International Journal Of Community Medicine And Public Health

Factors associated with home-based management of diarrhoea in children under 5 years among parents/guardians in the Ndongo community of Buea, South-West Region of Cameroon

Koudom Chelsy Takamo, Takamo Peter, Abdel Jelil Njouendou — Fri, 30 Oct 2026 00:00:00 +0000

Background: Diarrhoea remains a major cause of illness and death among children under-five year of age in sub‑Saharan Africa, where home-based care is often the first response and depends heavily on caregivers’ knowledge and practices. This study assessed the factors associated with home-based management of childhood diarrhoea among parents and guardians in the Ndongo community of Buea, Cameroon.

Methods: A cross-sectional survey was conducted among 385 participants recruited through snowball sampling. Data were collected using an interviewer‑administered questionnaire assessing knowledge and home‑management practices, then analyzed using descriptive and multivariate logistic regression statistics.

Results: The mean participant age was 26.21±7.11 years. Overall, 47.0% demonstrated good knowledge, while 45.7% exhibited good practices related to diarrhoea management. Good knowledge was more likely observed among women (aOR=1.112; 95% CI: 1.089-2.874), mothers compared with guardians (aOR=1.339; 95% CI: 1.192-1.798), individuals with tertiary education (aOR=1.388; 95% CI: 1.113-3.302), and those who were employed (aOR=2.108; 95% CI: 1.072-4.145). Good practices were likely reported by participants who attended tertiary education (aOR=1.443; 95% CI: 1.132-4.846), having two to three under‑five children (aOR=2.12; 95% CI: 1.272-3.534), and possessing good knowledge (aOR=2.383; 95% CI: 1.551-3.659).

Conclusions: The findings of this study indicate suboptimal levels of knowledge and practices amongst parents and caregivers of under-five children in Ndongo, supporting the need for strengthening caregiver awareness, mainly in the context the ongoing socio‑political unrest in Buea, which may further limit access to timely healthcare and reliable information.

Cardiovascular risk profile in a rural population of Colombia: a descriptive cross-sectional study

Miguel A. Trillod Arias, Jose M. Alba Maldonado — Fri, 30 Oct 2026 00:00:00 +0000

Background: Cardiovascular disease is the leading cause of mortality in Colombia, and rural populations carry a disproportionate, poorly characterized burden. Evidence on the application of the 2024 Colombian Dyslipidemias Consensus in rural primary care is scarce. This study describes the cardiovascular risk profile of the adult population of Úmbita, Boyacá.

Methods: Descriptive cross-sectional study using secondary data from the institutional information system of the E.S.E. Centro de Salud San Rafael de Úmbita (January 2024 to December 2025). 1,261 adults aged 30 to 75 years without prior cardiovascular events were included. Demographic, anthropometric, comorbidity, and lipid variables were described; ten-year risk was stratified with the four-step Colombian algorithm and the Framingham-Wilson scale recalibrated for Colombia (factor 0.75).

Results: Mean age was 54.8 years (SD 12.2). Abdominal obesity reached 65.9% and excess weight 62.4%. Low HDL-C was present in 83.9% (91.1% in women), and LDL-C of 160 mg/dL or higher in 48.1%. Hypertension affected 30.1% and prediabetes 30.1%. Under the four-step algorithm, 45.6% classified as high or very high risk, including 25.8% of adults aged 30 to 44 years. Mean recalibrated Framingham-Wilson risk was 15.4% (SD 14.6); 27.5% classified as high risk (20% or higher), higher in women (33.8%) than men (18.4%).

Conclusions: Úmbita presents a severe cardiometabolic burden defined by low HDL-C, abdominal obesity, and mixed dyslipidemia, with elevated risk among adults of working age. These findings support primary care interventions articulated with the territorial determinants of health.

Clinical profile and demographic characteristics of patients with trigeminal neuralgia in a Nigerian tertiary hospital

Fri, 30 Oct 2026 00:00:00 +0000

Background: Trigeminal neuralgia (TN) is a chronic neuropathic pain disorder characterized by recurrent episodes of sudden, electric shock-like facial pain affecting one or more branches of the trigeminal nerve. Its varied presentation may pose diagnostic challenges for dental practitioners. This study aimed to assess the clinical profiles and demographic characteristics of patients with trigeminal neuralgia in a Nigerian tertiary hospital.

Methods: A five-year retrospective study was conducted on all patients diagnosed with TN at the Oral Medicine Clinic, Lagos University Teaching Hospital, Idi-Araba, between August 2020 and August 2025. Data were analysed using IBM SPSS version 27. Categorical variables were presented using frequencies and percentages, while associations were assessed using Fisher’s exact test. Statistical significance was set at p<0.05.

Results: Of 563 patients seen during the study period, 35 were diagnosed with TN, giving a frequency of 6.2%. The mean age was 51.2±14.9 years, with 51.4% aged 40-59 years. Females accounted for 60.0% of cases. Right-sided involvement (62.9%) was more common than left-sided involvement (37.1%). Age group was significantly associated with laterality (p=0.036), whereas sex was not (p=0.568).

Conclusions: Trigeminal neuralgia occurred predominantly among females, individuals aged 40–59 years, and those with right-sided involvement. These findings were consistent with global trends and will provide valuable local epidemiological data that may enhance recognition and management of TN in Nigeria.

Functional dependence in later life: a cross-sectional study in a village of Bangladesh

Khadiza Khatun, Mohibul Islam — Fri, 30 Oct 2026 00:00:00 +0000

Background: Functional dependence is a major concern in ageing populations, yet evidence from rural Bangladesh is limited. This study aimed to examine functional dependence in basic and instrumental activities of daily living (BADL and IADL) among rural older adults in Bangladesh.

Methods: A community-based cross-sectional study was conducted in a village of Mymensingh District, Bangladesh. Of 118 older adults selected through simple random sampling, 112 were analysed. Interviews used a semi-structured questionnaire, with BADL and IADL items adapted from the Katz and Lawton-Brody scales. Multiple linear regression examined the effects of sociodemographic characteristics on functional dependency.

Results: Findings reveal that while 76.8% of older people remain independent in BADL, only 29.5% were independent in IADL, indicating higher dependency on instrumental activities of daily living. The regression analysis indicated a moderate correlation (R=0.535) between sociodemographic variables and BADL dependence, accounting for 28.6% of the variation in functional dependency, with age and occupation as statistically significant predictors of BADL dependence. In contrast, a more substantial relationship is observed between sociodemographic characteristics and IADL dependence (R=0.787, R²=0.620), suggesting that 62% of the variation in IADL dependency can be explained by such factors as age, sex, occupation, and health status.

Conclusions: The findings support a critical perspective on the disengagement theory of ageing, suggesting that disengagement is not a linear process driven solely by age. Given the influence of age, sex, occupation, and health conditions on everyday functioning, specific interventions should support older people.

Comparison of ALBI, PALBI, MELD and Child-Pugh scores in chronic liver disease: evidence from Bangladesh

Fri, 30 Oct 2026 00:00:00 +0000

Background: Accurate assessment of hepatic reserve is essential for prognosis in chronic liver disease (CLD). This study aimed to evaluate the correlation of ALBI and PALBI scores with MELD and Child-Turcotte-Pugh (CTP) scores and compare their predictive value in Bangladeshi patients with CLD of mixed etiologies.

Methods: A cross-sectional study was conducted among 105 patients with established CLD. Clinical and laboratory data were collected to calculate ALBI, PALBI, MELD, and CTP scores. Correlations were assessed using Spearman’s rank test, while hierarchical linear regression evaluated the independent predictive contribution of ALBI and PALBI.

Results: ALBI and PALBI showed significant positive correlations with MELD (ρ=0.539 and 0.625, respectively; p<0.001) and CTP (ρ=0.721 and 0.679, respectively; p<0.001). Age was not significantly associated with MELD or CTP scores. PALBI showed a stronger predictive contribution for MELD (ΔR²=0.085, p<0.001), whereas ALBI demonstrated greater unique contribution to CTP (ΔR²=0.054, p=0.001).

Conclusions: ALBI and PALBI are simple, objective, and economical indices that correlate well with conventional liver severity scores. PALBI better reflects MELD-related systemic components, while ALBI more closely represents hepatic functional reserve.

School-based vision screening for early detection of refractive errors among children aged 5-14 years in Mathare and Kibera, Nairobi, Kenya

Didan M. Amollo, Dorcus Maina, Felix B. Odhiambo, Khumbo Kalua — Fri, 30 Oct 2026 00:00:00 +0000

Background: Uncorrected refractive errors are a major cause of avoidable visual impairment among school-aged children, yet many children in underserved urban settings remain undiagnosed. This study evaluated school-based vision screening for early detection of refractive errors among children aged 5-14 years in Mathare and Kibera, Nairobi, Kenya.

Methods: A descriptive analytical cross-sectional study using a mixed-methods approach was conducted from 17^th April to 30^th May 2026 in seven selected primary schools. A total of 1,050 children underwent visual acuity screening and confirmatory refraction where indicated. Quantitative data were analyzed using descriptive statistics, chi-square tests and logistic regression in STATA 17. Qualitative data from focus group discussions and key informant interviews were analyzed thematically.

Results: Overall, 201 children had refractive errors, representing 19.1% of those screened (95% CI: 16.9-21.6). Myopia was the predominant refractive error (86.1%), followed by hyperopia (12.9%) and astigmatism (1.0%). Refractive error proportions differed significantly across schools (p=0.001). Public school attendance was associated with lower odds of refractive error compared with private school attendance (OR=0.64, 95% CI: 0.42-0.98; p=0.040), while increasing age was associated with higher odds (OR=1.07, 95% CI: 1.01-1.14; p=0.032). Key barriers to referral uptake included cost, limited awareness, stigma, weak follow-up systems and transport constraints.

Conclusions: School-based vision screening was feasible and identified a substantial burden of previously undiagnosed refractive errors. Integration of routine eye screening into school health services, strengthened referral systems and affordable spectacles are needed in informal settlements.

