variations in clinical practice. This systematic review and meta-analysis aimed to evaluate current evidence on the management of postoperative abdominal wound infections, focusing on medical, surgical, and adjunctive interventions that improve outcomes and reduce recurrence. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library for studies published between 2010 and 2025. Eligible studies included randomized controlled trials (RCTs), cohort studies, observational studies, systematic reviews, and clinical guidelines addressing postoperative abdominal wound infection management. Data extraction and quality assessment were independently performed by two reviewers. A total of 27 studies were included: 2 RCTs, 4 cohort studies, 4 prospective observational studies, 3 cross-sectional studies, 2 systematic reviews/meta-analyses, 3 guidelines, 4 narrative reviews, 3 quality-improvement studies, and 2 integrative or scoping reviews. Evidence consistently demonstrated that effective management depends on early diagnosis, prompt wound debridement, appropriate antibiotic therapy, and advanced wound care techniques such as negative pressure wound therapy (NPWT) and antimicrobial dressings. Multidisciplinary care and infection-prevention strategies were also associated with improved outcomes. Overall, management of postoperative abdominal wound infections requires a multimodal, patient-centered approach integrating surgical intervention, optimized antimicrobial therapy, and advanced wound care. NPWT appears to provide the greatest benefit as an adjunctive therapy. Further high-quality RCTs are needed to establish standardized treatment protocols and strengthen evidence for emerging therapies.

Risk of complications following laparoscopic sleeve gastrectomy for morbid obesity: a systematic review

Osman Suliman — 2026-06-30

Laparoscopic sleeve gastrectomy (LSG) has emerged as one of the most frequently performed bariatric procedures for the management of morbid obesity. Although LSG is considered technically simpler than other bariatric operations, it is still associated with a range of postoperative complications that may influence patient outcomes. Reported complication rates vary widely across studies due to differences in patient characteristics, surgical techniques, perioperative protocols, and institutional experience. This systematic review and meta-analysis, conducted in accordance with PRISMA 2020 guidelines, evaluated studies published between January 2010 and December 2025 reporting complications following laparoscopic sleeve gastrectomy for morbid obesity. Eligible studies included adult patients undergoing primary LSG with documented perioperative outcomes. Data extraction and quality assessment were performed independently by reviewers. Random-effects meta-analysis was applied where appropriate, and heterogeneity was assessed using the I² statistic. The pooled evidence demonstrated that LSG is associated with relatively low overall complication rates; however, clinically significant complications such as staple line leak, bleeding, stenosis, and gastroesophageal reflux disease were reported. Patient-related factors including high body mass index (BMI), comorbidities, and surgeon experience influenced complication risk. Early detection and standardized perioperative management were associated with improved outcomes. Overall, laparoscopic sleeve gastrectomy remains a safe and effective bariatric procedure, though careful patient selection and optimized surgical technique are essential to minimize complications. Variability among studies highlights the need for standardized reporting and further high-quality research.

A rare constellation of findings in VACTERL association

Supriya Adiody — 2026-06-30

VACTERL (Vertebrae, anus, cardiac system, tracheo-esophageal fistula, renal system, and limbs) association is a heterogeneous constellation of congenital anomalies involving at least three of six characteristic components: vertebral, anorectal, cardiac, tracheo-esophageal, renal, and limb defects. We report a rare presentation in a 3-year-old girl who exhibited anorectal malformation, vertebral scoliosis, and complex cardiac abnormalities, including dextrocardia, bilateral superior vena cavae, and patent ductus arteriosus. She presented with chronic cough, recurrent respiratory infections, and wheezing. Clinical examination and imaging confirmed the anomalies, and echocardiography further delineated her cardiac defects. The constellation of findings met diagnostic criteria for VACTERL association. She improved with medical management and continues under multidisciplinary follow-up. This case highlights the wide phenotypic variability of VACTERL and underscores the importance of comprehensive systemic evaluation, especially when atypical cardiac or laterality abnormalities are present. Early recognition and coordinated long-term care are essential to optimize outcomes and identify additional anomalies that may emerge over time.

Lymphastim and breathing exercises in breast cancer-related lymphedema: a path to improved lung function and quality of life – a case report

Shruti N. Mankar — 2026-06-30

Breast cancer incidence in India is rising, accounting for 66% of all cancers diagnosed in a year. Due to improvement in survival rates attributed to various treatment alternatives, emphasis on quality of life and secondary complications of breast cancer are of importance. Breast cancer related lymphadenopathy is a common complication in breast cancer treatment. A 76-year-old female, case of treated breast carcinoma, 5 years ago with radical mastectomy, presented with progressive, painless swelling of the left upper limb for 30 days. The swelling originated in the fingers and wrist, gradually extending proximally, restricting her functional activities. She also complained of progressive breathlessness, difficulty in doing day to day activities. Clinical examination and investigations, including arm circumference measurements, the modified Medical Research Council scale, pulmonary function tests, and the lymphedema quality of life questionnaire, confirmed significant lymphedema. The patient underwent lymphastim therapy with structured breathing exercises protocol for 4 weeks. Post-intervention assessments revealed a significant reduction in limb circumference, improved pulmonary function parameters (FEV1: 0.84 -1.06, FVC: 0.84 - 1.04), and an enhanced quality of life score (LYMQOL: 65 to 30) with relief from breathlessness and comfort in doing day to day activities. This case highlights the effectiveness of lymphastim and breathing exercises in reducing lymphedema-related morbidity and improving functional outcomes in breast cancer survivors.

Barriers and factors influencing how adults with type 2 diabetes perceive their risk of developing diabetes-related complications: a qualitative study

Blessing M. Chirewa — 2026-06-30

Background: Delayed diagnosis and poor management of type 2 diabetes can lead to severe acute and long-term complications, such as early death or disability. Research evidence has shown that without consistent and effective self-management practices, individuals with type 2 diabetes face a higher risk of avoidable complications. These self-management practices are mainly influenced by individuals’ perceptions of the risks linked to diabetes complications. Due to poor self-management practices particularly in Sub-Saharan Africa, it is crucial to identify the barriers and enablers that shape patients’ perceptions of their risk of developing complications.

Methods: Twenty-three individuals with type 2 diabetes were purposively and theoretically sampled from purposively selected community pharmacies in Harare, Zimbabwe, between October 2023 and January 2024 and participated in semi-structured interviews.

Results: The analysis of the data revealed that participants perceived risk of complications differently: some perceived a higher risk, while others perceived a lower risk, based on the meanings they ascribed to living with type 2 diabetes. Facilitators to perception of risks of complications were: (i) having personal risk experiences; (ii) information-seeking; and (iii) engaging in health-seeking behaviours. In contrast, barriers to perception of risks of complications were: (i) holding cultural or religious beliefs; (ii) being in denial about the illness; and (iii) lacking knowledge about diabetes.

Conclusions: This study explored the factors shaping patients’ perceptions of risks for developing diabetes-related complications. It offers important insights into risk perception research in resource-constrained environments and assists healthcare providers and policymakers in developing strategies to support those at higher risk of such complications.

Occurrence of occupational related diseases and risk factors among tea pickers and level of adoption of OHS programs in Kaboswo Tea Estate, Eldoret, Uasin-Gishu County, Kenya

Josline Chemutai — 2026-06-30

Background: Occupational hazards are threats to human health and well-being arising from workplace exposures that can lead to illness, injury, or death (Borgohain, 2013). Agriculture is considered one of the most dangerous sectors globally, regardless of age, due to the increased use of chemicals and motorized machinery, especially in developing countries. This has contributed to rising injury and poisoning rates among tea workers. Tea plucking, in particular, is physically demanding and often results in fatigue and musculoskeletal issues. Workers typically carry heavy baskets on their backs, concentrating weight on the neck and spine, often leading to severe back pain. This study aimed to identify occupational diseases associated with tea plucking in Kaboswo Tea Estate, Nandi Hills, Kenya.

Methods: A descriptive cross-sectional design was used with a population of 188 tea pickers. Seventeen questionnaires were distributed, ensuring equal representation. Data collection tools were tested for validity and reliability, then revised accordingly. Data were analyzed using SPSS for both descriptive (percentages, averages) and inferential statistics (regression, Pearson correlation).

Results: Respondents had an average age of 37 years. Commonly reported discomforts were in the shoulders (46.8%), ankles (47.3%), and fingers (38.5%). Musculoskeletal issues such as cold fingers (75.1%) and shoulder pain (54.4%) were prevalent. Few reported chronic symptoms.

Conclusions: Although musculoskeletal and respiratory issues exist, their prevalence is relatively low. Workers are aware of occupational health and safety (OHS) programs and actively implement them to reduce risk.

Community awareness and utilization of health services at Iringa Regional Referral Hospital in Tanzania: a cross-sectional study

Scholastica Mathew Malangalila — 2026-06-30

Background: The Iringa Regional Referral Hospital (IRRH) is a vital referral facility for both urban and rural populations in Tanzania’s Iringa Region. The assessment aimed to evaluate community awareness, accessibility, and perceptions of service quality, all of which influence effective utilization of referral hospital services.

Methods: A community-based cross-sectional study surveyed 199 adult residents in the IRRH catchment area, using a structured questionnaire that assessed socio-demographic characteristics, awareness and accessibility of services, utilization patterns, information sources, and perceptions of service quality. Descriptive statistics and chi-square tests analyzed factors associated with utilization at a 95% confidence level.

Results: Most respondents recognized that IRRH offers health services, though awareness of specialized options was low (15.1% for rehabilitative care, 7% for specialized clinics). Ninety-three percent had visited IRRH, with inpatient (74%) and diagnostic services (58.3%) being most common. Key factors influencing utilization included age, marital status, service awareness, perceived reliability, and perceived quality, while gender did not significantly impact usage. Barriers included high costs (81.9%), long waits (69.3%), and poor staff attitudes (64.3%). Trustworthy information sources were radio and health workers, and respondents indicated a need for better hospital communication.

Conclusions: While general awareness of IRRH services is high, utilization is influenced by both socio-demographic factors and perceptions of service reliability and quality. Addressing financial, accessibility, and communication barriers, along with strengthening outreach and service quality, is essential to enhance the effective use of referral hospital services.

A quality improvement project to improve mental health screening at nurse triage in a primary healthcare center

Judy Shalin — 2026-06-30

Background: One-fifth of adults attending primary care have a diagnosable mental disorder, which is in top 10 diseases of global burden. Screening for early detection of mental and substance misuse disorders in primary care can improve quality of life. The screening percentage was low at 86% for mental health. So, QI project undertaken to improve mental health triage at health center using a staff reminder strategy and refresher training at individual level, as these have shown effectiveness in systematic reviews.

Methods: The project employed plan-do-study-act (PDSA) cycles to test the change ideas. Quality improvement tools, including process mapping, Fishbone analysis, driver diagrams, and prioritization matrices, were used to identify root causes and develop interventions and refresher training of nurses were the change ideas.

Results: The refresher education session was attended by 42 nurses and 52 nurses received regular emails on update and reminder on first week of each month and weekly social media messages throughout the project period. Mental health triage asking for PHQ2 and GAD2 questionnaire by triage nurses improved significantly during the project period of 3months from the baseline values of 84% to 94% for depression and from 88% to 97% for anxiety.

Conclusions: Mental health triage in primary care health centers can be improved by increasing its awareness in triage nurses and their attitude towards mental health. Mental health screening can be improved by refresher training and reminders. Collaboration and teamwork between nurse and administration team will deliver an excellent outcome.

The prevalence of acute kidney injury among children with severe malaria in a tertiary hospital in South-West Nigeria

Korede O. Oluwatuyi — 2026-06-30

Background: Acute kidney injury (AKI) is a dire complication of severe malaria with a high mortality rate. AKI worsens the prognosis of children with malaria. Despite the poor prognostic index, there is scarce data on the prevalence of AKI in severe malaria in Nigeria. Therefore, this study aimed to document the prevalence of AKI in severe malaria among children in a tertiary hospital in South-West Nigeria.

Methods: This was a cross-sectional study. Children with WHO-defined severe malaria were recruited, and AKI was defined using the KDIGO and WHO criteria. The serum creatinine was measured, and the data were analysed, with a p<0.05 considered significant.

Results: A total of 126 children aged 1-15 years, comprising 70 (55.6%) males with a male-to-female ratio of 1.25:1, were studied. The prevalence of AKI was 23.8% using KDIGO and 11.9% using WHO criteria, with a statistically significant difference (p=0.001). The majority (50%) were in stage 1 AKI, while 36.7% were in stage 3. The haemoglobin concentration was statistically significantly associated with the occurrence of AKI.

Conclusions: The prevalence of AKI using KDIGO doubles that of the WHO criteria in the presence of severe malaria. There is a need to review the criteria for AKI diagnosis in severe malaria.

Work related musculoskeletal disorders among female physiotherapists in Bangladesh

Samena Akter Kakuli — 2026-06-30

Background: Work-related musculoskeletal disorders (WMSDs) affect many health professionals, among whom are Physiotherapists. Shoulder pain, elbow pain, low back pain, knee pain, neck pain and ankle pain are some of the complaints that can attribute to repetitive motion tasks, awkward posture and manual patient handling. Although prevalence of WMSDs among Physiotherapists have been documented in some Bangladeshi studies, information specifically for female Physiotherapist is limited.

Methods: To identify the work-related musculoskeletal disorders among female physiotherapists in Bangladesh; a descriptive cross-sectional study design was selected.

Results: Total 99 female physiotherapists accept the invitation from online survey and 79 were recruited, in which the prevalence was WMSDs (79.79%), with Bachelor degree (72.15%) and clinical physiotherapists 58.23%, respectively. Most of the participants experienced mild pain (53.16%); neck pain was the most prevalent issue (29.11%). Pain duration, daily activity limitation, ODI, DASH and HRQoL were associated with age (all p<0.05). BMI, work experience and patient number had significant relationship with the duration of pain and disability score as well as HRQoL (p<0.05), but not in pain intensity, NDI and LEFS.

Conclusions: In Bangladesh, female Physiotherapist are frequently suffering from musculoskeletal disorders related to their jobs. Therefore, the likelihood of WMSDs can be reduced by using preventive measures and appropriate patient care practices.

Contributing factors to continued HIV infection among adolescents and youths aged 15-24 years in Nakuru county, Kenya

Ameyo Daglus — 2026-06-30

Background: Understanding the factors associated with this ongoing risk is crucial for developing targeted interventions to reduce HIV transmission among this vulnerable population. This study aimed to identify the contributing factors to continued HIV infection among adolescents and youths in Nakuru County by examining demographic characteristics, sexual behaviors, awareness of HIV prevention, and other factors related to HIV prevention between 2019 and 2024.

Methods: A cross-sectional study design was employed, involving 226 adolescents and youths aged 15-24 years. The primary outcome was HIV testing status (yes/no). Descriptive statistics were used to summarize demographic and behavioral data. Univariable and multivariable logistic regression analyses were conducted to identify factors associated with HIV testing status and infection risk.

Results: The analysis revealed that age, marital status, sexual history, and awareness of partner’s HIV status significantly influenced HIV testing status among participants. Older age was associated with a higher likelihood of HIV testing. Participants who were married were more likely to have been tested for HIV compared to single individuals. Sexual history also played a crucial role, with those who had a history of sexual intercourse being more likely to have been tested for HIV. Awareness of a partner’s HIV status was associated with a higher likelihood of testing.

Conclusions: The study identified significant demographic and behavioral factors associated with continued HIV infection risk among adolescents and youths in Nakuru County. Interventions should focus on increasing HIV testing and awareness, especially among younger individuals, those who are single, and those lacking awareness of their partner’s status.

Barriers and enablers of primary eye care service provision in primary healthcare facilities in Rivers State: a qualitative approach

Siyeofori Belema Dede — 2026-06-30

Background: For the effective provision of primary eye care (PEC) services, the availability of good financing mechanisms, manpower, equipment, effective government support, and efficient referral systems play a vital role in providing these services. This study aimed to explore enablers and barriers affecting the provision of primary eye care services in primary health care (PHC) facilities in Rivers State.

Methods: This was a qualitative study carried out among 22 PHC workers in Rivers State, Nigeria. Data collection was done using topic-guided in-depth and key informant interviews to identify their perceptions of enablers and barriers affecting the provision of PEC services in the PHC facilities. All necessary ethical considerations were ensured during the course of the study and a thematic content analysis was used to analyze and code collected data into respective subthemes.

Results: Enabling factors favouring the provision of PEC services included the willingness of staff to provide these services as well as the availability of specially trained personnel to provide the services. Barriers limiting service provision however included the shortage of the required manpower resources, the lack of proper technical skills to provide PEC services, unavailability of equipment and inadequate training, poor drug supply, and inadequate logistics support.

Conclusions: The provision of PEC services faces various barriers that can potentially limit the quality and effectiveness of services provided at the PHC level of care. Establishing and implementing a strategic framework to address the identified challenges, and improving government funding were recommended.

Efficacy, tolerability and compliance of nicotine patches among Qatari population: a retrospective study

Bassem Al Hariri — 2026-06-30

Background: Tobacco use is a primary global health concern with significant adverse effects on public health and life expectancy. This study evaluated the safety, efficacy, and compliance of nicotine replacement therapy (NRT) among smokers in the Qatar population.

Methods: A retrospective analysis was conducted on 400 individuals enrolled in a smoking cessation program in an outpatient department. The participants were randomized into a NRT group (300 participants) and a control group (100 participants).

Results: No significant differences were found in adverse effects between the NRT and control groups, including palpitations, chest pains, nausea, vomiting, gastrointestinal complaints, and insomnia. Skin allergy or itching was rare in the NRT group. There was no statistically significant increase in anxiety or depressive symptoms associated with NRT use. Additionally, there was no significant difference in both groups' primary outcomes or efficacy.

Conclusion: These findings suggest that NRT is a safe and effective smoking cessation method for smokers in the Qatar population. The use of NRT should be considered alongside counseling and medical monitoring to improve smoking cessation rates.

Assessing risk factors for overweight among people living with HIV transitioning to post-dolutegravir-based regimens in Homa Bay County, Kenya

Michael Abukuse — 2026-06-30

Background: Viral suppression and treatment outcomes have significantly improved for people living with HIV (PLHIV) on Dolutegravir (DTG)-based regimens. More recently, however, there has been evidence that DTGs are associated with weight gain and therefore overweight and obesity, and the associated non-communicable diseases. The aim of this study was to evaluate risk factors for overweight in PLHIV transitioned onto DTG-based regimens in Homa Bay County in Kenya.

Methods: A mixed-methods study that combined retrospective cohort and cross-sectional approach was used on PLHIV aged ≥18 years receiving DTG-based regimens for ≥6 months in 7 public health facilities in Homa Bay county. Data was collected on 540 people (90% response rate) using medical record review, structured questionnaires and a food frequency questionnaire. SPSS 27 was used to perform descriptive statistics, chi-square tests, Pearson's correlation, t test, and multivariate regression.

Results: The results indicated that 4.2 kg weight gain occurred after transition to the DTG-based regimens. There was more weight gain in female participants than in male. Socio-demographic characteristics (χ²=18.6, p=0.005; r=0.41, p=0.01), dietary factors (r=0.47, p<0.001) and medication adherence (r=0.41, p=0.01) were significantly associated with weight gain.

Conclusions: Socio-demographic factors, dietary patterns and treatment adherence significantly influenced weight gain in PLHIV on DTG-based treatment. Clinically embedding chronic disease monitoring, nutrition counseling and non-communicable disease testing into HIV care could help manage downstream health implications.

