International Journal Of Community Medicine And Public Health

Comparative study on knowledge, attitudes and willingness regarding donation of living organs for transplantation among rural and urban dwellers of Kano state, Nigeria

Aliyu M. Maigoro — 2026-05-30

Background: Organ shortage is a major public health challenge for transplant programs globally. Organ transplantation is the most preferred treatment modality for those already affected by end-stage organ disease. This study compared the knowledge, attitudes and willingness regarding donation of living organs for transplantation among rural and urban dwellers of Kano State, Nigeria.

Methods: A comparative cross-sectional descriptive, mixed methods design was employed for the study. An interviewer administered questionnaires and Focused Group Discussions were used in collecting data from 490 respondents and 16 Focus Group Discussions in both rural and urban areas of Kano, Nigeria respectively. The data were analyzed using SPSS version 21 at 5% significance level.

Results: The results showed that most of the participants in the rural and urban areas (89.1%; n=212 and 94.6%; n=227) had heard of organ donation. Awareness of organ donation was significantly associated with gender, age and increasing educational attainment (p<0.05). The study identified electronic media (radio/television) as the respondents’ main source of information about organ donation. Nearly half of the respondents (47.7% in rural and 52.3% in urban areas) knew that kidneys can be donated (p=0.05). A significantly higher percentage of respondents in both the rural 180 (75.6%) and urban areas 190 (79.2%) expressed willingness to donate an organ when required by significant others.

Conclusions: It is recommended that the high level of awareness of and willingness to donate organs in this society could be further enhanced by provision of intensive educational programmes to encourage the public to donate organs.

Microbiological contamination of household water and its effects on public health in Likoni sub county, Kenya

Paul Ochieng Omolo — 2026-05-30

Background: Access to safe drinking water is crucial for human health, yet many communities, face chronic shortages. Residents often rely on wells and boreholes that are prone to contamination due to poor hygiene, overcrowding, improper waste disposal, and environmental pollution. This has led to frequent outbreaks of waterborne diseases, notably diarrhea. This study assessed microbial contamination in water from boreholes and household storage containers and evaluated water handling practices in Likoni Sub-County.

Methods: A descriptive cross-sectional and case-control study was conducted among 54 households (29 case households and 25 controls). Water samples were collected at the point of source (POS) and point of use (POU) and analysed using the Most Probable Number (MPN) method. Data were analysed using SPSS version 20.0.

Results: Microbial contamination was detected in a substantial proportion of samples. Among case households, Escherichia coli was present in 58% of samples at POS and 60% at POU, compared to 33% and 5%, respectively, among control households. Overall, 35% of samples tested positive for E. coli. Mean total coliform counts were higher in case households than in controls.

Conclusions: Household water in Likoni Sub-County is contaminated with faecal indicator bacteria, posing a public health risk. Interventions focusing on water treatment, safe storage, hygiene education, and improved sanitation infrastructure are recommended.

Addressing healthcare gaps in rural India: a cross-sectional study of patient concerns at a medical camp in Gujarat

Quintin Norris — 2026-05-30

Background: Rural regions of Gujarat, India faces significant healthcare challenges due to limited provider access, financial constraints and transportation barriers. Medical camps serve underserved populations, but data on presenting concerns remain limited.

Methods: A cross-sectional chart review was conducted at a free medical camp in Ahwa, Gujarat. Data collected included demographics, diagnoses, medications and anthropometric measures. A scoliosis screening was also performed in children aged 10–13 years.

Results: Of 786 patients, 646 met inclusion criteria (mean age 34.2 years; 56.4% female). Musculoskeletal conditions were most common (32.1%), followed by dermatologic (23.5%) and respiratory conditions (22.1%). Low back pain and knee pain predominated. Oral analgesics (31.0%) and multivitamins (18.7%) were most frequently prescribed. Among adults, 24.5% were overweight and 8.2% obese, while 20.2% of children were underweight. No scoliosis cases were identified.

Conclusions: Musculoskeletal, dermatologic and respiratory conditions represent primary healthcare needs in rural Gujarat. Coexisting adult overweight/obesity and pediatric undernutrition highlight the need for targeted interventions. These findings support integrating primary care, preventive education and low-cost treatment strategies into rural health programs.

Etiology of nosocomial infections in two general referral hospitals: CBCA-Virunga and Charité Maternelle de Goma, Democratic Republic of Congo

Sylvain Buhendwa Cirhulwire — 2026-05-30

Background: Nosocomial infections are a major cause of hospital morbidity and mortality. They usually occur during or after medical care. This study aims to identify the main etiologies of nosocomial infections in two general referral hospitals in Goma.

Methods: We conducted a microbiological study, of which 350 samples were analyzed in patients hospitalized for more than 48 hours with signs suggestive of IN these two hospitals, from February 15 to June 24, 2025. Data were collected using a standardized survey questionnaire. To identify the microorganisms involved, the biological parameters from blood culture and cytobacteriological examinations of urine and secretions taken from the surgical sites were carried out in two public health laboratories in Goma, namely Ami-Labo and La Reference.

Results: Among the 350 samples analyzed, 106 germs were isolated, including 98 bacteria and 8 yeasts. The main microorganisms identified were E. coli, S. typhi, S. aureus, K. pneumoniae, P. aeruginosa, A. baumannii and C. albicans. UTIs were the most common, followed by respiratory infections and surgical site infections. These isolated bacteria showed multi-resistance to commonly used antibiotics.

Conclusions: The analysis of the germs responsible for these infections revealed six main types of bacterial germs and one type of fungal germ. These bacteria are most often multi-resistant to common antibiotics.

Sociodemographic, obstetric and referral determinants of adverse foetal and perinatal outcomes in obstetric emergencies: evidence from referral hospitals in Benin city, Nigeria

Michael Ezeanochie — 2026-05-30

Background: Perinatal mortality remains unacceptably high in many low-resource settings, with a substantial proportion of these deaths occurring among women presenting with obstetric emergencies. This study assessed the sociodemographic, obstetric and referral predictors of adverse foetal and perinatal outcomes among women managed for obstetric emergencies in Benin City, Edo State, Nigeria.

Methods: This cross-sectional study was conducted across the four largest referral hospitals in Benin City using clinical data obtained from women who received EmONC services. Binary logistic regression was applied to assess associations between patient characteristics and outcome. Multivariable logistic regression models were fitted to estimate adjusted odds ratios (AOR) with 95% CIs for the association between explanatory variables and adverse foetal outcomes. To assess potential effect modification, interaction terms were specified between key maternal risk factors (booking status and referral status) and selected EmONC interventions.

Results: Among 526 women presenting with obstetric emergencies, 171 (32.6%) experienced adverse perinatal outcomes. The most frequently provided EmONC interventions were caesarean section (70.0%), parenteral antibiotics (66.4%), and uterotonics (41.4%). After controlling for potential confounders, referral status (AOR 2.11; 95% CI: 1.39–3.20) and booking status (AOR 0.25; 95% CI: 0.15–0.44) were strongly associated with adverse outcomes. Interaction analyses assessing modification of the associations between referral or booking status and adverse foetal and perinatal outcomes, showed no significant effects across any of the interventions evaluated.

Conclusions: Strengthening antenatal care utilisation and improving the efficiency and coordination of referral pathways for women requiring EmONC are essential for improving perinatal survival.

Evaluation of women in high-risk groups accepting prophylactic mastectomy and the options for reconstructive surgery in Saudi Arabia

Osman Suliman — 2026-05-30

Background: Breast cancer is the most common type of cancer in women. The choice to undergo prophylactic bilateral mastectomy (BPM) in high-risk patients to prevent breast cancer can intersect with social, cultural, and religious considerations. This study aimed to determine the knowledge, attitudes, and acceptability of BPM among high- risk patients in Saudi Arabia, as well as the available options for breast reconstruction.

Methods: A cross-sectional study in Saudi Arabia involved 371 high-risk patients, and data was collected through an online questionnaire.

Results: The mean BMI of respondents was 24.68±9.8. Participants aged between 20 and 25 constituted 53.1% (n=197) of the study population. A majority of participants (75.5%) had academic qualifications. Ninety-six (25.8%) reported a family history of breast cancer. Overall, 65.8% of participants were aware of BPM, yet 48.1% had a negative attitude towards it due to fear of losing their self-image. A significant proportion (65.2%) preferred alternative treatments to BPM. There was no significant association between age or qualification and knowledge of BPM (p>0.05).

Conclusions: While awareness of breast cancer and BPM is moderate among high-risk Saudi women, the acceptability of BPM is low, primarily due to concerns about body image and self-esteem. Age and educational qualifications do not significantly impact knowledge levels about BPM.

Prevalence of radiographic osteoarthritis in an outpatient clinic at a teaching and referral hospital in Laikipia County, Kenya

Andrew Tabu Kaggwa — 2026-05-30

Background: Osteoarthritis (OA) is a leading cause of chronic pain and disability globally, particularly among older adults. In sub-Saharan Africa, including Kenya, OA represents a growing public health burden amid demographic transitions and lifestyle changes. Despite this, there is limited local data on its prevalence, correlates especially in rural communities. This study aimed to determine the prevalence and predictors of radiographic OA in patients at a Teaching and Referral Hospital in Laikipia.

Methods: A cross-sectional study in an orthopaedic outpatient clinic was conducted for 4 months involving 194 participants aged ≥ 18 years. Systematic random sampling was employed. Data were collected using a structured researcher-administered questionnaire for sociodemographic and clinical information. Anthropometric measurements were taken and imaging reports were reviewed to confirm OA diagnosis and severity. Descriptive statistics summarized patient characteristics. Logistic regression models identified independent predictors of OA. Informed consent and ethical approvals were obtained.

Results: The overall prevalence was 32.5% (95% CI: 26.2–39.4). OA was significantly more common among females (61.9%), older adults (mean age 62.9±13.5 years) and those with comorbidities (60.3%). Nearly half (47.6%) were obese. The knee was the most frequently affected joint. Multivariate analysis revealed that increasing age (AOR=1.094, p<0.001), obesity (AOR=6.190, p=0.008) and poor functional status (ECOG≥1) (AOR=8.393, p=0.001) were independent predictors.

Conclusions: OA is highly prevalent in this rural setting. Advanced age, obesity and functional limitations are key predicting factors. Targeted screening prioritizing older patients and mandatory assessment of obesity and functional status are essential for timely management.

User satisfaction and priorities for improvement in public health services in rural Laos: a study of Phonthong district residents

Viengkhone Chaleunsay — 2026-05-30

Background: Evaluating user satisfaction is essential for improving public health service quality, particularly in rural and resource-limited settings. This study assessed demographic characteristics, service utilization, satisfaction levels, and priority areas for improvement among public health services in Phonthong district, Luang Prabang Province, Lao PDR.

Methods: A cross-sectional survey was conducted among 377 individuals who had used public health services in the district. Information on demographic characteristics, service utilization, and satisfaction across 6 service dimensions were collected. Participants were also requested to rank 8 predefined areas for improvement with lower mean scores indicating higher priority.

Results: Most respondents were female (59.4%), married (84.6%), and employed in agriculture (72.4%). Over half lived within 1 km of a health facility (52.0%), and 54.9% had health insurance. In the previous year, 62.9% had utilized public health services, mainly for acute illness (36.6%) and routine check-ups (31.8%). Overall satisfaction was high (x̄=3.64), with the highest scores for specific health services (x̄=3.94) and financial aspects (x̄=3.93). Moderate satisfaction was reported for administration and communication, accessibility, and facilities. Improving service quality and health education was identified as the top priority, followed by upgrading medical equipment and strengthening infrastructure and basic utilities.

Conclusions: Public health service users in Phonthong district generally reported positive experiences particularly regarding affordability. However, they clearly expressed a need for better service quality, equipment, and facility conditions. Addressing these priorities is essential for strengthening rural health services and improving rural public health services.

Ineffective vaccination coverage linked to inadequate cold chain management practices in routine childhood immunization program in Narok County, Kenya

Koskei Alfred — 2026-05-30

Background: Poor cold chain management contributes to ineffective vaccinations. Ineffective vaccinations pose a risk of occurrence of vaccine preventable diseases. The study assessed the effective vaccination coverage of measles, tetani toxoid and hepatitis B in relation to the status of cold chain management practices

Methods: This was a cross sectional serosurveillance study of 378 vaccinated children using indirect Elisa IgG antibody testing of measles, tetani toxoid and hepatitis B vaccine. It also assessed the status of cold chain management practices in all the 91 public immunizing health facilities in Narok County, Kenya.

Results: The measles effective vaccination coverage was 62.2% (235/378). The tetani toxoid effective vaccination coverage was 70.6% (267/378). The effective vaccination coverage of hepatitis B was 299 79.1% (299/378). The proportion of Children who were effectively vaccinated against measles was 70.5% (31/44) in level 2 health facilities, 72.2% (104/144%) in level 3 health facilities, 85% (85/100) in level 4 facilities and 75% (9/12) in level 5 health facilities. The observed condition of the cold chain system was inadequate in 25 (48%) level 2, 6 (18.2%) level 3 and 20% of level 4 facilities. Up to date operational plan was available in 30 (57.7%) level 2, 25 (75.8%) in level 3, 4 (80%) in level 4 facilities. Vaccine supply and quality were inadequate in 43 (47.3%) health facilities. Immunization service delivery charter was partially implemented in 53 (58.2%) health facilities.

Conclusions: Inadequacies in cold chain management practices has contributed towards ineffective vaccination of children aged 12-23 months in Narok County, Kenya.

Quality of life and predictors of poor quality of life among children with heart disease in Lagos, Nigeria

Olubukola Ransome-Kuti — 2026-05-30

Background: Children with heart disease (HD) experience significant morbidity beyond cardiovascular complications, including impaired growth, recurrent hospitalizations, and reduced quality of life (QoL). While studies in Africa have examined caregivers’ burden, limited data exist on QoL among children themselves, particularly those with acquired heart disease (AHD). The aim was to assess the QoL of children with HD in Lagos, Nigeria, and identify predictors of poor QoL.

Methods: A comparative cross-sectional study was conducted among 140 children aged 7–16 years: 70 with HD and 70 age-, sex-, and socio-economic status-matched healthy controls attending Lagos State University Teaching Hospital between February and August 2024. Data were collected using an interviewer-administered proforma and the Paediatric Quality of Life Inventory™ (PedsQL™ 4.0), both child- and parent-reported versions. A total score <70% was classified as poor QoL. Statistical analysis was performed with statistical package for the social sciences (SPSS) v24, using chi-square and logistic regression to identify independent predictors.

Results: Poor QoL was significantly more common among children with HD than controls (65.7% versus 4.3%, p<0.001). The most impaired domain was physical functioning. Children with AHD had the highest prevalence of poor QoL (90%), followed by cyanotic CHD. Absence of definitive cardiac surgery and multiple hospitalizations were identified as independent predictors of poor QoL. Anthropometric deficits and lower oxygen saturation were also associated with poorer scores.

Conclusion: Children with HD in Lagos experience a high burden of impaired QoL, particularly those with AHD and cyanotic CHD. Routine QoL assessment, timely surgical intervention, and integrated psychosocial support are recommended to improve holistic outcomes.

Cultural beliefs and partner support on postpartum bilateral tubal ligation decision-making

Mary Cris E. Campaner-Eguia — 2026-05-30

Background: Postpartum bilateral tubal ligation (BTL) is a permanent family planning method that requires informed and autonomous decision-making. Cultural beliefs and partner support are recognized as influential factors in reproductive health choices, yet their combined influence among multiparous mothers in local government hospital settings remains underexplored. This study examined the relationship between cultural beliefs, partner support, and decision-making regarding postpartum BTL among multiparous mothers in selected government hospitals in a province in southern Philippines.

Methods: A descriptive–correlational research design was employed involving 110 purposively selected multiparous mothers with at least three live births. Data were collected in Obstetrics and Gynecology wards using validated researcher-developed questionnaires measuring cultural beliefs, partner support, and decision-making. Instruments underwent pilot testing, expert validation, and reliability testing (Cronbach’s α≥0.70). Descriptive statistics summarized variable levels, while Pearson’s r and multiple regression analyses determined relationships and predictive influences, with significance set at p<0.05.

Results: Findings revealed high levels of cultural influence and partner support, alongside generally good decision-making. Religious and spiritual beliefs emerged as the most dominant cultural factors and were strongly associated with all decision-making dimensions. Partner support significantly correlated with knowledge, autonomy, and service access. Regression analysis identified family expectations and practical support as significant predictors, explaining 13.83% of the variance.

Conclusions: Culturally sensitive and couple-centered counseling is essential to enhance informed postpartum family planning decisions.

Comparative analysis of renal impairment in HIV-positive and HIV-negative individuals at Kono government hospital, Sierra Leone

Arthur B. C. Garber — 2026-05-30

Background: Non-communicable disease is of major concern affecting a significant portion of the global population. It is a serious and gradual condition marked by the progressive deterioration of kidney function. In recent years, Renal impairment has emerged as a clinically relevant and significant issue. The aim of this study was to compare analysis of renal impairment in individual with HIV, diabetes, and hypertension.

Methods: This was a cross-section quantitative study. It was conducted from June to September 2024. A total of 275 participants were selected. Serum creatine and CD4 counts were measured in HIV-Positive individuals, and the eGFR was calculated using the CKD-Epi 2021 formula. Data analysis was done using SPSS Version 16.

Results: Among the study population, 158 participants (57.5%) were HIV-Positive, while 62 (22.5%) and 55(20%) were HIV-Negative individuals diagnosed with hypertension and diabetes, respectively. The overall prevalence of renal impairment was found to be 34.2% among HIV-Positive, 30.6% among hypertensive participants, and 38.2% among those with diabetes. Participants aged 31-40 years demonstrated a significant higher likelihood of renal impairment (AOR=5.37, 95% CI: 2.414-12.489), and for those over 50 years (AOR=4.93; 95% CI:1.491-16.351). Among diabetic participants, older age was also significantly associated with renal impairment (OR=6.379; 95% CI: 1.129-36.060). Furthermore, hypertensive females were identified as having an increased risk of developing renal impairment.