Health related quality of life among type 2 diabetes mellitus patients of Nepal: a cross-sectional study

Fri, 30 Oct 2026 00:00:00 +0000

Background: To assess HRQOL and its associated factors among patients with T2DM attending Nepal Medical College and Teaching Hospital, Kathmandu.

Methods: A quantitative descriptive cross-sectional study was conducted among 72 T2DM patients selected using convenience sampling. Data were collected through a semi-structured questionnaire and WHOQOL-BREF tool. WHOQOL-BREF questionnaire (a standard tool developed by WHO) consists of 26 items divided into 4 domains i.e. physical health, psychological health, social relationships and environment. Data were analysed using descriptive statistics (frequency, percentage, mean, standard deviation) and Chi-square test for associations.

Results: The mean age of respondents was 52.31±11.15 years. The mean overall WHOQOL-BREF score was 83.54±7.46. Among domains, social relationship had the highest mean score, while environmental domain had the lowest. Most respondents (90.3%) reported excellent quality of life, while 9.7% had moderate quality of life. The age with physical health domain and marital status with social relationships domain have strong significant association at P value 0.035 and 0.003 respectively.

Conclusions: The study found relatively good HRQOL among T2DM patients, though variations existed across domains. Focused interventions targeting physical health, older age groups, and social support systems are recommended to further improve quality of life.

Prevalence, risk factors and management of uterine rupture: a five-year review at a tertiary hospital in South-West Nigeria

Fri, 30 Oct 2026 00:00:00 +0000

Background: Uterine rupture is a catastrophic event which poses severe risks to both the mother and the fetus. This study aimed to determine the prevalence of uterine rupture, the risk factors, and evaluate the maternal and fetal outcomes at Federal Medical Centre Owo.

Methods: A 5-year retrospective cross-sectional study of cases of uterine rupture that were managed at the Federal Medical Centre, Owo from 1^st January, 2019 to 31^st December, 2023. The case notes of patients were retrieved from the medical record department. The relevant data were collated using a structured questionnaire and transferred to a data sheet and analyzed using the IBM Statistical Product and Service Solutions (SPSS) version 27.

Results: The prevalence of uterine rupture in this study was 0.69% or 1 in 144 deliveries. The mean age of women was 28.7 years (SD=3.3). Unbooked patients (92.6%) accounted for most of the cases of uterine rupture. Previous cesarean section scar (66.7%) and prolonged obstructed labour (37.0%) were the common associated risk factors. Nine (33.3%) of women required hysterectomy, while 66.7% had repair with or without bilateral tubal ligation. Maternal death was 11.1%, while perinatal mortality was 70.4%.

Conclusions: The high maternal and perinatal mortality due to uterine rupture requires attention and the need to reduce the risk factors.

Empathy levels and their correlates among medical students at a private college in Karachi: a cross-sectional study

Fri, 30 Oct 2026 00:00:00 +0000

Background: We aimed to measure empathy using the Jefferson Scale of Empathy–Student version (JSE-S) among undergraduate Bachelor of Medicine, Bachelor of Surgery (MBBS) students at a private medical college in Karachi and to assess its association with sex, academic year and preferred future specialty.

Methods: We conducted a cross-sectional survey at Fazaia Ruth Pfau Medical College, Karachi, during November 2024 and January 2025. We approached 343 students and, after JSE-S and demographic assessment, included 304 in the final analysis. Using multivariable linear regression, we estimated adjusted associations between JSE-S scores and sex, academic year and specialty preference.

Results: The mean JSE-S score was 104.8 (SD 12.3). After adjusting for academic year and specialty preference, female students scored 5.5 points higher than male students on the JSE-S (adjusted β=5.5; 95% CI 2.9 to 8.1; p<0.001). In the adjusted model, Year 2 students scored 6.1 points lower than Year 5 students (adjusted β=−6.1; 95% CI −10.2 to −2.0; p=0.004). Students' specialty preference showed no meaningful association with JSE-S scores (F=1.21; p=0.298).

Conclusions: Among undergraduate medical students at a private medical college in Karachi, female students scored higher than male students and Year 5 students scored higher than Year 2 students, on self-reported JSE-S empathy; preferred future specialty showed no comparable association.

Perception of the learning environment among trainees of the Public Health Supervisor-I Training Program at the University of Community Health, Magway, Myanmar

Yamin Thaung, Chaw Su Maung, Khin Cho Aye, Ye Phyo Aung, Htun Tin, Tin Tun — Fri, 30 Oct 2026 00:00:00 +0000

Background: A positive and supportive learning environment is an important determinant for the academic achievement of trainees in health professional education. In Myanmar, the Public Health Supervisor-I Training Program has recently transitioned to a hybrid model, necessitating an assessment of its learning environment.

Methods: This study used a cross-sectional explanatory sequential mixed-methods design to assess the perceptions of 197 PSH-I trainees regarding their learning environment at the University of Community Health, Magway, using the Dundee Ready Educational Environment Measure (DREEM), and to explore their perspectives on the strengths and weaknesses of the current learning environment.

Results: The overall DREEM score was 152.57/200, indicating an excellent educational environment. The mean scores of five domains were: students’ perceptions of learning (35.38/48), students’ perceptions of teachers (36.65/44), students’ academic self-perceptions (25.53/32), students’ perceptions of atmosphere (34.49/48), and students’ social self-perceptions (20.52/28). Female students perceived the program more positively than male students (p=0.249), with a significant difference in students’ perceptions of teachers (p=0.034). In-depth interviews with 13 trainees showed transition burden, uneven learning environments, teacher support, academic pressure, peer support, and suggestions for system improvement. Trainees appreciated supportive teaching and peer relationships but experienced stress from the hybrid structure, travel, accommodation issues, crowded classrooms, inconsistency between on-campus and off-campus teaching, and academic pressure.

Conclusions: Overall, the learning environment was perceived positively. However, structural improvements are needed to reduce burdens associated with the hybrid model and create a more supportive, coherent, and learner-centered environment.

From pandemic shock to inflation: a comparative analysis of household food security and coping strategies in Jamaica, before, during and post COVID-19

Adella Campbell, Lisa Reid, Binol Balachandar, Kayann D. Ford, Fitzroy J. Henry — Fri, 30 Oct 2026 00:00:00 +0000

Background: Jamaica experienced successive shocks from the COVID-19 pandemic and the inflationary period that followed. This study compared household income, coping strategies and hunger indicators across 2018, 2020 and 2022, with 2018 used only as a contextual comparison rather than a stable baseline.

Methods: A comparative secondary analysis was conducted using aggregate household data. The main comparison was between 2020 and 2022. Descriptive percentage and percentage-point changes were examined for income categories, coping responses and household hunger.

Results: From 2020 to 2022, use of savings rose from 59.0% to 74.1%, borrowing from 24.6% to 46.0%, reduced meal quality from 16.0% to 31.0%, and begging from 5.5% to 28.0%; remittance use fell from 56.0% to 10.2%. No hunger declined from 58.3% to 32.9%, while moderate hunger increased from 13.5% to 41.8%. Combined moderate and severe hunger increased from 23.3% to 54.8%.

Conclusions: Household vulnerability was greater in 2022 than in 2020. The findings indicate increasing reliance on erosive coping strategies and worsening hunger during the post-pandemic inflationary period. Further study is required to clarify causal pathways and guide targeted social protection programmes.

Role of community champions in promoting inclusion of adolescents and young persons in family planning services: a quasi-experimental endline evaluation

Fri, 30 Oct 2026 00:00:00 +0000

Background: Adolescents and young people (AYPs) face disproportionate barriers to family planning (FP), especially in conservative and underserved contexts. This study assessed the role of community champions in improving FP knowledge, attitudes and utilization among AYPs aged 15–24 in Garissa and Tana River Counties, Kenya, under the DEESIP project.

Methods: A quasi-experimental, mixed-methods design evaluated 673 AYPs, using surveys, interviews and focus groups.

Results: Overall, 74% reported FP awareness, higher in Tana River (61%) than Garissa (39%) (p<0.001). Attitudes toward FP were generally positive with youth in intervention areas reporting higher attitudes than controls. Utilization was greater in Tana River (76%) than Garissa (24%) (p<0.001). Exposure to champions significantly increased uptake (OR≈35, p<0.001), particularly with religious leader engagement.

Conclusions: Champions reduced stigma and provider bias but faced sustainability challenges. Strengthening peer-led and faith-informed strategies is vital for equitable FP access among AYPs in marginalized settings.

Differential predictive ability of the novel obesity indices on hypertension among non-obese adults stratified by metabolic health

Fri, 30 Oct 2026 00:00:00 +0000

Background: Novel obesity indices that integrate visceral adiposity, insulin resistance, and lipid metabolism may predict hypertension (HTN) better than conventional anthropometric measures. We compared novel and traditional obesity indices for HTN among non-obese Mongolian adults according to metabolic health status.

Methods: We used data from the 2019 Mongolian WHO STEPwise survey (STEPS) and included adults aged 18-65 years with a body mass index (BMI) <30 kg/m². Exposures were triglyceride- and triglyceride-glucose (TyG)-derived indices, including the TyG-waist-to-height ratio (TyG-WHtR), and traditional anthropometric indices; the outcome was HTN. Participants with diabetes or dyslipidemia were classified as metabolically unhealthy (MUI) and the remainder as metabolically healthy (MHI). Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed.

Results: Of 3,031 participants, 61.4% had HTN, and the mean age was 40.9 (SD 11.5) years. TyG-WHtR had the largest odds ratio (OR) for HTN in both MHI (OR 1.68, 95% CI 1.43-1.97) and MUI (OR 1.72, 95% CI 1.46-2.04), followed by the body roundness index (BRI). Indices based mainly on lipids and glucose were not positively associated with HTN. Discrimination was modest; the highest areas under the curve (AUC) were for BMI (0.657) among MHI and for BRI and WHtR (0.691) among MUI.