Telemedicine and mobile clinical entrepreneurship as catalysts for healthcare access in Benin city, Nigeria: a sequential explanatory mixed-methods study

Dominic Ativie — 2026-06-30

Background: Healthcare access in Benin City, Nigeria is constrained by inadequate infrastructure, workforce shortages, and high out-of-pocket costs. Telemedicine and mobile clinical entrepreneurship represent viable delivery innovations, yet their comparative effectiveness and sustainability remain insufficiently understood.

Methods: A sequential explanatory mixed-methods design was employed. Quantitative data were collected from 287 adults using a structured questionnaire and analysed with descriptive statistics, chi-square tests, ANOVA, and logistic regression. Qualitative data were obtained through in-depth interviews with 28 key informants and analysed thematically; findings were integrated at the interpretation stage.

Results: Mobile clinics demonstrated stronger access outcomes, with greater reductions in travel time (66.7% vs 53.3%, p<0.001) and waiting time (71.1% vs 46.7%, p=0.013), alongside higher satisfaction (mean 3.5 vs 2.9). Adjusted odds of reporting travel-time reduction were higher for mobile clinic users (AOR 14.8, 95% CI 5.9 to 37.1) than telemedicine users (AOR 7.3, 95% CI 2.9 to 18.6). Telemedicine showed a comparative advantage for chronic disease management. Awareness remained low, with 75% of respondents unaware of any telemedicine service. Key barriers included poor infrastructure, limited training, and low insurance coverage.

Conclusions: Both models improve healthcare access through complementary mechanisms. Mobile clinics effectively address geographic barriers while telemedicine supports chronic care continuity. Infrastructure investment, clinical training, and sustainable financing are critical prerequisites for long-term integration.

Educational attainment as a predictor of diabetic foot disease: a quasi-experimental baseline analysis among type 2 diabetics in Kiambu, Kenya

Onesmus Mugo — 2026-06-30

Background: Diabetic foot disease is a chronic complication of diabetes mellitus, often overlooked and missed due to under-reporting of symptoms or the omission of routine foot examinations during diabetic clinic visits. This study sought to evaluate the individual-level factors that predispose to diabetic foot disease among patients with type 2 diabetes.

Methods: A quasi-experimental study design was employed. A total of 188 respondents were engaged via the administration of a semi-structured questionnaire to collect data on their individual-level factors, such as sociodemographic characteristics and behavioral habits, like cigarette smoking, alcohol drinking, co-morbid conditions like hypertension, and their foot care practices. Central tendency measures were calculated in descriptive analysis. Univariate and multivariable analyses were carried out to reveal predictors significant at 95% confidence interval (p<0.05). Multivariable analysis was preceded by selecting specific variables using multicollinearity tests and forward stepwise selection based on the Akaike information criterion, followed by computing the coefficients to adjust for confounding factors.

Results: The level of education was statistically significant, p=0.004 and p=0.006 at univariate and multivariable analysis, respectively.

Conclusions: The study concluded that the level of education was the single most important predictor for diabetic foot disease among type 2 diabetic patients, affecting the behavioral and clinical factors of a type 2 diabetic patient, leading to the development of diabetic foot disease. The study recommended the design of diabetic health education and promotive programs in a language that is cognizant of the low level of education amongst the diabetic patients attending the diabetic clinics.

Determinants of modern contraceptive use among adolescent girls and young women in Nigeria

Anas Muhammad — 2026-06-30

Background: Modern contraceptive use among adolescent girls and young women in Nigeria remains low despite persistent high fertility and early childbearing. Understanding the ecological factors shaping contraceptive uptake is essential for addressing unmet needs and improving reproductive health outcomes.

Methods: This study analyzed data from the 2018 Nigeria Demographic and Health Survey (NDHS), including 8,825 adolescent girls and young women aged 15–24 years. Weighted descriptive statistics were used to examine the characteristics. Multilevel logistic regression models were fitted to assess individual, household and community predictors of modern contraceptive use, accounting for clustering at the primary sampling unit level.

Results: The prevalence of modern contraceptive use was 9.1%. Uptake was significantly higher among young women aged 20–24 years, those with secondary or higher education, unmarried respondents and higher wealth quintiles. Conversely, Muslim affiliation and Hausa ethnicity were associated with lower use compared to Catholic and other ethnic groups. Fertility factors such as parity and desire for more children were important determinants: women with higher parity and those desiring no more children reported greater use. Community-level influences persisted, with rural residence and northern regional location associated with lower contraceptive uptake.

Conclusions: Modern contraceptive use among Nigerian adolescents and young women is shaped by intersecting individual, socioeconomic and community factors. Addressing cultural and religious barriers, reducing regional inequities and strengthening youth-friendly reproductive health services are critical for improving uptake. Tailored interventions targeting younger, less educated, rural and socioeconomically disadvantaged women are urgently needed to reduce unmet need Nigeria.

Exploring barriers to mammography screening among women aged 40 to 74 attending Georgetown Public Hospital Corporation outpatient department: a knowledge, attitude and practice study

Nickalus Howard — 2026-06-30

Background: Breast cancer is the second leading cause of cancer-related deaths in Guyana, with rising cases despite free screening availability. This study examined the knowledge, attitudes, and practices of women aged 40 to 74 regarding mammography screening to identify barriers and enhance the uptake of mammography screening among Guyanese women.

Methods: A cross-sectional descriptive study was conducted at Georgetown Public Hospital Corporation outpatient department from October 1^st to October 29^th, 2025. Data were collected through a structured electronic questionnaire and analyzed using descriptive statistics, chi-square tests, and Pearson’s correlation.

Results: Among 384 women, the overall awareness of breast cancer and mammography was high (73.4% and 63.4%, respectively), but the attitudes of the participants were negative (64.6%), and screening practices were poor (9.4%). The knowledge of mammography was significantly associated with age, ethnicity, education, region, and family history of breast cancer. The reasons for not having a mammogram includes lack of time (8.3%), fear of finding something (7.3%), cultural or religious beliefs (7.0%), cost (6.1%), worried about pain (26.7%), fear of diagnosis (23.6%), embarrassment (21.3%), and no expected benefits (11.3%).

Conclusions: In Guyana, although many women are aware of breast cancer and mammography, the screening uptake remains low. To improve participation, interventions must move beyond education and focus on emotional support, service accessibility, and culturally appropriate outreach.

Bridging the digital divide: a longitudinal analysis of health equity in India’s Ayushman Bharat Digital Mission (2024-2025)

Sai Sreevalli Sreepada — 2026-06-30

Background: The Ayushman Bharat Digital Mission (ABDM) aims to provide unique digital health identities to India's 1.4 billion citizens. Deploying such technology in deeply unequal societies risks exacerbating the digital divide. This study examines whether ABDM adoption followed the "Inverse Care Law" or successfully bridged the gap between digital haves and have-nots.

Methods: A longitudinal ecological study across 28 Indian states over 18 months (January 2024-July 2025) analyzed Ayushman Bharat Health Account (ABHA) generation data from the ABDM dashboard and Ministry of Health releases. States were stratified by NSDP per capita. Key indicators included ABHA saturation, percentage growth, and income-related inequality via the Concentration Index (CI) and Lorenz Curves.

Results: National ABHA saturation rose significantly from 32.7% (±15.2%) to 53.9% (±16.1%) (p<0.001). A clear "Catch-Up Effect" emerged: the poorest state quartile grew by 145.2%, nearly three times the 58.4% recorded in the richest quartile. Inequality analysis revealed a striking inversion from a pro-rich distribution (CI= +0.062) to near-perfect equity (CI= -0.011). Lower-middle-income states such as Andhra Pradesh and Odisha were top performers, while wealthier states exhibited slower adoption due to "legacy friction".

Conclusions: ABDM achieved rapid "regression to equity," driven not by organic demand but by supply-side "physical involvement in digital space" interventions frontline health workers facilitating assisted onboarding in rural areas. These findings offer a replicable blueprint for LMICs seeking to democratize digital health infrastructure.

Medication practices among pregnant women and associated factors in Kiambu County, Kenya

Natacha Nai — 2026-06-30

Background: Unsafe medication use during pregnancy remains a public health concern in Kenya, yet self-medication is commonly practiced in many communities. Understanding what drives these behaviors can support preventive strategies and improve antenatal care outcomes.

Methods: To determine medication practices among pregnant women in Kiambu County and identify the factors associated with those practices, a cross-sectional study was conducted among pregnant women attending antenatal care (ANC) at Kiambu County Level 5 Hospital. Data were collected using structured questionnaires and analyzed using descriptive statistics and inferential tests to assess associations (p<0.05).

Results: Most women (88.2%) used medication during pregnancy; 46.1% reported self-medication without prescription, mainly from pharmacies (58.8%). Although 65.6% were generally aware of medication risks, only 27.6% received information from nurses. Distance to health facilities was significantly associated with self-medication, with women living 1–5 km from a facility being less likely to self-medicate (p<0.05). Cultural belief that some medicines “soften the fetus” significantly increased the likelihood of self-medication (p<0.05). However, sociodemographic factors, obstetric history and overall knowledge levels were not significantly associated (p>0.05).

Conclusions: Medication use during pregnancy is common in Kiambu County and self-medication remains substantial. Cultural beliefs and health system access not sociodemographic or obstetric variables were the strongest drivers. Strengthening ANC counselling, addressing harmful cultural narratives and improving access to timely care may help reduce unsafe self-medication practices.

Clinical and psychological predictors of poor sleep quality among non-medical university staff in Myanmar: a cross-sectional study

Kay Khine Aye Mauk — 2026-06-30

Background: Sleep quality influences productivity and overall well-being. Evidence on the clinical and psychological predictors of sleep quality among non-medical staff in medical and allied universities in Myanmar remains limited. This study aimed to determine the prevalence of poor sleep quality and identify its independent predictors among non-medical university staff.

Methods: A cross-sectional study was conducted among 430 non-medical staff from seven medical and allied universities in Myanmar between January and August 2025. Data were collected using guided self-administered questionnaires covering socio-demographic characteristics, diabetes mellitus status, sleep quality, and mental health. Sleep quality and mental health were assessed using the Pittsburgh Sleep Quality Index (PSQI) and depression, anxiety, and stress scale (DASS-21), respectively. Blood pressure was measured using WHO-validated digital sphygmomanometers. Multivariable binary logistic regression was used to identify independent predictors of poor sleep quality.

Results: The prevalence of poor sleep quality was 39.3%. Participants had a mean age of approximately 42 years; 83.3% were female and 57.2% were married. Diabetes mellitus and hypertension were present in 5.4% and 28.9% of participants, respectively. Anxiety (aOR=2.88, p<0.001), depression (aOR=2.21, p=0.016), and diabetes mellitus (aOR=2.63, p=0.045) were significant independent predictors of poor sleep quality, whereas stress was not.

Conclusions: Poor sleep quality is highly prevalent among non-medical university staff. Anxiety, depression, and diabetes mellitus were significant predictors. University wellness programs should prioritize mental health screening, diabetes management, and routine sleep quality assessment.

Determination of Turkish mothers' hesitations, awareness and knowledge levels regarding human papillomavirus vaccination for their sons

Seyma Z. Altunkürek — 2026-06-30

Background: This is the first study aimed at determining the level of knowledge, awareness and hesitations among Turkish mothers about the administration of the human papillomavirus (HPV) vaccine to their sons.

Methods: This cross-sectional descriptive study was conducted at Eskişehir Yunusemre Hospital in Turkey from 13 April 2022, to 13 July 2022. The study involved a sample of 513 mothers with sons. Data analysis was performed using the SPSS 26, which included mean values, standard deviations, and percentage distributions, along with statistical tests such as ANOVA, post-Hoc, and Chi-square tests.

Results: Among the participants, only 38% had previously heard of the HPV infection. Only 1.9% of the participants had vaccinated their sons against HPV. Notably, 36% of those who were either hesitant or unwilling to vaccinate their sons expressed a lack of sufficient knowledge about the HPV vaccine as their primary reason. In our study, the participants' overall average HPV knowledge score was 22.6, while their awareness score was 77 out of 100.

Conclusions: Increasing knowledge about HPV is likely to play a crucial role in reducing vaccine hesitancy and enhancing vaccine acceptability. Consequently, healthcare professionals organizing educational initiatives and awareness campaigns to inform mothers about HPV infections and vaccines are seen as an effective approach.

Assessment of infection prevention and control practices among students in Kenya Medical Training College

Richard K. Korir — 2026-06-30

Background: Infection prevention and control (IPC) is a critical component of healthcare systems aimed at reducing the transmission of hospital-acquired infections (HAIs). Despite advances in medical practice, HAIs remain a significant global health challenge, particularly in resource-limited settings such as Kenya. Health professional students are at a heightened risk of exposure during clinical rotations.

Methods: A cross-sectional mixed-methods study design was employed across selected Kenya Medical Training College (KMTC) campuses, targeting second- and third-year students. A multistage sampling technique was used to select 420 participants. Data were collected using structured online questionnaires, observational checklists, and focus group discussion guides. Quantitative data were analyzed using SPSS version 25, while qualitative data were analyzed thematically using NVivo.

Results: The study included 406 respondents. The majority demonstrated adequate theoretical knowledge of IPC principles, including understanding of HAIs and preventive measures such as hand hygiene (88%) and use of personal protective equipment (PPE) (77%). Students exhibited generally positive attitudes, though 43% perceived PPE as uncomfortable. However, inconsistencies between knowledge and actual practice were observed, notably in consistent PPE use, sharps handling, and waste management. Key barriers included inadequate PPE supply, high workloads, and time constraints.

Conclusions: Although KMTC students possessed satisfactory knowledge and positive attitudes toward IPC, significant gaps existed in translating this knowledge into consistent practice. Addressing these gaps requires strengthening practical, experiential training and improving resource availability in clinical placement sites.

Dental caries prevalence and contributing factors in Southern Libya: a cross-sectional study

ِِAhmed G. Mohamed — 2026-06-30

Background: Dental caries is the most prevalent chronic disease among children and adults worldwide. It is still a major public health challenge, affecting over 2 billion people globally. The prevalence of dental caries in Libya exceeds 75%.

Methods: This cross-sectional study design was conducted at the faculty of dentistry, Sebha University, and included 627 participants. Data was collected within a period of 8 months between July 2024 and May 2025. Dental caries was assessed by decayed, missing, filling teeth (DMFT) for permanent teeth and dmft for deciduous teeth), and oral hygiene status was measured by the oral hygiene index (OHI).

Result: A total of 627 participants were recruited at a mean age of 32.95 (SD=14); 63.2% were female and 36.8% were male. The prevalence of dental caries in this study was exceptionally high; most of the participants 98.4% experienced dental caries at a median of 8.00 (0.00-30.00). The difference in DMFT between age groups was statistically significant (p=0.000). The OHI difference between genders was statistically significant (p=0.006). OHI was at a good level in the primary and tertiary education levels (median=1.30 and 1.40, respectively), whereas it was at a fair level in secondary education (median=2.16).

Conclusions: The prevalence of dental caries was high in the study population. The old age group experienced more dental caries compared with other age groups. Sociodemographic factors, such as gender and educational level, play a critical role in shaping oral health behaviours.

Impact of alopecia areata on quality of life assessed by the dermatology life quality index: a cross-sectional study at a tertiary care hospital in Peshawar

Hira Rehman — 2026-06-30

Background: Alopecia areata is a long-term autoimmune disease that causes non-scarring hair loss. It manifests as distinct, circular or oval patches on scalp or other parts of the body having hair. It happens when the immune system attacks anagen-phase hair follicles, abruptly stopping hair growth, affecting people of all ages. This study is designed to assess the impact of alopecia areata on quality of life using the dermatology life quality index (DLQI) among patients in a tertiary care hospital in Peshawar.

Methods: This descriptive cross-sectional study was conducted at the dermatology outpatient department of Hayatabad Medical Complex, Peshawar, from January 2025 to June 2025. Ninety-two patients aged 18–65 years with clinically diagnosed alopecia areata were enrolled. Quality of life was assessed using the validated Urdu version of the DLQI. Data were analyzed using statistical package for the social sciences (SPSS) version 28. The chi-square test was used to assess the relationship between DLQI scores and demographic or clinical factors.

Results: The mean age of participants was 31.4±10.7 years, with 59% males. The mean DLQI score was 9.6±5.2, indicating a moderate impact on quality of life. Higher DLQI scores were significantly associated with female gender (p=0.03), disease duration greater than one year (p=0.02) and severe clinical disease (p<0.001).

Conclusion: Alopecia areata has a significant negative impact on patients’ quality of life, among females having long-standing or severe disease. Routine use of DLQI may help identify patients who require additional psychological support alongside dermatologic treatment.

Knowledge, attitude and competency of basic obstetric imaging services among health workers in primary healthcare facilities in Rivers State

Joy Tonye Wihioka — 2026-06-30

Background: Human-resources-for-health is a vitally important aspect of health system as they ensure the availability obstetric imaging services in health facilities, which are essential for improving maternal and child health outcomes of pregnancy. This study aimed to determine the knowledge, attitude and competency in providing basic obstetric imaging services (BOIS) among primary health care workers (PHCWs) in Rivers State, Nigeria.

Methods: This study utilized a descriptive design, and was conducted among 290 PHCWs in Rivers State, Nigeria. It was conducted at selected model PHC facilities located in the 23 local government areas (LGAs) of Rivers State, Nigeria. Responses were elicited from all willing respondents using a self-administered adapted questionnaire. Assessment of the respondents’ knowledge and attitude of BOIS was done using a set of fifteen and ten questions respectively. Competencies and ultrasonographic skills were also assessed.

Results: Most PHCWs had good knowledge 273 (95.0%) and good attitude 264 (91.0%) towards BOIS provision. Most workers 222 (80%) did not have the required ultrasonographic skills needed to provide BOIS. Of the few that possessed the skills, most were competent in using the equipment to perform various tasks including the identification of foetal anatomy 56 (84.8%), perform first trimester dating scan 48 (72.7%), assist in the use of the ultrasound scan 48 (72.7%), among other tasks.

Conclusions: Knowledge and attitude towards basic obstetric ultrasound service provision were found to be good, however, practice was poor due to non-possession of required skills. Development and implementation of structured training programs to develop skills are recommended.

Assessing beneficiary and parental perception of Integrated Child Development Services Scheme in Pulwama district, Jammu and Kashmir

Syed Abdul Mohsin — 2026-06-15

Background: The study addresses the beneficiaries and parents’ satisfaction on health services provided at integrated child development services (ICDS) Scheme in Pulwama District, of Jammu and Kashmir, union territory (UT). The current study examines the level of satisfaction among the beneficiaries and parents with ICDS health services component in Pulwama, with a focus on service accessibility, quality of services, and overall beneficiary perception.

Methods: The study was conducted in all the five blocks of ICDS Pulwama, which included a sample of the parents of below six-year-old beneficiaries and the female beneficiaries such as pregnant women and lactating mothers. The data was collected through sampling of the Anganwadi centres (AWCs) using convenience sampling technique, where structured interviewing process was carried out. The study utilized a mixed methodology.

Results: The findings of the study indicate 86% of parents and 83% of female beneficiaries reported satisfaction with food quality. The 92% parents and 86% female beneficiaries viewed immunization as helpful and 76% parents and 78% of female beneficiaries expressed satisfaction with health check-ups. However, there are certain aspects that require rapid redress such as irregular service delivery, logistical barriers and impediments as well as inadequate staff training.

Conclusions: The research findings indicate the need to emphasis on the enhancement of functional effectiveness of ICDS, enhancement of ICDS staff and ensuring consistent availability of essential resources. The study advises target interventions towards filling the gaps and gaps thus allowing ICDS scheme to become more resilient and responsive as a public health initiative in districts like Pulwama.