Conclusions: The study highlights a concerning prevalence of renal impairment among participants, with age and gender as significant risk factors. These findings underscore the importance of monitoring renal function in at-risk populations.

Health system determinants of vaccine cold chain performance at the primary healthcare facilities in Nasarawa State, Nigeria: a mixed-methods study

Maureen A. Ifezulike — 2026-05-30

Background: Preserving vaccine potency through a robust cold chain is essential for immunization success. This study evaluates the health system determinants of vaccine cold chain performance at primary healthcare (PHC) facilities in Nasarawa State, Nigeria.

Methods: A mixed-methods, cross-sectional study was conducted between August and September 2025. Quantitative data were collected from 147 healthcare workers using structured questionnaires, while qualitative insights were gathered from 10 key informant interviews with immunization and cold chain officers. Data were analyzed using IBM SPSS version 31 and NVivo 15.

Results: Findings revealed a successful transition to renewable energy, with 82.3% of facilities utilizing solar power. However, infrastructure gaps persist, as 22.4% of refrigerators were non-functional, 41.5% of facilities face daily power outages, and 38.8% lack backup power systems. A significant workforce gap was identified. While 81.0% of facilities had Standard Operating Procedures, 50.3% of health workers had never attended formal cold chain training. Qualitative data highlighted that low sunlight causes temperatures to rise to +10°C to +11°C, and faulty equipment force workers to incur out-of-pocket expenses for vaccine transport.

Conclusions: While Nasarawa State has modernized its cold chain equipment, performance is undermined by inadequate training, poor maintenance, and lack of backup power. To secure immunization gains, the state must prioritize regular supportive supervision, systematic equipment maintenance, and comprehensive capacity-building for healthcare workers.

Influence of health promotion activities on immunization uptake among mothers of under-five children in Oron L.G.A, Akwa Ibom state Nigeria

Abia EME Eti — 2026-05-30

Background: Immunization is a cornerstone of global child survival strategies and a central component of the WHO–UNICEF Immunization Agenda 2030. However, immunization uptake remains suboptimal in many low- and middle-income countries due to sociocultural and informational barriers. This study assessed the influence of health promotion activities on childhood immunization uptake among mothers of under-five children in Oron Local Government Area, Akwa Ibom State, Nigeria.

Methods: The study was conducted between January, 2025 to June, 2025. A concurrent mixed-methods design was employed. The quantitative component used a cross-sectional descriptive design involving 384 mothers selected through multistage sampling, with data collected using a semi-structured questionnaire and analyzed using descriptive statistics. The qualitative component consisted of in-depth interviews with 60 purposively selected participants, and data were analyzed thematically.

Results: Social context factors, including cultural norms, belief systems, and the influence of significant others, accounted for 46.6% of the variation in childhood immunization uptake. Health promotion strategies, particularly community engagement forums and digital communication platforms—explained 47.9% of uptake. Overall, health promotion activities demonstrated a statistically significant positive influence on childhood immunization uptake 44.3%, p<0.05. Qualitative findings supported these results, highlighting the roles of socioeconomic conditions, cultural beliefs, and community influence in maternal immunization decision-making.

Conclusions: Childhood immunization uptake in Oron Local Government Area is strongly influenced by health promotion activities and sociocultural context. Context-specific and culturally responsive health promotion interventions, with emphasis on community engagement and trust-building, are essential for improving immunization coverage. Integrating such strategies into national and subnational immunization policies may help reduce vaccine hesitancy and promote equitable access.

Factors associated with contraceptive use among married women in Nigeria: evidence from the Nigeria demographic and health survey

Yasmin A. Ahmed — 2026-05-30

Background: Contraceptive use is a key component of reproductive health, reducing unintended pregnancies and improving maternal and child health outcomes. However, uptake remains low in Nigeria. This study examined factors associated with contraceptive use among married women in Nigeria.

Methods: This study analyzed secondary data from the Nigeria Demographic and Health Survey (NDHS). A total of 27,841 currently married women aged 15-49 years were included. The outcome variable was current contraceptive use (any method vs non-use). Descriptive statistics summarized respondents’ characteristics. Bivariate analyses assessed associations, while multivariable logistic regression identified individual, reproductive, partner and household-level variables associated with contraceptive use.

Results: Overall, 15.4% of married women reported current contraceptive use. Higher education was strongly associated with contraceptive use (aOR=2.30, 95% CI: 1.99-2.66). Women practicing Christianity/other religions (aOR=1.70, 95% CI: 1.51-1.91) had higher odds of use compared to their Muslim counterparts. Fertility preference and gender of living children were also significant. Partner’s education and urban residence increased likelihood of contraceptive use. Women from rich households had higher likelihood of use (aOR=1.92, 95% CI: 1.69-2.19), while those in the South-South region (aOR=0.60, 95% CI: 0.52-0.69) had lower odds.

Conclusions: Contraceptive use among married women in Nigeria remains low and is associated with socio-demographic, reproductive, partner-related and household factors. Targeted interventions addressing female education, promoting male involvement and inequities in access may improve contraceptive uptake and reproductive health outcomes.

HIV pre-exposure prophylaxis adherence among adolescent girls and young women in Muhoroni, Kisumu County, Kenya

Scholastica Jemutai — 2026-05-30

Background: This study assessed adherence patterns to oral pre-exposure prophylaxis (PrEP) and associated factors among adolescent girls and young women (AGYW) initiating PrEP in Muhoroni, Kisumu County, Kenya.

Methods: A retrospective longitudinal cohort study using routinely collected PrEP data from two high-volume public health facilities in Muhoroni Sub-County, including AGYW aged 15–24 years who initiated oral PrEP in January 2022 and followed for 24 months. Adherence was defined as continuous use without missed monthly visits, with appropriate discontinuation considered adherent. Descriptive statistics summarized characteristics and adherence patterns, while associations were assessed using modified Poisson regression with generalized estimating equations (GEE) accounting for within-individual correlation.

Results: PrEP adherence was high, with 82.2% (263/320) of participants’ adherent. In bivariate analysis, adherence was significantly associated with marital status (p=0.003), education level (p=0.046), population type (p=0.021), injection drug use (p=0.042), shared syringe use (p=0.032), and STI status (p=0.021), but not with age or school attendance (p>0.05). In unadjusted analyses, higher education was associated with increased adherence (secondary: PR=1.22, 95% CI: 1.00–1.50; tertiary: PR=1.31, 95% CI: 1.07–1.61). In adjusted models, tertiary education remained significantly associated with adherence (aPR=1.30, 95% CI: 1.05–1.60). Shared syringe use was associated with higher adherence (aPR=1.40, 95% CI: 1.00–1.96). Other factors were not statistically significant after adjustment.

Conclusions: PrEP adherence among AGYW was high. Education was a key determinant; however, behavioral factors highlight the need for targeted, context-specific interventions.

Assessment of nutritional status of children aged 6–59 months among internally displaced populations in Dongola locality, Northern State, Sudan

Asia M. Abdelmageed — 2026-05-30

Background: Malnutrition remains a major public health problem among children under five years, especially in conflict settings. Internally displaced children are more vulnerable to malnutrition due to food insecurity, poor living conditions, and limited access to health and nutrition services. This study aimed to assess the nutritional status of internally displaced children in Northern State, Sudan, in 2024.

Methods: A community-based analytical cross-sectional study was conducted from April to May 2024 among internally displaced children aged 6–59 months residing in school shelters in Dongola locality, Northern State, Sudan. A multistage sampling technique was used to recruit 150 children. Data were collected using interviewer-administered questionnaires and anthropometric measurements. Nutritional status was assessed using World Health Organization growth standards. Chi-square, bivariate, and multivariable logistic regression analyses were performed to identify factors associated with wasting and stunting.

Results: The prevalence of wasting and stunting was 39.3% and 51.3%, respectively. Wasting was significantly associated with lack of maternal education (AOR=7.38; 95% CI: 1.93–28.18) and poor maternal health status (AOR=17.93; 95% CI: 5.57–57.85). Stunting was significantly associated with younger child age (<12 months AOR=14.66, 95% CI: 3.37–63.83), poor maternal health (AOR=4.59; 95% CI: 1.52–13.83) and early discontinuation of breastfeeding (AOR=3.38; 95% CI: 1.51–7.63).

Conclusions: There is a high burden of wasting and stunting among internally displaced children in Dongola locality. Maternal education, maternal health, and infant feeding practices were significant determinants. Strengthening nutrition and maternal-child health interventions is urgently needed.

Knowledge and attitude towards cervical cancer and screening practices among women of reproductive age in Nandi County, Kenya

Poornima Ramasamy — 2026-05-30

Background: Cervical cancer remains a major public health concern, especially in developing countries such as Kenya. Despite the availability of screening services, uptake among women remains low. This study assessed knowledge and attitudes towards cervical cancer and their influence on screening practices among women of reproductive age in Nandi County, Kenya.

Methods: A descriptive correlational design was employed among 341 women aged 20-49 years attending maternal and reproductive health services at Kapsabet Referral Hospital. Data were collected using structured questionnaires and analyzed using SPSS version 23. Descriptive statistics and Pearson’s correlation analysis were used to examine relationships between knowledge, attitudes, and screening practices.

Results: Most respondents (83.8%) had heard about cervical cancer, although detailed knowledge of symptoms, risk factors, and screening methods was moderate. Positive attitudes towards screening were reported by the majority of participants, with 79.4% agreeing that screening is beneficial. However, screening uptake remained low. Pearson’s correlation analysis showed significant positive relationships between knowledge and screening uptake (r=0.38, p<0.05) and between attitudes and screening practices (r=0.41, p<0.05).

Conclusions: Although respondents demonstrated moderate knowledge and positive attitudes towards cervical cancer screening, actual screening uptake remained low. Addressing socio-cultural barriers, misconceptions, and limited access to screening services is essential to improve cervical cancer screening practices among women in rural Kenya.

Integrating statistical and machine-learning models to determine tuberculosis mortality rates in Malaysia

Amalina B. A. Asmail — 2026-05-07

Background: Tuberculosis (TB) mortality remains an important indicator of disease burden and health-system performance, reflecting the effectiveness of detection, treatment, and prevention efforts. In Malaysia, TB mortality rates based on temporal patterns remain insufficiently characterized, limiting understanding of mortality burden and forecasting performance; addressing this gap may strengthen public health planning. Thus, this study aimed to determine TB mortality rates and evaluate predicted mortality in 2024 alongside characterize temporal patterns from 2014 to 2024 using autoregressive integrated moving average (ARIMA), long short-term memory (LSTM), convolutional neural network (CNN), and hybrid CNN–LSTM models.

Methods: This time-series study analyzed monthly TB mortality data from 2014 to 2024 obtained from the National Tuberculosis Registry. The dataset comprised 132 monthly observations, with 80% used for model training and 20% for testing. Four forecasting models were applied: ARIMA, LSTM, CNN, and hybrid CNN–LSTM. Relative error (RE%) was used to evaluate deviation between observed and predicted mortality values.

Results: In 2024, observed monthly TB mortality rates ranged from 0.42 to 0.79 per 100,000 population, while age-standardized mortality rates ranged from 0.43 to 0.80 per 100,000 population. The hybrid CNN–LSTM model provided the best representation of Malaysia’s TB mortality pattern, capturing the upward trend, mid-year peaks, early-year troughs, and cyclical fluctuations.

Conclusion: Observed TB mortality rates in Malaysia were slightly higher than ranges reported in other international studies. The hybrid CNN–LSTM model produced the most accurate estimates, suggesting that hybrid deep-learning methods can strengthen TB mortality monitoring and support timely public health decision-making.

Determinants and gender differences in specialty choice among medical students and house officers in Punjab: a cross-sectional study

Zohad Fareh — 2026-05-30

Background: The career choices students make determine the future composition and distribution of the physician workforce. This study aimed to identify the factors that medical students and house officers in Punjab perceive as influencing their choice of future specialty, and to assess gender differences in those choices.

Methods: A cross-sectional survey was conducted among MBBS students and house officers from various medical colleges and hospitals in Punjab, Pakistan, between June and November 2025. All enrolled MBBS students from first to final year and house officers were invited to participate. A minimum sample size of 384 was calculated. Data were analyzed using SPSS version 25, with descriptive and inferential statistical methods applied.

Results: Participants (mean age 22.43±1.78 years) were predominantly female (58.1%). Gender differences were significant (χ², p=0.006): gynecology and obstetrics and dermatology were preferred specialties by females, whereas gastroenterology and cardiology were more commonly selected by male respondents. Gender showed bivariate associations with specialty choice (p=0.006). In a multinomial logistic regression, only academic year independently predicted specialty preference (likelihood-ratio χ²=66.68, df=40, p=0.005; Nagelkerke R²=0.171). The most attractive factors influencing specialty choice were the opportunity to make a meaningful impact on patients’ lives.

Conclusions: Medical students’ and house officers’ specialty choices in Punjab are influenced by multiple personal and academic factors, with gender-based differences. Understanding these influences can help medical educators and institutions provide targeted career counseling and support informed specialty decision-making.

Occupational exposure levels to sewer gases among informal sewer workers in Nairobi city county, Kenya

Obiero O. Sylivanus — 2026-05-30

Background: The aim of this study was to evaluate occupational exposure levels to sewer gases among informal sewer sanitation workers in Nairobi City County, Kenya.

Methods: An analytical cross-sectional study design was employed from October, 2023 to August, 2024 adopting quantitative and qualitative data collection methods. Nairobi City County was purposively sampled due to its high proportion of informal sewer sanitation workers. Interviewer-administered questionnaires to workers and semi structured key informant interviews were used to collect qualitative and quantitative data with an observation of exposure levels using EAGLE 2 multi-gas monitor equipment.

Results: Results from the study revealed a 116 (44.7%) cumulative exposure levels to sewer gases among the workers, with exposures to H2S at 91 (35.1%), CO2 at 106 (40.9%) respectively. A mean higher exposure was observed for CO2 and NH3. Majority 221 (85.3%) of the respondents were manual pit emptiers. Moderate level of knowledge was reported among respondents. A high proportion 212 (81.9%) of workers were not in the right PPEs and had not received any training. A negative correlation not statistically significant (p=0.349) was established in examining relationship between the gases. In ANOVA, there was a statistically significant difference in exposure levels among the four groups of sewer workers, F (3,255) =7.803, p<0.001).

Conclusions: The study concludes that 116 (44.7%) of informal sewer sanitation workers in Nairobi City County were exposed to cumulative elevated sewer gas levels beyond the TWA threshold. It is recommended that assessing the health impacts of both short-term and long-term exposure to sewer workers within informal sewer-operations.

Uptake of tuberculosis preventive therapy and its associated factors among health care workers in Nairobi City County, Kenya

Paul W. Maleya — 2026-05-30

Background: Tuberculosis (TB) remains a major occupational risk among healthcare workers (HCWs), with latent TB infection (LTBI) serving as a reservoir for future active disease. Tuberculosis Preventive Therapy (TPT) is an effective strategy to reduce this risk; however, uptake among HCWs remains suboptimal. This study examined the association between knowledge of the LTBI policy, general knowledge of TPT, and personal attitude and perception factors with willingness to uptake TPT among HCWs in Nairobi City County, Kenya.

Methods: An analytical cross-sectional study was conducted among HCWs in selected health facilities in Nairobi City County. Data was collected using structured questionnaires assessing knowledge of the LTBI policy, knowledge of TPT, attitudes and perceptions toward TPT, and willingness to uptake therapy. Descriptive statistics, bivariate analyses, and multivariable logistic regression were used to identify factors associated with TPT uptake.

Results: A total of 288 HCWs participated, of whom 60% were female. Nurses constituted 45% of respondents, and 62% reported awareness of the LTBI policy. Knowledge of the LTBI policy was significantly associated with TPT uptake (p<0.001). In multivariable analysis, knowledge of TPT was a strong predictor of uptake (OR>3, p=0.001). Pharmaceutical technologists and HCWs in other professions had significantly lower odds of uptake compared to clinician. Attitude and perception were not independently associated with uptake.

Conclusions: Knowledge of the LTBI policy is a key determinant of TPT uptake among HCWs. Strengthening policy dissemination and addressing profession-specific barriers may improve TPT uptake in healthcare settings.

Sociodemographic profile of road traffic accident victims in Vijayapura, North Karnataka: a cross-sectional study

Shamin Eabenson — 2026-05-18

Background: Road traffic accidents (RTA) are defined by the World Health Organization (WHO) as injuries resulting from collisions on public roads, whether they are fatal or not. At least one moving vehicle must be involved in these occurrences. RTA is defined as any collision involving at least one moving vehicle that occurs on a roadway or throughfare that is open to public traffic and results in death or serious injury of one or more people. WHO estimates that the economic cost of traffic accidents is usually around 3% of a nations GDP. Every year, traffic accidents claim the lives of almost 1.19 million individuals.

Methods: After obtaining Institutional ethical committee clearance, patients admitted with RTAs in BLDE hospital were interviewed using a semi structured, pre tested questionnaire to assess their epidemiological profile; informed consent was obtained from the study participants. The acquired data was entered into a Microsoft Excel spreadsheet, and statistical analyses with SPSS.

Results: Out of the 206 participants, the majority of the participants were in the 18 to 30 age group, which accounted for 73 people (35%). Majority of the victims were males (89.8%) and remaining (10.2%) were females. Majority of the study participants had their residence in rural areas accounting for (88.3%) and the rest (11.7%) residing in urban areas of Vijayapura.

Conclusions: Sociodemographic data helps us to take preventive measures in relation to RTAs.

Prevalence of hypertension and chronic disease awareness in South Kerala: a community-based study

Anjali Ajay — 2026-05-26

Background: Hypertension is a leading risk factor for cardiovascular mortality. Adequate awareness of chronic diseases is essential for effective prevention. The objective of the study was to estimate hypertension prevalence and assess awareness regarding chronic diseases (hypertension, diabetes, coronary artery disease, COPD) among adults in a Family Adoption Programme (FAP) area in South Kerala.

Methods: A community-based cross-sectional study included 300 adults (≥18 years) in Thiruvalla Municipality. Data were collected via an interviewer-administered questionnaire assessing sociodemographic and disease knowledge. Blood pressure was measured using standard procedures.