Conclusions: Among non-obese adults, anthropometric and TyG-anthropometric indices, particularly TyG-WHtR, were associated with HTN regardless of metabolic status, whereas lipid-only indices were not. Discrimination was modest and greater in MUI, and simple measures such as BMI and waist circumference performed as well as the novel indices.

Healthy lifestyle practices among government primary school teachers in selected districts of Pakistan

Fri, 30 Oct 2026 00:00:00 +0000

Background: Deaths due to unhealthy behaviors account for more than one-third of total deaths worldwide. In Pakistan, poor awareness and sanitation are major contributors to the diseases, but a balanced diet, hygiene, and exercise can reduce these risks. The present study aimed to determine the current status of healthy life practices among the teachers of the selected primary school.

Methods: A descriptive cross-sectional study was conducted from February to April 2019 in 600 selected government primary schools of three districts of Sindh: Thatta, Hyderabad, and Mirpur Khas. Two teachers of each school were selected through convenience sampling for the purpose of interviewing through a structured questionnaire.

Results: The results revealed a generally moderate level of healthy lifestyle practices among primary school teachers. The majority of the teachers demonstrated good healthy hygiene practices. Statistically, 85% of the teachers practiced washing their hands before meals, and 69% practiced water purification through alum. A majority of the teachers, 82%, claimed to be early risers. Only 14% of the teachers practiced physical exercise.

Conclusions: Although basic hygiene needs were adequately met, the level of physical inactivity among teachers suggests the need for health education programs for teachers.

Awareness about eye donation in medical undergraduates across Maharashtra: a cross-sectional study

Fri, 30 Oct 2026 00:00:00 +0000

Background: Corneal blindness is a major health concern in India, where donor shortages persist despite transplantation being the primary restorative therapy. This study assessed the knowledge, awareness, and attitudes regarding eye donation among MBBS students and interns across Maharashtra.

Methods: A cross-sectional study surveyed 755 MBBS students and interns across Maharashtra (April to December 2024) using purposive sampling. Data gathered via a self-administered Google form were evaluated using descriptive statistics (frequencies and percentages).

Results: Among 755 participants (53.7% male, 90% urban, 84.7% Hindu), 98.8% knew eyes can be donated, learning primarily from social media (39.2%) and textbooks (33.5%). Most recognized the cornea as the transplantable tissue (89%), keratoplasty as the surgical procedure (82.1%), the 4-6-hour post-mortem retrieval window (57.5%), and universal eligibility across genders (95.6%) and blood groups (96%). However, only 32.8% correctly identified Optisol GS as the storage medium (30.3% chose formalin), 29.1% knew of nearby eye banks, and 54.5% recognized national programs. While 64.5% were willing to pledge their eyes and 66.8% acknowledged a national donor deficit, direct exposure was low: only 34.6% knew a donor and 28.1% knew a recipient.

Conclusions: Despite high baseline awareness and positive attitudes, significant gaps exist in procedural and preservation protocols. Structured training, eye-bank postings, and practical exposure are vital to equip future clinicians for effective donor advocacy.

Impact paper on maternal, child health and nutrition in Madhya Pradesh

Wed, 14 Oct 2026 00:00:00 +0000

Background: Improving maternal, newborn, child health and nutrition (MNCHN) outcomes has been a sustained priority for the Government of Madhya Pradesh, particularly in high-burden districts, and the state has implemented various flagship schemes and programmes to strengthen public health systems and service delivery. As part of this effort, the Government launched the Akshita Programme with The Antara Foundation in 2019 to strengthen service delivery across nine districts. This study assessed the Programme's contribution to select MNCHN outcomes.

Methods: This longitudinal descriptive analysis compared trends across 38 intervention and 25 comparison blocks using Health Management Information System (HMIS) and programme data, analysed through a program-year (PY) framework (PY-1 to PY+4). Provider competency was assessed in 818 sub-health centres (Auxiliary Nurse Midwives and Community Health Officers) and 111 health facilities (staff nurses).

Results: Intervention areas demonstrated greater reductions in stillbirth, very early neonatal mortality and late neonatal mortality than comparison areas. Early antenatal registration rose from 65% to 90%, four antenatal care check-ups from 73% to 101%, intrapartum complication identification from 23% to 53% and home-based postnatal care coverage from 41% to 90%. Sub-health centres with strong technical knowledge scores increased from 2% to 25% while 97% of assessed facilities showed gains in staff nurse knowledge and skills. Low birthweight prevalence showed no meaningful improvement.

Conclusions: Strengthening frontline health systems through worker coordination, capacity building and nurse mentoring was associated with improved maternal and newborn outcomes. Persistent low birthweight underscores the need for targeted maternal nutrition interventions and stronger health–nutrition convergence.

Prevalence, severity and correlates of anemia among adolescent girls in an urban village of Delhi: a cross-sectional study

Anshu Tomar, Bhawna, Feba, Anney Avarachan — Wed, 14 Oct 2026 00:00:00 +0000

Background: Anemia is a major public health problem among adolescents in India, affecting growth and academic performance. Despite weekly iron folic acid supplementation (WIFS) program, data from urban villages is limited. Objective: To estimate prevalence, severity and assess socio-demographic, nutritional and knowledge correlates of anemia among adolescent girls in an urban village of Delhi.

Methods: A community-based cross-sectional study was conducted among 400 adolescent girls aged 10-19 years in Aali village, Delhi from 01 January 2025 to 31 March 2026. Multi-stage sampling was used. Haemoglobin was estimated using digital hemoglobinometer. Anemia was defined as Hb<12 g/dl. Data was analysed using SPSS v26. Chi-square and univariate logistic regression were used. p<0.05 was considered significant.

Results: Prevalence of anemia was 67.2%. Mild, moderate and severe anemia was 42.5%, 22.0% and 2.7% respectively. Prevalence was higher in 15-19 years 73.6% vs 10-14 years 59.4%, OR 1.86, p=0.003. Mother's illiteracy OR 2.61, p<0.001 and early menarche <13 years OR 1.74, p=0.013 were significant. Underweight girls had 4.67 times higher odds, p<0.001. Vegetarian diet OR 2.12, p<0.001. Non-consumption of IFA OR 4.52, p<0.001. Poor knowledge had highest odds OR 6.02, p<0.001.

Conclusions: Anemia burden is high. Modifiable factors like undernutrition, poor IFA compliance and poor knowledge are key drivers. A multi-sectoral approach strengthening WIFS, nutrition and targeted IEC through schools and mothers is needed.

Factors affecting maternal healthcare services utilization in the districts of Maharashtra

Pandurang Sontakke — Wed, 14 Oct 2026 00:00:00 +0000

Background: This study investigates factors influencing maternal healthcare service utilization across two contrasting districts of Maharashtra—Nandurbar (tribal) and Satara (non tribal).

Method: Using a descriptive quantitative design, primary survey data were collected from 240 mothers who had delivered within the preceding 11 months. Outcomes examined included full antenatal care (ANC), institutional delivery, and postnatal care (PNC), with associations tested against socio demographic and household characteristics.

Results: Findings reveal stark disparities. Full ANC utilization was significantly lower in Nandurbar (31%) compared to Satara (45%), with geography exerting a strong influence: plain talukas reported over 60% coverage, while hilly talukas recorded as low as 0%. Institutional delivery followed a similar pattern, with Satara achieving 81% compared to 51% in Nandurbar; plain regions reported nearly universal coverage (93%), while hilly regions lagged at 39%. PNC utilization also showed marked differences, with Satara at 75% and Nandurbar at 49%. Socioeconomic gradients were evident across all services. Women with higher education and wealth consistently reported greater utilization, while those with no schooling or low wealth indices had the lowest uptake. Parity further influenced outcomes, with first time mothers more likely to access services than those with three or more children. Caste disparities were pronounced, with Scheduled Tribe mothers consistently reporting lower utilization.

Conclusions: The study underscores that maternal healthcare access in Maharashtra is structured by geography, education, wealth, and parity. Addressing these inequities requires geographically sensitive strategies, targeted outreach in tribal and hilly regions, and interventions that strengthen education, awareness, and economic support for vulnerable women.

Patterns and determinants of self-medication for oral health problems among hospital outpatients in Jharkhand, India

Sudhanshu Saxena, Sonia Tiwari — Thu, 08 Oct 2026 00:00:00 +0000

Background: Unsupervised self-medication for dental ailments presents substantial clinical hazards, yet regional evidence from hospital settings in eastern India remains limited. This study evaluated the prevalence, patterns, and socio-demographic determinants of self-medication for oral health problems among hospital outpatients in Jamshedpur, Jharkhand.

Methods: This cross-sectional analytical study enrolled 400 adult outpatients aged 18 years and above at a tertiary dental facility in Jharkhand using census sampling over 12 months. Data regarding self-medication practices, reasons, drug classes, and information sources were collected using an interviewer-administered questionnaire and evaluated using descriptive statistics and Pearson's chi-square test.

Results: Overall, 248 of 400 participants (62.00%) reported self-medication in the preceding year. Prevalence was significantly higher among participants aged 41–60 years (96/136, 70.59%) than those aged 21–40 years (152/264, 57.58%) and in males (144/216, 66.67%) versus females (104/184, 56.52%). Toothache was the chief complaint (168/248, 67.74%), lack of time was the primary reason (176/248, 70.97%), analgesics were the most common drug class (176/248, 70.97%), and pharmacists were the main information source (136/248, 54.84%); adverse effects occurred in 16 participants (6.45%).

Conclusions: Oral self-medication is highly prevalent among hospital outpatients in Jharkhand, driven largely by acute toothache and time constraints, with older age and male gender significantly increasing likelihood. Public health initiatives and regulatory oversight of pharmacy drug dispensing are urgently needed to reduce inappropriate self-care.