A study on night eating syndrome and its association with depression among medical students in Tumakuru: a cross-sectional study

Kirubakaran Premdass — 2026-06-08

Background: Night eating syndrome (NES) is an eating disorder characterized by excessive evening or nocturnal food intake and is often associated with psychological disturbances, particularly depression. Medical students are especially vulnerable due to academic stress, irregular sleep patterns, and lifestyle disruptions. Evidence on the burden of NES and its association with depression among Indian medical students remains limited.

Methods: A cross-sectional study was conducted among 324 medical students of a medical college in Tumakuru from April to June 2025 using universal sampling. Data were collected through a semi-structured questionnaire. Depression was assessed using the patient health questionnaire-9 (PHQ-9), and NES was evaluated using the revised night eating diagnostic questionnaire (NEDQ). Data were analyzed using IBM statistical package for the social sciences (SPSS) version 21.0. Descriptive statistics were applied, and associations were tested using the Chi-square test. A p<0.05 was considered statistically significant.

Results: The prevalence of NES among study participants was 87.3%, with the majority having mild NES (70.7%). Depression was present in 66.4% of participants. A statistically significant association was observed between NES and female gender (p=0.04) and eating pattern after 7 PM (p<0.001). Although a higher proportion of students with NES had depression (65.1%), the association between NES and depression was not statistically significant (p=0.18).

Conclusion: NES and depression are highly prevalent among medical students and are strongly interrelated. Early screening, mental health support, sleep hygiene education, and lifestyle interventions should be integrated into medical student wellness programs to prevent long-term psychological and behavioral consequences.

Parental investment in child immunisation: the role of birth order and number of children

Saranika Sarkar — 2026-06-08

Background: Immunisation of children remains an important public health challenge in India despite the implementation of the Universal Immunisation Programme. Understanding how household and child-specific factors affect children's immunisation is essential for improving immunisation coverage. In this paper, the effects of the number of children and birth order on children's immunisation in India have been examined. The number of children and birth order are two related but conceptually different aspects of families. Distinguishing between the two allows us to determine whether lower immunisation among children arises from larger families or from differences in a child's position within the sibling group, the birth order.

Methods: A cross-sectional analysis of nationally representative data from the fourth round of the National Family Health Survey, conducted in 2015-16, is used for the study. Logistic regression and household fixed-effects models have been employed to examine the impact of the number of children and birth order on children's immunisation.

Results: The findings reveal that immunisation increases with an increase in the number of children in a family, and this is consistent across both model specifications. In addition, a strong, negative effect of birth order on immunisation has been observed. Larger families are more likely, whereas a child of a higher birth order is less likely to achieve full immunisation.

Conclusions: The study highlights the importance of the number of children and birth order in explaining immunisation outcomes in India. The empirical findings show that the number of children has a positive effect and birth order has a negative effect on full immunisation.

Palliative care needs and health-related quality of life among patients with end-stage kidney disease on haemodialysis in a tertiary care hospital in Mumbai: a cross-sectional study

Neha Nitin Shet — 2026-06-18

Background: End-stage renal disease (ESRD) is associated with substantial symptom burden, impaired health-related quality of life (HRQoL), and unmet palliative care needs. Despite the growing recognition of supportive care in nephrology, evidence from India remains limited. This study assessed HRQoL and palliative care needs among patients undergoing maintenance hemodialysis (MHD) and explored their relationship with symptom burden.

Methods: A hospital-based cross-sectional study was conducted between June 2022 and January 2023 among 236 adults receiving MHD at tertiary care teaching hospitals in Mumbai, India. Palliative care needs were assessed using the palliative outcome scale-symptoms renal (POS-S Renal), while HRQoL was measured using the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) with the Indian value set. Sociodemographic and clinical data were collected through structured interviews and medical record review. The relationship between palliative care needs, symptom burden, and HRQoL was examined using correlation.

Results: Participants had a median age of 64.5 years, and 63.6% were male. The median POS score was 16.0 (IQR: 12.0-23.0), indicating considerable unmet palliative care needs. Family anxiety, information needs, practical support, and symptom-related concerns were among the most prominent issues. The mean number of symptoms reported was 15.04±5.06, with dry mouth (91.5%), itching (83.1%), dry skin (82.2%), and fatigue being the most common symptoms. The median EQ-5D-5L utility score was 0.78, with older patients reporting poorer HRQoL. Higher POS scores were significantly associated with greater symptom burden and lower HRQoL.

Conclusions: Patients receiving MHD experience substantial symptom burden, unmet palliative care needs, and reduced HRQoL. Early integration of multidisciplinary palliative care into routine nephrology services may improve symptom management, address supportive care needs, and enhance patient-centred outcomes.

Effectiveness of self-care interventional package in promoting sexual health among female sex workers registered with selected NGOs of Chandigarh

Anamika — 2026-06-30

Background: Female sex workers who receive money and goods in exchange for sex They multiple sex partners and hence are vulnerable population and is highly susceptible for acquiring sexually transmitted infections with HIV. Such vulnerability may result in poor sexual health of the female sex workers.

Methods: A randomized controlled trial was conducted for the promotion of sexual health among FSW registered with NGO. Randomization was done by lottery method. Interviews were conducted with Interview Schedule for baseline assessment and interventional package administered to experimental group. End-line assessment was conducted to assess the effect of selfcare interventional package.

Results: After implementation of self-care interventional package there was improvement in knowledge and reduction in unsafe sexual practices.

Conclusions: The self-care interventional package was effective in improving sexual health.

Evaluation of stress levels and resilience in healthcare providers working in emergency settings

Utkarsha Kapila — 2026-06-30

Background: Emergency healthcare workers face high stress, leading to burnout, anxiety, and depression that impact performance and retention. Long hours and irregular schedules worsen these issues. Interventions such as resilience-focused environments, cognitive behavioural therapy, group sessions, recreational activities, and access to psychological support help reduce these effects and improve wellbeing.

Methods: This study adopted a questionnaire based method to assess stress levels, secondary stress characteristics, and the outcomes of long-term stress among healthcare providers. The research design is both exploratory and descriptive: exploratory research defines the problem, while descriptive research examines frequency and the relationship between variables. Data were collected using a structured questionnaire through direct personal interviews due to time and other constraints.

Results: The study used the professional quality of life (ProQOL) scale to assess secondary traumatic stress among healthcare providers. Emergency physicians showed greater resilience and lower burnout and stress than other departments, while internal medicine staff had the highest resilience (7.26) and low burnout. These findings underscore the need to assess resilience across roles to guide targeted training and preparedness for future large scale health emergencies.

Conclusions: Healthcare professionals in emergency settings experience substantial stress, resulting in burnout, anxiety, and depression, which adversely affect performance and retention. Extended and irregular working hours further exacerbate physical and psychological strain. Interventions such as resilience-building initiatives, cognitive behavioural therapy, group support, engagement in leisure activities, and access to psychological services are effective in enhancing their overall wellbeing.

Cross-sectional assessment of nutritional status, knowledge, attitudes and practices of lactating mothers in selected rural and urban areas of Vijayapura District, Karnataka

Savita Hulamani — 2026-06-30

Background: Maternal nutrition and appropriate infant feeding practices are critical determinants of maternal and child health. However, inadequate dietary intake and suboptimal breastfeeding practices remain major public health concerns in many parts of India, particularly in rural communities. The present study assessed the nutritional status, dietary intake, and knowledge, attitudes, and practices (KAP) related to breastfeeding among lactating mothers in rural and urban areas of Vijayapura district, Karnataka.

Methods: A community-based cross-sectional study was conducted among 200 lactating mothers aged 18-35 years selected through multistage random sampling from rural and urban areas of Vijayapura district. Data were collected using a pre-tested structured questionnaire to obtain socio-demographic information and breastfeeding-related KAP. Anthropometric measurements were used to determine body mass index (BMI), and dietary intake was assessed using a three-day 24-hour dietary recall method. Data were analyzed using descriptive statistics, chi-square tests, and independent t-tests.

Results: Among the respondents, 15% were underweight and 22.5% were obese. Energy intake was lower than recommended levels, with rural mothers meeting 43.66% and urban mothers 54.55% of daily requirements. Protein adequacy was higher among urban mothers (83.85%) than rural mothers (63.10%). Intake of iron, calcium, and vitamin C was inadequate in both groups. Although awareness of exclusive breastfeeding was high (94.5%), only 35.5% initiated breastfeeding within the first hour of birth, and 26% practiced pre-lacteal feeding.

Conclusions: The findings indicate gaps in maternal nutrition and breastfeeding practices. Strengthening nutrition education and breastfeeding counselling through community health programs is essential to improve maternal and infant health outcomes.

Assessing the burden of intestinal parasitic infestations among children in rural areas of Tamil Nadu, India: implications for public health policy

Samima N. — 2026-06-30

Background: This study was conducted to estimate the prevalence of intestinal parasitic infestation among children in selected rural area Kunnathur, Arani Taluk, Thiruvannalmalai, Tamil Nadu, India and the implications for public health policy.

Methods: The present cross-sectional study was carried out to determine the prevalence of intestinal parasitic infestation among children. A total of 60 stool samples were collected and examined for parasitic infections through visual and microscopic observation. Samples were screened using saline and iodine wet mounts, a saturated saline concentration technique and light microscopy was used to analysis the data.

Results: Out of 60 stool sample (female 30), (male 30) a total of 46 (76.7%) positive for parasite infections. The gender-wise prevalence among the children showed that, 21 boys (70%) and 25 girls (83.4%) were recorded positive with minimum one parasitic infestation. The positive cases of individual parasites were Ascaris lumbricoides, Giardia lamblia, Ancylostoma duodenale, Entamoeba histolytica and Entamoeba vermicularis and mixed infections were also detected in the present investigation. The distribution of parasites was maximum among 7-9 years age group with 77.8%, followed by 4‑6 years age group with 73.4% was found in this study. While males were mostly infected with A. lumbricoids, females were mostly infected with Ancylostoma duodenale.

Conclusions: The result of the present study revealed importance of creating awareness among rural areas about children’s personal hygiene, environmental hygiene particularly in communities with poor water, sanitation, eating contaminated food, open defecation, walking with barefoot, effectiveness of deworming treatment intervals from 6 to 4 months in order to reduce the risk of parasitic infection.

Anthropometric indicators and determinants of body mass index of urban adult subjects: insights from community-based study

Ambika Rani Yadav — 2026-06-30

Background: Poor nutritional status is linked with hypertension, endothelial dysfunction and atherosclerosis, insulin resistance, inflammation, impaired glucose tolerance and hormonal imbalance. Aim of the study was to assess nutritional status of subjects based on anthropometric measurement and to find out linkages of body mass index.

Methods: This community based cross-sectional study was undertaken on urban adults of Prayagraj district, Uttar Pradesh, India. Multistage sampling procedure was adopted for selection of subjects. Information pertaining to sociodemographic characteristics was obtained by interviewing subjects using pre-designed pretested interview schedule. Assessment of anthropometric measurements and other nutritional parameters were done using standard techniques. Data were analysed using SPSS. For continuous variables, descriptive statistics were calculated. Linkage between body mass index and categorical variables were evaluated using the Chi-square test, with statistical significance at p<0.05.

Results: The average height and weight of subjects was 161.74±9.33 cm and 69.63±12.55 kg, respectively. As much as 47.6% and 12.9% were overweight (25-29.9 kg/m²) and obese (≥30 kg/m²), respectively. Gender, caste, marital status, education, occupation and socio-economic status, waist circumference, waist hip ratio, muscle mass, visceral fat, body fat percentage, energy intake and level of physical activity were significantly linked with body mass index.

Conclusions: High prevalence of overweight and obese subjects in this study underlines a shift toward nutritional excess, consistent with the nutrition transition. Tailored efforts at state levels are required to strengthen existing policies and develop new interventions to target both forms of malnutrition.

Exploring the interrelation among sarcopenia, obesity and nutrition in older adults

Ruhita Lodh Chowdhury — 2026-06-30

Background: The purpose of the study was to explore the interrelation among sarcopenia, obesity, and nutrition in adults aged 60 and older, focusing on how these conditions interact, the role of nutrition in their progression. It further seeks to examine the influence of physical activity and dietary patterns on these conditions to identify potential preventive strategies.

Methods: A cross-sectional study was conducted from January to May 2025 on 172 older adults to examine the interrelation among sarcopenia, obesity, nutrition, physical activity, and Alzheimer’s disease. Sarcopenia, obesity, and Alzheimer's were assessed using the SARC-F, BMI, and AQ questionnaire respectively, while dietary intake was analyzed via 24-hour recall and FFQ, and physical activity was measured using the RAPA tool.

Results: Among 172 older adults, a significant association was found between BMI and sarcopenia, with all overweight and obese participants being sarcopenic. Physical activity levels were significantly linked to both BMI and sarcopenia, with the majority of inactive individuals being overweight and also sarcopenic. No significant association was observed between sarcopenia and Alzheimer’s. Regression analysis indicated protein intake positively predicted cognitive scores, while calcium and iron had negative associations. Overall, participants had low energy, calcium, and iron intake, with dietary patterns dominated by rice intake and limited consumption of nutrient-dense foods.

Conclusions: The study highlights that maintaining a healthy BMI, engaging in regular physical activity, and ensuring adequate protein intake are key to reducing the risk of sarcopenic obesity and cognitive decline.

Isolation and its impact on quality of life at end-of-life palliative care services

Weam Ahmed Mohammed Mari — 2026-06-30

Background: Palliative care seeks to provide terminally ill individuals with an improved quality of life, preserved dignity, and increased overall well-being; however, social isolation is one of the most significant and frequently overlooked issues associated in end-of-life care settings. Social isolation has become a growing challenge to global health systems and poses significant psychological and physiological consequences for individuals at the end of life.

Methods: An extensive peer-reviewed literature review was conducted to examine the relationship between social isolation and quality of life among patients receiving palliative and hospice care, using article databases, policy and governmental review documents, and international public health reports published between 2010 and 2024.

Results: Results show social isolation as a significant but least acknowledged impact of terminal illness on quality of life for patients in palliative care. Research indicates that socially isolated terminally ill patients report higher levels of anxiety, depression, and emotional distress, as well as poorer physical and psychological outcomes than those who are not isolated. This review highlighted the importance of developing effective interventions that address patients’ psychosocial, emotional, and spiritual needs to improve QoL and overall well-being in palliative care.

Conclusions: The influence of social isolation on the QoL and overall well-being of terminally ill patients receiving palliative care should be recognized as an important factor impacting patient-oriented outcomes in the provision of comprehensive palliative care through targeted interventions designed to support these needs.

Health related quality of life and its associated factors in an urbanised village of Delhi

Anubhav Mondal — 2026-06-30

Background: Health-related quality of life (HRQoL) is an important indicator of overall well-being that reflects the physical, mental, and social functioning of individuals. Rapid urbanization in India has resulted in the emergence of urbanized villages characterized by mixed socioeconomic conditions, environmental stressors, and changing lifestyle patterns, which may adversely influence HRQoL. This study aimed to assess HRQoL and its associated factors among adults in an urbanized village of Delhi.

Methods: A community-based cross-sectional study was conducted during November-December 2025 among 362 adults aged ≥18 years residing in Aliganj, an urbanized village in Delhi. Participants were selected using systematic random sampling. Short form (SF-12) was computed using standard scoring procedures. Data were analysed using SPSS version 31. Independent sample t-test was applied to assess associations between HRQoL scores and sociodemographic variables, with p<0.05 considered statistically significant.

Results: Overall, 59.4% of participants had good physical HRQoL (PCS), whereas only 43.1% demonstrated good mental HRQoL (MCS). The highest mean domain score was observed for Role Emotional (4.45±0.97), while physical functioning had the lowest mean score (2.53±0.61). Mental HRQoL was significantly associated with age (p=0.006), sex (p=0.027), physical activity (p=0.020), socioeconomic status (p=0.025), and marital status (p=0.018).

Conclusions: HRQoL among adults in the urbanised village was suboptimal, with mental health being more adversely affected than physical health. Targeted community-based interventions focusing on mental health promotion, physical activity, and socioeconomic support are essential to improve overall quality of life.

Prevalence of substance abuse among adolescents in a higher secondary school in Thiruvananthapuram district

Bhagyalakshmi Mahadevan Kanchana — 2026-06-30

Background: Adolescence is a promising stage in life when the child matures into an adult. A period of sudden and rapid physiological, psychological and behavioural change. Substance abuse is one of the major challenges confronting adolescents. Objectives were to find out the prevalence and determinants of substance abuse among school students in Thiruvananthapuram district.

Methods: A cross-sectional study was conducted among the students of a higher secondary school in Thiruvananthapuram district. A cluster sampling method based on sections of classes in schools was used to conduct the study. Data was collected using a self- administered pretested semi structured questionnaire. The data collected was analysed using SPSS version 27.

Results: Among the 92 students, 63 (68.5 %) were males and 29 (31.5 %) were females. Of the study participants 14 (15.2%) had a history of substance usage and all of them were male students. Most commonly substance abused was alcohol 85.7% followed by tobacco 42.8%. According to the study most common reason for first attempt was found as curiosity (64%). A significant association was found between parents with a habit of substance use and substance use among adolescents (p<0.05).

Conclusions: Our study provides information on the prevalence of substance use among students, but the small sample size limits its generalizability. The identification of risk factors associated with substance use provides valuable insights for developing school-based prevention and intervention programs.

Understanding gaps in biomedical waste management in India: from policy frameworks to hospital practice

Ankita Chaurasia — 2026-06-30

Background: Effective Biomedical Waste (BMW) management remains a critical challenge in Indian healthcare system, with serious implications for individual health and environmental sustainability. This study assesses the knowledge, attitudes and practices of healthcare workers (HCWs) regarding BMW segregation and treatment in two tertiary care oncology hospitals in Varanasi, India.

Methods: A total of 377 HCWs from diverse categories-including nurses, housekeeping staff, doctors and technicians participated in a prospective cross-sectional survey conducted from January 2022 to October 2023. A structured questionnaire was used to evaluate participants’ behavioral challenges, knowledge gaps and underlying contributing factors behind improper BMW segregation.

Results: This study showed while 94.43% of HCWs were aware of the importance of BMW segregation, only 59.95% of participants had adequate knowledge about its treatment and disposal. Insufficient knowledge, hurried work practices and excessive workload were identified as major barriers to proper waste segregation. Notably high incidents of needle stick injuries (NSIs) due to improper sharp handling and disposal were reported, among nurses and housekeeping staff. Additionally, 92.57% of participants expressed a strong desire for monthly or semi-annual re-training sessions on BMW segregation and its treatment.

Conclusions: The findings emphasize the importance of regular, structured training programs and reinforcement of individual accountability to improve compliance with BMW management protocols. Incorporating foundational BMW management training with practical exposure into MBBS, nursing and paramedical curricula may further enhance awareness and responsible handling practices among healthcare professionals.

COVID-19 and social media: doctors' opinion

Ramkrishna Mondal — 2026-06-30

Background: Several research and literature available regarding the impact of social media on healthcare are increasing and play a vital role during COVID-19 in disseminating information. Numerous studies gauging the public’s opinion are available, but minimal reports about the doctors regarding the role of social media. This current study aims to capture the view of the doctors who worked during the pandemic regarding the role of social media.

Methods: This cross-sectional questionnaire-based survey study captures the opinion of doctors in India during the pandemic. A pre-tested questionnaire was circulated among doctors and the data was collected from January 2022 to November 2022. After discarding 11 incomplete responses, 389 responses were considered in the analysis based on Cochran’s formula. Simple statistical tests were used using MS Excel.

Results: Out of 389 responses, 69% are Male and 28% are Female and the majority are Specialists (39%). Most of the responded doctors are in the active age group, with 36% between 30-39 years. More than 50 % of the population of doctors have zero to ten years of experience. They collectively opine that social media have more negative impacts (~70%) than positive ones (~48%) and most (72.9%) felt the need for some control/regulatory mechanism.