Results: The prevalence of hypertension was 32.0% (95% CI: 26.7%-37.3%). Prevalence increased significantly with age (p < 0.001) and was higher among widowed individuals (p=0.011) and Christians (p=0.004). The mean overall knowledge score was 10.44±4.57 (out of 20). Awareness was lowest for COPD. Overall knowledge varied significantly by socio-economic status (p=0.019), but not by hypertension status. Normotensive participants exhibited significantly better diabetes knowledge (p=0.01).

Conclusions: A high hypertension prevalence and moderate disease awareness highlight the need for targeted community-based screening and health education, particularly for less-recognized conditions like COPD.

Prevalence of stress amongst postgraduate residents by using DASS-21 and perceived stress scale: a cross-sectional study at a tertiary care centre

Vanashree A. Kamble — 2026-05-30

Background: The medical profession is uniquely challenging, offering both professional and personal satisfaction. However, postgraduate residents face multiple stressors due to their demanding clinical duties, academic responsibilities and long working hours. Prolonged exposure to such stress can lead to anxiety, depression or even suicidal tendencies. To assess the prevalence and causes of stress among postgraduate residents using the DASS-21 and perceived stress scale (PSS).

Methods: A cross-sectional study was conducted among all postgraduate residents of a tertiary care teaching hospital for duration of 4 months i.e., from July 2025 to October 2025. After obtaining informed consent, participants were provided with a self-administered, predesigned questionnaire containing demographic details, stress-related factors and standardized tools-PSS and DASS-21 (stress subscale). Data were collected and analysed to determine stress levels and contributing factors.

Results: Majority of study participant belong to 24 to 29 years of age. 32.72% of PG residents were suffered from mild to extremely severe degree stress as per DASS-21 scale and 56.36% were included in moderate level of stress as per PSS scale.

Conclusions: Stress does affect physical and mental health. Academic and psychological were the leading causes of stress. Various preventive measures such as improving time management, coping skills to optimize the balance between professional and social commitment, fixed duty hours, better living facilities in hostel and good quality of food in mess would go a long way to improve the physical and mental well-being of these young doctors.

Exploring dentists' attitudes and perceptions towards transgender patients: a cross-sectional study in Karnataka, India

Aswini Madhavan — 2026-05-30

Background: Transgender individuals in India face significant social, economic, and healthcare challenges. Despite growing recognition of transgender rights, the healthcare community, including dental professionals, may lack the necessary training and sensitivity to adequately serve this marginalized group. This study aimed to assess the attitudes and perceptions of practicing dentists in Karnataka, India, toward providing dental care to transgender individuals and to identify barriers to care within the dental healthcare setting.

Methods: A cross-sectional internet survey was conducted among 127 practicing dentists in Karnataka. The survey included demographic questions and nine items from a dentist perception questionnaire to gauge attitudes toward transgender patients.

Results: Most participants believed that transgender people are a viable and contributing members of society and agreed that healthcare providers should care for LGBTQ patients. However, many participants reported awareness of negative attitudes toward transgender individuals among dental and healthcare staff, which they viewed as a barrier to providing care. 83% of participants believed that healthcare camps exclusively for transgender people would improve access to care. Despite the generally positive attitudes toward transgender patients, significant gaps in training and awareness were identified.

Conclusion: There is an urgent need for improved education on transgender healthcare within dental and medical curricula, as well as policies to address discrimination and enhance healthcare access for the transgender community. Further research is necessary to explore these issues and develop evidence-based solutions to improve care.

Effectiveness of a community-based awareness session on vaccine knowledge, attitudes and improving dissemination in rural India

Isha Purohit — 2026-05-30

Background: One of the most significant barriers to increasing global immunization rate is Vaccine hesitancy (VH). This disparity is underreported in rural India where several misconceptions still persist. The aim of this study was to understand the effectiveness of a community-based intervention on improving the knowledge and attitude amongst people in rural India.

Methods: This was a community based pre- and post- interventional study conducted amongst 158 participants. Data was collected through a structured questionnaire assessing the demographic detail, obstetric and birth history, pre- and post- questionnaire and an open-ended feedback form assessing the effectiveness of the intervention. Paired t-test was used to assess significance between the pre- and post-intervention mean scores and logistic regression was used to identify predictors of willingness to promote vaccine-related information.

Results: The mean pre-intervention score was 11.33±3.11, which increased to 12.92±1.95 post-seminar (p<0.001). A total of 85.4% of participants were willing to disseminate the information they learned through the seminar. Logistic regression revealed that participants who did not associate vaccination with religion were significantly more likely to support dissemination (p<0.001).

Conclusions: This intervention significantly improved the knowledge score post-intervention and also addressed the common misconceptions regarding hesitancy. Religious beliefs were found to be a key component of hesitancy. Future public health strategies must prioritize such educational interventions to combat vaccine hesitancy.

Effectiveness of a self-instructional module in enhancing pre-service teacher trainees’ knowledge and attitudes towards children with Attention-Deficit Hyperactivity Disorder (ADHD): a multicentre study

Valliammal Shanmugam — 2026-05-30

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder affecting children’s academic, behavioural, and social functioning. Teachers play a vital role in early identification and classroom management of children with ADHD; however, inadequate knowledge and negative attitudes among teacher trainees remain a concern. This study evaluated the effectiveness of a Self-Instructional Module (SIM) in improving knowledge and attitudes regarding ADHD among pre-service teacher trainees.

Methods: A multicentric pre-experimental one-group pre-test-post-test study was conducted among 203 pre-service teacher trainees selected through simple random sampling from teacher-training institutions in Tamil Nadu, South India. Data were collected using a structured knowledge questionnaire and a five-point Likert attitude scale before and after administration of the SIM. Data were analysed using descriptive and inferential statistics.

Results: The mean post-test knowledge score significantly increased from 9.84±2.31 to 16.27±2.08 (t=24.63, p<0.001). The mean attitude score also improved significantly from 61.72±7.85 to 81.64±6.93 (t=20.17, p<0.001). A positive correlation was observed between knowledge and attitude scores both before (r=0.46) and after intervention (r=0.58).

Conclusions: The Self-Instructional Module was effective in improving knowledge and fostering positive attitudes towards children with ADHD among pre-service teacher trainees. Incorporating structured ADHD education into teacher-training curricula may promote inclusive educational practices.

Morbidity patterns of psychiatric disorders among patients attending psychiatry OPD in a tertiary care hospital of upper Assam: a retrospective study

Rehab Farhin — 2026-05-30

Background: Understanding the burden of psychiatric disorders in a tertiary care hospital is crucial for healthcare planning and resource allocation. Identifying common diagnoses helps to tailor outpatient services to address patient needs and ensure optimal management of psychiatric illnesses. The present study aims to assess the morbidity pattern and distribution of cases attending the Psychiatry OPD at Jorhat Medical College, Assam, and also study the referral patterns from other departments.

Methods: The study was a retrospective cross-sectional study, where data was collected from OPD register of the Psychiatric Department of Jorhat Medical College. Data on age, gender, religion, department-wise referral, and diagnosis (as per ICD-10 criteria) were obtained. Data analysis was performed using SPSS Version 21.0.

Results: A total of 4,350 patients were included in the study. Substance use disorders were the most prevalent diagnosis (26%), with alcohol use disorder being the most common among them (20%). Schizophrenia, schizotypal, and delusional disorders accounted for 15.8%, with schizophrenia being the most frequent (8.9%). Mood disorders and neurotic, stress-related disorders were diagnosed in 5.8% and 25.3% of patients, respectively. The majority of patients (77.4%) were self-referred, while 22.6% were referred from other departments.

Conclusions: The study highlights the significant burden of substance use disorders and schizophrenia among psychiatric OPD attendees. The high rate of self-referrals indicates a considerable level of awareness among the patients. The referrals from other departments underscore the interrelationship between physical and mental health, emphasizing the need for integrated care.

Flushed, burned, or forgotten? The climate cost of menstrual waste in rural Punjab

Kavita Saharan — 2026-05-30

Background: Menstrual waste management has long remained a neglected concern despite increasing policy attention to menstrual hygiene and awareness. Persistent socio-cultural taboos and limited coordination among key stakeholders, including the Central Pollution Control Board, solid waste management (SWM) authorities, and other implementing bodies, have weakened the planning and execution of effective disposal systems. This misalignment not only affects the health, dignity, and mobility of women and adolescent girls, but also restricts their access to education and public spaces, reinforces gender-based inequalities, and contributes to environmental degradation, positioning menstrual waste as a critical yet overlooked component of sustainable development.

Methods: The present study draws on empirical data collected from adolescent girls in rural villages of Fazilka district, Punjab. Individual interviews were conducted, and government schools were visited to observe and document the availability and condition of menstrual hygiene facilities, including waste disposal strategies, to assess infrastructural support.

Results: The findings reveal that although a majority of adolescent girls now use disposable sanitary pads, safe and sustainable disposal remains a major challenge. Despite the rapid expansion of the sanitary product market in India, disposal systems continue to be severely neglected. Socio-cultural norms, product availability, personal preferences, and levels of awareness significantly shape menstrual product choices and disposal practices.

Conclusions: The study further establishes a clear linkage between menstrual waste management and multiple sustainable development goals (SDGs), emphasizing the urgent need for comprehensive menstrual education for all genders, contextual revision of existing schemes, and stronger monitoring and implementation mechanisms to integrate menstrual waste management into broader frameworks of environmental sustainability and gender equity.

Comparing primary health care delivery through family health centres in tribal Kerala: a two-centre study

Manju Madhavan — 2026-05-30

Background: ‘Aardram Mission’, a Government of Kerala health initiative, aims to transform Primary Health Centres (PHCs) into Family Health Centres (FHCs) -one of its four key-components - focusing on people-friendly outpatient-services, comprehensive health service access for all including marginalized populations and standardizing healthcare from primary to tertiary settings. The research study compares healthcare service provision, innovations and challenges in delivering healthcare to tribal communities at two distinct Family Health Centres.

Methods: This qualitative study was conducted in FHC Noolpuzha in Wayanad and FHC Edamalakudy in Idukki districts, Kerala, India. It was carried out with provider stakeholders from two FHCs serving tribal populations in two different districts of Kerala, aiming to highlight contrasting examples of healthcare service delivery. These selections aim to showcase the diversity and mechanisms of service provision. Thematic analysis was done on the inputs obtained through the qualitative study.

Results: While one FHC demonstrated judicious use of resources and better functioning, attributed to strong team-building efforts among human resources and active engagement from local political leaders and the community, the other FHC faced significant barriers to healthcare access for tribal communities, including inadequate infrastructure, high direct and indirect costs to the beneficiaries and limited social support.

Conclusions: The findings offer practical insights for enhancing health services for tribal communities in Kerala by promoting stronger collaboration within and between departments, fostering political support and adopting more socially inclusive approaches to healthcare.

Quality of life of postmenopausal women in rural area of Northern Kerala: a community based cross-sectional study

Mary Linu — 2026-05-30

Background: Menopausal health requires greater attention in India due to increasing life expectancy and the growing population of postmenopausal women. Awareness regarding menopausal problems remains inadequate, especially among rural women, where menopause is often not openly discussed. This study aimed to assess the quality of life (QoL) of postmenopausal women in rural areas and examine its association with socio-demographic factors.

Method: A community-based cross-sectional study was conducted among 120 postmenopausal women in Cheruthazham Panchayath from December 2021 to May 2023. Four wards were selected by simple random sampling, and 30 women from each ward were recruited consecutively. Data were collected through direct interviews using the MENQoL questionnaire and analysed using SPSS version 24.

Results: The mean age of participants was 52.59±3.31 years, and the mean age at menopause was 48.88±3.70 years. Most women were Hindus (87%), married (77%), and homemakers (52.5%). Comorbidities were present in 63% of women. Previous use of hormone replacement therapy (HRT) was reported by 9%.

The overall QoL mean score was 2.84±1.2, indicating a mild decline in QoL. Vasomotor symptoms had the highest mean score (4.09±2.5), with hot flushes being the commonest symptom (63.3%). Psychosocial symptoms were reported by 83%, mainly anxiety (47.5%), while physical symptoms were reported by 92%, with tiredness being most common (65.8%). Significant associations were observed between age and QoL, age at menopause and psychosocial domain, and HRT use and QoL.

Conclusion: Postmenopausal women showed a mild decline in QoL, with vasomotor, psychosocial, and physical symptoms being commonly reported.

Urban-rural disparities in cervical cancer awareness and reproductive health practices among women in Rajkot, India: a cross-sectional survey study

Shweta Pathak — 2026-05-30

Background: Urban-rural disparities in cervical cancer awareness and reproductive health practices challenge prevention, early detection, and equitable healthcare delivery in low- and middle-income settings. Limited knowledge, sociocultural constraints, and unequal access to services adversely affect women’s health, particularly in rural communities. Understanding these gaps is essential for designing targeted public health interventions. This study compared cervical cancer awareness, contraceptive use, and barriers to healthcare access among urban and rural women in Rajkot, India.

Methods: A community-based cross-sectional survey was conducted among women from urban and rural Rajkot using structured, pretested questionnaires. Data included sociodemographic characteristics, cervical cancer knowledge, screening awareness, contraceptive practices, and perceived healthcare barriers. Descriptive analysis and chi-square tests assessed statistically significant differences between urban and rural groups, with p<0.05.

Results: Marked sociodemographic differences existed between groups. Urban women had higher educational attainment, including bachelor’s degrees (χ²=10.90, p=0.0043), while rural women were largely employed in agriculture (χ²=67.96, p<0.0001). Modern contraceptive use was significantly lower among rural women (χ²=101.25, p<0.0001). Awareness of cervical cancer and screening methods was substantially higher among urban women (p <10^-14). Screening barriers differed, with urban women reporting privacy concerns, whereas rural women faced transportation and cost constraints.

Conclusions: Pronounced urban-rural disparities in cervical cancer awareness, contraceptive use, education, and healthcare access persist among women in Rajkot. Tailored, context-specific public health strategies are needed to improve awareness, reduce structural barriers, and strengthen preventive and reproductive healthcare services for rural populations.

Effect of pranayama on quality of life of sweepers: a pre-post experimental study

Anisha Vishnu Jedhe — 2026-05-30

Background: Sweepers perform physically demanding work and remain exposed to dust, noise and environmental stressors, which may negatively influence their wellbeing. Pranayama, a yogic breathing practice, is known to support both physical and psychological health. To study the effect of pranayama on the quality of life of sweepers using the WHOQOL-BREF scale.

Methods: Sixty sweepers aged 25–40 years took part in this pre–post experimental study. Participants practiced Anulom Vilom and Bhramari pranayama for 20 minutes per session, five days a week, for four weeks. Quality of life scores were recorded before and after the intervention. Data were analyzed using the paired t-test.

Results: Significant improvements were observed in the physical health (p=0.001, t=12.648), psychological (p=0.001, t=6.9515) and social relationship (p=0.0042, t=2.97734) domains. No significant change occurred in the environment domain (p=0.3672, t=0.909)

Conclusions: Regular practice of pranayama improved physical, mental and social aspects of wellbeing among sweepers. It can be considered a simple, cost-effective method for enhancing quality of life.

Addressing the debate of menstrual leave-understanding the relationship between attitude towards menstruation and perception towards menstrual leave among undergraduates in a medical college in Kerala

Athmia Charles — 2026-05-30

Background: The debate on menstrual leaves has evolved into a polarizing discourse. It critiques gender equity, workplace politics and the position of women in academic and professional spaces. It also interweaves the religious, social and political norms surrounding menstruation. This study addresses the views on menstruation and menstrual leaves among female medical undergraduates whose attitudes strike a balance between their sound medical knowledge and the prevailing societal norms.

Methods: This cross-sectional study was conducted using the 4th edition protocol of Menstrual Attitude Questionnaire (MAQ) and items assessing awareness, utilization and support for menstrual leave. Descriptive statistics were used to summarize variables and analysis between variables was done using the chi-square test.

Results: 54.5% of female students perceived menstruation to be a debilitating event, 43.2% agreed menstruation to be a Bothersome event and 66.45% perceived menstruation as a natural event. Although 51.4% of females reported having not taken leave during menstruation, a substantial majority (89.1%) believed women should be entitled to menstrual leaves. The debilitating and bothersome aspects of menstruation contributed to women taking leave during menstruation, with the debilitating nature of menstruation being associated with supporting the provision of menstrual leaves. There was a positive association between having taken leave during menstruation and supporting the provision of menstrual leaves.

Conclusions: The findings indicate that perception of menstruation as debilitating and bothersome event strongly influence the support for the provision of menstrual leaves. This advocates the need for policies that are both evidence based and empathetic.

Menstrual health management: effect on learning outcomes on young adolescent girls: a case study of Sub-District Bijbehara

Sajad Hussain Mir — 2026-05-30

Background: Menstrual hygiene management (MHM) is an important component of adolescent health and has a direct influence on school participation and learning outcomes among adolescent girls. However, inadequate awareness, limited access to sanitary products, and poor sanitation infrastructure in schools often create barriers that affect girls’ comfort, dignity, and educational engagement.

Methods: This study was conducted in 26 Government schools of Educational Zone Bijbehara (Jammu and Kashmir). Data were collected from Heads of Institutions (HOIs) to assess the prevailing status of MHM in school settings, focusing on awareness initiatives, availability of sanitary products, infrastructural facilities, waste disposal mechanisms, and training received by school leadership regarding menstrual health.

Results: The findings reveal a mixed scenario of progress and persistent gaps. While 84.6% of schools had conducted awareness programmes on menstrual hygiene, only 38.5% reported availability of sanitary pads, and merely 3.8% had functional incinerators. Separate toilets for girls (96.2%) and running water (100%) were largely available; however, only 3.8% of schools reported adequate lighting in toilets. Nearly half of the schools lacked proper sanitary waste disposal systems, and vending machines for sanitary pads were almost absent. A significant capacity gap was observed as only 11.5% of HOIs had received formal training on menstrual health. Additionally, 50% of schools did not track absenteeism related to menstruation or evaluate the impact of MHM awareness on attendance.