Clinical study to evaluate the therapeutic safety and efficacy of Pyrethrum indicum L. in primary knee osteoarthritis: a randomized controlled trial

Mir I. Hanief, Shameem A. Rather, Fouzia Farooq, Zarfah Fida, N. Z. Ahmed — Fri, 16 Oct 2026 00:00:00 +0000

Background: Primary knee osteoarthritis (OA) is a common degenerative joint disorder characterized by pain, stiffness, and functional limitation due to progressive cartilage degeneration and inflammation. Conventional therapies such as non-steroidal anti-inflammatory drugs (NSAIDs), COX-inhibitors, corticosteroids etc. provide symptomatic relief but may have limited long-term efficacy and potential adverse effects. Consequently, interest in complementary and alternative medicine has increased. Pyrethrum indicum L. (Bozidān), traditionally used in Unani medicine for its anti-inflammatory and analgesic properties, has limited clinical evidence regarding its safety and efficacy in knee OA. The present study aimed to evaluate the therapeutic safety and efficacy of Pyrethrum indicum L. in participants with primary knee OA.

Methods: An open-label randomized controlled trial was conducted on 60 participants aged 40-70 years diagnosed with primary knee OA (Kellgren-Lawrence grade I and II). Participants were randomly allocated to a test group or a control group. The study received approval from the institutional ethics committee (IEC No. RRIUM-SGR/MD-2018/CT/WR/OA/BD) and was registered with the Clinical Trials Registry of India (CTRI/2021/03/032178). The test group received Pyrethrum indicum L. (5 grams once daily), while the control group received tablet glucosamine sulfate (1500 mg once daily) for 45 days.

Results: The test group showed significant improvement in pain, swelling, tenderness, and restriction of movement compared with the control group. A significantly greater reduction in the overall WOMAC score was also observed in the test group.

Conclusions: Pyrethrum indicum L. was well tolerated and demonstrated greater short-term symptomatic improvement compared with glucosamine sulfate in participants with primary knee OA.

The premenstrual mind: examining cognitive distortions across symptom domains and severity levels of premenstrual syndrome

Saumyashree Mohapatra, Somani Acharya, Pratiti Das, Jashobanta Mahapatra — Fri, 16 Oct 2026 00:00:00 +0000

Background: Premenstrual syndrome (PMS) is a prevalent condition in menstruating women, encompassing varied symptoms ranging from physical, behavioural, emotional, psychological, to cognitive symptoms. Cognitive changes during the PMS phase may contribute to distorted thinking patterns such as all-or-nothing thinking, emotional reasoning, personalization, etc, which may worsen mood, leading to exaggerated emotional responses. Emerging evidence suggests that the nature and extent of these cognitive distortions may vary with the severity of PMS symptoms. This study aims to investigate the presence of cognitive distortions during the premenstrual phase and examine whether the types of cognitive distortions vary across symptom profiles of PMS.

Methods: This cross-sectional study targeted female B.Sc. nursing students ranging from 17 to 26 years of age from S.C.B Medical College of Nursing, recruited after obtaining informed consent. PMS severity and cognitive distortions during the premenstrual phase are assessed and categorised using the premenstrual syndrome scale (PMSS) and cognitive distortion scale (CDS), respectively. Data is analysed for descriptive statistics and correlation was done using appropriate statistical packages.

Results: The PMS total score and PMS severity showed moderated positive correlation with most cognitive distortions, with the strongest relationship observed for emotional reasoning, catastrophization, all-or-nothing thinking, and mind reading. Moreover, within symptom domains, psychological symptoms demonstrated the strongest associations across most cognitive distortions.

Conclusions: The present study highlights a significant associations between the severity of PMS and cognitive distortions, among female nursing students, highlighting the importance of addressing cognitive patterns in the psychological management of PMS among young women.

Knowledge, attitudes and practices of contraception among women in an urban slum of Coimbatore, Tamil Nadu: a community-based cross-sectional study of a Gondi tribal settlement

Balaji Prasad, Raja Ramasamy, Sangeetha Priya — Fri, 30 Oct 2026 00:00:00 +0000

Background: Urban slum communities in India bear a disproportionate burden of unmet reproductive health needs, driven less by unawareness than by barriers to access and use, compounded by gendered norms that assign reproductive responsibility to women. This study assessed contraceptive knowledge, attitudes, and practices (KAP) among women of Gondi tribal descent in an urban slum of Coimbatore, Tamil Nadu.

Methods: A community-based cross-sectional survey of 190 married women aged 18-45 years was conducted using a structured interviewer-administered questionnaire covering sociodemographics, reproductive history, and KAP, supplemented by field observations. Socioeconomic status was classified using the updated BG Prasad scale (2025). Descriptive statistics and chi-square tests were used.

Results: Mean age was 32.9 years; 50.5% were illiterate and 51.6% belonged to the lower socioeconomic class. Awareness was highest for female sterilization (79.5%) and injectables (68.4%) and lowest for oral contraceptive pills (8.9%); 20.0% had never heard of any method. Although 95.8% wanted no more children, only 51.1% had ever used contraception. Female sterilization accounted for 46.4% of ever-users; the remainder had used reversible or traditional methods, but fewer than 5% of all women were currently using a reversible method. No husband had undergone vasectomy. Higher parity and any formal education were significantly associated with ever-use (p<0.001 for both).

Conclusions: The knowledge-practice gap in this Gondi community is shaped by social isolation, gendered norms excluding men from reproductive responsibility, undifferentiated fear of side effects, and reactive healthcare use. Doorstep outreach, male partner engagement, and community-based education on all methods are needed.

A cross-sectional study to assess the knowledge, attitude and practice of artificial intelligence in medical field among doctors in a tertiary care hospital

Keerthi S., Shamini M., Joshithaa D. — Fri, 30 Oct 2026 00:00:00 +0000

Background: Artificial intelligence (AI) has already been widely adopted in various fields which has accelerated its growth in the medical field as well. As AI becomes increasingly important in healthcare, it is essential to foster future healthcare professionals with the required skills and knowledge. Therefore, the primary objective of our study was to assess the knowledge, attitude, and practice related to AI in medicine among doctors in a tertiary care hospital.

Methods: A cross-sectional, observational and questionnaire-based study was conducted among doctors with their consent working in various departments of our hospital. A total of 17 questionnaire were included: 5 knowledge based, 7 attitude-based, 5 practices based. Statistical analysis was performed using SPSS software version 26.0. Descriptive analysis including frequency, percentages and central tendencies was calculated for each domain and were tabulated.

Results: A total of 135 doctors were enrolled in this study. Among which 87.4% of associate professors had wider knowledge about AI in medical filed. The attitude-based questionnaire followed a Likert scaling ranging from strongly agree to strongly disagree which revealed 70.1% of professors strongly agreed that AI is a much-needed tool in medical field and has positive impact on healthcare. The overall practice-based Likert scaling reflected that 69% of the professors often used AI in their medical field for treating patients and for conducting research.

Conclusions: AI in healthcare is still at a rudimentary level and more such research has to be conducted to pave a path for upskilling patient care.

Perspectives on surrogacy among nursing professionals: awareness, attitudes and ethical concerns

Fri, 30 Oct 2026 00:00:00 +0000

Background: Surrogacy is an important assisted reproductive option that raises ethical, legal, and social concerns. Nursing professionals play a key role in providing reproductive healthcare and counselling. Aim was to assess the awareness and attitudes of nursing professionals towards surrogacy and surrogate children.

Methods: A descriptive cross-sectional study was conducted among 281 nursing professionals using convenience sampling. Data were collected through a self -reported questionnaire and analyzed using descriptive statistics.

Results: Most participants supported legalization of surrogacy (74.0%) and surrogacy for infertile heterosexual couples (76.2%). However, awareness regarding The Surrogacy (Regulation) Act was limited (29.5%). Less than half felt they had adequate knowledge regarding surrogacy care, though most expressed willingness to learn more. Attitudes towards surrogacy for same-sex couples and single individuals were less favourable.

Conclusions: The study revealed moderate awareness and varied attitudes towards surrogacy among nursing professionals, highlighting the need for education on surrogacy, reproductive ethics, and legal aspects.

Access to mental healthcare and coping strategies among rural women: a qualitative study from Amroha district, Uttar Pradesh, India

Balvinder Kumar, Rati Khurana, Nimisha Kumar — Fri, 30 Oct 2026 00:00:00 +0000

Background: Rural women in India are often confronted with situations that make it difficult for them to access formal mental health services such as inaccessibility, internalized stigma, believing that suffering is due to external causes and gender inequalities. These barriers delay receiving formal care for mental health and make these women resort to informal ways of coping such as community support and local faith healers.

Methods: This study aimed to explore the informal coping strategies and beliefs around mental health among 100 rural women over the age of 18 years residing in Amroha district of Uttar Pradesh, India. Being a qualitative study, the method employed for the survey was focused group discussions and the participants were included through a convenience snowball sampling. The discussions were held in Hindi language for the ease of the participants and were recorded for analysis which was done through a thematic analysis approach.

Results: The results highlighted six broad themes: (1) burden of responsibilities and emotional burnout, (2) physiological manifestations of psychological distress, (3) normalization of chronic stress, (4) psychological distress arising from marital conflict and gender-based adversity, (5) reliance on spiritual and informal coping strategies in place of formal mental healthcare, and (6) emotional suppression and silent tolerance.

Conclusions: The findings suggest the urgent need to design culturally aligned psychotherapeutic interventions that focus on creating awareness through psychoeducation that could reduce stigma as well as helping rural women deal with their unmet mental health challenges.

Understanding musculoskeletal symptoms in small-scale dairy employment: insights from a cross-sectional epidemiological study in Bhubaneswar, Odisha

Snigdha Singh, Sonali Kar, Avinash Naik — Fri, 30 Oct 2026 00:00:00 +0000

Background: The increased demand of dairy products in the urban areas is encouraging an increase in uptake of dairy as an occupation. Thus, this ownership generates a silent demand for task specialization, work efficiency and working hours. This study was done with the objective of bringing out the nexus between dairy work and different musculoskeletal symptoms reported in these dairy workers.