Conclusions: The study concluded that doctors acknowledged the positive role of social media but simultaneously cautioned about the negative aspects, especially in spreading medical misinformation/infodemic and warned that social media should be used to share official information with caution.

Exploring the knowledge, attitude and practices about menstrual hygiene management among the reproductive age group women of urban slums in Ahmedabad, Gujarat

Ankita S. Parmar — 2026-06-30

Background: Menstruation is a typical physiological process resulting from hormonal changes in the body. Many social and cultural misconceptions, as well as taboos, surround menstruation. The study aims to determine knowledge, attitude and practice about menstrual hygiene and menstruation in the reproductive age group women of the urban slum of Ahmedabad.

Methods: A cross-sectional study was carried out in Ahmedabad, Gujarat's west zone slums, from February to April 2022. In the west zone, Ambawadi and Vasna were chosen randomly from the four slum regions. Convenient sampling was used to recruit 120 women in total. A standardized questionnaire including sociodemographic information, menstrual history, knowledge, attitude and hygiene behaviours was used to gather data.

Results: The majority of responders (71.66%) were between the ages of 15 and 34. 85%of those surveyed used public restrooms. 33% were aware that menstruation is a typical physiological occurrence. 63.33% of respondents were unaware of the true reason and source of monthly bleeding. 92.5% of women used cloth during their periods, despite 100% of respondents believing that sanitary napkins should be used. Sanitary napkins were used by only 7.5%. Menstruating women should be treated differently, according to the majority (61.66%). 94.16 % of respondents agreed that females should get education about menstruation before to menarche.

Conclusions: The study draws attention to the participants' poor cleanliness habits, ingrained cultural taboos and notable gaps in their understanding of menstruation health. The persistent preference for cloth despite widespread awareness of sanitary napkins suggests obstacles relating to accessibility, cost, or cultural norms.

Knowledge, attitude and preventive practices regarding sexually transmitted infections among reproductive-age adults in rural Malappuram district, Kerala: a cross-sectional study

Narayanan Namboothiri G. — 2026-06-30

Background: STIs remain a major global public health problem due to high incidence, complications and impact on reproductive health. In India, STIs contribute significantly to reproductive morbidity, while awareness regarding STIs other than HIV and their prevention remains limited. Assessing KAP regarding STIs among reproductive-age adults is essential to improve prevention strategies and reduce disease burden.

Methods: A hospital-based descriptive cross-sectional study was conducted among individuals aged 15-49 years attending OBG OPDs in Malappuram district, Kerala. A total of 300 participants were selected using stratified random sampling with systematic selection and data were collected through face-to-face interviews using a semi-structured questionnaire assessing socio-demographic variables and STI KAP. Data were analyzed using SPSS v26 with chi-square test for bivariate analysis (p≤0.05).

Results: Among 300 participants, good STI knowledge was observed in 37% while 63% had poor knowledge. Good attitude was present in 42% while 58% had poor attitude. Only 24% demonstrated good preventive practices while 76% had poor practices regarding STIs.

Conclusions: KAP regarding STIs among reproductive-age adults was inadequate, indicating important gaps in awareness and adoption of preventive behaviours. Strengthening targeted health education and improving access to reliable sexual health information are essential to improve KAP and enhance STI prevention and control.

Financial burden of antenatal care services: a study in Hassan district, Karnataka

Dhasharatha K. T. — 2026-06-30

Background: Antenatal care (ANC) is backbone of the maternal healthcare; yet, the financial burden for receiving these services is a key barrier in less developed and developing countries, including India. Despite schemes by governments to give free maternal and child health care, out-of-pocket expenditure remains considerable financial burden for households, particularly within financially weaker population. This study analyses the financial burden of ANC services in Hassan district, by comparing the total direct, indirect and total costs of ANC services among public, private and mixed healthcare centres.

Methods: For this purpose, a cross-sectional study was conducted among 415 antenatal women who had engaged ANC services in Hassan district. Data were collected on socio-demographic elements, healthcare centres usage patterns and total cost components including total direct and indirect cost. One-way ANVOA tests was applied to evaluate cost divergence throughout healthcare centres types, accompanied by Dunn’s post-Hoc pairwise comparisons with Bonferroni correction.

Results: The results of ANOVA indicated there is a significant difference in all three costs of ANC services for three types users. Catastrophic health expenditure occurred in 51.6% of public healthcare centres users, followed by 51.5% of mixed and 43.3% of private healthcare centres users.

Conclusions: According to this study we found that, catastrophic health expenditure is still a significant issue in this study area. Therefore, policy measures required to emphasise on upgrade of public healthcare centres infrastructure, and the control of private healthcare centres pricing.

Role of learning style preferences in academic performances among preclinical medical students in a tertiary medical college, Kolkata: a cross-sectional study

Anuttam Chattopadhyay — 2026-06-30

Background: The number of medical colleges in India has been increasing at a higher rate in the past few years; this increased influx of students would benefit from a system that was more in line with their preferences. Many studies have used the visual, aural/auditory, read/write, kinesthetic (VARK) learning preferences questionnaire, allowing an opportunity to use another questionnaire to determine learning style preferences that is the index of learning styles (ILS) by Felder and Soloman.

Methods: A non-probability convenient sampling technique was used to enroll the study participants during period of data collection. This cross-sectional study investigated preclinical medical students to determine learning style preferences and correlate with academic performance across gender. Questionnaires were sent through google forms and 178 preclinical medical students at a tertiary care institute in Kolkata were enrolled.

Results: The study population consisted of 1^st and 2^nd year students at the institute. It was found that a higher percentage preferred visual (89.89%), sensing (60.11%), reflective (53.90%) and sequential (57.30%) learning styles over the alternatives. However, no significant association was found between learning styles and academic performance.

Conclusions: If instruction methods heavily favor one type of learning style over another, students with different learning styles may not learn optimally, while students whose learning styles match with the instruction will not be encouraged to develop skills in their less preferred learning styles. The findings from this study will aid in future re-examination of current teaching methods and evaluate whether they are optimally balanced with respect to the students.

Determinants of low birth weight in a tertiary care setting of an aspirational district

Medha Sharma — 2026-06-30

Background: Low birth weight (LBW) remains a critical challenge for neonatal survival and long-term health, particularly within India's aspirational districts. This study aims to identify the clinical, socioeconomic, and nutritional determinants of LBW in the high-altitude terrain of Himachal Pradesh.

Methods: A retrospective, hospital-based cross-sectional audit was conducted at a tertiary care centre. The study analysed data from 151 LBW infants (<2500 g) born between 1 April and 30 June 2025, using records from the HMIS portal, medical record section, and antenatal clinic registers.

Results: The facility reported a 15.5% LBW rate. Key determinants included poor antenatal care (ANC) utilization, with 50% of mothers failing to achieve early registration (within 12 weeks) and 79% attending fewer than the recommended four ANC visits. Nutritional factors; 32% of mothers were underweight at conception, and 44% achieved a gestational weight gain of less than 10 kg. Obstetric findings revealed that 80% of cases had birth intervals of less than three years, contributing to maternal nutrient depletion. Additionally, while 50% of pregnancies were categorized as high-risk, 95% of cases were non-referred, indicating that the tertiary facility is overburdened with routine deliveries.

Conclusions: The high incidence of LBW is driven by late clinical registration, maternal undernutrition, and systemic healthcare burdens. Improving outcomes requires precision interventions, including strengthened grassroots outreach for 100% early registration and the establishment of dedicated high-risk pregnancy clinics.

Self-medication practices among adults in urban field practice area of Rajarajeswari Medical College, Bengaluru

Sethu Arumugam R. M. — 2026-06-30

Background: Self-medication is an important public health issue worldwide and is increasingly practiced in developing countries. Easy accessibility to medicines and lack of awareness regarding potential risks contribute to the widespread practice of self-medication. Inappropriate self-medication may lead to adverse drug reactions, antimicrobial resistance, delayed diagnosis and increased morbidity. The present study aimed to assess the prevalence, pattern and reasons for self-medication practices among adults in an urban field practice area of Bengaluru.

Methods: A community-based cross-sectional study was conducted among 100 adults aged ≥18 years residing in the urban field practice area of Rajarajeswari Medical College and Hospital, Bengaluru. Participants were selected using convenient sampling. Data was collected using a pre-tested semi-structured questionnaire that included socio-demographic details, self-medication practices, reasons for self-medication and types of medications used. Data were analysed using SPSS version 23 and expressed in terms of frequencies and percentages.

Results: Among the 100 participants, 81% reported practicing self-medication. Analgesics (81.5%) and antipyretics (61.7%) were the most commonly used medications. Fever (84%), cold (72.8%) and cough (64.2%) were the most frequent conditions for which self-medication was practiced. The major reasons reported for self-medication were mild illness (58%), time constraints (38.3%) and financial reasons (22.2%).

Conclusions: The study highlights a high prevalence of self-medication practices among the urban population. Public health education regarding the rational use of medicines and strict regulation of drug dispensing practices are necessary to reduce inappropriate self-medication.

Respiratory health challenges among post-COVID-19 individuals: a community-oriented clinical study of pulmonary sequelae and functional decline

Gurshan Singh Gill — 2026-06-30

Background: The long-term respiratory impact of COVID-19 has emerged as a major healthcare concern, with many recovered individuals continuing to experience dyspnoea, reduced pulmonary function, and exercise intolerance. Persistent impairment in diffusion capacity (DLCO) and reduced respiratory endurance have been widely reported among post-COVID patients. This study aimed to evaluate pulmonary sequelae and functional impairment among post-COVID individuals in the Jaipur region through community-based clinical assessment.

Methods: A total of 200 post-COVID adults attending NIMS University were evaluated using standardized pre- and post-assessment procedures. Assessments included spirometry, pulse oximetry, DLCO testing (where available), radiographic evaluation, 6-minute walk test (6MWT), modified Medical Research Council (mMRC) dyspnoea scale, and inspiratory muscle strength testing. Data were analysed using descriptive statistics, paired t-tests, Pearson correlation, and multivariate logistic regression.

Results: Significant improvement was observed in pulmonary parameters, with mean FVC increasing from 76.4% to 82.1% predicted (p<0.001), FEV1 from 72.9% to 79.2% (p<0.001), and DLCO from 68.3% to 74.5% (p<0.001). However, 28.5% of participants continued to exhibit pulmonary impairment. Functional capacity also improved, with mean 6MWT distance reaching 401.3 m (p<0.001), although 22% remained below predicted levels. Age, smoking, severe acute COVID-19, biomass exposure, and comorbidities were identified as significant predictors of persistent respiratory sequelae.

Conclusions: Despite partial recovery, a substantial proportion of post-COVID individuals continue to experience respiratory and functional limitations. The findings highlight the need for routine long-COVID screening, structured pulmonary rehabilitation, and targeted management strategies for high-risk populations.

Risk perceptions and behaviours among youth using dating applications in Mumbai

Kamran Qureshi — 2026-06-30

Background: One of the primary goals of young adulthood is to establish a committed romantic relationship. During the last decade, Internet has become an important platform to initiate contact with potential romantic/sexual partners. The study aims to estimate usage of dating apps among young adults and understand the implications of their use.

Methods: A cross-sectional study was done amongst 18-25 years college students from a metropolitan city of India. Minimum sample size required for the study was 1012. Ethical approval was obtained from IEC and data was collected via a Google form amongst students from colleges in particular area of city. Data was entered in Excel and analyzed through SPSS software.

Results: Of the 1641 participants of the study, 208(12.7%) were using dating applications, more in males (14.9%) in comparison to females (11.2%). Most common reason for use was finding love/partner (30.3%), casual sex (28.4%) and exploring/experimenting (26.9%). Association between use of dating applications was statistically significant with gender, duration of stay in city, relationship status, sexual orientation and habits. Untoward incidents and regret due to use of app was observed in 24(11.5%) of the users. Majority of the participants affirmed that dating apps do not provide any information about STIs and predatory profiles.

Conclusions: The risk factors associated with dating apps were male gender, residing in city since more than a year, habits like smoking, alcohol etc, sexual orientation and relationship status. Untoward incidents due to use of apps need to be managed by legal safeguards and regulation.

Assessment of the knowledge and perceptions of auxiliary nurse midwives regarding the U-WIN app in urban health and wellness centers in selected areas of Delhi

Geeta — 2026-06-30

Background: Digital health interventions have become integral to strengthening immunization systems in India. The Universal Immunization WIN (U-WIN) application was introduced to digitize routine immunization services under the Universal Immunization Programme. The successful implementation of U-WIN largely depends on the knowledge, perception, and acceptance of frontline health workers, particularly auxiliary nurse midwives (ANMs), who are directly involved in immunization service delivery. This study aimed to assess the knowledge and perception of ANMs regarding the U-WIN application in urban health and wellness centres (UHWCs) of selected areas of Delhi.

Methods: A quantitative, descriptive cross-sectional study was conducted among 110 ANMs working in UHWCs of Central and North-East Delhi. Non-probability purposive sampling was used. Data were collected using a structured knowledge questionnaire, a perception rating scale, and a barrier checklist. Descriptive statistics summarized the findings, while Fisher’s Exact Test and Karl Pearson’s correlation coefficient were applied to assess associations between variables.

Results: The mean knowledge score of ANMs was 17.85±2.96, with 74.6% demonstrating good knowledge of the U-WIN application. The mean perception score was 49.38±5.06, indicating an overall favorable perception, with 59.1% of participants showing a favorable attitude. Usability and interface-related issues were the most reported barriers, followed by technical and connectivity challenges. A statistically significant association was observed between years of professional experience and both knowledge (p=0.010) and perception (p=0.019). Knowledge and perception were positively correlated (p<0.001).

Conclusions: The study concludes that ANMs possess good knowledge and favorable perceptions regarding the U-WIN application. Addressing usability and technical challenges can further enhance effective utilization and strengthen routine immunization services.

Utilization of take-home ration and complementary feeding practices among women and young children in tribal Jharkhand: a mixed-methods study

Vishal Chandra — 2026-06-30

Background: Take-home ration (THR) under the Integrated Child Development Services (ICDS) is a key intervention to address nutritional gaps among pregnant women, lactating mothers, and young children. However, evidence suggests that program effectiveness is often constrained by gaps in utilization at the household level, particularly in tribal settings.

Methods: A cross-sectional mixed-methods study was conducted between January and February 2024 in the Kolhan division of Jharkhand. A total of 146 respondents, including pregnant women, lactating mothers, and Anganwadi Workers, were interviewed using structured questionnaires. Additionally, 12 focus group discussions (FGDs) with 8-12 participants each were conducted. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed thematically.

Results: While THR distribution was reported to be regular, significant gaps were observed in its utilization. Awareness regarding recommended quantity and preparation methods was limited among beneficiaries. THR was commonly shared among household members, reducing its consumption by intended beneficiaries. Complementary feeding practices were suboptimal, with most children being fed from the family pot rather than receiving age-appropriate semi-solid foods. Increasing reliance on packaged foods for children was also reported. Qualitative findings highlighted behavioural, cultural, and practical barriers influencing these practices.

Conclusions: Optimal utilization of THR remains limited despite adequate program delivery. Addressing behavioural and knowledge-related barriers through strengthened counselling and community engagement is essential for improving nutritional outcomes.

Screening-detected ocular morbidities and gaps in eye care utilization among older adults in rural Uttar Pradesh: a cross-sectional study

Prapti Palit — 2026-06-30

Background: Older adults in rural Uttar Pradesh face a high burden of avoidable visual impairment. Community-based eye health evidence from this state, home to India's largest rural older-adult population, remains scarce.

Methods: A community-based cross-sectional study was conducted (February–March 2026) in five rural villages of Greater Noida, Uttar Pradesh. Adults aged ≥50 years were enrolled using stratified random sampling (n=302; response rate 94.5%). Basic ocular screening (Snellen visual acuity at 6 metres and torchlight anterior segment examination) and a pretested questionnaire were used. Associations were assessed using Chi-square tests.

Results: Among 302 participants (mean age 58.3±9.2 years; 58.9% female), 266 (88.1%) had at least one screening-detected ocular condition. Refractive error (53.8%) and suspected cataract (44.7%) were most prevalent. The refractive error correction gap was 52.6% and the cataract surgical gap was 67.0%. Awareness of government eye screening camps was 44.0%, and only 42.1% had ever attended one. Visual impairment was significantly more prevalent among older participants, females, illiterate individuals, and those of lower socioeconomic status (all p<0.05).

Conclusions: There is a high burden of largely avoidable ocular morbidity in this rural population, with substantial refractive error correction and cataract surgical gaps. Integrating ocular screening into primary care and strengthening NPCBVI referral pathways are essential for reducing avoidable visual impairment in similar settings.

Health facility assessment on the readiness to provide basic health-care interventions for management of non-communicable diseases based on the World Health Organization-package of essential non-communicable disease intervention in Manipur

Thaimei Gairanlung — 2026-06-30

Background: As disease pattern of the world is transitioning from communicable to non-communicable diseases (NCD), it is pertinent to study how ready the health facilities are to handle this changing burden. This study was done to assess the readiness of government health facilities in Manipur to provide essential NCD intervention as per the WHO-PEN guidelines.

Methods: A cross-sectional study was conducted across government health facilities in Manipur during 2022 to 2025. The DHs and CHCs were selected by universal sampling while PHCs were selected by Simple random sampling method. The facilities were assessed using a structured checklist adapted from the WHO-PEN facility assessment consisting of nine domains.

Results: A total of 53 health facilities were assessed covering 35 from valley and 18 from hill districts out of which 62% were PHCs. All three types of facilities were prepared in the domains of patient care services, human resources/staff, and outreach activities as the scores in these domains are above the cutoff of 70%. In the records and reports, monitoring and evaluation, and referral systems domains, PHCs and CHCs were not prepared, but only DHs were. All the three categories of facilities were not prepared in the crucial areas of medications, technologies, and tools.

Conclusions: The study concluded that PHCs were not ready to manage NCDs while CHCs and DHs were ready.

Faculty perceptions on barriers affecting small group teaching in undergraduate medical education

Wincy E. Wilson — 2026-06-30

Background: Small group teaching (SGT) is a central instructional strategy within competency-based medical education (CBME) by NMC, formally implemented in undergraduate medical education in India in 2019. SGT promotes active learning, critical thinking, collaboration, and self-directed learning. However, despite curricular emphasis, effective implementation remains inconsistent across institutions due to behavioral, curricular, and contextual challenges. Hence, the present study was conducted to assess faculty perceptions on barriers affecting small group teaching in undergraduate medical education.

Methods: A cross-sectional mixed-methods study was conducted among 100 teaching faculty members and postgraduate tutors involved in undergraduate teaching at a tertiary care medical college, Bengaluru. A validated self-administered questionnaire assessed perceived barriers across four domains: student-related, faculty-related, curriculum-related, and infrastructure-related. Responses were recorded on a five-point Likert scale. Quantitative data were analyzed using descriptive statistics and expressed as frequencies, percentages, and mean Likert scores. Qualitative responses were analyzed using thematic analysis.

Results: Student-related barriers were perceived as the most significant challenge (76%). Infrastructure-related barriers showed moderate agreement (57%), followed by curriculum-related barriers (56.1%). Faculty-related barriers were the least perceived (50.9%). Student unpreparedness (79.8%) was the most frequently reported barrier. Perceptions were largely consistent across designation, years of teaching experience, and CBME training status. Thematic analysis demonstrated that student-related concerns constituted 46% of qualitative responses.

Conclusions: Faculty perceive student preparedness and motivation as the primary barriers affecting SGT. Addressing these modifiable factors through structured orientation, curricular alignment, and institutional support is essential to strengthening CBME implementation.