Conclusions: Strengthening MHM in schools is essential for safeguarding the health, dignity, and educational participation of adolescent girls. A coordinated, multi-sectoral approach focusing on infrastructure, training, product availability, and systematic monitoring is necessary to improve menstrual health and promote educational equity.

Comorbidity patterns in children aged 6-12 years diagnosed with ADHD in South Kerala: a cross-sectional study

Deepa Bhaskaran — 2026-05-30

Background: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder of childhood, frequently associated with psychiatric, behavioural, sleep, and learning comorbidities which contribute significantly to functional impairment and complicate management. This study aimed to assess the prevalence of comorbid conditions among children aged 6-9 years diagnosed with ADHD.

Methods: A cross-sectional study was conducted among 206 children diagnosed with ADHD using the AIIMS-modified INDT ADHD tool. ADHD subtypes were identified using the Vanderbilt assessment scale-parent informant questionnaire. Sleep problems were assessed using the children’s sleep health questionnaire, epilepsy using the INDT-EPI tool, and specific learning disability using NIMHANS SLD battery. Psychiatric comorbidities were diagnosed based on DSM-5 criteria. Data were analysed using SPSS version 26.

Results: The mean age was 7.1±1.0 years, with males constituting 85.4% of participants. The combined ADHD subtype was most prevalent (66.5%), followed by the inattentive (26.2%) and hyperactive/impulsive (7.3%) subtypes. Oppositional defiant disorder was the most common comorbidity (24.8%), followed by specific learning disability (10%), sleep disorders (7.8%) and conduct disorder (7.3%). Academic difficulties were reported in 78% of children. A significant association was observed between ADHD subtypes and both oppositional defiant disorder (p<0.001) and conduct disorder (p<0.05), predominantly in the combined subtype.

Conclusions: Children with ADHD, especially the combined subtype, have a high burden of disruptive behaviour and academic comorbidities, underscoring the need for early comprehensive assessment and integrated interventions.

Optimizing state per capita health expenditure to alleviate cancer burden on hospitals in India: an exploratory study

Sumesh Kumar — 2026-05-30

Background: One death among six is due to cancer globally. Low-and middle-income countries contribute 70% of total cancer cases. In India, cancer cases increased 44% in the last twelve years, but related infrastructure could not be developed. Indian states are lacking cancer-care services and patients need to travel long distance for treatment. This additional cost put pressure on the financial health of patients. The study aimed to analyse cancer burden and inequities in cancer-care services in different states of the country, and the importance of healthcare expenditure in reducing cancer burden.

Methods: Data has been collected from various secondary sources such as ministry of health and family welfare, National-Cancer-Grid and Finance commission of India. Primary data has been collected from randomly selected hospital in Delhi with the help of structured questionnaire. Regression-analysis has been performed with the help of SPSS-version-22. Total 238 patients have been purposively selected as samples.

Results: Cancer-cases are increasing across most of the Indian states. There is skewed availability of cancer-care hospitals in the country. In Bihar there is one cancer hospital for 12142 patients whereas in Maharashtra the figure is 1281. In the primary survey it was found that 75% patients were coming from outside the city for the treatment and travel expenses account for 43.8% of total indirect expenditures.

Conclusions: Disparities in cancer-care facilities accentuates economic burden of cancer in the country. Increase in government expenditure reduces cancer burden on hospitals. The study provides actionable recommendations for policymakers, healthcare providers, and other stakeholders.

Family adoption program as a teaching-learning tool perspectives from Vijayapura, North Karnataka, India: a cross-sectional study

Shamin Eabenson — 2026-05-30

Background: The family adoption program (FAP) is an amazing initiative that seeks to give underprivileged families all-encompassing support so they can achieve sustainable livelihoods and improve their quality of life. FAP tackles issues like health literacy and lack of disease awareness because 65.5% of India’s population lives in rural areas with limited access to healthcare. Through community participation, medical students get a firsthand look at the living circumstances of the patients they see in hospitals. Beginning in 2022, MBBS students are required to participate in the FAP by the National medical commission (NMC). At least five households must be assigned to each student. It is required of the students to build rapport, comprehend their health and associated factors.

Methods: The cross-sectional study required a sample size of 370 for estimating the expected prevalence with 4% absolute precision and 95% confidence level.

Results: Regarding the perception on FAP, when enquired if FAP has improved their understanding of patient’s family dynamics, out of the 406 medical students, the majority 343 (84.5%) agreed. When asked if FAP had enhanced their communication skills with patients and their families, the majority 343 (84.5%) agreed.

Conclusions: Although FAP increased baseline data collection, healthcare use and experience learning, it’s limited by logistical issues, underscoring the need for better community-based initiatives. Family Adoption Program should be streamlined to address the issues raised by medical students, family members, faculty members and administrators.

Self-medication practices and associated factors among adult population in rural field practice area of a tertiary care hospital: a cross-sectional study

Navyasree U. R. — 2026-05-30

Background: Self-medication is a common public health concern in developing countries like India. Easy drug availability, limited healthcare access, and prior experience contribute to this practice, which may lead to adverse drug reactions and antimicrobial resistance. This study aimed to estimate the prevalence of self-medication and associated factors among adults in a rural community.

Methods: A community-based cross-sectional study was conducted from October to December 2025 in a rural field practice area of a tertiary care hospital among 368 adults selected by simple random sampling.

Results: The mean age of participants was 40 years, and the prevalence of self-medication was 61.7%. Pharmacies were the main source of medicines (74%), and headache (78.8%) and fever (66.4%) were the most common indications. Female gender, unemployment, easy access to pharmacies, availability of medicines at home, peer influence, and previous experience were significantly associated with self-medication.

Conclusions: The study revealed a high prevalence of self-medication in the rural community. Female gender, unemployment, easy access to pharmacies, availability of medicines at home, peer influence, and prior experience were significantly associated with this practice.

Quality of life assessment among leprosy patients residing at leprosy home in a district of Eastern Odisha: a cross-sectional study

Subham Mohanty — 2026-05-30

Background: Leprosy remains a significant public health concern in India, contributing substantially to disability, stigma, and impaired quality of life (QoL), despite its elimination as a public health problem. Persons affected by leprosy often experience long-term physical, psychological, and social consequences, particularly those with visible disabilities. This study aimed to assess the quality of life and patterns of disability among leprosy-affected persons residing in a leprosy care and rehabilitation centre in a district of Eastern Odisha.

Methods: A cross-sectional study was conducted in December 2024 among 80 adult leprosy patients residing at the Leprosy Care and Rehabilitation Centre, Cuttack, using universal sampling. Sociodemographic details and disability grades were recorded. QoL was assessed using the WHOQOL-BREF questionnaire. Domain-wise transformed scores were calculated, and data were analyzed using SPSS version 17. Statistical significance was set at p<0.05.

Results: Of the 80 participants, 64% were male and the mean age was 56.6±18.2 years. A majority (87%) had Grade 2 disability. The lowest QoL scores were observed in the social and psychological domains. Overall, 62% of participants rated their quality of life as poor or very poor. Male gender, younger age, higher education, better socioeconomic status, unmarried status, and contact with family were significantly associated with better QoL in one or more domains.

Conclusions: Leprosy continues to severely compromise quality of life, particularly in the social and psychological domains, among affected individuals in Eastern Odisha. Comprehensive rehabilitation, stigma reduction, psychosocial support, and family-centered interventions are essential alongside medical management to improve overall well-being.

Awareness and attitude towards menstruation and menstrual hygiene among college students in Ernakulam district, Kerala

Anakha Beena Aravind — 2026-05-30

Background: Menstruation is a normal physiological process essential for women’s physical, mental, and social well-being. However, social norms, cultural beliefs, and misconceptions continue to influence perceptions regarding menstruation, particularly among young adults.

Methods: A cross-sectional study was conducted among college students aged 18-25 years using a pre-validated semi-structured questionnaire. Convenience sampling and online data collection were employed. A total of 315 responses were analyzed using SPSS version 21. Knowledge and attitude scores were assessed, and associations with sociodemographic variables were analyzed using the Chi-square test, with p<0.05 considered statistically significant.

Results: Among participants, 47.9% were females and 52.1% were males, with a mean age of 20.7 years. Overall, 54.3% demonstrated adequate knowledge regarding menstruation and menstrual hygiene. Adequate knowledge was significantly higher among females, urban residents, and participants whose mothers had high school education or above. Positive attitudes towards menstruation were observed in 59% of participants and were significantly associated with nuclear family structure (p=0.021). Participants with adequate knowledge were more likely to exhibit positive attitudes (p=0.011). Misconceptions regarding menstruation were relatively less prevalent.

Conclusions: College students demonstrated moderate to adequate knowledge and generally positive attitudes towards menstruation and menstrual hygiene. Improved awareness was associated with favourable attitudes, emphasizing the role of education and family environment in promoting healthy menstrual perceptions and practices.

Awareness and misconceptions about contraception in post-partum period in a tertiary care centre in North India: a cross-section study

Manisha Jhirwal — 2026-05-30

Background: Most common reason of unintended pregnancy is non-use of contraception and contraception failure. To get rid of unintended pregnancy, abortion is most common procedure done which can lead to increased maternal morbidity and mortality. The aim of this study is to explore the sociodemographic variables of reproductive women with awareness about contraception, outlook for contraception use and reason for not using contraception in all reproductive women.

Methods: A cross-sectional study was conducted including 825 postnatal women during March 2025 to August 2025 in department of obstetrics and gynaecology at AIIMS Jodhpur. The data was analysed using SPSS version 26.

Results: A total of 825 postpartum women were included, predominantly aged 25-30 years (46.7%), Hindu (84.1%), and from middle socioeconomic status (75.8%). Awareness of contraception was high (93.5%), with condoms being the most commonly known method (82.6%). However, only 68.2% had ever used contraception. Condoms (32%) and oral contraceptive pills (14.4%) were the most commonly used methods, while 31.1% used none. Fear of side effects (37%), partner/family opposition, and misconceptions regarding fertility and IUCD safety were major barriers. Contraceptive use was significantly associated with age, education, socioeconomic status, planned pregnancy, and prior LSCS.

Conclusions: Despite high awareness of contraception among postpartum women, actual use remains suboptimal due to misconceptions, fear of side effects, and partner or family opposition. Targeted, structured counselling integrated into antenatal and postnatal care is essential to bridge the knowledge–practice gap and improve postpartum contraceptive uptake.

Musculoskeletal disorders among group D healthcare workers in a tertiary care hospital in urban Bengaluru

Vidya Basavaraju — 2026-05-30

Background: Musculoskeletal disorders (MSDs) are a major cause of disability worldwide, with healthcare workers—especially Group D staff—being particularly vulnerable due to physically demanding tasks such as lifting, prolonged standing, and repetitive movements. This study aimed to determine the prevalence of MSDs and identify associated risk factors among Group D healthcare workers in a tertiary care hospital in Bengaluru.

Methods: A cross-sectional study was conducted among 100 Group D healthcare workers with at least six months of work experience. Data were collected using a structured questionnaire assessing sociodemographic details, work history, and MSD symptoms. Interviews were conducted face-to-face in the local language. Statistical analysis was performed using SPSS version 20.0, applying descriptive statistics and relevant associations.

Results: The study revealed a high prevalence of MSDs, with 54.3% reporting lower back pain, and nearly one in three workers reporting neck and knee pain. Females reported a higher proportion of musculoskeletal symptoms compared to males. Long working hours, repetitive tasks, awkward postures, and lack of ergonomic support were identified as major contributing factors. Sleep disturbances, mood changes, and reduced ability to perform daily activities were also commonly reported.

Conclusions: More than one in two workers experienced MSDs, largely due to long hours and poor ergonomics, leading to reduced quality of life. Strengthening workplace ergonomics and preventive health measures is essential to protect this workforce.

Evaluation of clinicomycological profile in patients of chronic rhinosinusitis

Dimple Sahni — 2026-05-30

Background: Rhinosinusitis (RS) poses a major health problem, substantially affecting quality of life, productivity, and finances.

Methods: This prospective clinical study was conducted in the Department of ENT at Government Medical College, Patiala, from March 2022 to June 2024 (2 years) involving 60 patients diagnosed with Chronic Rhinosinusitis (CRS) based on the diagnostic criteria outlined in the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS-2012).

Results: The study comprised patients with a mean age of 37.42 years (±14.43) with male to female ratio of 1.22:1. Mycological evaluation showed fungal filaments on KOH mount in 35% patients and Aspergillus flavus being the most frequently isolated species on culture. Histopathological analysis confirmed fungal rhinosinusitis in 30% of patients, with allergic fungal rhinosinusitis being the most common finding, followed by fungal ball.

Conclusions: In our study, Aspergillus flavus being the most commonly isolated fungus, followed by Aspergillus fumigatus and Mucorales species. These findings highlight the common fungal association in CRS. Mycological identification is essential for accurate diagnosis, guiding appropriate treatment and preventing complications.

Discrimination among people living with HIV attending an antiretroviral therapy Centre in Gwalior: a cross-sectional study

Sourav Mandal — 2026-05-30

Background: In India, despite advances in HIV prevention and treatment, the well-being of people living with HIV (PLHIV) continues to be affected by persistent stigma and discrimination. Beyond community-level prejudice, discriminatory attitudes within families remain common and are influenced by socio-economic factors and access to accurate HIV-related information. Family-level discrimination continues to pose a significant challenge to the overall HIV response.

Methods: A hospital-based cross-sectional design conducted over a twelve-month period. The study focused on 380 HIV-positive participants within the 25 to 35 years of age. Assessments were performed using a structured questionnaire to access the discrimination. Data were analysed using SPSS v27, with p<0.05 considered significant. Chi square test was applied wherever appropriate.

Results: Out of 380 participants, 85 (22.4%) reported having faced discrimination, while the majority, 295 (77.6%), did not report any discriminatory experiences.

Conclusions: The findings indicate that although overt discrimination is uncommon among most PLHIV, it remains a substantial barrier for vulnerable groups, including those socially marginalized, newly enrolled in treatment, or lacking domestic support. Discrimination, in conjunction with stigma, continues to negatively influence mental health and overall well-being.

Prevalence and factors associated with school absenteeism during menstruation among higher secondary female students in Kannur district: a school based cross-sectional study

Rafeeda Pothangode — 2026-05-30

Background: Adolescence marks transition from childhood to adulthood involving physical, cognitive, psycho-social and emotional changes. School absenteeism is a significant issue that affects academic performance and overall well-being of students. In recent years, there has been growing concern about the prevalence of school absenteeism among adolescent girls, particularly in developing countries. Menstrual disorders have been identified as the leading cause of school absenteeism, which seriously impacted their academic achievement. But, in India there are only limited studies on the topic, especially in Kerala. So, this study aims to estimate the prevalence and factors associated with school absenteeism during menstruation.

Methods: School based cross-sectional study conducted among 624 higher secondary female students in Kannur district. Stratified random sampling was done among all higher secondary schools based on their location and management type. Data was collected using a self-administered pretested semi structured questionnaire and analyzed using SPSS 21. Results were expressed in terms of frequencies, percentages, mean, standard deviation. Chi-square test, Fisher’s exact tests were used to test association.

Results: The median age of the population was 17 (±1) years. Median age at menarche was 13 (±1) years. Among the 624 participants prevalence of school absenteeism during menstruation was 59.8%. Most common reason was pain, followed by tiredness, discomfort etc. Significant factors associated were academic stream, age group, residence, menorrhagia.

Conclusions: Prevalence of school absenteeism during menstruation was 59.8%. Most common reasons for absenteeism were pain and tiredness. Significant associations were noted between age, academic stream, location of school, residence, age at menarche, presence of menorrhagia.

Satisfaction of cancer patients receiving chemotherapy in day care units: a cross-sectional study

Khina Sharma — 2026-05-30

Background: Chemotherapy remains a cornerstone of cancer treatment and more than half of all cancer patients undergo chemotherapy at some stage of their illness. It is widely delivered in outpatient day care settings. The study aimed at evaluating the satisfaction levels of cancer patients receiving chemotherapy in outpatient day care units and examining the association of satisfaction with selected socio-demographic and clinical variables.

Methods: A quantitative study with a cross-sectional research design was conducted among 500 cancer patients attending the day care chemotherapy unit of a tertiary care centre. Participants were selected using a non-probability convenience sampling technique. Self-structured tools, including socio-demographic ad clinical variables and a patient satisfaction rating scale, were used for data collection.

Results: The study revealed that the majority of patients (96%) were satisfied with the care they received at day care chemotherapy unit, while only a few (1%) reported dissatisfaction. Significant association was found between patient satisfaction and age (p=0.002), whereas other demographic and clinical variables showed no significant association.

Conclusions: The study indicates that the majority of cancer patients receiving chemotherapy in day care chemotherapy unit reported a high level of satisfaction with the services provided. As age was found to have a significant influence on satisfaction levels, suggesting that age-specific preferences and needs should be taken into account when planning and delivering care. These findings emphasize the importance of continuous quality assessment to ensure that patient-centered care remains a priority in oncology day care settings.

Knowledge and practice of medical faculties regarding alignment and integration in medical education: a cross-sectional study

Mrunalini Kalikar — 2026-05-30

Background: The term integration has gained importance in medical education over the last two decades. Integration is one of the major changes incorporated in the new competency-based curriculum for the undergraduate medical program. However, the concept of integration/integrated curriculum lacks significant clarity as, how to implement it in medical institutions. Many medical faculties are not clear about the concept. Therefore, the present study was planned to assess the knowledge and practice of medical faculties regarding various methods of Integration.

Methods: This was a cross-sectional, questionnaire-based study conducted at a tertiary care teaching hospital after approval from the institutional ethics committee. Respondents were around 100 medical faculties specialties who have consented to participate in the study. The study instrument was a self-developed, pre-validated semi-structured questionnaire consisting of both open and closed items. Two focus group discussions were conducted with faculties and medical students.

Results: Data was expressed as percentages. The majority of the faculties were aware of the term integration; however, they had poor knowledge regarding the types of integration and the difference between alignment and integration. Practice regarding integration was poor.