Methods: A cross-sectional study conducted from September 2018 to August 2020, among 360 small-scale dairy workers of Bhubaneswar in whom work-related musculoskeletal symptoms and its association with type of work done at dairy farm were assessed, using a pretested semi-structured, mixed questionnaire along with a hand symptom questionnaire.

Results: 96.7% workers reported MSS in any anatomical site while 88.4% reported MSS in ≥2 sites. There was strong association between type of work at dairy farm and MSS among dairy workers (aOR 3.44; 95%CI: 1.03-5.86; p=0.045).

Conclusions: Musculoskeletal symptoms are prevalent among dairy workers due to repetitive tasks, heavy lifting, inappropriate postures, and prolonged time of standing and is more prevalent among those doing parlor work.

Prevalence and predictors of substance abuse among patients with depressive and anxiety disorders: a cross-sectional study at a tertiary care hospital in Udaipur

Fri, 30 Oct 2026 00:00:00 +0000

Background: Substance abuse is a serious public health concern among individuals with psychiatric disorders, particularly anxiety and depression. However, data on its prevalence and association with symptom severity in Indian patients remain limited. This study aimed to determine the prevalence of substance abuse among patients with anxiety and depressive disorders and to evaluate its association with symptom severity.

Methods: A cross-sectional study was conducted on 162 participants diagnosed with anxiety or depressive disorders. Data were collected on socio-demographic factors, psychiatric diagnosis, and substance use through standardized tools and urine drug screening. Severity of disorders was assessed using standard clinical rating scales. Symptom severity was evaluated using the Hamilton Depression Rating Scale (HAM-D) and the Hamilton Anxiety Rating Scale (HAM-A).

Results: The majority of participants were male 119 (73.5%) and belonged primarily to the upper lower socio-economic class 68 (42.0%). Benzodiazepines 19 (11.7%) were the most frequently found substance, followed by tricyclic antidepressants 13 (8.0%) and Alcohol 8 (4.9%). Substance abuse prevalence was higher among participants with profound depression 11 out of 19 (57.9%) and among those participants with moderate anxiety 15 out of 48 (31.3%). No statistically significant difference was observed in overall substance abuse prevalence between depressive disorders 33/98 (33.7%) and anxiety disorders 18/64 (28.1%) (p=0.457).

Conclusions: Substance abuse is common among patients with anxiety and depressive disorders, particularly in severe depressive depression. It is essential to address comorbid substance use in psychiatric populations through early detection and integrated management strategies.

Corporate social responsibility inequality and persistent anemia burden: insights from KBK region of Odisha, India

Shourjya Mukherjee, Mithun Mondal — Fri, 30 Oct 2026 00:00:00 +0000

Background: Anemia remains a major public health concern in India, with NFHS-4 and NFHS-5 documenting increasing prevalence among women and children. Despite growing corporate social responsibility (CSR) investment, regional inequities persist, particularly in Odisha’s vulnerable KBK region. This study examines anemia trends across India, selected states, and KBK districts and assesses their alignment with CSR spending on health and nutrition.

Methods: A secondary-data analysis used NFHS-4 and NFHS-5 factsheets, official government datasets and portals, and CSR disclosures. Descriptive, comparative, and trend analyses assessed anemia prevalence and the distribution of corporate investment in health, nutrition, water, and sanitation.

Results: Anemia among pregnant women increased nationally, while KBK districts consistently exceeded state and national averages. Odisha’s CSR expenditure on health, hunger and malnutrition, drinking water, and sanitation rose from ₹130.58 crore in 2019 to ₹416.27 crore in 2024; however, anemia among women of reproductive age increased by 13.3% between NFHS-4 and NFHS-5. Improvements in health- and water-related SDGs contrasted with weaker poverty outcomes, suggesting that higher expenditure alone has not resolved underlying nutritional and socio-economic barriers.

Conclusions: Anemia reduction in the KBK region requires better-targeted CSR investment aligned with local governance and public programmes. Priorities include stronger ICDS implementation, community-based nutrition education, reliable iron and folic acid supplementation, and improved healthcare access in vulnerable areas.

Dietary behaviour and body composition among young adults aged 18-25 years: a cross-sectional study using bioelectrical impedance analysis

Stanzin Wangmo, Akhitha Kangoju, Saniya Siddiqua, Akshatha Kanthraj — Fri, 30 Oct 2026 00:00:00 +0000

Background: Dietary behaviour and body composition are closely interrelated determinants of nutritional and metabolic health. Young adulthood (18-25 years) is a critical transition period during which lifestyle changes predispose individuals to unfavourable eating patterns and adverse shifts in body composition. This study examined dietary behaviour, nutrient intake, and body composition among young adults using bioelectrical impedance analysis.

Methods: A cross-sectional study was conducted among 138 undergraduate and postgraduate students (18–25 years) selected through stratified random sampling. Anthropometric measures, body composition (via BIA) and habitual dietary intake (via a validated food frequency questionnaire) were assessed. Data were analyzed using descriptive statistics and chi-square tests with statistical significance set at p<0.05.

Results: Meal skipping was more common among males (37.1% vs. 19.4%, χ²=9.12, p<0.05), while low protein intake was more common among females (60.2% vs. 8.6%). Elevated percent body fat was observed in 60.9% of participants, with higher prevalence among females (71.9% vs. 28.6%, χ²=20.61) and older students aged 22–25 years (70.6% vs. 55.2%, χ²=6.98). Fat control was poorer among females and older students, while muscle control was favourable overall (89.1%). Segmental lean and fat distribution showed no significant age-group differences.

Conclusions: Despite generally favourable muscle control, female and older students demonstrated elevated body fat, inadequate protein and micronutrient intake and unhealthy eating behaviours. These findings underscore the need for targeted nutrition education and lifestyle intervention among university students with particular attention to female and older sub-groups.

Perceptions and challenges of the family adoption programme among medical students of a medical college in central India: a cross-sectional study

Fri, 30 Oct 2026 00:00:00 +0000

Background: The family adoption programme (FAP) was introduced by the National Medical Commission (NMC) under the competency-based medical education (CBME) curriculum to provide undergraduate medical students with community-based experiential learning and to foster social accountability. This study assessed the perceptions of medical students of a medical college in central India regarding the family adoption programme and the challenges faced during its implementation.

Methods: First-, second- and third-year MBBS students who had participated in the family adoption programme at a medical college in central India, over four months (July-October 2025), using a convenience sampling technique. Data were collected using a structured, pre-tested questionnaire administered through Google forms, comprising demographic characteristics and 18 items rated on a 3-point Likert scale (agree/disagree/neutral) covering perceptions of, and challenges within, the programme.

Results: 105 (52.5%) were male and 95 (47.5%) were female; maximum students 102 (51.0%) were in their second year of study. Most students reported that their mentor guided them properly during visits (91.0%), that they had obtained consent before collecting information from the family (94.5%), and that they understood the purpose and objectives of the programme (88.5%). Only 17 students (8.5%) reported facing language barriers.

Conclusions: The majority of medical students had a positive perception of the family adoption programme, reporting improvements in communication skills, understanding of community health, and motivation toward community-based practice. Strengthening faculty support and student preparedness could further improve the programme’s implementation.

Marathi version of Global Physical Activity Questionnaire: translation, reliability and validation in individuals with metabolic syndrome

Aditi Ketkar Berry, Abhijit Diwate — Fri, 30 Oct 2026 00:00:00 +0000

Background: Regionally translated version of Global Physical Activity Questionnaire (GPAQ) will help ensure comprehension; cultural relevance. MS is a cluster of conditions that contributes towards cardiovascular diseases. Physical inactivity is one factor that has impact on all of the associated co morbidities. Evaluation of physical activity (PA) will help to implement strategies to overcome burden of physical inactivity and sedentary behavior.

Methods: Phase was translation in Marathi was done via forward -backward translation, expert panel discussions and cognitive debriefing interviews. Utmost attention was paid to retain original concept of questionnaire. Phase 2 was psychometric testing and validation in individuals with MS; Purposive sampling. Sample size -50 using: n= Z².k.(1-p)/E²; z = 1.96, k =1, keeping margin of error as 0.1, ICC of 0.87. Sequence of administration of versions was selected randomly by participants and were administered with gap of 7 days. Participants were instructed to follow same activity pattern they usually practice.

Results: Phase 1 following a through item- by- item review, panel reported good agreement between two versions of GPAQ in terms of semantic, conceptual and cultural equivalence. Phase II ICC of 0.998 (95% CI: 0.997-0.999, p<0.001), indicates a very high degree of consistency between repeated administrations. Wilcoxon signed rank test suggested no significant difference in ratings between both versions of GPAQ.

Conclusions: Marathi version of GPAQ demonstrated high level of agreement, linguistic equivalence. Translated Marathi version demonstrated acceptable concurrent validity and reliability in individuals with metabolic syndrome. Findings support its use as subjective tool for assessment and surveillance of physical activity and sedentary behavior among Marathi-speaking populations.

Knowledge, attitude and practice regarding diabetes mellitus and hypertension among non-teaching staff of a tertiary care hospital in Tamil Nadu: a cross-sectional study

Rajakumar P. — Fri, 30 Oct 2026 00:00:00 +0000

Background: Diabetes mellitus and hypertension are major non-communicable diseases. Adequate knowledge, positive attitudes, and healthy practices are important for their prevention and control. This study assessed knowledge, attitude, and practice (KAP) regarding diabetes mellitus and hypertension among non-teaching staff and their association with selected sociodemographic characteristics and risk factors.

Methods: An institution-based cross-sectional study was conducted among 110 non-teaching staff at Government Medical College and Hospital, Cuddalore, Tamil Nadu, during May–June 2024. Participants were selected by simple random sampling. Data were collected using a validated structured questionnaire, and anthropometric measurements were recorded. Data were analysed using SPSS version 26. Differences in continuous KAP scores across groups were assessed using independent samples Student's t-test and one-way ANOVA, while categorical associations were evaluated using the Chi-square test (p<0.05 considered significant).