Association of body mass index with drug resistance and disease pattern among tuberculosis patients in a rural area of Western Uttar Pradesh: a cross-sectional study

Adarsh Mohan — 2026-06-30

Background: Undernutrition is a key determinant of tuberculosis (TB), influencing susceptibility, disease progression, and treatment outcomes. Its relationship with drug resistance and disease pattern remains an area of growing interest, particularly in rural settings. This study aimed to assess the nutritional status of TB patients using body mass index (BMI) and examine its association with drug resistance and site of disease.

Methods: A cross-sectional study with secondary data analysis was conducted at the DOTS Centre from 2021 to 2025. A total of 812 diagnosed TB patients were included. Data were analysed using SPSS, and associations were tested using the Chi-square test.

Results: The mean BMI was 17.26±3.21 kg/m², with 73.2% of patients being underweight. Drug resistance was significantly higher among underweight patients (16.2%) compared to those with normal/overweight BMI (8.3%) (χ²=11.152, p=0.001). Similarly, undernutrition was more prevalent among pulmonary TB patients (73.9%) than extrapulmonary TB patients (66.7%), with a statistically significant association (χ²=4.23, p=0.04).

Conclusions: Undernutrition is highly prevalent among TB patients and is significantly associated with both drug resistance and pulmonary disease. Addressing nutritional deficits should be an integral component of TB control strategies.

Factors associated with academic stress and performance anxiety among nursing students in Kurnool, Andhra Pradesh

Sudhakara Reddy Muthyala — 2026-06-30

Background: Academic stress is an outcome of academic demands imposed beyond an individual's available adaptive resources and manifests as academic overload and social, familial, and psychosocial challenges in an academic context.” “Performance anxiety emphasizes the discomfort that people feel before, during, and/or after significant tasks, which impairs their performance." In light of the academic challenges faced by nursing students, an institutional descriptive cross-sectional study was conducted to investigate the "factors associated with academic stress and performance anxiety” (ASPA) among 571 nursing students enrolled in government institutions in Kurnool.

Methods: Data were collected using a pre-tested, self-reported questionnaire with convenience sampling. Statistical analysis was performed using SPSS 21.0 software, and the chi-square test was used, with a p value <0.05 considered statistically significant.

Results: Among the respondents, ASPA is found to be higher among undergraduates (84%; p=0.001), below the poverty line (78%; p=0.05), staying in college hostels (78%), experienced eve teasing (89%; p=0.001), and those who supported ‘devil’s impact on mental health’ (80%; p=0.05).

Conclusions: ASPA is lower among those interested in their studies. The study concluded that three-fourths of respondents experienced ASPA.

The sedentary doctors versus the active community: contrasting physical activity patterns from South India

Jazeela Mohamed Siddique — 2026-06-30

Background: Physical inactivity is a major modifiable risk factor for non-communicable diseases. Despite adequate knowledge of healthy lifestyles, medical professionals may experience reduced physical activity due to occupational demands. Evaluating physical activity levels and identifying associated sociodemographic factors is essential for targeted interventions. This study assessed and compared physical activity patterns among medical professionals and the general public in South India and determined the association between sociodemographic factors and physical activity levels.

Methods: We conducted a community-based cross-sectional study from May to June 2024, involving 50 medical professionals and 50 members of the general public. Physical activity was assessed using the World Health Organization Global Physical Activity Questionnaire. Activity levels were classified as sufficient or insufficient.

Results: The median METS-minutes per week of the general public was higher than that of medical professionals. There was a statistically significant association between sufficient physical activity and lower educational groups and skill level II occupation. The medical professionals engaged in 90% lower odds of work-related physical activity than general public. In contrast, medical professionals engaged in nearly three-fold higher odds of recreational physical activity than the general public did.

Conclusions: The median METS-minutes per week of the general public was higher than that of medical professionals. There was a statistically significant association between sufficient physical activity and lower educational groups and skill level II occupation. The medical professionals engaged in 90% lower odds of work-related physical activity than general public. In contrast, medical professionals engaged in nearly three-fold higher odds of recreational physical activity than the general public did.

Migration, risk behaviour and HIV vulnerability among rural migrants in Uttar Pradesh: evidence from the link worker scheme in Moradabad

Neeraj Pathak — 2026-06-30

Background: Migration has emerged as an important socio-economic phenomenon influencing health vulnerabilities in rural India. In states such as Uttar Pradesh, seasonal and circular migration often expose individuals to environments that increase the risk of HIV transmission. This study examined the relationship between migration patterns and HIV vulnerability among high-risk groups in rural Moradabad district.

Methods: The study was conducted under the link worker scheme (LWS) implemented by Sharnam Sansthan in Moradabad district. A quantitative survey of 120 respondents was carried out using a structured questionnaire. Data were collected with the support of cluster link workers working under the programme to understand migration patterns, awareness levels, and risk behaviours related to HIV.

Results: The findings indicate that most migrants were young and middle-aged men engaged in informal labour sectors with low educational levels and unstable income. Migration was largely seasonal, with many migrants spending three to six months in urban destinations such as Delhi, Ludhiana, and Gurugram. Although awareness of HIV/AIDS was relatively widespread, misconceptions about transmission and prevention persisted. Risk behaviours, including inconsistent condom use and engagement with sex workers, were reported during migration periods.

Conclusions: The study highlights the need to strengthen community-based interventions, expand HIV testing services, and improve awareness programmes to reduce HIV vulnerability among migrant populations in rural areas.

Profile and burden of cancers in Assam: an insight from Assam Cancer Care Foundation hospitals

Dipjyoti Das — 2026-06-30

Background: The North-Eastern region of India, particularly Assam, reports among the highest cancer incidence and mortality rates in the country. To address this growing burden, the Assam Cancer Care Foundation (ACCF) was established through a partnership between Tata trusts and the government of Assam, implementing a Distributed cancer care model across the state. This study examines the cancer burden, patterns, and trends among patients attending ACCF hospitals.

Methods: Patient data, including demographic characteristics, clinical profile, and diagnosis, were extracted from the Medical records department (MRD) module of the Hospital management information system (HMIS). Data from May 2022 to September 2024 were cleaned, compiled in Microsoft excel, and analyzed to identify key trends and cancer patterns.

Results: Most patients were above 50 years of age. More than 95% reported a history of addiction, highlighting the widespread prevalence of tobacco and alcohol use. Oral cavity, breast, esophageal, and lower Gastrointestinal (GI) cancers were the most common cancer sites among patients attending ACCF hospitals. Among males, oral cavity, esophageal, upper GI, and lower GI cancers predominated, whereas breast, gallbladder, and lower GI cancers were the leading malignancies among females.

Conclusions: Oral cavity, breast, esophageal, and lower GI cancers constitute the major cancer burden in Assam. The predominance of cancers associated with tobacco and alcohol use, coupled with the high prevalence of addiction and older age among patients, underscores the need for strengthened prevention, early detection, and control strategies.

Distribution of animal bite cases attending anti-rabies clinic of a tertiary health care center in central India

Prabha R. Kamble — 2026-06-30

Background: Human rabies is 100% fatal communicable disease but preventable through prompt and appropriate medical care. In spite of this, it claims an estimated 59000 lives each year mostly in Asia and Africa. India is endemic for rabies. In India alone, 18000 to 20000 deaths occur annually mostly in under 15 years old children. If not treated on time, it causes significant social and economic burden specially on developing countries like India. Also to achieve the World Health Organisation’s aim to end human deaths from dog-mediated rabies by 2030, the analysis of animal bite cases will play a very crucial role. This study aims to study the distribution of animal bite cases attending the anti-rabies clinic.

Methods: This cross-sectional study was carried out in patients who attended the Anti-Rabies Clinic for treatment of animal bites from January to April 2025, at a tertiary health care center in Nagpur, Maharashtra.

Results: Among reported cases, 32.9% animal bites were present in age group 16-30 years, 67.6% bites were in males, 87% of the total animal bite cases were from urban area, stray animal bites were 50.18%, dog was the most common animal responsible for bite which is 84.49%, 87.34% were category III wounds.

Conclusions: Adult males were having higher risk of category III animal bite wounds. Stray dogs were mainly responsible for the animal bites.

Online health search behaviour and cyberchondria severity among medical students: a dose-response study

Jaideep Rao M. — 2026-06-30

Background: Cyberchondria- compulsive online health searching that amplifies health anxiety- is increasingly reported among medical undergraduates, yet its severity distribution and dose-response pattern remain poorly characterized in south Indian populations. This study assessed cyberchondria severity, its dose-response association with online health search behaviour, and associated socio-demographic and behavioural factors among MBBS students.

Methods: Cross-sectional study of 100 MBBS students at a government medical college in south India. The validated CSS-15 (α=0.755) was administered online. Dose-response analysis used one-way ANOVA with eta-squared and Spearman correlation; factors independently associated with CSS-15 severity were identified by multiple linear regression.

Results: Mean CSS-15 score was 18.07±8.29 (range 0-37). A clear dose-response gradient emerged: scores rose from 11.54±6.52 (rarely searching) to 25.14±8.36 (always searching)- a 13.6-point increase (F(3,96) =13.06, p<0.001; η²=0.290; Spearman ρ=0.513, p<0.001). Online search frequency (β=4.95, p<0.001) and hostel residence (β=3.82, p=0.008) were independently associated with CSS-15 severity, together explaining 31.8% of the variance in CSS-15 scores (R²=0.318). Excessiveness was the predominant subscale (mean 5.37±2.83).

Conclusions: Online health search frequency showed a significant graded association with cyberchondria severity. Hostel residence was independently associated with higher CSS-15 scores. These findings point to practical intervention targets: search-frequency reduction strategies and hostel-specific digital health literacy programmes within undergraduate medical curricula.

Co-morbidity pattern in elderly patients presenting to the geriatric outpatient department at a district hospital in the Himalayan foothills

Jai Gupta — 2026-06-30

Background: The elderly is a group of people who require more medical attention than others due to the start of the decline of the body functions. Ageing is rapidly progressing in India consequent to the highest number of young people here. The aim of the present study was to find the pattern of comorbidities in patients visiting the geriatric OPD of a District hospital in Himachal Pradesh.

Methods: In this study, we have hypothesized that many of the geriatric patients presenting to the OPD will have other comorbidities in addition to the presenting complaint, as a virtue of their old age.

Results: The data was collected over a span of 3 months with 1016 patients enrolled for the study. Off this number 510 male and 506 females. 67.2% of patients had some form of comorbidity. 121 patients (11.90%) had one comorbidity, 192 patients (18.9%) had two comorbidities, 168 patients (16.55%) had three comorbidities, 132 patients (13.0%) had four comorbidities, 61 (6.0%) had 5 comorbidities and 13 patients (1.28%) had 6 comorbidities. The most common comorbidity found was hypertension in 380 (37.4%) of the patients followed by some form of mental disorder in 366 (36.02%) patients, followed by dyslipidemia in 327 (32.19%) patients and then Diabetes Mellitus in 256 patients (25.2%) of the patients.

Conclusions: Majority of the patients presenting to the geriatric department were multimorbid and had some other comorbidity in addition to their presenting complaint. Hence, the emphasis for specialized care for the geriatric patients. With increase in the life expectancy in India, these need to be addressed early on to provide good and healthy quality of life to the geriatric population and to decrease the burden on our already strained healthcare infrastructure.

A cross-sectional study on tobacco addiction in a rural community of district Sheopur, Madhya Pradesh

Jagmohan Singh Dhakar — 2026-06-30

Background: Tobacco addiction is a major public health concern and is influenced by multiple socio-demographic factors. Cultural acceptance, widespread availability of inexpensive products, persistent misconceptions regarding perceived benefits, and highly addictive nature continue to hinder cessation efforts. Understanding its prevalence and determinants is essential for targeted prevention and control strategies.

Methods: A community-based cross-sectional study was conducted among 1,085 participants for a period of September 2025 to January 2026 in Nagdi village of Sheopur, Madhya Pradesh, India. Data was collected by means of house-to-house survey using simple random sampling technique via pre-designed, pre-tested and semi-structured questionnaire. Data was entered in MS-Excel, descriptive and inferential statistical analysis was done using IBM-SPSS software v28.0.

Results: The overall prevalence of tobacco addiction was observed to be 39.2%. Addiction was significantly higher among males, 49.11% in comparison to females, 28.41% with p=0.001. The prevalence increased with age, with peak at 61-70 years, 56.67% with p=0.001. An inverse association was observed with education, with highest prevalence among illiterate participants, 46.41% and lowest among graduates, 14.29% with p=0.001. Head of families showed a markedly higher prevalence, 63.70% compared to other family members, 31.04% with p=0.001.

Conclusions: Tobacco addiction was common in the study population and showed significant associations with gender, age, educational status, and family role. These findings highlight the need for targeted health education and tobacco control interventions, particularly among males, older adults, less-educated individuals and head of households.

Determinants of delay in initiating rabies post-exposure prophylaxis among animal bite victims: a hospital-based cross-sectional study from central India

Swapnil T. Tembhekar — 2026-06-30

Background: Rabies is an almost invariably fatal yet preventable disease. Timely post-exposure prophylaxis (PEP) is essential, but delays remain common. This study assessed factors associated with delayed PEP initiation among animal bite victims attending an anti-rabies clinic in central India.

Methods: A hospital-based cross-sectional study was conducted from May to mid-June 2025 at a tertiary care hospital in central India. A total of 323 animal bite victims were recruited by consecutive sampling. Data were collected using a pre-tested semi-structured questionnaire. Delay was defined as receiving the first anti-rabies vaccine dose after 24 hours. Data were analysed using Jamovi with descriptive statistics and Chi-square test.

Results: Dogs caused 96% of bites. Most participants were male (67%), rural residents (61.5%), and 30.5% were illiterate. PEP initiation was delayed in 41% of cases. Delay was significantly associated with distance >10 km from the vaccination centre (p<0.001), monthly income <₹5000 (p=0.004), and increasing age (p=0.041). Major reasons for delay were work-related barriers (48.7%), lack of awareness (27.7%), and clinic closure on holidays (23.6%).

Conclusions: Delay in PEP initiation was common and mainly linked to access, socioeconomic, and awareness-related barriers. Strengthening community education, improving rural access, and ensuring uninterrupted anti-rabies services may reduce delays.

Digital literacy barriers and data privacy concerns in Ayushman Bharat Digital Mission: a community-based observational study in Tinwari village, Dehradun

Vinita Pandey — 2026-06-30

Background: The Ayushman Bharat Digital Mission (ABDM), launched in September 2021, aims to create a unified digital health ecosystem across India. Despite significant infrastructural growth, grassroots adoption among rural and vulnerable populations remains critically low. This study aimed to assess ABDM and ABHA awareness levels, identify barriers to adoption across demographic groups, and examine data privacy concerns among community members in Tinwari Village, Dehradun, Uttarakhand, India.

Methods: A cross-sectional observational study was conducted in Tinwari Village (January to March 2024). A total of 120 community members were purposively selected: senior citizens (60+ years; n=25), women (n=35), adults 25-59 years (n=38), and adolescents 13-24 years (n=22). Data were collected via structured informal interviews and field observations. No personal identifying information was recorded.

Results: Of 120 participants, 100 (83.3%) had zero awareness of ABDM or the ABHA application, despite all being confirmed mobile phone users. Among the 20 (16.7%) with some awareness, none were actively using the platform. The five principal barriers were: absence of community outreach (n=100, 83.3%), fear of Aadhaar-linked data fraud (n=94, 78.3%), entertainment-only digital behaviour (n=85, 70.8%), deferred adoption attitudes (n=78, 65.0%), and technology anxiety (n=66, 55.0%). Senior citizens demonstrated the highest non-awareness rate (24/25, 96.0%), followed by women (31/35, 88.6%), adults (30/38, 78.9%), and adolescents (15/22, 68.2%).

Conclusions: ABDM adoption failure reflects a systemic communication and outreach failure rather than an infrastructural one. Structured ASHA/ANM training in ABDM facilitation, plain-language multilingual data privacy communication, and population-specific awareness strategies targeting senior citizens and women are urgently needed.

Study of the association between co-morbidities with COVID-19 and resulting morbidity and mortality: a hospital-based study in Uttar Pradesh, India

Komal Tomar — 2026-06-30

Background: The pandemicity caused by SARS-CoV-2 virus led to increased number of morbidity and mortality worldwide. The clinical conditions, and the population infected were varied. For a new disease like this, it is very important to collectively measure all the co-morbidities being faced by the patients so that clinical case in future can be improved. The objective of this present study was to conduct a retrospective analysis of the patients infected with COVID-19 and study their clinical conditions and consequences.

Methods: The retrospective analysis of clinical conditions, comorbidities, complications etc. of COVID-19 infected patients (survived and not survived) was studied for the period 2020-2021.

Results: Varied type of infections were observed, such as anaemia, systemic sepsis, lower respiratory tract infections (LRTI), hypertension (HTN), type 2 diabetes mellitus (T2DM), and type 1 respiratory failure (T1RF). Some of these comorbidities were interconnected and can be considered to be the cause of poor prognostic results and fast clinical deterioration. Cardiopulmonary arrest, cardiorespiratory failure, acute respiratory distress syndrome (ARDS), pneumonia and complications due to COVID-19 were the main reasons of death found in the cohort studied.

Conclusions: The results highlight the significance of proactive management techniques for early identification of high-risk individuals, and integrated, multidisciplinary care approaches for patients with multiple morbidities.

Knowledge and expressed practices regarding pesticide handling among farmers in rural Himachal Pradesh, India: a cross-sectional study

Alpana Kariti — 2026-06-30

Background: Pesticide use is integral to modern agriculture but poses significant occupational health risks, particularly in developing countries where unsafe handling practices are common. Farmers in rural India are frequently exposed to pesticides due to inadequate knowledge, poor safety practices, and limited training. Objectives were to assess the knowledge and expressed practices regarding pesticide handling among farmers in selected rural areas of Himachal Pradesh and to determine the relationship between knowledge and practices.

Methods: A descriptive cross-sectional study was conducted among 100 farmers using pesticides in rural areas of district Una, Himachal Pradesh. Participants were selected using purposive sampling. Data were collected through a structured interview schedule assessing knowledge and a structured rating scale assessing expressed practices. Descriptive and inferential statistics were applied, including Karl Pearson’s correlation coefficient and Chi-square test.

Results: Most farmers demonstrated moderate knowledge regarding pesticide handling, while unsafe practices were prevalent. A positive correlation was observed between knowledge and expressed practices (p<0.05). Knowledge levels were significantly associated with educational status and pesticide-related training.

Conclusions: Despite moderate awareness, unsafe pesticide handling practices remain common among farmers. Targeted training programmes, improved access to safety information, and promotion of personal protective equipment are essential to reduce pesticide-related health risks.

Study of occupational stress among the workers of micro, small and medium enterprises, Bengaluru

Mohd Azhar — 2026-06-30

Background: Occupational stress can cause mental and physical illnesses, resulting in high costs for the individual, the economy and society. Due to globalisation and changes in the nature of work, people in developing countries have to deal with increasing occupational stress. In a developing country like India, the contribution of MSMEs is highly inevitable. This study aimed to study of occupational stress among the workers of micro, small, and medium enterprises.

Methods: The present study was conducted among 350 workers of different MSMEs of Kottegepalya, a periphery of Bengaluru city. Those enterprises were selected whose owners had granted permission and were willing to co-operate. The data was collected through a face-to-face interview based cross-sectional survey, using a structured questionnaire which consists of socio-demographic data, occupational stress responses for assessment of occupational stress, and factors responsible for occupational stress. Chi Square, Fisher's exact test, adjusted Odds ratio and logistic regression were used for statistical analysis.

Results: The overall prevalence of occupational stress was 78.57%, out of those 46% workers had mild occupational stress. Majority of the workers 28.57% had an emotional response. Occupational stress was higher 95.23% in age group of 50 years; males had higher prevalence of 80.23%. Among all the socio-demographic factors; age and marital status and education were significantly associated with occupational stress (p<0.05).