Conclusions: Knowledge and practice among medical faculties regarding alignment and integration were poor. There is a need to have training of medical faculties for better implementation of this concept in the CBME curriculum.

Unmasking diabetes risk: screening of bank employees in Belagavi city

Vivek Jirankali — 2026-05-30

Background: Diabetes is rising rapidly. Early identification of high-risk individuals and timely intervention are essential to prevent its onset and complications. This study aimed to screen bank employees in Belagavi using Indian Diabetic Risk Score (IDRS) and identify factors influencing risk levels.

Methods: A cross-sectional study was conducted among employees of nationalized banks in Belagavi city. The estimated sample size was 330, and participants were selected through a simple random sampling technique. Data on demographic characteristics and IDRS scores were systematically recorded for all individuals.

Results: Among the participants, most were male (72.27%) and aged above 50 years (59.39%). The majority were Hindus (96.06%), graduates (83.63%), and belonged to the upper socioeconomic class (87.57%). Regarding diabetes risk assessment, 187 (56.66%) of the bank employees were classified as having a very high risk, while 124 (37.57%) fell into the moderate-risk, and only 19 (5.75%) were identified as low risk. A significant proportion of individuals aged above 50 years (144,73.09%) and those leading a sedentary lifestyle (98, 68.53%) exhibited high IDRS scores.

Conclusions: The study findings underscore that a substantial proportion of bank employees are at a very high risk of developing diabetes. Key factors such as age, physical inactivity, body mass index (BMI), and waist circumference were significantly associated with elevated IDRS scores. These results highlight the need for targeted preventive measures and lifestyle modifications to mitigate the risk of diabetes in this occupational group.

Effect of using face shield and its relation to musculoskeletal disorder among health practitioners

Nikitha Damavarapu — 2026-05-30

Background: Personal protective equipment (PPE) is considered a very essential element in controlling the spread of infection in health care facilities; however, prolonged use of various PPE, especially face shields cause discomfort, neck impingement and restricted movement leading to musculo skeletal disorders (MSDs).

Methods: A cross-sectional survey was conducted with 145 Health Practitioners (HPs) at a tertiary care hospital in Chennai, utilising a validated questionnaire from December 2022 to May 2023. Univariate analysis was using Social Sciences (SPSS) Statistics version 23.0.

Results: Approximately 52% indicated experiencing MSDs, while 44.7% reported MSDs associated with the prolonged use of face shields in the workplace. The risk of MSDs was 3.4 times higher among individuals who used Personal Protective Equipment (PPE) (95% CI: 1.0–11.2). PPE-related restrictions on movement resulted in MSD for 72% of healthcare professionals, presenting a 2.5-fold risk (95% CI: 1.2-5.0). A significant association was observed between the history of work-related MSDs and their prevalence among healthcare professionals utilising face shields (OR: 9.5; 95% CI: 2.7-33.5). Many HPs reported discomfort, diminished visual clarity and movement restrictions, all of which are associated with MSDs. Although not statistically significant, 9% of healthcare professionals who wore PPE for more than 6 hours/day reported experiencing MSDs.

Conclusions: PPEs can serve as a deterrent in certain aspects, yet they are essential for safeguarding HPs from various infections. Customising and utilising tailored PPEs can assist healthcare professionals in safeguarding themselves from both infections and MSDs.

Knowledge and practice of rabies post-exposure prophylaxis and animal-bite management among postgraduate trainees and faculty at a tertiary hospital in Goa: a cross-sectional study

Switzel V. Braganza — 2026-05-30

Background: Rabies is almost uniformly fatal after symptom onset but preventable with timely wound care and post-exposure prophylaxis (PEP). Physicians across specialties must apply current guidance to avoid preventable deaths. This study was done to assess knowledge and self-reported practices regarding rabies prophylaxis and animal-bite management among postgraduate trainees (PGT) and faculty at a tertiary care teaching hospital in Goa.

Methods: A cross-sectional survey was conducted during September 2024 to October 2024 among PGT and faculty (excluding Community Medicine due to prior structured training in anti-rabies clinic protocols). A sample size of 220 was estimated using a single-proportion formula (p=0.833, d=0.05, 95% confidence) and selected by simple random sampling from an eligible roster (n=350). Participants received a self-administered online questionnaire after electronic consent. Responses were scored as correct/incorrect against the National Guidelines for Rabies Prophylaxis (2019). Descriptive statistics were reported as frequencies and percentages.

Results: Of 220 invited doctors, 146 responded (response rate 66%); 96 (65.8%) were PGT and 100 (68%) belonged to clinical departments. Correct responses were generally higher for rabies epidemiology than for clinical management domains, particularly wound management, RIG indications/dosing, pre-exposure prophylaxis, and management of re-exposure in previously vaccinated individuals (only 36/146, 25%, correct).

Conclusions: Substantial gaps were observed in practical rabies PEP decision-making and wound management despite relatively adequate epidemiologic knowledge. Regular, competency-based refreshers and protocol reinforcement across departments are warranted to support rabies elimination goals.

Assessment of hepatitis B vaccination status among healthcare workers in South Delhi: a cross-sectional study

Asia Khanam — 2026-05-30

Background: Healthcare workers (HCWs) are at increased risk of hepatitis B virus (HBV) infection due to occupational exposure to blood and body fluids, particularly needle-stick injuries. Hepatitis B vaccination is a safe and effective preventive measure recommended for all HCWs.

Methods: A hospital-based cross-sectional study was conducted in 2018 among 539 healthcare workers using a structured questionnaire. Participants included doctors (including interns and postgraduate students), nurses, laboratory technicians, and other healthcare staff exposed to blood and body fluids during patient care. Vaccination status was categorized as complete (three doses), partial (one or two doses), and unvaccinated. Data were analyzed using descriptive statistics. Ethical clearance was obtained from the Institutional Ethics Committee.

Results: Among 539 participants, 379 (70.32%) were fully vaccinated, 115 (21.33%) were partially vaccinated, and 45 (8.34%) were unvaccinated. Vaccination coverage was highest among nurses (84.18%), followed by doctors and internees (69.79%) and laboratory technicians (63.46%). Coverage was lowest among other healthcare workers, with 41.07% unvaccinated.

Conclusions: Although most healthcare workers were vaccinated, gaps remain, particularly among supportive staff. Strengthening institutional vaccination policies and awareness programs is necessary to achieve complete coverage and reduce occupational risk of HBV infection.

Maternal mental health matters: understanding postpartum depression using EPDS

Prabhjot Kaur — 2026-05-30

Background: Postnatal depression (PND) is a global public health concern with significant implications for maternal and infant health. It is a common but underdiagnosed mental health disorder affecting women during the postpartum period, particularly in low- and middle-income countries. A validated screening tool such as the Edinburgh Postnatal Depression Scale (EPDS) is essential for early detection and prevention of adverse maternal and infant outcomes.

Methods: A cross-sectional observational study was conducted at BJRM Hospital, Delhi in 250 postpartum women using the Edinburgh Postnatal Depression Scale (EPDS) at 6 to 8 weeks postpartum. A score ≥13 indicated probable depression and data was analysed using descriptive statistics.

Results: Probable postnatal depression (EPDS≥13) was observed in 23% (n=59), with 17% showing possible depression (EPDS 10–12) mainly anxiety symptoms. Mean EPDS scores did not show any significant association with maternal age(p=0.086), parity (p=0.086) or mode of delivery (p=0.363). There was significant association of EPDS scores with the newborn sex (p=0.002).

Conclusions: Nearly 25% of postpartum women screened positive for probable depression. Extremes of maternal age, primiparity, mode of delivery and sex of newborn were associated with higher EPDS scores. Routine postpartum screening using EPDS should be integrated into maternal health services to enable early identification and timely intervention.

Awareness on etiology and preventive measures of cancer cervix among female medical students in Rajarajeswari Medical College, Bengaluru

Sabarinath Purushothaman — 2026-05-30

Background: Cervical cancer is a major cause of cancer-related morbidity and mortality among women worldwide. Persistent infection with high-risk human papillomavirus (HPV) is the primary etiological factor. Although HPV vaccination and Pap smear screening are effective preventive measures, awareness and utilization remain inadequate in many settings. This study assessed awareness regarding cervical cancer etiology and preventive measures among female medical students.

Methods: A cross-sectional study was conducted among 150 female medical students at Rajarajeswari Medical College, Bengaluru. Data were collected using a pretested semi-structured questionnaire assessing knowledge regarding HPV infection, risk factors, screening and HPV vaccination. Data were analyzed using SPSS software. Descriptive statistics and Chi-square test were applied.

Results: All participants had heard of HPV infection and cervical cancer. Awareness regarding HPV transmission through genital contact was reported by 87% of participants, while 84% identified sexually transmitted diseases as a risk factor. Pap smear as a screening method was known to 98.7% of students. Awareness regarding HPV vaccine was reported by 98.7% and 94.7% were willing to receive vaccination; however, only 38.7% had been vaccinated. Educational level showed significant association with knowledge regarding target age for HPV vaccination (p=0.035) and recommended age for first Pap smear (p=0.030).

Conclusions: Awareness regarding cervical cancer and preventive measures was high among medical students, but HPV vaccine uptake remained low despite high willingness. Improved educational interventions and better vaccine accessibility are needed.

Assessment of knowledge and skills of vaccine cold chain handlers in Nadia district, West Bengal: a cross-sectional study

Deepak K. Singh — 2026-05-30

Background: The effectiveness of vaccination programs hinges on a reliable cold chain infrastructure, which is essential for maintaining vaccine potency. Individuals tasked with managing the vaccine cold chain play a key role in preserving this efficacy, thereby facilitating effective immunization by adhering to established storage and handling protocols. The current research aims to evaluate the proficiency and technical expertise of these handlers in managing the cold chain across selected subdivisions of the Nadia District in West Bengal.

Methods: Vaccine cold chain handlers at cold chain points in the chosen subdivisions participated in a descriptive cross-sectional facility-based study. Of the 38 handlers identified, 30 met the eligibility criteria and were included using a census method. Data was gathered using an observation checklist to evaluate the practical skills and a pretested structured questionnaire to assess knowledge. Both descriptive and suitable inferential statistical analyses were carried out.

Results: The majority of the participants were female (28; 93.3%) with a mean age of 42.6±10.3 years. The mean knowledge score was 13.66±1.18 (out of 15), with 96.7% demonstrating good knowledge. The mean skill score was 4.16±0.91 (out of 5). While temperature monitoring was correctly performed by 93.3%, only 60% correctly demonstrated the shake test. Knowledge and skill scores showed a significant positive correlation (r=0.564, p=0.001).

Conclusions: Although the majority of cold chain handlers demonstrated good knowledge, certain gaps in practical skills were identified, indicating the need for periodic refresher training and strengthened supportive supervision.

Clinical evaluation of Nadifit-guided acupuncture in male infertility with oligospermia: a prospective observational study with TCM organ energy correlation analysis

Manjunatha Yagachikatte Chandrashekaraiah — 2026-05-30

Background: Male infertility contributes to approximately 40-50% of infertility cases worldwide. Oligospermia and impaired sperm motility are major etiological factors, frequently associated with metabolic dysfunction. Conventional pharmacological therapies often yield limited improvement in sperm kinetics and do not comprehensively address systemic bioenergetics imbalance. This study aimed to evaluate the clinical effectiveness of Nadifit pulse–guided acupuncture in improving semen parameters in patients diagnosed with oligospermia and associated metabolic dysfunction.

Methods: A prospective observational study was conducted on 32 male patients (age 28-42 years) with oligospermia (sperm count <30 million/ml). Treatment consisted of structured acupuncture targeting Kidney Yang deficiency and Damp-Cold obstruction, guided by Nadifit pulse assessment. Semen parameters were recorded at baseline and after 4 weeks of treatment.

Results: Data were expressed as Mean±SD. Paired t-test was applied with significance threshold set at p<0.05. Across the cohort (n=32), a statistically significant increase in sperm concentration was observed (p<0.05). In the representative case, average sperm concentration improved from 22.5 million/ml to 58 million/ml (+157%). Progressive motility increased from 60% to 70%, while morphology remained within normal limits (70%). Semen volume improved from 2.0 ml to 3.0 ml. The intervention demonstrated clinically meaningful improvement in sperm kinetic energy and forward progression.

Conclusions: Nadifit-guided acupuncture demonstrated moderate therapeutic impact in male infertility associated with Kidney Yang deficiency and metabolic dysfunction. These findings support further randomized controlled trials integrating bioelectrical pulse diagnostics with reproductive medicine.

Long-term visual outcome among adults availing free cataract surgery in Southern India

Lijiraj Sundararaj — 2026-05-30

Background: Cataract surgery aims to restore vision and independence, yet long-term follow-up in low-resource settings remains low. This study evaluates the sustainability of visual outcomes in patients who received free cataract surgery in South India.

Methods: A multicenter, observational study was conducted among adults who underwent cataract surgery at six tertiary care hospitals in Tamil Nadu and Karnataka. Two cohorts were assessed: individuals operated 2 years prior (n=319) and 4 years prior (n=361). Participants were selected using random-proportional sampling followed by convenience sampling. Data collection included home-based interviews and visual acuity assessment using a Snellen tumbling E chart. Baseline visual acuity obtained from medical records was compared with follow-up measurements. Both uncorrected and pinhole-corrected visual acuity were analyzed in LogMAR units. Paired t-tests and ANOVA were used to assess differences.

Results: In the 2-year cohort, mean uncorrected VA remained stable from baseline (0.34±0.37 LogMAR) to follow-up (0.35±0.30; p=0.08). Pinhole-corrected VA also showed no significant change (0.34±0.36 to 0.25±0.29; p=0.05). In the 4-year cohort, a significant decline in visual acuity was observed. Uncorrected VA worsened from 0.23±0.20 at baseline to 0.31±0.31 at 4 years (p=0.03). Similarly, pinhole-corrected VA declined from 0.17±0.22 to 0.21±0.28 (p=0.01).

Conclusions: While visual outcomes remained stable at 2 years post-surgery, a significant decline was evident at the 4-year follow-up among South Indian patients who underwent free cataract surgery. This underscores the necessity for structured, long-term postoperative care and monitoring systems in resource-limited settings to sustain the initial benefits of cataract intervention and address late complications.

Influence of dietary habits and physical activity on body mass index and dental caries in children of Visakhapatnam

Manjusha Dumpala — 2026-05-30

Background: Healthy diet and adequate physical activity are necessary for optimal growth of children. Dental caries is the most common disease in children, with diet being one of the contributing risk factors. Lack of physical activity in children also leads to weight gain, which may lead to systemic complications in adulthood. Hence the present study is designed to find out the association between dietary habits and physical activity with body mass index (BMI) and dental caries in children.

Methods: Children between 8–13 years attending the Department of Pedodontics, Gitam Dental College and Hospital were selected through convenience sampling for the survey. Children were given a printed questionnaire regarding the physical activity and individual food preferences. BMI and decayed, missing and filled teeth (DMFT) index of the individual subjects were calculated. Mean scores of the individual questions were tabulated and subjected to statistical analysis.

Results: There is no significant relation between physical activity and increased BMI. Poor dietary habits resulted in increased BMI, with increased junk food and fatty food intake and decreased consumption of vegetables and fruits being important risk factors. Environmental factors including age and gender are additional factors for prevalence of dental caries. Moreover, there is increased caries activity in children with lower BMI.

Conclusions: The findings of this study provided an insight into the oral health status, dietary habits and the changes in lifestyle of school going children in Visakhapatnam post COVID-19, which may be useful in designing and planning preventive oral health programs.

Prevalence of insomnia and its association with comorbid conditions among elderly attending an urban health training centre in Nagpur, Maharashtra: a cross-sectional study

Anjali V. — 2026-05-30

Background: Insomnia is characterised by dissatisfaction with the quality or quantity of sleep, accompanied by difficulty in falling asleep or maintaining sleep which is common among elderly due to age-related physiological changes and chronic medical conditions. Despite its high prevalence insomnia is under-recognised, under-diagnosed and inadequately treated among elderly population. Therefore, this study aims to estimate the prevalence of insomnia among the elderly and to assess its associated co morbid conditions.

Methods: A hospital based cross-sectional study was conducted among 251 elderly individuals (aged ≥60 years) at the Urban health training centre of a tertiary care centre in Nagpur, Maharashtra. Socio-demographic and clinical information were gathered using a pre-designed and pre-tested questionnaire. The severity of insomnia was assessed using the Insomnia Severity Index (ISI). Data analysis was performed with Jamovi version 2.3.28, employing descriptive statistics as well as Chi-square and Fisher’s exact tests.

Results: The mean age of the participants was 68.9±6.29 years and the prevalence of insomnia was 59.2%. A significant association was observed between insomnia and factors such as age, family type and medical conditions like diabetes and musculoskeletal disorders, cardiovascular disease and genitourinary problems.

Conclusions: More than half of the elderly individuals in the study were affected by insomnia. Several socio-demographic and co morbid conditions were associated with insomnia, underscoring the importance of early identification and routine screening for sleep disturbances in elderly. Such measures may contribute to improving their overall health and quality of life.

Assessment of type 2 diabetes risk using the Indian diabetes risk score and its association with selected risk factors among adults attending a rural health training centre in central India: a cross-sectional study

Shubham S. Bhawane — 2026-05-30

Background: Type 2 diabetes mellitus (T2DM) is a significant public health concern in India, with a large proportion of cases remaining undiagnosed, especially in rural populations. Early identification of individuals at risk is essential to prevent or delay disease onset. This study aimed to assess the risk of T2DM using the Indian Diabetes Risk Score (IDRS) and to examine its association with selected risk factors among adults attending a rural health training centre in Central India.

Methods: A cross-sectional study was conducted from August to October 2025 among 236 adults aged ≥30 years at the Rural Health Training Centre, Saoner. Known cases of diabetes mellitus, pregnant women and lactating women were excluded. Data were collected using a pre-designed, semi-structured proforma. Participants were classified into low, moderate and high-risk categories based on IDRS. Convenience sampling was adopted. Data analysis was performed using Jamovi statistical software (version 2.6.44). Associations between IDRS categories and selected variables were analysed using Fisher’s exact test (Freeman–Halton extension), with p<0.05 considered statistically significant.