Results: Among 110 participants, 88 (80.0%) had good knowledge, 103 (93.6%) had a positive attitude, and 29 (26.4%) had good practices. Most participants were male (80.0%), and 53 (48.2%) were aged 41–50 years. Educational status was significantly associated with knowledge (p=0.007) and practice (p=0.009). Diabetes mellitus was present in 41 (37.2%) and hypertension in 53 (48.2%) participants. Participants with ≥3 risk factors had a significantly higher proportion of diabetes mellitus (47.5% vs. 24.5%; χ²=6.18, p=0.013) and hypertension (60.7% vs. 32.7%; χ²=8.53, p=0.003) compared with those with <3 risk factors.

Conclusion: Despite good knowledge and positive attitudes, preventive practices were suboptimal. Workplace-based health education, regular screening, lifestyle counselling, and risk-factor reduction strategies may improve NCD prevention among non-teaching staff.

Assessment of stress and coping strategies among geriatric men and women in a selected rural area of Uttar Pradesh: a comparative study

Sadiya Khanam, Bindu Shaiju, Uzma Anjum — Fri, 30 Oct 2026 00:00:00 +0000

Background: Stress and coping are significant determinants of psychological well-being among older adults. Geriatric men and women encounter various physical, psychological, and social challenges that may influence their stress and strategies. The present study was conducted to assess and compare the level of stress and coping strategies among geriatric men and women residing in a selected rural area of Uttar Pradesh.

Methods: A quantitative research approach with a descriptive comparative study design was adopted. A total of 200 participants, including 100 geriatric men and 100 geriatric women, were selected using a non-probability purposive sampling technique. Data were collected through the interview technique using a structured interview schedule, through the perceived stress scale (PSS-10), and the brief COPE Scale. Descriptive and inferential statistics were used for data analysis.

Results: The findings showed that the majority of geriatric men (88%) and women (81%) had moderate levels of perceived stress. Geriatric women demonstrated significantly higher stress scores than geriatric men (p=0.039). Significant differences were observed in problem-focused coping (p=0.001) and avoidant coping (p=0.018), whereas emotion-focused coping did not differ significantly between the two groups (p=0.775).

Conclusions: The findings highlight the need for gender-sensitive mental health interventions, early identification of stress, and promotion of effective coping strategies to improve the psychological well-being and quality of life of geriatric population in rural areas.

Knowledge and willingness towards organ donation among undergraduate students: a college-based cross-sectional study

Frank J. C., Suman Vashist, Deva Pon Pushpam I. — Fri, 30 Oct 2026 00:00:00 +0000

Background: Organ donation is one of the most meaningful ways to save the lives of people with end-stage organ failure. Even with advances in transplantation, the shortage of available organs remains a serious public health concern. Undergraduate students are an important group to engage because, with the right knowledge, they can help spread awareness and encourage positive attitudes toward organ donation in the wider community. Understanding what students know and how willing they are to donate is therefore important for planning effective educational programmes. This study aimed to assess the level of knowledge and willingness regarding organ donation among undergraduate students, examine the association between knowledge and willingness and identify the association of knowledge and willingness with selected socio-demographic variables.

Methods: A quantitative, non-experimental cross-sectional design was used among undergraduate students of Government Degree College, Mishriwala. A total of 100 students were selected through purposive sampling. Data were collected using a self-developed, self-administered questionnaire covering socio-demographic details, knowledge regarding organ donation and willingness to donate. Descriptive and inferential statistics were used for data analysis.

Results: Most participants (78%) had an average level of knowledge regarding organ donation and 44% expressed willingness to donate their organs. Knowledge was significantly associated with age, religion and occupation of the head of the family. Willingness was significantly associated with gender and religion.

Conclusions: The findings suggest that educational interventions addressing misconceptions and highlighting the benefits of organ donation may help improve willingness among young adults.

Correlates of childhood undernutrition: a cross-sectional study from an underserved area of eastern part of India

Punyabrata Gun, Piyali Dey Biswas, Aditi Gain, Satabdi Mitra — Fri, 30 Oct 2026 00:00:00 +0000

Background: Undernutrition, comprising of underweight, wasting and stunting are pose significant public health problem globally with highest prevalence in India among Southern Asian region of UNICEF. Nearly 1/3rd of slum dweller children have been found to have one or multiple forms of growth failures in eastern part of India.

Methods: A community-based cross-sectional study was conducted among children <10 years in a tribal village by house-to-house surveying for 2 months with questionnaire containing socio-demographic information, history on illness, nutrition, immunization, anthropometric measurements with expressing any failure in Composite Index of Anthropometric Failure (CIAF). Following the survey health check-up camps were organized and nutritional supplementation is being given to children.

Results: Out of total 43 children, 90.7% were found to have single or multiple forms of anthropometric failures. In binary logistic regression, parental education to illiterate or just literate, deprivation of child from exclusive breastfeeding, non-maintenance of minimum dietary diversity, frequent illness and reduction of feed during illness were found to have significant association with anthropometric failure. On clinical examination in health camps, children were detected to have various respiratory, gastrointestinal, dermatological diseases.

Conclusions: In agency of local health care providers, initiatives are needed targeting this underserved population to bring them under government-led schemes to combat childhood undernutrition.

Gestational diabetes mellitus: a case-control study at a tertiary care centre in India

Mounika Gudala, Smita Andurkar — Fri, 30 Oct 2026 00:00:00 +0000

Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance first recognized during pregnancy.it is one of the most common metabolic disorders complicating pregnancy. there is an increased burden of GDM and its significant consequences for maternal and child health. This study aimed to identify the risk factors associated with GDM among pregnant women at a tertiary care centre and determine their strength of association.

Methods: A hospital-based case-control study was conducted from March 2024 to October 2025.Cases included 92 antenatal women with plasma glucose levels above 140 mg/dl and controls were those with glucose levels below 140 mg/dl matched for age. Data was collected using predesigned, pre-structured questionnaires covering sociodemographic details, reproductive and obstetric history, any chronic diseases. then univariate and multivariate logistic regression analyses were performed.

Results: The Mean age among cases was 25.06±3.87 years and in controls was 24.8±3.81 years. Significant determinants in univariate analysis were education status, occupation of husband, age at marriage, gravidity, parity, past history of GDM, Pre-pregnancy BMI and history of abortion. In multivariate analysis, education of participant (OR: 1.509, 95% CI: 1.041-2.188), Duration of marriage (OR:2.539, 95% CI: 1.016-6.346), Pre-pregnancy BMI (OR: 3.180, 95% CI: 1.547-6.537), History of abortion (OR: 2.873, 95% CI: 1.401-5.894) Parity (OR: 3.320, 95% CI: 1.339-8.233) remained significant determinants.

Conclusions: GDM is associated with adverse maternal as well as foetal complications. Early screening and targeted counselling for women with these risk factors can help in timely detection and management of GDM, thereby improving maternal and fetal outcomes.

A comparative evaluation of toothpaste tablets and a conventional toothpaste in assessing supragingival plaque and gingivitis among patients in Nellore city, Andhra Pradesh: a randomized clinical trial

Fri, 30 Oct 2026 00:00:00 +0000

Background: Toothpaste tablets have emerged as a sustainable alternative to conventional toothpaste by reducing plastic waste. However, evidence regarding their effectiveness in controlling supragingival plaque accumulation and gingival inflammation remains limited, particularly among Indian adults. This study aimed to compare the effectiveness of toothpaste tablets and conventional toothpaste in reducing supragingival plaque accumulation and gingival inflammation among adults.

Methods: A parallel-arm, randomized, open-label clinical trial was conducted among 60 adults attending Narayana Dental College and Hospital, Nellore, Andhra Pradesh. Following baseline assessment using the O'Leary Plaque Control Record and the Loe and Silness Gingival Index, all participants underwent oral prophylaxis and were randomly allocated to the toothpaste tablet group (n=30) or the conventional toothpaste group (n=30). Participants brushed twice daily using the modified bass technique for four weeks. Intragroup and intergroup comparisons were performed using the Wilcoxon Signed-Rank Test and Mann-Whitney U test, respectively, with statistical significance set at p<0.05.

Results: Both intervention groups demonstrated significant reductions in plaque control record and Gingival Index scores after four weeks (p<0.001). No statistically significant differences were observed between groups for plaque control (p=0.847) or gingival health (p=0.629).

Conclusions: Toothpaste tablets demonstrated clinical effectiveness comparable to conventional toothpaste in reducing supragingival plaque accumulation and gingival inflammation after four weeks. These findings suggest that toothpaste tablets may serve as a sustainable alternative to conventional dentifrices without compromising clinical outcomes. Further randomized clinical trials with larger sample sizes and longer follow-up are recommended.

Socio-economic determinants of modern contraceptive use among married women in Kerala, Bihar and North-East India: a comparative analysis

Heisnam Ruhi Singh, Kshetrimayum Anand Singh — Fri, 30 Oct 2026 00:00:00 +0000

Background: The various effective ways to use contraceptive methods taken divergent steps toward attaining the SDG target of universal access to sexual and reproductive health care services by 2030. However, due to the lack of widespread use of contraceptive methods by married women due to the misconceptions about female contraceptive methods and lack of proper information, women are often reluctant to family planning, and men have to tolerate the problem. So, it is essential to study the significant determinants of modern contraceptive methods. The present research aimed to examine the trend of use of modern contraceptive methods among currently married women using data from latest three rounds of NFHS in Kerala, Bihar, and North-East India. Also, to identify the significant covariates that influence the use of modern contraceptives.

Methods: A multivariate logistic regression to estimate the odds ratio (OR) for various covariates that are found to be significantly associated with modern contraceptive use.