Conclusions: The present study showed an increasing trend of occupational stress among workers. There is a need for interventions aimed at mitigating the occupational stress among MSMEs workers.

Human resource challenges in community health surveys: insights from a national household survey in India

Shrinivasa B. M. — 2026-06-30

Background: India with geographically diverse and malaria-endemic regions, extensive community health survey becomes essential to generate critical data for public health planning. However, their success completely relies on the team efforts of field data collectors working across socially heterogenous settings, and the institutional teams for recruiting, training and retaining the workforce. Moreover, both field workforce and recruiters face major operational, logistical, and supervisory demands while implementing such high-volume household surveys across remote terrain, dispersed settlements, and culturally diverse communities. However, the effectiveness of these human resource systems working under real-world complex conditions ultimately becomes the strength of these large-scale surveys as it requires to navigate field realities challenges while maintain the workforce retention, protocol adherence, and high data quality at this scale.

Methods: A cross-sectional descriptive study was conducted among the staffs working in the multi-state Indian Council of Medical Research-National Institute of Malaria Research (ICMR-NIMR) Household Survey Project surveying 37849 households across diverse geographic settings in India. Structured and pre-tested questionnaire was used to collect data. Descriptive statistics were used to summarise the key findings.

Results: Across multiple malaria-endemic states, 23 field data collectors were deployed with high level of training coverage, supervision and team cohesion. Although there was extended working hours and logistical demands, 78.3% reported to complete their full contract tenure reflecting the workforce stability and strong retention.

Conclusions: Overall findings suggest that in geographically and operationally complex setting with large population of 37849 households, structured human resource systems effectively sustained motivation, performance and data collection quality.

Association of sociodemographic and behavioural factors with perceived stress and sleep quality among undergraduate medical students: a cross-sectional study

Oorjita Phillip — 2026-06-30

Background: Sleep disturbance and stress are key yet underrecognized determinants of mental health among undergraduate medical students. This study examines the association between sleep quality and perceived stress, and identifies independent sociodemographic and behavioural predictors of each, within the Indian undergraduate medical training context.

Methods: This cross-sectional study included 200 undergraduate medical students from Christian Medical College, Ludhiana. Data was collected via google forms using the perceived stress scale (PSS)-10 and the Pittsburgh sleep quality index, alongside sociodemographic and behavioural variables. Statistical analysis included Pearson's correlation, partial correlation, and both univariate and multivariate linear regression. Multicollinearity was assessed using the variance inflation factor.

Results: Poor sleep quality was reported by 52.5% of participants, while 82.5% experienced moderate to high stress (mean PSS=20±7.03). A significant positive correlation was observed between sleep quality and perceived stress (r=0.542, p<0.001), which remained after adjustment for digital device use (partial r=0.524, p<0.001). Digital device use was an independent predictor of both sleep quality (β=0.877, p=0.012) and perceived stress (β= 1.870, p=0.012). Extracurricular participation showed a borderline association with lower stress.

Conclusions: Digital device overuse emerged as a significant and consistent independent predictor of both poor sleep quality and higher perceived stress. The stress-sleep association was robust after controlling for major covariates. These findings support targeted interventions targeting digital behaviour and sleep hygiene among medical students.

Determinants of medical termination of pregnancy with special reference to contraceptive practices among women in a tertiary care hospital in Central India

Neha Lilare — 2026-06-30

Background: A safe and efficient way to end pregnancies in their early stages is by medical termination of pregnancy (MTP), commonly referred to as medical abortion. Considering the increasing MTP rates in our country and their consequences on women’s health, it is important to understand the underlying determinants of women choosing MTP in India. Hence this study was carried out is to assess contraceptive practices, the antenatal and socio-demographic determinants among women undergoing MTP in a tertiary care hospital.

Methods: This was a hospital based cross-sectional study conducted in Obstetrics and Gynaecology ward of a tertiary care hospital in Nagpur, Maharashtra from July 2025 to October 2025 among 185 women undergoing MTP. Association between categorical variables was analyzed using Chi-square test and Fisher’s exact test.

Results: The most common reason for undergoing MTP was completed family while most common indication found was non usage of contraceptives. Age, socioeconomic status, gestational age, previous abortion, and spacing between pregnancies showed significant associations with indication for MTP.

Conclusions: The findings highlight the need for strengthening contraceptive services and addressing behavioural and social barriers to reduce unintended pregnancies. Based on the above research findings, we recommend that a comprehensive counseling should be provided at all contact points, especially during antenatal visits, postnatal care, and post-abortion services to promote informed contraceptive choices including awareness programs for husbands.

Impact of a structured AI awareness session on knowledge and attitude of undergraduate medical students in Maharashtra: an interventional study

Preeti Pawde — 2026-06-30

Background: Artificial intelligence (AI) is rapidly transforming healthcare, necessitating that future medical professionals possess adequate knowledge and a positive attitude towards its integration. This study aimed to assess the impact of a structured AI awareness session on the knowledge and attitude of first-year MBBS students in Maharashtra.

Methods: An interventional study was conducted on 600 first year MBBS students from six medical colleges in Maharashtra over a period of seven months. A pre-test/post-test design was employed. Participants completed a validated questionnaire assessing their knowledge and attitude towards AI in medicine before and after a standardized, structured AI awareness session. The difference in the means of pre-intervention scores and post-intervention scores were analyzed for statistical significance using ‘paired t-test’ (‘p’ value <0.05 considered significant).

Results: The mean pre-intervention knowledge score was 41.22±7.42 (out of 100), which significantly increased to 72.45±8.78 after the intervention (t=-150.73, p<0.001). Similarly, the mean pre-intervention attitude score was 3.10±0.40 (on a 5-point Likert scale), which significantly improved to 4.29±0.47 post-intervention (t=-101.18, p<0.001). Significant improvements were observed across all the participants of six medical colleges across Maharashtra.

Conclusions: The structured AI awareness session significantly improved both the knowledge and attitude of first-year MBBS students towards AI in medicine. These findings underscore the importance of integrating AI education into the undergraduate medical curriculum to prepare future doctors for the evolving healthcare landscape.

Financial burden of intranatal care services: a study in Hassan district, Karnataka

Dhasharatha K. T. — 2026-06-30

Background: In India, the financial burden of institutional delivery remains a major barrier to equitable maternal healthcare access. Significant cost disparities between public and private healthcare centres create substantial barriers, particularly for economically vulnerable households. Out-of-pocket expenditure on delivery care is a key driver of catastrophic health expenditure (CHE) among Indian households.

Methods: A cross-sectional study was conducted including 415 mother who experienced institutional delivery. Cost data were classified into total direct and total indirect delivery costs. Statistical analysis used Welch’s t-test for comparing group means and Cohen’s d for effect size assessment. CHE was defined as total delivery cost exceeding 10% of household’s annual income.

Results: The average direct cost of normal deliveries in private healthcare centres (₹34,270) was 48.5-fold higher compared to public healthcare centres (₹706). For caesarean deliveries, the average direct expense in private healthcare centres (₹69,981) was around 42 times greater than in public healthcare centres (₹1,647). However, total indirect expenses showed no statistically significant variation across centres and delivery types (normal delivery, p=0.189; caesarean delivery, p=0.081). CHE occurred in 56% of private healthcare centres users compared to 8% of public healthcare centres users. For cesarean deliveries, CHE occurred in 64.4% of private healthcare centres cases versus 11.8% in public healthcare centres.

Conclusions: This study identified higher CHE in private healthcare centres; therefore, the government should regulate delivery costs in private healthcare centres and enhance quality facilities in public healthcare centres, and creating public awareness to promote their utilization.

Comparative assessment of anthropometric parameters, body mass index and vital signs among school children and college students

M. Ismail M. Ibrahim — 2026-06-30

Background: The present study highlights comparative evaluation of anthropometric measurements, Body mass index (BMI), and vital parameters among school children (6^th-7th standard) and college students.

Methods: A total of 69 students were included, comprising 50 school children and 19 undergraduate students. Parameters such as height, weight, BMI, heart rate (BPM), and oxygen saturation (SpO₂) were recorded and analyzed.

Results: The results showed significant differences in anthropometric characteristics between the two groups, reflecting normal growth and developmental progression. College students exhibited higher mean height (5.26±0.33 ft) and weight (49.53±10.70 kg) compared to school children (4.40±0.27 ft and 27.32±5.92 kg, respectively). The mean BMI of college students (19.92±3.54) fell within the normal adult range, while school children showed a lower mean BMI (15.78±2.83), consistent with age-related standards. However, instances of undernutrition were observed in both groups. Vital parameters revealed slightly higher mean heart rate in college students (103.47±15.41 BPM) compared to school children (100.00±12.03 BPM), possibly influenced by situational factors. Oxygen saturation levels were within normal limits for both groups, indicating overall good respiratory health.

Conclusions: The findings highlight the coexistence of undernutrition and overweight conditions, reflecting the emerging double burden of malnutrition. This study underscores the importance of regular health monitoring and targeted nutritional interventions in educational institutions. Future studies with larger and more diverse populations are recommended to better understand the determinants of health in different age groups.

Anxiety and depression: prevalence and correlates among undergraduate students of a government nursing college of Murshidabad District, West Bengal

Ophelia Mukherjee — 2026-06-30

Background: Mental health issues, particularly anxiety and depression, have become significant concerns among college and university students worldwide. Nursing students, due to their unique academic and clinical training stressors, are particularly vulnerable. The present study aimed to estimate the prevalence and correlates of anxiety and depression among undergraduate nursing students of a Government Nursing College in Murshidabad, West Bengal.

Methods: An institution based descriptive cross-sectional study was conducted during August-November 2024 among a calculated sample of 160 nursing students selected through stratified random sampling. A pre-designed and pre-tested schedule; validated tools- patient health questionnaire-9 (PHQ-9) for depression and generalized anxiety disorder-7 (GAD-7) for anxiety were used for data collection. Descriptive statistics were used to estimate the prevalence, while bi-variate and multivariable logistic regression was performed to identify significant correlates.

Results: The mean (±SD) age of participants was 20.82 (±1.41) years. The prevalence of depression (PHQ-9≥10) and anxiety (GAD-7≥10) was 48.8%, and 40.6% respectively. Perceived academic workload, conflict with friends/roommates, perceived adequacy of sleep and familial financial vulnerability were significantly associated with both depression and anxiety. Only familial financial crisis/vulnerability appeared as significant predictor for both depression (aOR 2.652; CI: 1.252-5.618) and anxiety (aOR 2.657; CI: 1.254-5.631).

Conclusions: Depression and anxiety are quite prevalent among nursing students with some of the familial and personal attributes emerging as significant correlates. These findings highlight the need for targeted mental health interventions, including stress management, peer support systems and institutional strategies to enhance student well-being.

A cross-sectional study on the prevalence of respectful maternal care among postnatal women during facility-based childbirth in a tertiary care centre in Bihar, India

Dipti Das — 2026-06-30

Background: Respectful maternal care (RMC) protects pregnant women’s rights to maintain dignity and respect, ensuring appropriate, supportive care and autonomy. This study aimed to explore the prevalence of RMC in a tertiary healthcare setting and investigate its association with sociodemographic and obstetric variables.

Methods: A cross-sectional descriptive study design was conducted using a convenience sampling method. RMC was assessed among postnatal mothers using the standard Indian Person-Centred Maternity Care (PCMC) tool through face-to-face interviews conducted between mid-January and mid-March 2025. The data were analysed using SPSS version 25, calculating means±SD and frequency percentage distributions, and the chi-square test.

Results: In this study, it was found that the mean value of the PCMC score was 76.25% and 54% of women received adequate RMC. The most deficient domains were communication and autonomy, followed by supportive care. Women reported experiences of verbal abuse (23.3%), physical abuse (1.9%), feeling exposed with a lack of privacy during examinations (47%), providers never introducing themselves (36.7%), and delays in receiving treatment (78.1%). Moreover, 78.6% of women said they were never allowed to choose a birth companion during delivery. RMC was significantly associated with religion (p<0.05, df=1 at the 95% confidence level). It reflects the influence of religious diversity on experiences of disrespect.

Conclusions: The prevalence of RMC was only 54%. Therefore, healthcare providers require training to upgrade their communication skills and supportive care for women, which will improve access to quality public health services.

Awareness and knowledge of growth charts among mothers of children under 24-months attending a tertiary care paediatric outpatient department in Puducherry: a cross-sectional study

Anithadevi Kumaravel — 2026-06-30

Background: Growth charts are essential tools for monitoring child growth and early detection of malnutrition. Maternal awareness and knowledge regarding growth charts play a crucial role in ensuring appropriate child health practices.

Methods: A cross-sectional study was conducted among 110 mothers of children under 24 months attending the Paediatric outpatient department (OPD) of a tertiary care teaching hospital in Puducherry (Sri Lakshmi Narayana Institute of Medical Sciences and Hospital) from April 1, 2025, to June 30, 2025. Data were collected using a structured questionnaire. The Chi-square test and multivariable logistic regression were used to assess associations. A p<0.05 was considered statistically significant.

Results: Among the participants, 46 (41.8%) mothers were aware of growth charts, while 78 (70.9%) had adequate knowledge of them. Maternal education was significantly associated with both awareness and knowledge (p<0.001). Socio-economic status was also significantly associated with awareness (p=0.028). Other variables such as age, occupation, number of children, child age, and sex were not significantly associated.

Conclusions: The study highlights a gap between awareness and knowledge of growth charts among mothers. Maternal education emerged as the key determinant influencing both awareness and knowledge. Strengthening awareness through targeted health education is essential to improving growth monitoring practices.

Prevalence and patterns of self-medication for oral health problems among dental college patients in Mangalore, Karnataka: a cross-sectional study

Manish Nayak — 2026-06-30

Background: Self-medication for dental problems is a widely prevalent practice, particularly in developing countries, yet localized evidence from urban dental settings in India remains limited. This study aimed to assess the prevalence, patterns, and determinants of self-medication for oral health problems among patients attending a dental college hospital in Mangalore, Karnataka.

Methods: A hospital-based cross-sectional questionnaire study was conducted among 262 patients attending the outpatient department of a dental teaching hospital. Data were collected over a two-month period using a structured and pre-validated questionnaire and analysed using descriptive statistics.

Results: Self-medication was reported by 65.3% of participants. Toothache (71.3%) was the most common reason, followed by sensitivity (13.5%) and oral ulcers (11.1%). Home remedies (38.6%) and analgesics (33.9%) were most frequently used, while 16.4% reported antibiotic use. Pharmacies (56.7%) and the internet (29.2%) were the main sources. Although 63.2% eventually consulted a dentist, awareness regarding risks such as antibiotic resistance (37.8%) remained limited.

Conclusions: Self-medication for dental problems is highly prevalent, with notable antibiotic misuse and poor awareness. Public education, improved access to affordable dental care, and stricter regulation of drug sales are needed.

Effectiveness of Kinesio taping along with core strengthening exercises on diastasis recti abdominis following full term normal delivery in primiparous females: an experimental study

Saee Sohoni — 2026-06-30

Background: Diastasis recti abdominis (DRA) is a common musculoskeletal condition in postpartum women which is characterized by separation of the rectus abdominis muscles due to stretching of the linea alba. It affects functional stability, posture, and quality of life. Conservative physiotherapy interventions such as core strengthening exercises and Kinesio taping (KT) have shown potential benefits. However, limited literature exists on their combined effect in primiparous females following normal vaginal delivery.

Methods: This experimental study included 33 primiparous females aged 18–35 years, in 4–6 weeks postpartum period following full-term normal delivery. The participants were selected using purposive sampling. Baseline diastasis recti abdominis was measured using Vernier calipers. All the participants underwent a 4-week intervention consisting of Kinesio taping along with progressive core strengthening exercises. Post-intervention measurements were recorded, and data were analyzed using the Wilcoxon signed rank test.

Results: The mean pre-intervention DRA value was 3.17±0.47 cm, which reduced to 2.79±0.38 cm post-intervention. Statistical analysis showed a significant reduction in the inter-recti distance (W=465, p<0.001), with a mean difference of 0.40 cm (95% CI: 0.35-0.50). The effect size was large (r=1), indicating strong clinical significance.

Conclusions: The combination of Kinesio taping and core strengthening exercises is effective in reducing diastasis recti abdominis in primiparous females following a full term normal vaginal delivery. This combined intervention can be recommended as a non-invasive and clinically effective approach for postpartum rehabilitation.

Profile of Enterococcus species isolated from cases of urinary tract infections in a tertiary care hospital in Uttar Dinajpur: a retrospective study

Arup Roy — 2026-06-30

Background: Urinary tract infection (UTI) is a leading cause of morbidity and mortality worldwide. Enterococcus species is a commensal in our gastrointestinal tract and a leading cause of UTI in humans. Enterobacterales group were the common organisms causing UTI, but in the recent years there is increase in prevalence of other organisms. This retrospective study was undertaken to understand the profile of Enterococcus species causing UTIs and their antibiogram.

Methods: This study was conducted in the department of microbiology, Raiganj Government Medical College for a period of 1 year from January 2025 to December 2025. Urine samples were received in sterile universal containers and cultured using standard precautions in Hichrome UTI agar. Identification (ID) and antibiotic susceptibility testing (AST) were performed by using Vitek II ID and AST cards.

Results: Out of 2908 urine samples received, 356 (12.2%) showed growth of organisms. Out of 356 isolates, the most common isolate was Escherichia coli 41.0%, followed by Enterococcus species 30.6%. Among the Enterococcus species, E. faecalis were 76.1% and E. faecium 23.9%. The most sensitive antibiotic was linezolid showing 100% susceptible, followed by teicoplanin 89.9% susceptible. The Enterococcus species were highly resistant to ampicillin. The prevalence of VRE was found to be 25.6%.

Conclusions: The increase in drug resistance and treatment failure makes it important for proper identification and AST for targeted therapy. Proper diagnosis and starting treatment at correct time will decrease the morbidity and mortality related to these infections in humans.

Sleep disturbances and their association with intrinsic capacity in older adults: insights from the longitudinal aging study in India

Shreya Biswal — 2026-06-30

Background: Intrinsic capacity (IC), encompassing cognition, locomotion, sensory function, vitality, and mood, is a key indicator of healthy aging. Sleep problems are common among older adults and may contribute to functional decline, but evidence from low- and middle-income countries is limited.

Methods: We analysed cross-sectional data from 27,395 community-dwelling adults aged ≥60 years from the longitudinal aging study in India (LASI). IC was assessed across five domains, and an IC score was generated on a scale of 0 to 10. Sleep problems were evaluated using self-reported difficulty falling asleep, nighttime awakenings, early morning awakenings, feeling unrested during the day, and daytime napping.

Results: The median age of participants was 67 years (IQR 63-72), and 51.7% were female. Regarding sleep, 19.8% reported trouble falling asleep, 23.2% experienced nighttime awakenings, 21.6% reported early morning awakenings, 20.5% felt unrested during the day, and 28.6% reported daytime napping. Older adults with difficulty initiating sleep, waking at night, waking too early, or feeling unrested during the day had significantly lower median IC scores compared with those without these problems (all p<0.001). Daytime napping was positively associated with IC (β=0.123, p<0.001).

Conclusions: Sleep disturbances are associated with reduced intrinsic capacity among older Indian adults, highlighting the importance of sleep assessment in geriatric care. Daytime napping may have a supportive role in maintaining functional capacity. Interventions targeting sleep could be a modifiable pathway to promoting healthy aging in this population.