Results: Among the participants, 64.8% were aged ≥50 years. Based on IDRS, 4.2% were at low risk, 41.5% at moderate risk and 54.3% at high risk. Age, gender, physical activity, family history of diabetes, body mass index, waist circumference and hypertension were significantly associated with higher IDRS risk categories (p<0.05).

Conclusions: A considerable proportion of adults attending a rural health training centre were found to be at high risk of developing T2DM. Routine screening at the primary care level using IDRS, along with targeted lifestyle interventions, may facilitate early detection and prevention of diabetes.

Survey on cancer incidence around Chengannur, Kerala, with focus on major risk factors

Annies Joseph — 2026-05-30

Background: Community awareness regarding the specific risk factors that enhance susceptibility to cancer is limited. This survey was undertaken to examine the prevalence of cancer cases in and around Chengannur, including the Alappuzha and Pathanamthitta districts of Kerala, with special attention to risk factors.

Methods: Cancer cases were identified through direct and indirect interviews with cancer patients and their relatives. Hospital records at the Government Hospital, Kozhencherry and the Health Centre, Chengannur, were also examined for data collection.

Results: A total of 285 cases were analysed with 26 cancer types recorded. The highest number of cases was observed with cancers of the breast (18.2%), followed by lungs (15.1%). Females comprised 52.6%, while males accounted for 47.4%. Chi-Square test (p<0.001) confirmed a significant association between cancer type and gender, with lungs, oral, brain and liver largely affecting males, while breast, cervix and ovary were female dominant. A peak of incidence of cancer was observed within the 40–60 years age group. Tobacco use was found to be the predominantly contributing risk factor (37.2%), followed by alcohol consumption (32.6%) and was strongly associated (p<0.001) with specific cancer types. Age, certain chemicals, family history, poor diet and certain hormones were also significant, comprising 17.5%, 16.8%, 14.7%, 12.6% and 10.9%, respectively.

Conclusions: The study provides valuable perspectives into cancer profiles of the Chengannur region, predominantly driven by lifestyle factors. Findings recommend community campaigns on cancer awareness focusing on midlife surges, gender-specific patterns and sustainable lifestyle shifts to reduce cancer risk.

A study to assess the level of occupational stress and associated factors during COVID-19 outbreak among police personnel at selected police stations, West Bengal

Sayani Singha — 2026-05-30

Background: The importance of emergency services wouldn’t be significant to us if we had not faced this crisis namely, the COVID pandemic. Police service features a distinguished role to tackle this pandemic. This study aimed to assess level of occupational stress and associated factors during COVID-19 outbreak.

Methods: A descriptive study was conducted among the police personnel of Durgapur subdivision. Occupational stress was measured using the organizational and operational police stress questionnaire and structured questionnaire for associated factors. Data were analyzed using descriptive statistics and inferential statistics.

Results: 37% police personnel had reported High organizational stress, 55% and 8% as moderate and low organizational stress respectively and 57% police personnel had reported high operational stress, 43% as moderate operational stress during COVID-19 outbreak. Police personnel responded that there was an increased number of violent confrontations between the public and them while enforcing new regulations and restrictions. The majority of the participants having a fear of getting affected from co-worker, infecting family member and responded that they didn’t get enough supply of protective equipment. Organizational stress was significantly associated with educational status and designation. Operational stress was significantly associated with place of posting and COVID test report.

Conclusions: This calls for urgent action from the officials as occupational stress can have extremely negative impact on their physical, mental and social health and wellbeing as well as professional life of police officers during this grim situation. There is a need for holistic support for their job satisfaction.

Awareness and attitude towards routine immunization of children aged 12-23 months among migrant workers in Southern Karnataka: a community based cross-sectional study

Shweta Neminath Kurkuri — 2026-05-30

Background: Immunization is one of the most cost-effective public health interventions for preventing childhood morbidity and mortality. The aim of the study was to assess the knowledge and attitude of parents towards routine immunization of children aged 12-23 months among migrant workers and to determine the correlation between knowledge and attitude scores.

Methods: A community-based cross-sectional study was conducted among 500 parents/guardians of migrant children aged 12-23 months in an urban area of Southern District of Karnataka. Data were collected using a pre-tested structured questionnaire assessing knowledge and attitude towards routine immunization. Descriptive statistics, independent t-test, and Pearson’s correlation coefficient were used for analysis.

Results: Awareness regarding routine immunization was found in 99.2% of parents and 97.2% believing that immunization protects children from diseases. However, substantial misconceptions were observed regarding contraindications to vaccination, as 67.8% considered common cold, 79.6% diarrhoea, and 87.2% fever as contraindications. Most parents expressed a favorable attitude, with 95.0% agreeing that immunization is safe and necessary. The mean knowledge score was significantly higher among parents of fully immunized children compared to partially immunized children (p<0.001). A significant positive correlation was observed between knowledge and attitude scores (r=0.38, p<0.001).

Conclusions: Despite high awareness and positive attitudes towards routine immunization among migrant parents in urban Mysuru, critical knowledge gaps and misconceptions persist, particularly regarding vaccine contraindications. Strengthening targeted health education and behavior change communication through frontline health workers is essential to translate favorable attitudes into informed and sustained immunization practices.

Effectiveness of holy basil leaves and turmeric powder in steam inhalation to relieve symptoms of acute upper respiratory tract infection among school going children

Apexa G. Parmar — 2026-05-30

Background: Acute upper respiratory tract infection is the most common infection in children worldwide, causing significant morbidity and sometimes leading to mortality in children. Steam inhalation with herbal additives is a widely practiced traditional remedy, yet evidence-based data on its effectiveness in children is limited. This study aimed to assess the effectiveness of steam inhalation with holy basil leaves and turmeric powder in relieving symptoms of acute upper respiratory tract infection among school-going children.

Methods: The study utilized a quantitative approach, employing a quasi-experimental non-equivalent control group design. A total of 40 samples were selected from the Kachigam community area in Daman, based on specific selection criteria, with convenience sampling being the chosen technique. Data collection involved using a structured questionnaire schedule for demographic variables and an observational checklist assessment conducted before and after the intervention of steam inhalation with holy basil leaves and turmeric powder.

Results: The post-test mean score in experimental group 3.95 (SD=1.95) was less than control group post-test mean score in control group 5.55 (SD=1.73) and ‘t’ value of post-test was 2.737 which shows the significant effect of the steam inhalation with holy basil leaves and turmeric powder (p<0.05) and there is significant mean difference between experimental and control group post-test was 1.6.

Conclusion: Statistical significance was calculated by using paired and unpaired “t” test and Chi-square. After steam inhalation with holy basil leaves and turmeric powder the relieved the symptoms of acute upper respiratory tract infection among the school going children.

A study on patient satisfaction with therapeutic communication of nurses in multispecialty hospital

Renita Menezes — 2026-05-30

Background: Therapeutic communication is a fundamental component of nursing practice that significantly influences patient satisfaction and overall healthcare quality. It is also a critical element of patient safety, as effective communication helps reduce medical errors, enhances patient understanding and supports safe clinical decision-making. Effective nurse-patient communication promotes understanding, alleviates anxiety, fosters trust and enhances health outcomes. As primary caregivers, nurses play a pivotal role in delivering patient-centered care through their communication skills.

Methods: A quantitative descriptive cross-sectional study was conducted among 73 patients admitted to orthopaedic, oncology and surgical wards of a tertiary care hospital. Participants were selected using convenience sampling techniques. Data was collected using structured questionnaire assessing various components of nurses’ therapeutic communication. Responses were measured on a five–point Likert scale and analyzed using descriptive statistics, including frequency, percentage, mean and Standard Deviation.

Results: The overall mean satisfaction score was 4.13±0.83, indicating a high level of patient satisfaction. The highest satisfaction was observed in nurses’ knowledge and skills (4.32±0.69) and clarification of patient doubts (4.29±0.79). Patients also reported high satisfaction with emotional support, responsiveness and communication regarding health status. However, neutral responses were noted in areas such as interaction during admission and time spent with patients.

Conclusions: Therapeutic communication has a significant positive impact on patient satisfaction and quality of nursing care. Strengthening nurses’ communication skills through regular training and institutional support is essential to enhance patient-centered care.

Comparative analysis of palmar dermatoglyphics in diabetic and non-diabetic individuals of Nashik

Sheetal Safi — 2026-05-30

Background: Dermatoglyphics, the scientific analysis of epidermal ridge configurations on the fingers and palms, has been increasingly explored as a potential tool in medical research due to its strong genetic basis and lifelong stability once established during fetal development. Type 2 diabetes mellitus is a multifactorial metabolic disorder characterized by chronic hyperglycaemia resulting from impaired insulin secretion, insulin action or both. It represents a major and growing global public health concern, particularly in developing countries such as India, where rapid urbanization, lifestyle changes and population aging have contributed to its rising prevalence.

Methods: This case-control study was conducted to evaluate dermatoglyphic patterns in individuals with type 2 diabetes mellitus. The study included 25 clinically and laboratory- confirmed cases of type 2 diabetes mellitus and 25 apparently healthy control subjects selected from local residents of Nashik. Palmar and digital prints of both hands were recorded using the standard ink and pad technique.

Results: The study shows that there is no significant difference in the arches, loops and whorls observed among the study group (diabetic mellitus type 2 patients) and control group (non-diabetic individuals), but the axial tri radius angle shows that the angle is increased in diabetic mellitus type 2 patients than the control group.

Conclusions: It is concluded that the arches, loops and whorl patterns are independent of diabetic and non-diabetic patients, while the a-t-d angle is useful for the prediction of diabetes by dermatoglyphic studies.

Knowledge, awareness on cervical cancer and attitude towards human papillomavirus vaccine among medical students in private medical institution: a cross-sectional study

Shree Harshini Murugesan — 2026-05-30

Background: Human papillomavirus (HPV) infection is the most common sexually transmitted infection worldwide and the leading cause of cervical cancer, which significantly affects women in their reproductive age group. Cervical cancer is the second most common cancer among women in India, with approximately 1,22,845 new cases and 67,480 deaths annually. However, HPV vaccines are still not included in the National Immunisation Program, even if they are very immunogenic, safe, well-tolerated, and very effective in preventing HPV infection.

Methods: A cross-sectional study was conducted among MBBS students from phase I to IV between March and May 2025 to assess knowledge, attitude, and practices regarding HPV and cervical cancer. Data were collected using a structured Google-based questionnaire.

Results: A total of 466 students participated, with a mean age of 18-24 years. About 57.6% were aware that cervical cancer can be detected early, and 66.9% identified Pap smear as the screening method. Overall, 76.8% demonstrated good knowledge of cervical cancer. However, gaps persisted: 70.1% knew cervical cancer is vaccine-preventable, and 66.9% were aware of vaccine availability in India, but 43.4% were unaware of the number of doses. Additional misconceptions included incorrect age of vaccination, need for prior screening, and limited awareness regarding vaccination in HPV-positive individuals. These findings were statistically significant (p<0.05).

Conclusions: Despite moderate awareness, detailed understanding of HPV vaccination and screening remains inadequate among medical students, indicating a significant knowledge-practice gap. Key barriers to vaccination included lack of information, cost, fear of side effects, and concerns regarding efficacy.

Opinion, perception and attitude towards family adoption program among MBBS students: a cross-sectional study

Suwetha — 2026-05-30

Background: The family adoption program (FAP) is an innovative and significant aspect of latest the competency based medical education (CBME) proposed by the National Medical Commission of India. FAP comes with both challenges and opportunities. Assigning families to each student and maintaining their follow-up throughout the undergraduate years is a difficult task. It is important to gather feedback during the early stages of implementation. While clinical medicine focuses on individual patient, community medicine recognizes that many other factors also contribute to the development of health condition. The FAP aims to develop strong communication skills, which are back bone for the profession.

Methods: A cross-sectional study was conducted among MBBS students from Phase I-IV from March 2025- May 2025 to assess the opinion, Perception and attitude towards FAP. Participants were individually approached, informed consent was obtained and they were requested to complete a structured Google-based questionnaire.

Results: Among 454 participants, the mean age of participants was 18-20 years. 75.6% of students considered FAP to be an innovative method of learning and this finding was statistically significant (p=0.006) (p <0.05). majority 215 (47.4%) students were primarily motivated by helping families in need and building a stronger community (208; 45.8%).

Conclusions: Although most findings were not statistically significant, the overall trend indicates that FAP is an effective and innovative teaching-learning method. Thus, FAP serves as a valuable bridge between theoretical knowledge and real-world community exposure and should be continued and optimized in medical education. Moreover, this study can be done in qualitative study among smaller samples for the clear understanding and perception of student’s view on FAP.

Menstrual health and hygiene practices in higher educational institutions: a case study of female students in Dibrugarh, Assam, India

Preeti Barsha Borah — 2026-05-30

Background: Menstruation health and hygiene management (MHM) remains a critical public health concern in educational institutions, particularly in developing countries where sanitation infrastructure and awareness vary widely. Though it is a natural biological process, however, many face significant menstrual problems, including dysmenorrhea, irregular periods, and menorrhagia, which can affect their physical and emotional well-being.

Methods: This cross-sectional study examines menstrual health practices, hygiene satisfaction and sanitation infrastructure among female students of Dibrugarh, Assam, India. A total of 218 students (177 postgraduate, 41 undergraduate) participated using a structured questionnaires distributed both in person and via online forms. Simple random sampling was employed. Descriptive statistics and correlation analysis were performed using Jamovi software.

Results: The majority 73.39% reported regular, while 95% relied on sanitary pads, indicating low adoption of sustainable alternatives such as menstrual cups (7.3%). Approximately 64% of respondents avoided campus toilets during menstruation, primarily due to poor hygiene and lack of sanitation facilities.

Conclusions: Although 79% reported reliable access to running water facilities, dissatisfaction with washroom cleanliness remained high. Disposal practices showed moderate hygiene infrastructure, sanitation awareness, waste management practices in educational institutions. The findings suggest the need for policy interventions including improved sanitation infrastructure, increased awareness programs and sustainable menstrual waste management systems.

Assessment of the magnitude of goitre in the age group of 6-12 years in district Bandipora of Kashmir division

Malik W. Raja — 2026-05-30

Background: Iodine deficiency disorders (IDD) have remained an unresolved public health problem in India. This study was done to determine the prevalence of goitre among school-aged group of 6–12 years in district Bandipora.

Methods: This was a cross-sectional study done among children of 6–12 years in district Bandipora. Multi-stage 30 cluster sampling was used to select the study sample. For the selection of 30 clusters in each district, probability proportional to size (PPS) was employed. From each cluster, 90 children were selected.

Results: Out of 2700 children examined, Grade 1 goiter was found in 359 (13.3%) children and Grade 2 goiter was found in 50 (1.85 %) with a total goiter rate (sum of grade first and grade second) of 15.14%. On analysing the urine samples, about 22% of the children had mild to moderate iodine deficiency.

Conclusions: The study showed mild goitre prevalence in school-aged children of 6–12 years in the Bandipora district of Kashmir valley. Continuous periodic surveys to assess the magnitude of the iodine deficiency disorders (IDD) and ensuring the availability of iodized salt should be undertaken to ensure sustainable elimination of IDD in India.

The impact of scholarship-based training programmes for allied ophthalmic personnel in India

Shajer Shaikh — 2026-05-30

Background: The availability of trained Allied Ophthalmic Personnel (AOP) is critical for effective eye care delivery, particularly in underserved regions. Globally, eye care professionals are insufficient to meet population demands, especially in low- and middle-income countries. India has approximately 40,000 optometrists and 30,000 ophthalmologists, with a significant concentration in urban areas, creating challenges for rural access.

Methods: This study evaluated a 100% scholarship-based AOP training programme in India using a mixed-methods approach. Data were collected through surveys, interviews, and self-developed questionnaires. AOPs were surveyed on job satisfaction, skill usage, career progression, income growth, and socio-economic changes. Employers provided feedback on AOP skills and organizational efficiency. Semi-structured interviews explored participant experiences and challenges.

Results: The study surveyed 62 AOPs with minimum one-year employment across India, predominantly female, with a mean age of 23±2.42 years. Participants held various roles, primarily Operation Theatre Assistants. Motivators for programme enrolment included financial goal setting, personal growth, skill improvement, and career advancement. The programme enhanced skills in computer operations, mobile applications, and hospital software. Many respondents expressed interest in returning to rural, underserved areas for future employment. Feedback from 7 employers and 4 training institutions highlighted improved community engagement and good retention rates. Identified challenges included dropout rates, lack of hands-on training instruments, and need for better student accommodation.

Conclusions: The free AOP training programme has positively impacted AOPs, their families, communities, and eye health institutions. Participants benefited professionally and personally, with potential for addressing workforce shortages in underserved areas.

Rising hypertension and post-COVID cardiovascular risk among rural women in Punjab: implications for community-based screening and surveillance

Ramandeep Kaur — 2026-05-30

Background: Hypertension is the foremost modifiable cardiovascular risk factor globally and constitutes a growing non-communicable disease (NCD) burden in rural India. The COVID-19 pandemic has introduced an additional layer of complexity to hypertension epidemiology.

Methods: A community-based cross-sectional study was conducted among 2,160 adult women aged 18-69 years residing in rural Punjab. Participants were recruited through multistage stratified cluster sampling, with data collection guided by the WHO STEPwise approach to Non-Communicable Disease Risk Factor Surveillance (STEPS). Blood pressure was measured using standardised protocols and JNC VIII guidelines.

Results: Among the 2,160 participants, more than one-third (38.3%, n=827) were found to be hypertensive, comprising 27.9% with Stage 1 and 10.4% with Stage 2 hypertension, while an additional 31.1% were classified as pre-hypertensive. Significant associations were identified between hypertension and older age (45-69 years: 66.1%), married marital status (90.7%), illiteracy (64.6%), labourer occupation (71.0%), lower socioeconomic class (45.9%), and overweight or obese BMI (≥23 kg/m²). While a prior history of COVID-19 infection did not independently predict hypertension status (χ²=0.411, p=0.524), the occurrence of blood pressure fluctuations during or following COVID-19 illness and the presence of pre-existing comorbidities before COVID-19 infection were both strongly and significantly associated with hypertension.