Results: There is a decline in modern contraceptive use from NFHS-3 to NFHS-4 but increases in NFHS-5. Kerala shows the highest prevalence among the three regions. Age of women, educational level, religion, ethnicity, place of residence, desire for more children, number of living children, ideal number of children, wealth index, and media exposure are important covariates that significantly influence the use of modern contraceptive methods.

Conclusions: However, the educational level of women, except for higher education and ethnic groups belonging to OBC, does not affect the behavior of using modern contraceptives significantly.

Epidemiological patterns and post-exposure management of cat bite injuries: a cross-sectional study from North India

Fri, 30 Oct 2026 00:00:00 +0000

Background: Cat bite injuries are an under-recognized public health concern due to traumatic injuries, bacterial infections, and potential rabies exposure. However, limited epidemiological evidence is available regarding cat bite injuries and post-exposure management practices in India. This study assessed the epidemiological patterns and post-exposure management practices among cat bite victims attending a tertiary care Anti-Rabies Vaccination (ARV) clinic in North India.

Methods: A cross-sectional observational study was conducted among 152 cat bite victims attending the ARV Clinic of MDB ASMC Hospital, Deoria, Uttar Pradesh, from January to June 2025. Data regarding socio-demographic characteristics, injury patterns, and post-exposure management practices were collected using a structured, pre-tested tool after obtaining informed consent and ethical approval. Data were analyzed using descriptive statistics, chi-square test, and multivariate logistic regression.

Results: Adults >15 years constituted 60.5% of victims, with females comprising 50.7%. Most bites were caused by stray cats (90.1%) and occurred at home (56.6%). Upper limb injuries (46.7%) and Category II exposures (66.4%) predominated. Reporting within 24 hours occurred in 74.3% of cases, while 70.4% practiced first aid. Although overall rabies vaccination coverage was high (94.1%), only 28.0% received vaccination on the day of exposure. Anti-Rabies Serum uptake among advised patients was low (33.3%). No significant socio-demographic predictors were identified for most post-exposure practices, except same-day vaccination among adolescents.

Conclusions: Cat bites represent an important public health concern, with gaps in timely post-exposure prophylaxis and Anti-Rabies Serum uptake. Strengthening awareness regarding wound care, early healthcare seeking, and appropriate rabies prophylaxis is essential.

Knowledge and attitude regarding cervical cancer and its screening among women and its association with socioeconomic status: perspective from Western India

Fri, 30 Oct 2026 00:00:00 +0000

Background: Cervical cancer remains a major yet preventable cause of morbidity and mortality among women in India. Socioeconomic and educational disparities greatly influence awareness and uptake of preventive measures, especially in low and middle income countries, making it important to study their association within this context.

Methods: In this study, a cross-sectional survey was conducted among 380 women aged 25-65 years attending a tertiary care hospital. Data was collected using a structured questionnaire. Knowledge, attitudes, and perceived barriers related to cervical cancer, Pap smear screening, and HPV vaccination were assessed, with knowledge scores classified according to Bloom’s criteria, and associations with socioeconomic status were measured.

Results: Of 380 participants, only 43.42% (165) of participants had heard of cervical cancer. Amongst, just 10.9% demonstrated good knowledge of its risk factors, symptoms, screening, and prevention. Attitude towards prevention was generally positive, with 63.03% of participants willing to undergo Pap smear testing and 64.24% willing to receive free HPV vaccination. Higher socioeconomic status and educational level were significantly associated with greater awareness and higher knowledge scores. Both educational level and knowledge category were associated with more favorable attitudes toward screening and prevention. Major barriers to screening noted were the absence of symptoms or perceived need, embarrassment, and a male doctor.

Conclusions: These findings demonstrate a dire need for targeted health education, improved accessibility of affordable and gender-sensitive screening services, and strengthened initiatives for cervical cancer prevention in order to reduce the morbidity and mortality associated with this disease in Indian women.

Prevalence, knowledge and predictors of Text Neck Syndrome among undergraduate students in East Khasi Hills, Meghalaya, India: a cross-sectional study

Liku M. Sarma, Namita Singha, Alila Jamir, Shanthosh P. Sundaram — Fri, 30 Oct 2026 00:00:00 +0000

Background: Young adults' extensive use of smartphones has resulted in several health concerns and one of which is Text Neck Syndrome. Prolonged neck flexion during smartphone use can lead to neck pain, disability and functional limitations. The study focused on determining the prevalence and knowledge regarding Text Neck Syndrome and identify predicting factors associated with the condition.

Methods: A cross-sectional study was carried out among 240 undergraduate students selected using convenience method of sampling from four colleges in East Khasi Hills, Meghalaya. A standardized questionnaire with questions on demographics, participant behaviour and understanding of text neck syndrome was used to gather data. Two standardized tools neck disability index and the smartphone addiction scale-short version were used with prior permission to assess neck disability and smartphone addiction.^8,9

Results: The results demonstrated that, prevalence of Text Neck Syndrome among the participants discovered to be 35.8% (95% CI:29.8%–42.3%) and 41.0% participants had smartphone addiction. Majority (71.7%) participants had adequate knowledge regarding Text Neck Syndrome and smartphone addiction was identified as a significant independent predictor of Text Neck Syndrome, with 2.2 times higher odds of developing the condition. Additionally, there was a significant positive correlation found between smartphone addiction and neck disability.

Conclusions: Text Neck Syndrome is a prevalent health issue among undergraduate students in Meghalaya, affecting more than one-third of the study population. Although most of the participants had adequate knowledge regarding text neck syndrome, the occurrence of the syndrome suggests the need of targeted educational, ergonomic and behavioural interventions among young adults.

Evaluating the WhatsApp-based mMitra intervention: a hybrid tech-plus-touch approach for managing maternal anemia in Mumbai, India

Fri, 30 Oct 2026 00:00:00 +0000

Background: Under the mMitra program, a pilot intervention was rolled out in Vasai Virar, Mumbai to understand the use of WhatsApp for delivering messages on anemia. It included health education videos, behavioral prompts, interactive quizzes, a helpline for support, and personal follow-up by community health workers (CHW). This study was a retrospective evaluation of the intervention to explore its potential role in supporting pregnant women with anemia.

Methods: Study included 287 pregnant women with hemoglobin (Hb) levels below 10 gm/dL, a gestational age of ≤30 weeks, and having received the eight-week intervention. The study descriptively measured message delivery and engagement rates, and changes in Hb levels. Feedback was collected from 64 women on recall of key messages, acceptability, and self-reported use of iron and folic acid (IFA). Institutional ethics review board approved the study.

Results: Approximately, 93.38% of women had high exposure to messages, 55.75% of the women had moderate anemia and 43.21% had mild to moderate anemia at enrollment. Total 244 women with follow-up Hb level data, 55.33% showed increase, but remained below 10 g/dL, 17.62% improved to 10-11 gm/dL, and 6.15% had anemia fully reversed. Having a personal phone was significantly associated with improved Hb levels (p=0.030). Feedback data showed 82.81% of women watched the entire videos and 73.43% made lifestyle changes related to diet and exercises.

Conclusions: The exploratory findings suggested the feasibility of a tech-plus-touch approach for managing maternal anemia, but larger studies are needed to prove its effectiveness.

Association of chronotype with glycemic control, sleep patterns and meal timings among adults with type 2 diabetes mellitus

Fariya Khaled, P. Ashlesha, Sujatha Stephen, K. Mounika — Fri, 30 Oct 2026 00:00:00 +0000

Background: Type 2 Diabetes Mellitus (T2DM) is a major public health concern, with lifestyle factors such as chronotype potentially influencing glycemic control and daily behavioral patterns. The present study aimed to assess the association of chronotype with glycemic control, sleep patterns, and meal timings among adults with type 2 diabetes mellitus.

Methods: A hospital-based cross-sectional study was conducted among 100 adults with T2DM attending Yashoda Hospital, Malakpet, Hyderabad. Data were collected using a structured questionnaire, clinical records, and the Reduced Morningness-Eveningness Questionnaire (rMEQ). Glycemic control was assessed using fasting blood glucose (FBG), postprandial blood glucose (PPBG), and glycated haemoglobin (HbA1c). One-way analysis of variance (ANOVA) and Chi-square tests were used for statistical analysis, with p<0.05 considered statistically significant.

Results: The intermediate chronotype was the most prevalent (49%), followed by the evening chronotype (28%) and morning chronotype (23%). The mean HbA1c was highest among participants with the evening chronotype (8.257±1.641%) and lowest among those with the morning chronotype (7.617±0.780%); however, the difference was not statistically significant (p=0.242). Similarly, no significant associations were observed between chronotype and FBG (p=0.962) or PPBG (p=0.725). Significant associations were observed between chronotype and wake-up time (p<0.001), bedtime (p<0.001), lunch timing (p=0.013), and dinner timing (p=0.004). No significant associations were observed with breakfast timing (p=0.089), sleep duration (p=0.640), sleep quality (p=0.109), or BMI (p=0.229).

Conclusions: Chronotype was significantly associated with certain daily behavioral patterns, particularly wake-up time, bedtime, lunch timing, and dinner timing, but was not significantly associated with glycemic control in the study population.

Knowledge, attitude and perception of biostatistics among post-graduate students in Vokkaligara Sangha Dental College and Hospital, Bengaluru: a cross-sectional study

Fri, 30 Oct 2026 00:00:00 +0000

Background: Biostatistics is essential for postgraduate dental research and evidence-based practice. However, many students find it challenging to understand statistical concepts and apply them confidently in research. This study assessed and compared the knowledge, attitude and perception of Biostatistics among 1^st, 2^nd and 3^rdyear postgraduate dental students across various specialties.

Methods: A cross-sectional study was conducted among 97 postgraduate dental students at Vokkaligara Sangha Dental College and Hospital, Bengaluru. Data were collected using a validated, self-administered questionnaire covering knowledge, attitude and perception of Biostatistics. Descriptive and Inferential statistics, including one-way ANOVA and Chi-square test, were used for analysis. Statistical significance was set at p<0.05.