Prevalence of occupational health hazards, stress level and associated factors among traffic police officers in Delhi: a cross-sectional study

Kalpana Verma — 2026-06-30

Background: Traffic police officers are routinely exposed to adverse environmental, ergonomic, and psychosocial conditions due to prolonged outdoor duties, vehicular pollution, noise, and occupational stress. These exposures place them at increased risk of physical, social, and mental health problems, particularly in metropolitan cities such as Delhi. Objectives were to assess the prevalence of occupational health hazards and perceived stress among traffic police officers and to determine the association between stress and selected demographic variables.

Methods: A quantitative descriptive cross-sectional study was conducted among 140 traffic police officers working in selected regions of Delhi. Participants were selected using purposive sampling. Data were collected using a self-structured questionnaire assessing occupational health hazards and the perceived stress scale-14 (PSS-14). Descriptive and inferential statistics were used for analysis.

Results: Occupational health hazards were reported by 37.9% of participants. Mental health hazards were most prevalent (80.83%), followed by social (74.84%) and physical hazards. Common physical problems included respiratory, gastrointestinal, eye, and musculoskeletal complaints. The mean perceived stress score was 15.89, indicating overall low stress. Low stress was reported by 62.9% of officers, moderate stress by 35.7%, and high stress by 1.4%. Stress levels were significantly associated with education (p=0.014) and substance use (p=0.047).

Conclusions: Traffic police officers face considerable occupational health risks, particularly related to mental and social well-being. Regular health screening, stress management interventions, and enforcement of occupational safety measures are recommended.

Evaluating the impact of human assistance in wayfinding experience of outpatient visitors in a tertiary healthcare centre

Mustansir Abbas Ali — 2026-06-30

Background: Effective wayfinding is essential in large healthcare facilities, where complex layouts, crowded environments, and frequent structural changes often create confusion for first-time visitors. Despite the availability of signage and digital tools, many patients still struggle to navigate outpatient departments efficiently. This study aimed to compare wayfinding experiences among first-time outpatient visitors who received human assistance with those who navigated without such support in a tertiary care teaching hospital.

Methods: An analytical cross-sectional study was conducted across outpatient departments of Gandhi Medical College, Bhopal. A total of 336 first-time visitors were recruited through consecutive sampling. Data were collected using a validated semi-structured questionnaire administered during exit interviews. Participants were categorized based on whether they received human assistance while finding their destination. Descriptive statistics and comparative analyses were performed, followed by multivariate regression to identify factors associated with seeking human assistance.

Results: Among all participants, 69.6 percent relied on human assistance for navigation. Difficulty locating signage, language barriers, and confusion were the most common challenges reported. Participants who took longer than ten minutes to reach their destination were significantly more likely to seek help. Higher educational attainment showed a strong association with requesting assistance, while labourers were less likely to do so compared to salaried individuals. Stress levels also influenced help-seeking behaviour.

Conclusions: The study highlighted the continued importance of human navigators in improving wayfinding in busy hospital settings. Although signage and maps are useful, they often fall short in dynamic environments. Integrating trained personnel into wayfinding systems may enhance patient experience, reduce delays, and support smoother outpatient flow.

Impact of traditional Indian practices combined with modern medicine on physiological and lifestyle parameters in reproductive-age women with polycystic ovarian disease: a comparative interventional study

Kasthuri A. — 2026-06-30

Background: Polycystic ovarian disease (PCOD) is a most common endocrine disorder among women of reproductive age, closely linked to metabolic, lifestyle, and psychological factors. This study investigated the additional impact of incorporating selected ancient traditional Indian practice mindfulness of the Mooladhara chakra and Kayakalpa yoga- alongside MMRT. Objective was to compare changes in physiological and lifestyle parameters over one year between two groups of PCOD women- those receiving only MMRT (group 1) and those receiving yogic intervention as an adjunct to MMRT (group 2).

Methods: A one-year comparative interventional study was conducted on 131 women aged between 15 to 45 years, diagnosed with PCOD using Rotterdam’s criteria. Group 1 (n=63) received MMRT alone, while group 2 (n=68) received MMRT plus the Mooladhara chakra and Kayakalpa yogic intervention were given and assessed.

Results: Both groups were demographically comparable. Group 2 showed a clinically meaningful decrease in BMI, waist-hip ratio, HbA1c, and ovarian volume. Menstrual regularity and ovulation rates significantly improved in group 2 (p<0.001). Lifestyle improvements including reduced junk food intake, better protein intake, improved sleep and healthier oil usage were more prominent in group 2.

Conclusions: Integrating traditional yogic practices with standard medical therapy offers multidimensional benefits in PCOD management. While not a substitute for pharmacologic treatment, these interventions effectively support metabolic, hormonal, and lifestyle regulation. Further research with larger samples and randomized design is recommended to validate these findings.

Maternal and newborn health services in urban Andhra Pradesh: a household assessment

Sudhakara Reddy Muthyala — 2026-06-30

broader socio-economic and healthcare landscape. Despite initiatives, maternal mortality and morbidity persist due to inadequate access to healthcare services, delayed care, socio-cultural practices, and lack of awareness. In light of the persistence of maternal mortality and morbidity, the Commissioner of Health and Family Welfare (CH&FW), Andhra Pradesh (AP), has directed the lady health visitor (LHV) trainees of the Regional Training Centre (female) RTC (F), Kurnool, to conduct a household survey.

Methods: Data were collected using a pretested interview schedule communicated by the CH&FW, AP, via convenience sampling. Statistical analysis was performed using statistical package for the social sciences (SPSS) 21.0, and the chi-square test was used; a p<0.05 was considered statistically significant.

Results: The majority of households are Hindu (76%), BPL (80.8%), daily labourers (52.7%), and illiterate (35.5%). 98.1% have a pucca house, and 98.9% have a toilet. Among all pregnant women, 94% are registered before 12 weeks of pregnancy, 97% have ABHA, 60% have used only JSSK and 102 services, and 88% are planned for a safe birth. All deliveries have taken place in the hospitals. Of all respondents, 23.3% suffered from NCDs, and 6.7% incurred out-of-pocket expenses.

Conclusion: This study has compared the health indicators of the study region, with those at the state and national levels; however, the comparison is not suggestive. Anyhow, this study has highlighted gaps in the implementation of maternal and newborn health services. This study serves as an eye-opener for those who set common targets for all regions and a roadmap for policymakers to identify better strategies to improve maternal and newborn healthcare services.

Evaluation of knowledge, attitude and practice among different groups of health-care workers towards the transmission of blood-borne pathogens in a tertiary care hospital in Delhi

Maansi Mudgil — 2026-06-30

Background: Healthcare workers (HCWs) are at increased risk of acquiring blood-borne infections such as HIV, hepatitis B, and hepatitis C due to occupational exposure. Assessment of knowledge, attitude, and practice (KAP) towards standard precautions is essential to reduce this risk.

Methods: This cross-sectional study included 317 HCWs (doctors, nurses, and technicians) in a tertiary care hospital. Data were collected using a structured questionnaire assessing KAP. Scores were categorized as good (≥80%), moderate (50-79%), and poor (<50%). Anti-HBs titres were estimated using ELISA. Statistical analysis was performed using chi-square test and descriptive statistics, with p<0.05 considered significant.

Results: Good knowledge was observed in 82.7% of doctors, 51.4% of nurses, and 10% of technicians (p=0.001). A positive attitude was noted in 78.7% of doctors, 76.6% of nurses, and 50% of technicians (p=0.001). Practice showed variability, with 79.4% completing hepatitis B vaccination; however, only 54% had assessed anti-HBs titres. Occupational exposure was reported by 50.7% of doctors, 71% of nurses, and 26.7% of technicians. Among exposed individuals, only 63% completed post-exposure prophylaxis. Unsafe practices such as needle recapping persisted in 34% of HCWs.

Conclusions: Significant gaps in KAP, particularly among technicians, highlight the need for regular training, reinforcement of standard precautions, and monitoring of vaccination and immunity status to reduce occupational risk.

Frequency and determinants of missed appointments in the outpatient clinics of a tertiary care Hospital

Sumit Yadav — 2026-06-30

Background: Missed outpatient appointments remain a major challenge in healthcare delivery, leading to inefficient resource utilization, longer waiting times and disrupted continuity of care. This descriptive cross-sectional study assessed the rate and factors contributing to missed appointments among patients attending the outpatient department of a tertiary care hospital.

Methods: A total of 100 patients who missed their scheduled appointments were included. Data were collected using a structured questionnaire and analyzed using SPSS version 26 with descriptive statistics, chi-square tests and Pearson’s correlation.

Results: Most participants were urban residents (66%), aged 25–40 years (61%) and self-employed or employed in small private enterprises (60%). Forgetfulness (mean=4.05) and lack of appointment reminders (mean=4.00) were the leading reasons for non-attendance. No significant association was found between appointment reminders or work-related obligations and missed appointments (p>0.05). However, forgetfulness showed a significant positive correlation with missed appointments (r=0.392, p<0.001). Distance from the hospital was not significantly associated with non-attendance (p=0.525).

Conclusions: Behavioural and healthcare system–related factors, particularly forgetfulness and limited rescheduling flexibility, had a greater influence on missed appointments than demographic or geographic factors. Strengthening reminder systems, simplifying rescheduling and improving patient awareness may enhance appointment adherence and outpatient efficiency.

Perceived dietary adherence and its barriers to dietary recommendations among type 2 diabetes mellitus patients in Mysuru city: a cross-sectional study

Jesymol Joy — 2026-06-30

Background: Type 2 diabetes mellitus (T2DM) is a major public health challenge requiring long-term lifestyle modifications. Dietary adherence is essential for effective disease management, yet many patients struggle to follow recommended dietary practices due to sociocultural, behavioral and economic barriers, especially in low- and middle-income countries. To assess perceived dietary adherence to dietary recommendations among T2DM patients in Mysuru City, identify barriers to adherence and factors associated with it.

Methods: A community-based cross-sectional study was conducted from April to October 2025 among 300 T2DM patients aged ≥18 years, diagnosed for more than 6 months and attending primary health centers in Mysuru. Simple random sampling was employed. Data were collected using a semi-structured questionnaire and the validated Perceived Dietary Adherence Questionnaire (PDAQ). Statistical analysis was performed using SPSS, with p < 0.05 considered significant.

Results: The mean age was 54±9.37 years; 55.1% were male, 91.3% Hindu and 86% from nuclear families. Dietary adherence was poor in 27.8%, moderate in 54.2% and good in 18%. Common barriers influencing adherence included difficulty following dietary recommendations during social or work-related events, lack of dietary education, financial constraints, stress and low motivation. Significant associations were observed between dietary adherence and age, educational status, duration of diabetes, BMI, smoking and alcohol consumption.

Conclusions: Dietary adherence among patients with T2DM remains suboptimal and is strongly influenced by sociocultural and behavioral factors. Comprehensive, culturally appropriate and patient-centered dietary counseling along with behavioral and family support strategies are essential to improve adherence and diabetes-related outcomes.

Complementary feeding practices and their determinants among children aged 6–23 months in Aligarh, North India

Jhilmil Agrawal — 2026-06-30

Background: Appropriate complementary feeding during the first two years of life is essential for optimal growth, development and prevention of malnutrition. This study assessed complementary feeding practices and identified their determinants among children aged 6–23 months.

Methods: This baseline assessment of a community-based quasi-experimental study included children aged 6–23 months. Data were collected using a pretested semi-structured questionnaire based on WHO infant and young child feeding guidelines. Information on socio-demographic characteristics and feeding practices was obtained. Minimum meal frequency (MMF), minimum dietary diversity (MDD) and minimum acceptable diet (MAD) were assessed. Multivariable logistic regression analysis was performed to identify determinants of inappropriate feeding practices and adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated.

Results: MMF was achieved by 83.5% of children, whereas MDD and MAD were achieved by only 17.25% and 14.25%, respectively. Children aged 13–23 months had lower odds of inappropriate MMF (OR=0.375, CI: 0.179–0.784; p=0.009), MDD (OR=0.189, CI: 0.067–0.533; p=0.002) and MAD (OR=0.189, CI: 0.055–0.654; p=0.009). Normal birth weight was associated with lower odds of inappropriate MDD (OR=0.264, CI: 0.105–0.663; p=0.005) and MAD (OR=0.218, CI: 0.074–0.639; p=0.006). Lack of mass media exposure increased the odds of inappropriate MDD (OR=2.382, CI: 1.222–4.646; p=0.011) and MAD (OR=2.556, CI: 1.306–5.001; p=0.006). Non-overcrowding reduced the odds of inappropriate MDD (OR=0.429, CI: 0.220–0.839; p=0.013) and MAD (OR=0.341, CI: 0.176–0.659; p=0.001), while Muslim religion (OR=2.246, CI: 1.092–4.622; p=0.028) and higher maternal education (OR=6.533, CI: 1.437–29.704; p=0.015) were associated with inappropriate MMF.

Conclusions: Complementary feeding determinants can guide targeted social and behaviour change communication interventions to improve feeding practices and nutritional outcomes among young children.

Predictors and incidence of intraoperative and postoperative complications in infant pyloromyotomy: a meta-analysis

Osman Suliman — 2026-06-30

Infantile pyloromyotomy remains the definitive surgical treatment for hypertrophic pyloric stenosis (HPS). While generally considered safe and effective, both intraoperative and postoperative complications can arise, impacting patient recovery and overall outcomes. This meta-analysis aimed to evaluate the incidence systematically and identify predictors of intraoperative and postoperative complications associated with infantile pyloromyotomy. A comprehensive systematic literature search was performed across PubMed, Embase, Scopus, and the Cochrane Library (Jaunary2016 to March 2026) to identify studies reporting intraoperative and postoperative complications after infantile pyloromyotomy. Eligible studies included randomized controlled trials, prospective and retrospective cohort studies, and observational analyses. Two independent reviewers extracted data on complication types, incidence rates, and potential risk factors. Pooled incidence rates were calculated using random-effects meta-analysis models, and subgroup analyses investigated the influence of surgical approach (open vs. laparoscopic), patient characteristics (e.g., prematurity, low birth weight), and surgeon experience. Across included studies, the overall pooled incidence of complications ranged from X-Y%. The most frequently reported complications included mucosal perforation, incomplete pyloromyotomy, wound infection, and persistent postoperative vomiting. Significant predictors of increased complication risk identified were prematurity, low birth weight, presence of coexisting comorbidities, and lower surgeon experience. Both open and laparoscopic pyloromyotomy methods had similar overall safety profiles, but there were some small differences in the types of complications that occurred with each method. Infantile pyloromyotomy is still a safe procedure with low rates of serious complications. Identification and awareness of both patient and procedure related risk factors are crucial for optimizing surgical planning, enhancing patient outcomes, and facilitating comprehensive parental counseling. Future high quality, multicenter prospective studies are warranted to further refine risk stratification models and optimize perioperative management protocols.

Personal hygiene among school children in India: a meta-analysis

Mohammed Ismail — 2026-06-30

Good personal hygiene is essential for overall well-being, and it starts from a school age. As parents, it is our responsibility to teach our children the importance of maintaining body healthy. Majority of people, especially school-aged children, suffer from the various diseases, such as scabies, periodontitis, and tooth decay. The Unani system of medicine (USM) put a lot of emphasis on good oral health. Aim was to conduct a meta-analysis of different observational studies to assess school children’ personal hygiene and to highlight the possible management and preventive measures of oral diseases through school health programme, education and health policies. Relevant cross-sectional observational studies were included to assess the level of knowledge and awareness regarding Personal hygiene among school children. Data source was electronic and manual search of scientific databases like Google Scholar, PubMed, MEDLINE, and EMBASE. Data selection was 10 studies out of 25 were finally included. Children who have studding in primary to high school. This many studies shows that oral health and knowledge among children was low, oral health practices are poor that can lead many oral health problems like tooth decay, gingivitis and dental caries. Study shows 5.33% children use tooth powder, 7.33% children use coal, ash, neem etc., only one study A. Harikaran show 23.70% children use tooth pick. Overall, about average 60% student think oral health impact on general health, and mostly study shows children not aware for oral health and hygiene and routine dental checkup.

Traumatic brain injury in infants and children: emergency management and prognostic factors – a meta-analysis

Osman Suliman — 2026-06-30

Traumatic brain injury (TBI) is a leading cause of mortality, disability, and long-term neurodevelopmental impairment in children worldwide. Despite advances in emergency and neurocritical care, optimal management strategies and prognostic factors across injury severities remain incompletely understood. The objectives of the study were to evaluate emergency management approaches, clinical outcomes, and prognostic factors associated with pediatric TBI and identify predictors of morbidity and mortality. This meta-analysis followed preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines and included studies published between January 2022 and March 2026. Randomized controlled trials, cohort studies, case-control studies, registries, and systematic reviews assessing pediatric TBI were eligible. Data on patient characteristics, injury patterns, emergency interventions, and outcomes were extracted. Random-effects models were used to calculate pooled estimates, with subgroup and sensitivity analyses performed to assess heterogeneity. Twenty-five studies were included in the qualitative synthesis, and 25 met criteria for quantitative meta-analysis. Early protocol-driven emergency care significantly improved survival (OR 1.42, 95% CI 1.18-1.71) and reduced secondary brain injury (RR 0.74, 95% CI 0.63-0.87). Prevention of hypoxia and hypotension was strongly associated with favorable neurological outcomes. Intracranial pressure monitoring and hyperosmolar therapy demonstrated benefits in severe TB.

Double burden index – measuring complex facets of malnutrition

Mrudula A. Phadke — 2026-06-11

For over the past three years, world has been facing many challenges regarding various aspects of malnutrition in children under 5 years. Similar are the experiences from Maharashtra. National Family Health Survey (NFHS) 4 and 5 data and other surveys have shown conflicting results on various subgroups of malnutrition, like stagnation of wasting, stunting and underweight decrease in some areas but increase in obesity in some population groups.

Gambling and betting in India: an interplay of history, law and public health

Akash Nagar — 2026-06-30

Gambling and betting in India have evolved from ancient cultural practices to a rapidly expanding digital industry, shaped by complex legal, economic, and public health dynamics. Historically rooted in traditional games and later influenced by colonial and modern developments, gambling regulation in India remains fragmented, with significant state-level variation. The rise of online platforms and fantasy sports has intensified participation and economic stakes, while blurring distinctions between games of skill and chance. Despite substantial government revenue and industry growth, gambling poses serious public health concerns, including addiction, financial distress, and suicide. Recent legislative efforts, including the 2025 nationwide ban on monetary online gaming, reflect increasing recognition of these harms but lack adequate provisions for prevention and rehabilitation. Persistent regulatory gaps and emerging digital monetization strategies further complicate governance. A balanced approach integrating legal reform, public health interventions, and awareness is essential to mitigate risks while addressing the socio-economic realities of gambling in India.

Regenerative dentistry across specialties: current evidence, clinical relevance and translational limitations

Almiqdad Dashti — 2026-06-06

Regenerative dentistry covers a range of biologically based approaches rather than a single treatment model. This comprehensive review examined the main regenerative domains in contemporary dentistry, including periodontal regeneration, alveolar bone regeneration, pulp–dentin regeneration and regenerative endodontics, pediatric applications, orthodontic relevance, prosthodontic site development, and the role of biomaterials and tissue-engineering strategies. Literature from PubMed, Scopus, and Web of Science was reviewed and interpreted comparatively according to target tissue, biologic aim, representative interventions, outcome measures, and degree of clinical support. The evidence showed clear variation across domains. Periodontal regeneration had the strongest clinical support, particularly in well-selected intrabony defects. Regenerative endodontic procedures offered important advantages in immature teeth, especially with respect to continued root development, although uncertainty remained regarding the exact nature of the tissue formed. Alveolar bone procedures were clinically useful for ridge preservation and site development, but volumetric improvement could not be assumed to represent true regeneration. In pediatric dentistry, regenerative strategies appeared especially relevant because of the healing potential of developing tissues. By contrast, orthodontic and prosthodontic applications were better understood as adjunctive uses of regenerative principles that support periodontal stability, tissue contour, and restorative planning. Overall, regenerative dentistry is best viewed as a field of uneven but meaningful clinical progress, with its strongest support in selected periodontal and endodontic applications.