Conclusions: Rural women in Punjab carry a substantial and largely underdiagnosed burden of hypertension, with 38.3% prevalence and an additional 31.1% at the pre-hypertensive threshold. These findings underscore the urgent need for systematic community-based blood pressure screening, gender-sensitive preventive interventions, and dedicated post-COVID cardiovascular surveillance to reduce long-term cardiovascular morbidity in this vulnerable population.

Exploring experiences, perceived barriers and needs of menopausal women: a qualitative meta synthesis

Pushpa — 2026-05-30

This study aimed to identify, compare, and synthesize qualitative evidence to understand the experiences, perceived barriers, and needs of women undergoing menopause. A qualitative meta-synthesis was conducted to integrate findings across multiple studies and provide a comprehensive view of menopausal experiences. Published articles were systematically searched in PsycINFO, PubMed, ABSCO, Embase, and selected journals, along with reference lists, focusing on studies published since 2020. Eleven articles meeting predefined criteria were included in the synthesis. The studies included 227 participants experiencing natural or surgical menopause across diverse cultural contexts, including Sri Lanka, India, Iran, China, Malaysia, the UK, and the USA. Sample sizes ranged from 12 to 30, with ages spanning 35–65 years. The synthesis identified five overarching themes capturing the multidimensional experiences of menopausal women. These themes reflected the interplay of physical, emotional, social, and healthcare-related challenges during the menopausal transition. The findings highlight significant challenges faced by women during menopause. Strengthening coping strategies, facilitating peer support, providing empathetic and holistic care, and addressing societal taboos are essential strategies to help women navigate menopause with dignity, resilience, and improved quality of life.

Reaching beyond the Sustainable Development Goals targets: unfolding Kerala’s feat in reducing infant mortality rate

Neha N. Shet — 2026-05-30

The state of Kerala has recorded the lowest infant mortality rate (IMR) in India, with just 5 deaths per 1,000 live births, according to the Sample Registration System (SRS) report for 2023. The state has steadily improved, unmatched by other states and UTs, while reducing urban-rural inequalities. This news spread rapidly in both electronic and social media, with varied appreciation and analysis. Given the important role social media and electronic media play in extracting the information, especially on nuanced, socially relevant issues, we adopted a qualitative study design to identify key factors contributing to this remarkable achievement and extract major insights to propose a replicable framework. The emerging themes and subthemes were then presented using the proximate and distal determinants framework. Targeted neonatal care, robust grassroots-level infrastructure, high female literacy, effective community outreach and health education emerged as the key approaches adopted. This remarkable feat highlights the role of a robust, evidence-based policy approach aimed at improving key social determinants of health.

The untold story of migraineurs at micro level: a patient-centred public health perspective

Ujeeta Sharma — 2026-05-30

Despite living in a technological world, multiple structural and social determinants of our society impede our progress towards realising the Sustainable Development Goals, especially in health and well-being. A prime reason for this is the inadequate attention paid to the contextual and social processes that precipitate and perpetuate illness. For community medicine or public health, understanding the “why” behind disease requires sustained communication built on trust that allows patients to articulate experiences at the root-cause level. Many chronic conditions, including migraine, arise from a complex interplay between biological vulnerability and psychosocial stressors, which are often under-recognised in routine clinical care. Approaching these chronic ailments, including migraine, requires integration of medicinal and contextual grounds.

Empowering lives through compassion: my experience as a Ni-kshay Mitra

Vignesh Dhakshinamoorthy — 2026-05-30

Tuberculosis (TB) is one of the major public health problems in India. Although medical science has made considerable progress, social and economic constraints continue to deny many patients proper treatment and cure. My journey as a Ni-kshay Mitra began with a humble but impactful conversation with a senior leader. One of my seniors Post graduates was doing her thesis on TB patients. By seeing the sufferings of patient to meet day to day calorie and protein requirement and her knowledge about improved nutrition on outcome of the disease made her contribute in providing nutrition through Ni-kshay Mitra. My role as Ni-kshay Mitra began with provision of monthly nutrition kits containing energy dense food such as protein supplements, pulses, rice, cooking oil, and fresh fruits. But over the time I felt my support should be beyond food. One of the patients from a poor background, had been fighting TB while taking care of her infant child. She had nearly lost her treatment because of financial hardships. Through regular counselling and nutritional assistance, she regained her strength and successfully finished her treatment with her remarkable resilience. In retrospect, becoming a Ni-kshay Mitra has been the most impactful experience of my professional and personal life. It brought me back to the reality that healthcare is not always about the hospital or the pills. It finds its strength in human contact, listening to a person's tale, showing up even when it's hard, and believing recovery.

Traditional system of medicine and its exclusion in India's publicly funded health insurance: clinical and health system implications

Balasankar Jayapal Mini — 2026-05-30

India’s health system is pluralistic, with traditional systems of medicine- collectively referred to as Ayush (Ayurveda, Yoga & Naturopathy, Unani, Siddha, Homoeopathy, and Sowa-Rigpa) coexisting alongside biomedicine. Despite policy initiatives to mainstream Ayush through the Ministry of Ayush, the National Ayush Mission (NAM), and co-located service delivery models, Ayush services remain excluded from India’s flagship publicly financed health insurance scheme, Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). This exclusion represents a persistent policy gap that limits therapeutic choice and constrains the broader goal of universal health coverage. Beyond policy considerations, insurance exclusion has practical implications for clinicians and patients. Structural constraints within the Ayush sector, including limited health technology assessment and cost-effectiveness evidence, uneven infrastructure, fragmented integration with public health programs, and variable public trust, have restricted its role within insurance frameworks. For physicians, particularly those managing chronic and lifestyle-related conditions, the absence of insurance coverage for Ayush affects continuity of care, disclosure of concurrent therapies, and referral pathways. However, the implementation of clinical protocols and monitoring mechanisms, supported by referral pathways, could strengthen coordination of care while safeguarding patient safety.

Anorectal mucinous adenocarcinoma in a child: a case report

Osman Suliman — 2026-05-30

Primary gastrointestinal malignancies constitute approximately 2% of pediatric neoplasms, and colorectal carcinoma is the second most common gastrointestinal malignancy after primary liver tumors. Anorectal adenocarcinoma in children is exceptionally rare, accounting for less than 1% of all colorectal cancers and is often diagnosed at an advanced stage due to nonspecific symptoms. We describe the case of a 12-year-old boy who presented with a 3-month history of recurrent abdominal pain, diarrhea mixed with mucus and blood, and intermittent rectal bleeding, and was found to have a rectal mass. A per-rectal biopsy confirmed the diagnosis of adenocarcinoma. Computed tomography of the abdomen and pelvis revealed locally advanced disease without distant metastasis. The patient was evaluated by a multidisciplinary team to determine the optimal therapeutic approach. Anorectal adenocarcinoma in children remains a rare but aggressive malignancy with a poor prognosis if diagnosis is delayed. Early recognition, prompt biopsy of suspicious lesions, comprehensive staging, and genetic evaluation are essential for optimal management. Surgical resection remains the mainstay of treatment, often combined with neoadjuvant and adjuvant therapies. Reporting such rare cases contributes to improved awareness and may aid in developing evidence-based management strategies.

Orthobiologics treatment for meniscal injury with early osteoarthritis of the knee: a case report

Venkatesh Movva — 2026-05-30

Meniscal injuries are a common cause of knee pain with functional impairment with early degenerative changes in knee joint. Orthobiologics therapies have emerged as promising, minimally invasive approaches enhancing tissue healing and regeneration. We report case of 50-year-old female presenting with bilateral knee pain, with right knee being more inflammation over one year. Clinical examination revealed mesomorphic build, antalgic gait, swelling, and grade II tenderness over the medial aspect of right knee joint. The numeric pain rating scale (NPRS) score was 7/10. Knee flexion was limited to 100° (right) and 120° (left). Muscle strength using Oxford manual muscle testing (MMT) scale showed knee flexors at 4/5 bilaterally, and knee extensors at 3/5 (right) and 4/5 (left). Magnetic resonance imaging (MRI) demonstrated a radial tear of medial meniscus with mild degenerative changes and joint effusion. The Western Ontario Meniscal Evaluation Tool (WOMET) score was 1055/1600 (34%). The patient underwent autologous bone marrow aspirate concentrate (BMAC) along with enriched platelet-rich plasma (PRP) intra-articularly for two-days under fluoroscopic/ultrasound-guidance. At 9-month follow-up, the patient demonstrated significant clinical improvement. Interestingly, NPRS score reduced (1/10), knee flexion improved to 125° bilaterally, muscle strength to 5/5 in both flexors and extensors and WOMET score to 453/1600 (71.6%). Follow-up magnetic resonance imaging (MRI) showed no evidence of meniscal tear and stable mild osteoarthritic changes without progression. This case demonstrates that intra-articular intervention therapy (BMAC+PRP) serves as an effective non-surgical option for meniscal injuries followed by reduction in pain and functional responses evidenced by radiological outcomes.

Geriatric health care in rural setting: a community-based case report of an older adult with hypertension

Srishti Mishra — 2026-05-30

India’s demographic transition is increasing the burden of chronic diseases, functional decline, and psychosocial problems among older adults. Hypertension remains a leading contributor to cardiovascular morbidity, while sarcopenic obesity is emerging as an important but under-recognized geriatric concern, particularly in rural areas. A 65-year-old man from a remote village with an eight-year history of hypertension on angiotensin receptor blockers presented with mild breathlessness, body ache, and intermittent headache. He was overweight with a calorie-rich, protein-poor diet, predisposing him to sarcopenic obesity. Long-term tobacco use was a major risk factor, while strong family support acted as a protective psychosocial determinant. Household overcrowding and poor ventilation were noted. The case highlights the need for a comprehensive geriatric approach integrating nutritional, psychosocial, environmental, and medical management to improve healthy ageing in rural elderly populations.

Primary atrophic rhinitis associated with Klebsiella pneumoniae subsp. ozaenae: a case report with microbiological correlation

Emmanuel Jabakumar — 2026-05-30

Primary atrophic rhinitis (ozena) is a chronic, debilitating nasal disorder characterized by progressive mucosal atrophy, crust formation, foul smell, and widening of the nasal cavity. Although its etiology is multifactorial, K. pneumoniae subsp. ozaenae has been frequently associated with this condition, although its exact pathogenic role remains debated. Early microbiological diagnosis and confirmation is essential for targeted antimicrobial therapy and prevention of chronic complications. A 32-year-old male presented with chronic nasal crusting, foul-smelling discharge, and recurrent upper respiratory tract infections. Computed tomography (CT) of the paranasal sinuses revealed pansinusitis with bilateral osteomeatal complex obstruction. Direct microscopy showed no acid-fast bacilli or fungal elements. Culture of nasal crust specimens yielded mucoid, non-lactose fermenting colonies identified as K. pneumoniae subsp. ozaenae using conventional biochemical tests and also confirmed by automated VITEK 2 (bioMérieux). Antimicrobial susceptibility testing (Kirby-Bauer method, CLSI guidelines) demonstrated susceptibility to amoxicillin-clavulanate, piperacillin-tazobactam, cefepime, aminoglycosides, ciprofloxacin, cotrimoxazole, and carbapenems, with resistance to ceftriaxone. The patient improved following culture-directed oral ciprofloxacin therapy combined with local nasal care. This case highlights the diagnostic challenge in distinguishing colonization from pathogenic involvement and emphasizes the importance of clinicomicrobiological correlation. Culture-guided therapy ensures favourable outcomes and supports antimicrobial stewardship.

The impact of improved water and sanitation on water-related diseases: a propensity scores matching analysis from Palghar District, Maharashtra, India

Mangesh Jagdhane — 2026-05-30

Inadequate water, sanitation, and hygiene (WASH) are responsible for a significant portion of the global disease burden. However, establishing the causal effect of improved WASH is challenging due to confounding socioeconomic factors. This study employs propensity score matching (PSM) to estimate the causal effect of improved water and sanitation on water-related diseases in Palghar District, India. Using cross-sectional household survey data, households with improved WASH were matched with statistically similar households without improved WASH. The average treatment effect on the treated (ATT) was estimated for diarrhoea, jaundice, malaria, skin disease, typhoid, and dengue. The analysis reveals a statistically significant reduction in jaundice prevalence (ATT: -0.21, p<0.10) attributable to improved WASH. Effects on diarrhoea, typhoid, and skin disease showed protective trends but were not significant. A counterintuitive finding was a significant increase in malaria risk (ATT: 0.38, p<0.05), potentially linked to water storage practices. The protective effect of improved WASH is not uniform. While critical for faecal-oral diseases like jaundice, its impact is mediated by behavioural and contextual factors. Policy must integrate behavioural change communication, targeted vector control, and equity-oriented interventions.

The influence of social media on dietary supplement use: a rapid review

Nikitha Devanaboyina — 2026-05-30

Dietary supplements are widely consumed to address perceived nutritional inadequacies and promote health. In recent years, social media platforms have emerged as influential channels for the marketing of dietary supplements. These promotions often disseminate unsubstantiated health claims and may contribute to inappropriate or excessive supplement use, raising concerns about population-level health risks, particularly among young adults. A rapid review was conducted in accordance with updated Cochrane guidance for rapid reviews of effectiveness. Systematic searches were performed in PubMed, Google Scholar, and CINAHL to identify peer-reviewed studies published in English within the past 10 years. Studies examining social media exposure, dietary supplement use, and health-related behaviours among U.S. adults aged 18–50 years were eligible for inclusion. Data were extracted and synthesized narratively due to heterogeneity in study designs and outcome measures. Across included studies, exposure to dietary supplement content on social media was consistently associated with increased body image dissatisfaction, heightened susceptibility to persuasive marketing and greater likelihood of unsupervised or non-evidence-based supplement use. Young adults frequently reported modifying dietary practices or health behaviours in response to online content rather than professional medical advice. This review highlights the growing public health implications of social media–driven dietary supplement promotion. The findings support the need for enhanced regulatory oversight of online supplement marketing, improved health literacy interventions, and more proactive patient–provider communication regarding supplement use. Future research should prioritize longitudinal studies to evaluate the long-term health outcomes associated with socially mediated supplement consumption and to inform evidence-based policy development.

The resurgence of bedbug infestation: a review of biology, behavior and multi-faceted impacts on human health

John O. Sibuor — 2026-05-30

Infestation by Bedbug whose origin is traced back to antiquity is a global public health menace common in densely populated dwellings. Bedbug is a blood sucking insect which is attracted by warmth and Oxygen from human host. The feeding is basically nocturnal through unique routine pattern. It is a slightly flat-oval crawling insect with other unique features. This review aimed to highlight key literature findings on the impact of resurgence of the infestation with respect to biology, behavior, potential to transmit diseases, and on various facets of human life. The selection of articles for review was based on the title, the date of publications and the subtopics. The articles that met the selection criteria were picked and interrogated. The review was conducted thematically where issues were grouped together and a central theme emerged. The review interrogated existing literature and paid attention to methodology, findings, discussions conclusions and recommendations. Findings are that control of bed bug has challenged most interventions through decades because of the insect thrift adaptive behavior; the manner the affected individuals shun talking about the attacks; and the resistance to the existing pharmaceutical products. The review further determined that bed bugs harbor a number of pathogenic organisms but their potentials to cause diseases has not been conclusively documented. The infestation has impacts on public health, economic, and individuals’ quality of life. The Conclusion is that the eradication of bedbug menace is doable by involving multisector approach enforced by government policies. It is recommended that eradication strategies should target individual empowerment.

The impact of dietary patterns and nutrient status on adolescent mental health and emotional well-being

Lesego Pholi — 2026-05-07

Adolescence is a pivotal period of strong neurodevelopment combined with high emotional and psychological vulnerability. This review explores the integral relationship between dietary status and adolescent mental health outcomes, examining how systemic dietary patterns often shaped by socioeconomic factors influence the gut-brain axis. It summarises current evidence elucidating the bidirectional communication through which the gut microbiome influences the synthesis and regulation of key neurotransmitters (e.g., serotonin and dopamine) required for mood stabilisation. The paper highlights the importance of certain micronutrients, including omega-3 fatty acids, B vitamins, and magnesium in maintaining structural brain integrity and modulating stress responses. In contrast, it analyses the impact of western dietary patterns, which are abundant in refined carbs and sugar, on systemic inflammation and glucose dysregulation, both of which exacerbate mood instability and cognitive impairments. By identifying nutrition as a key, modifiable predictor of emotional resilience, this synthesis underscores the importance of pushing beyond traditional psychological treatment. It concludes by advocating for targeted, integrated nutritional intervention and public health strategies that promote adolescent mental well-being during this critical developmental stage.

Therapeutic uses, pharmacological and clinical importance of Cannabis sativa: a review article

Pramod Chandra Dwivedi — 2026-05-30

Hempro Cannabis is a commonly used herbaceous plant, Cannabis sativa L., or hemp, is a plant that has been used multifunctionally in the past as a medicine, nutritional, and industrial crop since ancient times. Throughout the last few decades, its medicinal properties have acquired new scientific interest because of the development of phytochemistry and the identification of an endocannabinoid system in humans. The plant has a vast array of bioactive compounds with the majority of cannabinoids, terpenoids, flavonoids, all contributing to the various pharmacological effects of it. Among them, Δ 9 -tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most researched constituents with unique physiological action. The effects of THC are mainly psychoactive, analgesic, antiemetic and muscle relaxant by acting mediated by the CB1 receptors in the central nervous system. CBD in its turn, has anti-inflammatory, neuroprotective, antioxidant, anxiolytic and anti-epileptic effects without psychoactive adverse effects, by regulating multiple non-cannabinoid receptors and ion channels. The Mult synergy between cannabinoids, together with other minor constituents, results in a so-called encouragements effect, which improves the effects of therapy, reducing the number of adverse effects. According to the pharmacological studies, Cannabis sativa and its active components have a plethora of biological systems in that they can exert effects on the nervous, immune, metabolic and gastrointestinal systems.

Next-gen solution: AI's influence on biomedical waste management practices

Srikanta Padhan — 2026-05-30

Artificial intelligence (AI) is revolutionizing the management of biomedical waste (BMW) by enhancing processes like segregation, collection, monitoring, and recycling. Traditional approaches often face inefficiencies that pose risks to both the environment and public health. AI-powered systems leverage advanced sensors and machine learning to boost accuracy, efficiency, and compliance. Innovations such as smart bins, predictive analytics, and real-time tracking streamline waste collection, while AI-driven sorting and robotics enhance the safety of recycling efforts. Internet of things (IoT) based monitoring enables continuous oversight, thereby minimizing hazards. However, challenges like high costs, data security concerns, and scalability issues persist. To achieve sustainable and effective BMW management solutions, collaboration, investment in AI infrastructure, and the establishment of regulatory frameworks are crucial.

Strengthening cause-of-death certification in India: evidence from the 2021-2023 MCCD report

Ayeshik Chakraborty — 2026-05-30

Planning for public health and disease surveillance depends on precise cause-of-death information. The Medical Certification of Cause of Death (MCCD) system in India continues to experience difficulties, such as poor coverage, geographical differences, and problems with data quality. Using information from the 2023 national MCCD report, we sought to evaluate the level of medical certification, demographic trends, and cause-specific mortality. We conducted a descriptive secondary data analysis using the Office of the Registrar General, India's 2023 MCCD report. We examined medically certified deaths by location, age group, sex, and state. We also evaluated cause-of-death patterns and compared the findings with previous years' data and pertinent national statistics. We used descriptive statistics to look at certification coverage, demographic changes, and cause-specific mortality. Of the 8,659,679 deaths recorded in India in 2023, 1,900,956 (22.0%) were medically certified. The certification rates varied greatly between states; in Goa, it was 100%, whereas in Bihar, it was only 5.5%. Circulatory diseases continued to be the leading cause of death (36.4%), followed by respiratory disorders (11.5%) and symptoms and abnormal clinical findings (11.9%). Males accounted for 62.8% of certified fatalities, continuing the trend of male-dominated reporting. Despite an increase in the overall number of certified deaths, the nationwide coverage rate remains relatively constant at about 22%. The system still exhibits significant regional disparities as well as a bias towards institutional and male mortality. To improve, the 2023 RBD Amendment Act must be properly implemented, and medical personnel must get consistent training.

Occupational infection risks and infection prevention gaps in autopsy and mortuary practice: a narrative review and public health recommendations

Abhishek Sharma — 2026-05-30

Autopsy and mortuary services represent a frequently overlooked occupational setting with potential for exposure to blood-borne pathogens and airborne infections. In many institutions, undiagnosed infections, incomplete clinical histories, inconsistent screening, and resource limitations can contribute to “silent” transmission risks for mortuary and autopsy personnel. This narrative review highlights key infection control gaps across mortuary workflow, staff practices, personal protective equipment use, waste handling, and environmental disinfection. Evidence and guidance relevant to infection prevention and control (IPC) are summarized with emphasis on low-resource and high-workload settings. Public health relevance includes protection of healthcare and support staff, strengthening of occupational surveillance, and reducing preventable exposure events. Practical recommendations include standard precautions, risk-based PPE, safe handling of sharp instruments, improved triage and communication of infection status, staff training and vaccination (where applicable), and strengthening institutional policies and audits. Addressing infection control in mortuary and autopsy practice is essential for workforce safety and overall health system preparedness.

Folic acid supplementation in pregnancy: established benefits, emerging evidence and public health implications

Suhas Srinivasan — 2026-05-30

Folic acid supplementation during pregnancy is one of the most effective nutritional interventions for preventing neural tube defects (NTDs). This narrative review synthesizes evidence from randomized controlled trials, observational studies, systematic reviews, and mechanistic research to evaluate the role of folic acid in maternal and foetal health. Robust and consistent evidence demonstrates that periconceptional folic acid supplementation substantially reduces the risk of NTDs, providing the scientific basis for global supplementation guidelines and mandatory food fortification programmes. Beyond NTD prevention, maternal folate status has been associated with a range of pregnancy and offspring outcomes, including foetal growth, neurodevelopment, and long-term metabolic health. These associations are supported by emerging evidence from epidemiological and experimental studies, with epigenetic mechanisms proposed as a key biological pathway. However, evidence for these broader effects remains less consistent and is largely observational in nature. In the post-fortification era, concerns have emerged regarding excessive folic acid intake, including the potential accumulation of unmetabolised folic acid and disruption of balanced one-carbon metabolism. This review critically evaluates established benefits, emerging evidence, and ongoing controversies surrounding folic acid supplementation in pregnancy, and identifies priorities for future research and public health practice.

Incidence and correlation of oral cancer with tobacco and malnutrition in Asia: a comprehensive review

Praveen S. Anigol — 2026-05-30

Oral cancer represents a significant public health burden in Asia, accounting for the majority of global cases. The region’s unique patterns of tobacco use and nutritional deficiencies contribute substantially to this disproportionate burden. This comprehensive review examines the incidence and correlation of oral cancer with tobacco use and malnutrition across Asian populations, analyzing regional variations, underlying mechanisms, and prevention strategies. We conducted a systematic review of current literature from PubMed, GLOBOCAN databases, and recent epidemiological studies focusing on oral cancer in Asian countries. Data on incidence rates, tobacco consumption patterns, nutritional status, and their synergistic effects were analyzed. Asia reported 248,360 new oral cancer cases in, with South Asia bearing the highest burden. Tobacco use, particularly betel quid chewing, remains the primary risk factor, with prevalence exceeding 50% in high-burden regions. Malnutrition, characterized by deficiencies in vitamins A, C, E, and micronutrients, significantly increases oral cancer risk through impaired immune function and reduced antioxidant capacity. The synergistic interaction between tobacco and malnutrition amplifies carcinogenic effects through oxidative stress, DNA damage, and inflammation. Oral cancer in Asia requires urgent, multifaceted interventions combining tobacco control, nutritional supplementation, and early detection programs. Population-specific prevention strategies addressing both tobacco cessation and nutritional improvement are essential for reducing disease burden. Implementation of evidence-based policies and community-level interventions can significantly impact oral cancer incidence and mortality in Asian populations.

Health technology assessment in Ayurvedic insights

Pramod Chandra Dwivedi — 2026-05-30

Health Technology Assessment (HTA) is a multidisciplinary approach in evaluating the clinical, cost-efficacy, ethical and the social attributes of health interventions in order to facilitate the process of evidence-based decision-making. With the current transformation of health systems in the world towards integrative and Adeo type of care, the traditional medical systems like Ayurveda must be assessed systematically to prove their relevance and applicability in the modern health care systems. The holistic, preventive and personal approach to healthcare, Ayurveda, represents an immensely rich store of therapeutic, diagnostic and prophylactic healthcare, or health, technologies, which can be used to play a significant role in sustainable and equitable healthcare models. Purpose: The purpose of this review is to understand the conceptual incorporation of HTA principles in Ayurvedic healthcare. It attempts to establish the obstacles, prospects and methodological modifications that are required to evaluate Ayurvedic interventions in accordance with the contemporary evidence-based paradigms and yet maintain the philosophical and holistic integrity of the system. Methods: Narrative and conceptual review method was followed based on the WHO documents on HTA, national policy models as HTAIn (India) and peer-reviewed articles on Ayurveda, integrative health, and evidence generation.

Effectiveness and wear-out effect of health warning labels on cigarette packets in India: a comprehensive review

Sudarshan Chanda — 2026-05-30

India is home to 182 million tobacco users, with tobacco consumption contributing to over 1.35 million deaths annually. Health warning labels on cigarette packets represent a critical public health intervention under the Cigarettes and Other Tobacco Products Act (COTPA) 2003. Understanding their effectiveness and potential wear-out effects is essential for evidence-based tobacco control policy. This comprehensive review synthesizes evidence from national surveys (GATS 2010 and 2016-2017), published research on pictorial health warning labels, tobacco control policies, and consumer behavioral studies. The review examines the effectiveness of health warning labels, wear-out effects, cognitive and behavioral reactions, pricing impacts, and mass communication strategies in the Indian context, aligned with WHO Framework Convention on Tobacco Control (FCTC) guidelines. GATS 2016-2017 demonstrated that 61.9% of adult cigarette smokers, 53.8% of bidi smokers, and 46.2% of smokeless tobacco users considered quitting primarily due to warning labels. Tobacco use declined from 34.6% (2009-2010) to 28.6% (2016-2017), with an 18% decrease among youth aged 15-24 years. However, 71.2% of respondents believed current pictorial warnings were insufficient in size and positioning. Research demonstrates that pictorial warnings with graphic imagery generate stronger cognitive and affective responses than text-only warnings, but effects may diminish over time without refreshing images. Health warning labels on cigarette packets in India demonstrate significant effectiveness in motivating quit attempts and reducing tobacco consumption. However, evidence suggests potential wear-out effects necessitating periodic rotation of warning images. India's tobacco control policies partially align with WHO FCTC recommendations but require strengthening in warning label size, tax increases, and comprehensive advertising bans.

Millets in the dietary management of childhood obesity: bridging modern nutrition and Ayurvedic principles

Himanshu Rawat — 2026-05-30

Childhood obesity is a growing public health concern, with long-term implications for physical and metabolic well-being. Conventional approaches often fall short in offering sustainable solutions. In this context, traditional dietary systems like Ayurveda offer promising alternatives. Millets, long valued in Ayurvedic literature, are recognized for their Laghu (light) and Ruksha (dry) qualities, which help regulate Kapha Dosha and Meda Dhatu (fat tissue), both implicated in the pathology of obesity. Modern nutrition also supports the inclusion of millets due to their low glycaemic index and high dietary fibre content, which aid in weight regulation and metabolic health. Hence, an attempt has been made to review the utility of millets as functional foods in managing childhood obesity from both Ayurvedic and contemporary perspectives. The findings suggest that millets like finger millet, foxtail millet, barnyard millet, and pearl millet not only support healthy digestion and stimulate Agni (digestive fire), but also assist in reducing Ama (toxins) and balancing Doshas. These properties align with their documented benefits in modern nutritional studies, including improved glycaemic control, enhanced satiety, and reduction in adiposity. Overall, millets represent a culturally acceptable, nutritionally sound, and Ayurvedically validated approach to preventing and managing childhood obesity.

The road to rabies elimination in India by 2030: a review on the functionality of anti-rabies clinics in India

Neha Choudhary — 2026-05-30

Rabies is the deadliest but preventable Neglected tropical diseases. Anti-Rabies Clinics (ARCs) are on the frontline in the management of animal bite cases and more research is needed to assess their operation. The present review is done to determine the extent of Anti- Rabies Clinic functionality in the country and to identify the prevailing gaps as to achieve the elimination of Rabies elimination by 2030. From 2010- 2025, a systematic search of scientific publications, on Medline and Google scholar was done on Anti- rabies clinic in India. Five articles were selected using the key terms “anti-rabies clinic,” “facility assessment,” “post-exposure prophylaxis,” “rabies biologicals,” and “India”. Articles were included if- in English language, full text availability and assessed one or more aspects of ARC functionality- minimum available facilities, staffing pattern, Minimum infrastructure, Logistics. Studies were excluded if they belonged to a non- Indian setting, animal and laboratory-based studies. Studies (n=3) depicted lack of availability of ARV and RIG. Some studies (n=2) reported on untrained staff in terms of low knowledge regarding post-exposure prophylaxis delivery and animal bite management. 2 studies reported non availability of wound washing facility. 1 study reported supply gap due to procurement and logistic issues. The review highlights that while some ARCs demonstrate best practices, systemic gaps persist, particularly in RIG supply and training. Strengthening cold chain management, expanding RIG availability, improving health worker training, and standardizing documentation are critical to meeting India's target of eliminating dog-mediated rabies by 2030.

Can vaccination reduce catastrophic health spending? Evidence from rotavirus disease and vaccine introduction in India: a narrative review

Subhajit Chakraborty — 2026-05-30

In any healthcare system with a high reliance on out-of-pocket spending, treatment for severe rotavirus gastroenteritis can lead to catastrophic health expenditures owing to the costs associated with hospitalization and nonmedical care. While the significant impact of rotavirus vaccination programs on reducing disease incidence, hospitalizations, and childhood mortality is well established, much less attention has been given to their potential impact on the financial burden of diseases that patients, particularly impoverished patients, may experience as a result of the need for medical care. The available literature demonstrates that rotavirus vaccination programs markedly decrease the incidence of severe gastroenteritis and hospitalizations, which are responsible for the high out-of-pocket health expenditures suffered by households. By preventing severe cases and hospitalizations, the vaccines lower direct costs but also indirect costs associated with transportation to and from care facilities and time spent caring for children instead of earning an income. Although no direct estimates currently exist regarding the degree to which the introduction of rotavirus vaccination programs in India reduced catastrophic health expenditures since their introduction, economic evaluations and modeling studies consistently identify that all the financial protective effects of vaccination programs are progressive and disproportionately benefit poorer households. The evidence thus supports the role of rotavirus vaccines not only as lifesaving interventions but also as lifesaving interventions that specifically reduce household financial burdens, promoting universal health coverage and health equity in India.

Current status, challenges and future potential of implementing occupational telehealth services in Indian industries

Ponnarasu P. — 2026-05-30

India is undergoing rapid industrial expansion, resulting in a growing workforce exposed to diverse occupational hazards, including musculoskeletal disorders, lung diseases, accidents, and high levels of work-related stress. Telehealth has emerged as a promising strategy to improve access to specialist care; however, its role in occupational health within Indian industries remains poorly understood. A narrative review was conducted to synthesise available evidence on the status, challenges, and future potential of telehealth in occupational health care in India. A comprehensive literature search was performed across PubMed, Scopus, Web of Science, and Google Scholar for English-language publications from 2000 to 2025. Peer-reviewed articles and grey literature, including government reports and policy documents, were included. The review identified a marked paucity of India-specific evidence on tele-occupational health implementation. While national platforms such as e-Sanjeevani demonstrate large-scale telemedicine feasibility, occupational health–specific applications are rarely documented or evaluated. Major barriers include digital infrastructure gaps, low digital literacy, data privacy concerns, medico-legal uncertainties, and a shortage of trained occupational health professionals, with training largely limited to short-term programs such as the AFIH course. Provider-level resistance and inadequate ICT training further impede adoption. Nevertheless, opportunities exist through integration with national digital health systems (ABDM), hybrid service delivery models, workforce capacity building, and assisted telemedicine facilitation at workplaces. Tele-occupational health holds significant potential to improve access, continuity of care, and productivity for India’s industrial workforce. Strengthening occupational health training, improving digital readiness, and generating India-specific implementation research are critical to realising scalable and effective tele-occupational health services.

Standardizing non-communicable diseases surveillance: a review of variables, tools, digital platforms and a proposed integrated HMIS framework

Nalmasu Harshitha — 2026-05-30

Non-communicable diseases (NCDs) account for a significant share of preventable morbidity and mortality, yet data collection on NCDs is carried out in separate, disconnected and often inconsistent ways. This review showcases the variables, tools and digital platforms used for NCD data collection, monitoring and implementation by collecting the data elements such as behavioural risks, physical measurements, biochemical markers, clinical diagnostic and treatment variables, outcomes and system performance indicators and to classify the tools used to capture and manage them. This work also proposes a baseline NCD dataset and a unified framework for integrating survey and routine care data within a single ecosystem-wide Health Management Information System (HMIS), enabling consistent measurement, programme monitoring and actionable decision support.

Integrating agent-based modelling with Ayurvedic principles a conceptual framework for systems health

Pramod Chandra Dwivedi — 2026-05-30

The emergent nature of health and disease is due to the complexity of interactions between the biological system, behavioural system and the environmental system. In Ayurveda, the traditional Indian system of medicine, the human organism has traditionally been viewed as a living system of Dosha (functional principles), Dhatu (tissues), Agni (metabolic energy) as well as Shrotas (circulatory channels). These organizations constantly are at work with both internal and external variables in order to preserve harmony within the system. The current systems biology and computational science is also understanding health as an emergent phenomenon of complex adaptive systems. which gives a framework of enormous power to computational simulation. This review seeks to understand the conceptual and methodological combination of Ayurvedic principles with Agent-Based Modelling in order to develop a systems framework of organising, predicting and controlling the dynamics of health and disease. Narrative and conceptual review was done ensuring that classical Ayurvedic literature is analysed together with the modern systems biology, computational models, and ABM readings. Ayurvedic objects were equated to computational analogs: Dosha as control agents, Dhatu as a structural matter, Agni as the processors of metabolism, Ama as mala adjusting products and Shrotas as the communication channels. It has been used to develop a conceptual model of human physiology as a multi-agent system the interactions of individual agents governed by the Ayurvedic laws of balance and feedback regulation give rise to global health. Findings: The proposed schematic illustrates how ABM has the capability of simulating Ayurvedic processes (Prakriti (individual constitution), Samprapti (pathogenesis), and Chikitsa (therapeutic intervention)) using computational logic.

Gender as a determinant of health: a narrative review from a public health perspective

Srikanta Padhan — 2026-05-30

Gender shapes not only how we view ourselves but also how we are perceived by others; how we behave towards, treat, and interact with one another play a large role in determining our health outcomes. There is often a gap between what we understand and how we utilize our understanding; being aware of this gap can lead to improved awareness and utilization of health services. Gender-based differences include both biological and social construction. The inter-relationship between biological and societal constructs will produce different total wellness experiences for men, women and the transgender community. Gender has a significant impact on the types of illnesses we develop and thus the types of health promotion programmes that are effective. This narrative review will compile research from the fields of public health (globally) and Indian public health and synthesise what is already known regarding how gender influences disease incidence, morbidity, and mortality, as well as programmatic efficacy. Additionally, the review will look at how gender is integrated into national health system policies as well as identifying gaps in the existing literature related to gender and health. Understanding the role of gender in public health is critical if we want to reach our goal of Health for All and also to achieve equity and improve health outcomes.