Implementation determinants of national antimicrobial resistance strategies: a comparative policy analysis of the Russian federation and Nigeria

Muqadas B. Raheem — 2026-06-30

Antimicrobial resistance (AMR) policies implementation across national health systems is still poorly understood, despite the growing global health burden. A comprehension of how different countries implement AMR policies will help identify effective and context-sensitive control measures. A comparative scoping review was carried out in accordance with PRISMA Scoping Review guideline. Grey literature and structured database searches were employed to find peer-reviewed literature, national policy documents, and institutional reports released between 2010 and 2025. The One Health framework served as the basis for the analysis, which encompassed cross-sectoral coordination, pharmaceutical regulation, antimicrobial stewardship, governance structures, surveillance systems, and funding sources. The findings were narratively synthesised, with a focus on implementation capacity rather than policy formulation. National action plans that were in conformity with the WHO Global action plan were adopted by both nations in 2017; however, their implementation approaches were substantially different. Integrating stewardship and prescription control into formal institutional structures proved practicable in the Russian Federation, with centralised governance authority, structured surveillance advancement, and continuous domestic funding. Implementation of AMR in Nigeria operates in a setting of poorly coordinated government, weak enforcement, donor-dependent funding, a dysfunctional medical sector and weak data-to-policy correlation. Implementation performance across domains is more about institutional coherence than policy alignment in isolation. AMR containment is essentially an implementation challenge. Cross-country analysis highlights phased adaptation to institutional capabilities rather than direct replication of external policy models.

Quality of life in individuals with lower limb amputation: an integrative review

Uma Phalswal — 2026-06-30

Lower limb amputation (LLA) is a life-altering condition that significantly affects the physical, psychological and social well-being of individuals. With the increasing global prevalence of LLA due to diabetes, trauma and vascular diseases, understanding the quality of life (QoL) among affected individuals has become essential. This integrative review synthesized evidence on QoL in adults with LLA and identified major influencing factors. A systematic search of PubMed, CINAHL, Scopus, Embase and Google Scholar was conducted for studies published between 2013 and 2025. Peer-reviewed studies involving adult LLA patients and assessing QoL using standardized tools such as SF-36 and WHOQOL-BREF were included. Ten eligible studies were critically appraised using JBI tools and narratively synthesized. The findings revealed that QoL among LLA patients was generally reduced, particularly in psychological and social domains. Important determinants included gender, level of amputation, prosthesis use, pain, comorbidities, and social support. Male participants and individuals with below-knee amputations reported better QoL outcomes. Prosthesis use and strong social support were associated with improved mobility, independence and overall well-being, whereas pain, comorbid conditions and lack of support negatively affected QoL. Cultural and regional differences also influenced QoL perceptions. The review highlights the need for holistic, gender-sensitive and culturally appropriate rehabilitation strategies, emphasizing psychosocial support, prosthetic accessibility and regular QoL assessment to improve overall well-being in LLA patients.

Global research on tobacco taxation and pricing policies: trends, themes and collaboration: a bibliometric analysis

Vanessa Ravel — 2026-06-30

Tobacco taxation is widely recognised as one of the most effective and cost-effective strategies for reducing tobacco consumption and associated health harms. Despite strong global evidence supporting tobacco taxation and its endorsement within the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC), the implementation and research emphasis on tobacco tax and price policies have varied considerably across regions and over time. To examine the evolution of this field, a bibliometric analysis was conducted using publications indexed in the Scopus database between 1965 to 31 December 2024. A total of 8,058 eligible documents were analysed using the Bibliometrix R package, Biblioshiny, and VOSviewer. Bibliometric indicators included annual scientific production, citation impact, author productivity, country-level contributions, international collaboration networks, keyword co-occurrence, thematic mapping, and thematic evolution. The findings demonstrated a sustained increase in tobacco taxation research, with a marked surge in publications after 2015, although research output remained predominantly concentrated in high-income countries. Keyword co-occurrence and thematic analyses identified three major interconnected research clusters encompassing behavioural and epidemiological studies, product-focused nicotine research, and policy-oriented economic interventions. Taxation, price, and public policy emerged as the most central and rapidly expanding themes within the literature. The global evidence base has evolved toward a more integrated, policy-oriented, and equity-focused research agenda; however, substantial geographic and contextual evidence gaps persist, underscoring the need to strengthen research capacity and international collaboration in low- and middle-income countries (LMICs) to support effective and equitable tobacco tax policies.

Prevalence, risk factors and quality of life in gestational diabetes mellitus: a scoping review

Priyanka Pandey — 2026-06-30

Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with adverse maternal and neonatal outcomes. Its burden is increasing globally, particularly in low- and middle-income countries. Beyond physical health impacts, GDM may also affect the quality of life (QoL) of pregnant women; however, evidence on this aspect remains limited. This scoping review aimed to map existing evidence on the prevalence of GDM, associated risk factors and quality of life among women diagnosed with GDM. The review followed Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Electronic databases including PubMed and Google Scholar were searched for studies published in English between 2010 and 2025. Observational studies, systematic reviews and narrative reviews reporting on prevalence, risk factors or quality of life related to GDM were included. Eleven studies met the inclusion criteria. Reported prevalence ranged from 9.7%-37.6%, with higher prevalence observed in Asian populations and hospital-based studies. Common risk factors included advanced maternal age, obesity, family history of diabetes, previous GDM and hypertension. None of the included primary studies assessed quality of life using validated instruments. The review concludes that GDM is a growing public health concern, but evidence regarding quality of life among affected women remains scarce, highlighting the need for future research incorporating standardized QoL assessments.

Beyond pregnancy: life-course management of gestational diabetes mellitus and its intergenerational impact: comprehensive review

Vidyashri R. — 2026-06-30

Gestational diabetes mellitus (GDM) is a common metabolic disorder occurring during pregnancy and is increasingly recognized as a major public health concern due to its long-term implications for both mothers and their offspring. Although traditionally considered a temporary condition limited to pregnancy, growing evidence suggests that GDM is an early indicator of future metabolic disorders, including type 2 diabetes mellitus, metabolic syndrome and cardiovascular disease. This review aimed to examine the life-course management of gestational diabetes mellitus and explore its intergenerational impact on maternal and offspring health. A comprehensive literature review was conducted using electronic databases including PubMed, Scopus, Web of Science, CINAHL and Google Scholar. Relevant studies published between 2000 and 2024 were identified using keywords related to gestational diabetes, postpartum management, life-course approach and intergenerational health outcomes. The findings indicate that women with a history of GDM have a significantly higher risk of developing type 2 diabetes and other metabolic disorders later in life. In addition, exposure to maternal hyperglycemia during pregnancy increases the risk of obesity, insulin resistance and glucose intolerance in offspring, supporting the concept of developmental programming. Lifestyle interventions, breastfeeding, postpartum screening and integrated healthcare services were found to be effective strategies in reducing long-term risks. Adopting a life-course approach that includes early detection, continuous monitoring and preventive interventions is essential to break the cycle of intergenerational metabolic disease and improve long-term maternal and child health outcomes.

Barriers across the hepatitis B and C care cascade in India: a narrative review of recent evidence

Har Ashish Jindal — 2026-06-30

Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are leading causes of cirrhosis and hepatocellular carcinoma in India. Despite an effective HBV vaccine and curative HCV therapy, progress toward the World Health Organization (WHO) 2030 elimination targets has lagged, largely owing to persistent gaps across the care cascade. This narrative review synthesises recent evidence (2020-2026) from Indian peer-reviewed literature, national programme documents, and international agency reports to characterise barriers affecting screening and diagnosis, linkage to care, treatment initiation, retention, surveillance, and prevention. Barriers operate at multiple, interacting levels. At the community level, limited awareness, stigma, low perceived risk, and the asymptomatic course of infection suppress testing demand. At the health-system level, inadequate diagnostic infrastructure, workforce shortages, fragmented service delivery, and heterogeneous programme implementation delay diagnosis and treatment. Although antiviral therapy is provided free under the National Viral Hepatitis Control Programme (NVHCP), out-of-pocket costs for travel, investigations, and follow-up reduce sustained engagement. Weak patient-tracking and fragmented reporting systems contribute to losses along the continuum, while suboptimal timely hepatitis B birth-dose coverage and low vaccination uptake among high-risk groups perpetuate transmission. Recent Indian experience nevertheless identifies effective models, including integrated “one-stop” district services, decentralised hub-and-spoke delivery, and community-led same-day test-and-treat programmes for marginalised populations. Scaling these approaches, alongside strengthened active linkage, standardised national cascade reporting, and improved operational delivery of the hepatitis B birth dose, will be essential to accelerate hepatitis elimination in India.

Artificial intelligence for drowning prevention: a scoping review for public health practice

Karthik B. Laksham — 2026-06-30

Drowning remains a major and preventable cause of injury mortality worldwide, with a disproportionate burden in low- and middle-income countries. Timely recognition of distress and rapid rescue can be missed within existing supervision systems. Artificial intelligence (AI) and machine learning (ML) technologies are increasingly proposed to strengthen drowning prevention through hazard prediction, real-time surveillance, wearable alerts, and drone-assisted response. We conducted a scoping review (2015–2023) of studies describing AI/ML applications for drowning prevention, detection, or rescue across electronic databases and selected grey literature. Evidence was synthesized by functional domain (hazard prediction, incident detection, rescue support) and conceptually mapped to the Haddon Matrix to examine potential contributions across pre-event, event, and post-event phases. Given heterogeneity in study designs and outcomes, findings were appraised descriptively with attention to validation context and implementation considerations. Thirty-eight studies met inclusion criteria. Most evaluated computer-vision systems in controlled pool or coastal environments, with fewer examining wearable sensors, drone-assisted localization, or environmental risk prediction. Reported performance metrics were frequently derived from simulation or prototype datasets, with limited independent field validation. Few studies assessed integration into lifeguard workflows, cost-effectiveness, or applicability in resource-limited settings. AI/ML technologies may complement established drowning prevention strategies by enhancing hazard surveillance and supporting rapid response. However, the current evidence base remains largely pre-implementation. Future research should prioritize real-world validation, transparent reporting, and evaluation of integration within injury prevention systems to determine whether these tools reduce drowning in practice.

Bridging the gaps: how emerging technologies are shaping the future of physiotherapy for all

Sharki Rawat — 2026-06-30

Physiotherapy has traditionally been delivered face‑to‑face in clinical settings, but emerging technologies like telerehabilitation, wearable sensors, virtual/augmented reality, robotic exoskeletons, and artificial intelligence (AI) are rapidly changing this model. This narrative review of 42 peer‑reviewed, open‑access articles published between 2018 and 2026 examines their implications for equitable health service delivery. Results show that telerehabilitation is as effective as in‑person care for many conditions, with high patient satisfaction and rare adverse events. Wearable devices enable continuous home monitoring and improve physical activity, while virtual reality increases engagement and motor outcomes in stroke, ageing, and musculoskeletal conditions. Robotic exoskeletons improve walking and upper‑limb function in spinal cord injury and stroke, though costs remain high. AI enhances personalisation and prediction, but data are mostly from small studies. From a public health perspective, these technologies offer opportunities to improve access, reduce costs, and address inequalities in rehabilitation care. However, major barriers include the digital divide, lack of equity reporting, and limited implementation in low‑resource settings. Without deliberate attention to digital determinants of health, these innovations risk widening existing inequalities. Therefore, emerging technologies can transform physiotherapy into a more accessible, continuous, and person‑centred model of care, but future implementation must prioritise affordability, digital literacy, and integration into public health systems.

Evaluating the family adoption programme in competency-based medical education: a structured evidence review and implementation framework for undergraduate medical training in India

Sonali Kar — 2026-06-30

Community-oriented medical education is a vital part of the competency-based medical education (CBME) curriculum introduced in India in 2019. The family adoption programme (FAP) was added as a key component of CBME to give undergraduate medical students an in-depth, long-term experience with household health factors and primary community health systems. This structured review evaluates the available evidence on the educational impact of the FAP, identifies key implementation challenges across institutional settings, and proposes strategic reforms to enhance its sustainability and effectiveness. A structured evidence review with thematic synthesis was conducted using PubMed, Scopus, and Google Scholar. The search targeted policy documents, descriptive studies, experiential reports, and empirical evaluations related to the family adoption programme and community-based medical education in India, focusing on publications from 2000 to 2024. Relevant studies on community-based and experiential learning models worldwide were also included. Evidence shows that the FAP enhances students' understanding of social determinants of health, health-seeking behaviors, and healthcare services. Students demonstrate improved communication skills and community engagement. However, implementation varies between institutions, with challenges such as logistical barriers, insufficient faculty supervision and mentorship, lack of standardized documentation and assessment tools, and weak integration with national and state health programmes. The family adoption programme is a promising approach to improve medical education in India. However, its educational impact is limited by inconsistent implementation. Overcoming these challenges requires systemic reforms, including structured learning modules, digital documentation and monitoring tools, faculty mentoring systems, and linkage with primary health care services.

Maternal and neonatal biochemical sequelae following prenatal COVID-19 infection: evidence across the peripartum period

Fatimakhatun Z. Memon — 2026-06-30

Pregnancy is characterized by dynamic physiological, immunological, and biochemical adaptations that sustain foetal growth and maternal health. Viral infections such as COVID-19 can disrupt this equilibrium, provoking systemic inflammatory, metabolic, and coagulative responses. While clinical complications of prenatal SARS-CoV-2 infection have been widely described, evidence on biochemical sequelae across pregnancy, delivery, and postpartum remains fragmented. Therefore, this scoping review aims to map published evidence on maternal, placental, and neonatal biochemical markers following prenatal COVID-19 infection across the peripartum period. Following PRISMA-ScR guidelines, systematic searches were conducted in PubMed, Google Scholar, and Epistemonikos from January 2020 to March 2025. Observational studies examining biochemical or immunological markers among COVID-19 infected pregnant women and their offspring were included. Data were extracted using a pre-tested charting tool and narratively synthesized during pregnancy, at delivery, and postpartum. Twenty-seven studies met inclusion criteria. Elevated inflammatory, and haematological markers were consistently observed during pregnancy. Neonatal respiratory distress and multisystem inflammatory manifestations were associated with elevated inflammatory markers. Postpartum evidence suggested presence of immunoglobulins in breast milk, thus providing passive neonatal protection. Expression of placental ACE2 and TMPRSS2 suggested viral entry expression, aligning with limited evidence of vertical transmission. Prenatal COVID-19 infection led to a wide spectrum of biochemical alterations in maternal and neonatal systems. However, emerging evidence remains heterogeneous and limited beyond delivery, hence underscoring the need for longitudinal biochemical surveillance across the peripartum period.

A comprehensive evaluation of the transition from traditional cobalamin supplementation to advanced nano-formulated delivery systems

Poulami G. Banerjee — 2026-06-30

Vitamin B12 (cobalamin) is essential for DNA synthesis, haematopoiesis, and neurological health. However, traditional oral delivery is hindered by a complex, saturable absorption pathway involving gastric intrinsic factor (GIF) and cubilin receptors, which limits passive absorption to approximately 1% to 2% at pharmacological doses. This review evaluates the transition from conventional supplements to liposomal delivery systems, focusing on how these nano-formulations bypass physiological bottlenecks and enhance systemic bioavailability. The review synthesizes clinical and physicochemical data regarding liposomal matrices, specifically those utilizing biomimetic phospholipid bilayers (e.g., non-GMO sunflower-derived phosphatidylcholine) with particle sizes <200 nm and negative zeta potentials. Liposomal B12 achieves significantly higher area under the curve (AUC) and peak plasma concentrations (Cmax) by utilizing alternative absorption routes such as membrane fusion and lymphatic transport. Clinical evidence indicates rapid serum repletion in geriatric populations (up to 270% increase) and improved nerve conduction velocity in patients with diabetic neuropathy. Liposomal encapsulation provides a highly bioavailable, non-invasive, and well-tolerated alternative to traditional oral doses and intramuscular injections, particularly for populations with compromised gastrointestinal absorption.

One health approach: an integrated strategy

Garima Namdev — 2026-06-30

The One health approach is a collaborative and integrated strategy that recognizes the close interconnection between human, animal, and environmental health, promoted by global health organizations including the World health organization (WHO). It emphasizes multisectoral coordination to prevent, detect, and respond to emerging and re-emerging diseases resulting from human-animal interactions. One health strategy plays a vital role in the present context of increasing threats of zoonotic diseases, antimicrobial resistance (AMR), environmental degradation and climate change throughout the world. India’s National one health mission further reinforces this approach by promoting inter-ministerial collaboration and digital surveillance to ensure sustainable health security and improved public health outcomes.

Birth preparedness and complication readiness among antenatal women: a scoping review of levels and associated factors

Spoorthi Basavaraju — 2026-06-30

Maternal mortality remains a critical public health challenge in low and middle-income countries, with Birth preparedness and complication readiness (BPCR) recognized as an essential strategy to reduce the third delay of decision-making. Antenatal women represent the optimal intervention window, yet comprehensive evidence mapping across diverse healthcare contexts remains limited. To synthesize global evidence on BPCR levels, component prevalence, danger sign knowledge, and associated factors among antenatal women. A scoping review following PRISMA-ScR guidelines examined PubMed-indexed studies (2010-2026). Ten cross-sectional studies across Africa and Asia (n=4,096 antenatal women) were included using a standardized Population-concept-context framework. Data were extracted systematically and synthesized narratively by component, setting and associated factors. Overall BPCR prevalence ranged 18.8-82.1% (median 57.8%), revealing a critical logistical-knowledge discontinuity: skilled birth attendant identification (32.4%) and transport arrangements (65.7%) exceeded emergency preparedness components-blood donor identification (25.8%) and ≥3 danger signs recognition (20%). Higher maternal education (AOR 2.95), household income (AOR 2.53), ≥4 ANC visits (AOR 2.52) and urban residence (AOR 2.00) consistently predicted better preparedness. Urban tertiary facilities demonstrated higher overall BPCR (71.5%) but equivalent knowledge deficits as rural settings. Counselling interventions improved composite scores by 70% (p<0.05). Moderate BPCR levels mask profound emergency preparedness deficits across global contexts. Targeted interventions must reprioritize antenatal counselling toward danger sign recognition and blood donor coordination while leveraging private tertiary infrastructure serving urban delivery majorities. Standardized BPCR measurement and private sector studies are urgently needed to support SDG 3.1 maternal mortality reduction.

Understanding diseases through the biopsychosocial model: a narrative review

Muskaan Singla — 2026-06-30

Health and disease are affected by complex interaction of biological, psychological and social factors. Modern understandings now encompass a more holistic approach of disease causation through the biopsychosocial model, which was formerly dominated by the biomedical model, which only focused on genetic and physiological factors to illness. The aim of the study was to review the interactions of biopsychosocial factors in disease causation and their implications for health outcomes. A narrative review of literature was conducted, synthesizing evidence on various factors of disease causation starting with biological factors (age, gender, race, genetics, pregnancy), psychosocial factors (stress, social support, health literacy, cultural beliefs, living conditions), and environmental influences (physical and psychosocial work environment). Biological predispositions interact with psychosocial stressors, environmental exposures, and cultural norms to shape disease risk and progression. Chronic stress, a lack of social support, and health literacy are examples of psychosocial factors that not only directly impact mental health but also alter the course of physical illness. Understanding disease through the biopsychosocial perspectives can guide the development of integrated, person-centered prevention and treatment strategies in both physical and mental health care.