Results: The participants had a mean age of 25 years; 81.4% were female and 18.6% were male. Knowledge scores differed significantly across academic years, with 3rd year students demonstrating the highest scores (p<0.05). Attitude scores also varied significantly, with 3rd year students showing the most favourable attitude (p<0.05). Perception scores were highest among 3rd year students and differed significantly across the 3 years (p<0.001). A significant association was observed between prior Biostatistics training and confidence in interpreting research data (χ²=8.5, p<0.05). Gender differences were significant only for knowledge scores (p<0.05).

Conclusions: Although postgraduate dental students generally recognise the importance of Biostatistics, gaps remain in practical application and statistical interpretation. While the attitude towards Biostatistics is generally positive, there is a notable deficiency in practical skills among postgraduates.

Effect of moringa powder on blood pressure among hypertensive patients

Fri, 30 Oct 2026 00:00:00 +0000

Background: Hypertension, which is an increase in blood pressure, has a prevalence based on Riskesdas in 2018 at the age ≥18 years, which is around 34.1%. Various treatment methods have been developed because if hypertension is not treated it can cause symptoms and serious complications.

Methods: The study was conducted by using quantitative research approach and a Quasi experimental pre-test and post-test control research design was used. Total 40 participants (20 experimental and 20 control group) were selected by non-probability purposive sampling technique. Established the content validity of the tool from 22 experts of different areas. Corrections were made as per the suggestion and the final tool was prepared. The reliability co-efficient was done by using test-retest method and ‘r’ value is “0.9’’which is more than 0.7 so tool found that reliable.

Results: Experimental group mean was 143, standard deviation (SD) was 4.7016 and in control group mean was 172.5 and SD was 9.1046 and t-value Was 12.8748 and p value was 0.00001<0.05 is the systolic blood pressure among hypertensive patients and diastolic blood pressure in experimental group mean was 91, SD was 3.0779 and in control group mean was 107.5 SD was 7.8639 and p value is 0.00001 <0.05.

Conclusions: This reveals the systolic and diastolic BP after giving moringa powder on blood pressure among hypertensive patients was effective according to post-test in experimental and control group.

Assessing the knowledge of HPV vaccination among nursing students in selected nursing college at Meerut, Uttar Pradesh

Vir Vikram Sahdev Singh, Shipra Mittal — Fri, 30 Oct 2026 00:00:00 +0000

Background: Cervical cancer is the third most commonly diagnosed cancer worldwide and the fourth leading cause of cancer death in women. But in India, it is the leading cancer among women accounting for more than 74,000 deaths per year. This study aimed to evaluate knowledge regarding Human Papillomavirus (HPV) vaccination among nursing students and find out the association between their level of knowledge and selected demographic variables.

Methods: The study was conducted in selected nursing colleges at Meerut (U.P.). Data was collected 100 nursing students who meet inclusion criteria. A quantitative descriptive research approach was used. Researcher used non-probability convenience sampling technique. Data were obtained with the help of a structured closed ended knowledge questionnaire.

Results: The study of 100 participants reveals that a majority (77%) demonstrated good knowledge (21%) had average knowledge and (2%) reflect poor knowledge. The overall mean knowledge score was 16.09±2.91 (73.1%).

Conclusions: It is suggested that there is a need for educational intervention and structured awareness campaigns to augment HPV Immunization programs for control of cervical cancer in India.

Bacteriological assessment of drinking water sources in an institutional campus in Northeast India using the most probable number method

Bhaskar Jyoti Neog, Suman Mallah, Chellapandi Karuppasamy — Fri, 30 Oct 2026 00:00:00 +0000

Background: Safe drinking water is essential for preventing water-borne diseases and maintaining public health. Microbial contamination of drinking water remains a concern, and coliform bacteria are widely used as indicator organisms of microbiological safety.

Methods: A laboratory-based cross-sectional study was conducted in May 2023 at the Regional Institute of Paramedical and Nursing Sciences (RIPANS), Aizawl, Mizoram. Forty-two drinking water samples were collected aseptically from hostels, academic blocks, administrative offices, library and canteen areas. Samples were analyzed using the Most Probable Number (MPN) technique for coliform detection. Positive samples were further examined by culture on Eosin Methylene Blue (EMB) agar and Gram staining.

Results: Of 42 water samples, 8 (19.0%) were positive for coliform organisms and 34 (81.0%) showed no bacteriological contamination. Positive samples showed gas production in lactose broth, green metallic sheen colonies on EMB agar and Gram-negative rod-shaped bacteria consistent with Escherichia coli. Contamination was detected in hostels, academic blocks, canteen, library and administrative areas.

Conclusions: Detection of coliform organisms indicates possible fecal contamination in parts of the institutional water supply system. Regular microbiological surveillance, maintenance of water purification systems and periodic sanitation of storage facilities are needed to support safe drinking water in institutional settings.

Prevalence of hepatitis B and hepatitis C virus infections among patients attending a sub-district government hospital in Kashipur, Uttarakhand: a hospital-based observational study

Nidhi Tiwari, Akash Chandra Mishra — Fri, 30 Oct 2026 00:00:00 +0000

Background: The hepatitis B virus (HBV) and hepatitis C virus (HCV) infections frequently go unnoticed for years before developing into chronic liver disease, cirrhosis, and liver cancer. Sub-district government hospitals are frequently rural and semi-urban populations' only access to healthcare in India, but prevalence data from this tier are still hard to come by. This study was to ascertain the prevalence of HBsAg and anti-HCV in patients at a sub-district government hospital in Kashipur, as well as to look at variations over time and between the three service arms of OPD, JSY, and family planning.

Methods: This retrospective study was carried out in the laboratory records of L. D. Bhatt Sub-District Government Hospital, Kashipur from April 2025 to February 2026 comprising 6,227 HBsAg and 6,003 anti-HCV tests in OPD, JSY and Family Planning. 95% confidence intervals were used to express the prevalence; z-tests and chi-square tests of homogeneity were employed, with p<0.05 being considered significant.

Results: Total 200 of 6,003 people had anti-HCV (3.33%, 95% CI 2.88–3.79%) and 98 of 6,227 people had reactive HBsAg (1.57%, 95% CI 1.26-1.88%). HCV positivity was significantly higher (z=6.30, p<0.001). Monthly positivity varied significantly from month to month (HBsAg χ2=21.42, p=0.018; HCV χ2=22.89, p=0.011), with a December 2025 spike in HBsAg and a November 2025 spike in HCV driving the range of 0.81% to 3.53% for HBsAg and 1.63% to 5.88% for HCV.

Conclusions: Both infections are still prevalent enough to warrant ongoing screening, with HCV being noticeably more prevalent than HBV. Prenatal HBsAg screening should be universal rather than selective, as evidenced by the high percentage of cases discovered through JSY.

Objective functional mobility and functional disability in patients with rheumatoid arthritis: a cross-sectional study

Gunpreet Kaur, Arindam Adhikary, Pooja Sharma — Fri, 30 Oct 2026 00:00:00 +0000

Background: Rheumatoid arthritis (RA) is linked to ongoing inflammation, disability and reduced physical performance. Conventional measures of disease activity may not properly reflect patients realized functional capacity. The goal of this study was to explore whether objective functional mobility adds information on functional disability beyond inflammatory disease activity.

Methods: A cross-sectional study involving 382 RA patients. Disease activity, functional disability and mobility were assessed using DAS28-ESR, HAQ-DI and 8-foot up-and-go test. Spearman’s rank correlation and multiple linear regression were used to evaluate relationships between the variables and the independent association of functional mobility with HAQ-DI after adjustment for disease activity.

Results: The mean age was 51.99±8.48 years with females comprising 91.6%. Participants of 61-70 years had significantly higher disability, disease activity and poorer functional mobility then younger group (p=0.036, <0.001 and 0.025 respectively). HAQ-DI correlated strongly with 8-foot up-and-go time (ρ=0.877, p<0.001), but weak correlation with DAS28-ESR (p=0.235 and p<0.001). The regression model explained 78.4% of the variance of HAQ-DI (R²=0.784; adjusted R²=0.783). 8-foot up-go was independently associated with HAQ-DI (t=35.94, p<0.001), whereas DAS-28 ESR was not (p=0.078).

Conclusions: Objective functional mobility was more strongly associated with functional disability than inflammatory disease activity and independently associated with HAQ-DI. Adding performance-based assessment of mobility to disease-activity and patient-reported measures may provide a more comprehensive functional assessment of RA and help guide rehabilitation planning.

Screening of school children in rural areas to detect early hearing loss: a population based necessity

Aabha M. Gune, Jeevan R. Galagali — Fri, 30 Oct 2026 00:00:00 +0000

Background: This study is aimed to detect early hearing loss in school going children and to create awareness about the same in the parents with necessary counselling for further necessary management and correction, so as to avoid hearing disability and to improve social communication.

Methods: School going children in primary classes 1^st-6^th standard in a village close to the Murbad region of Maharashtra state were screened to detect early loss. A total of 619 students out of 683 students studying underwent screening. After initial checkup of ears, free field hearing (FFH) and tuning fork tests (TFTs) were done. Pure tone audiometry (PTA) was reserved and was done for children who had suspected hearing loss on tuning fork tests.

Results: Hearing loss was detected in 50 students with an overall prevalence of hearing impairment of 8.1% (50/619). Hearing loss was noticed more in girls (9.3%) than boys (6.9%). Most of the hearing loss was conductive in nature.

Conclusions: This screening study highlights the need for conducting regular screening tests for early detection of hearing impairment in rural school going children at an early age to avoid hearing disability and to provide necessary hearing rehabilitation at an early age.

Knowledge and practices related to wound care among rural adults in Aligarh, India: a cross-sectional study

Iram Abid, Sadiq Husain, Shaista Perveen, Uzma Eram, Shadma Perveen — Fri, 30 Oct 2026 00:00:00 +0000

Background: Wounds are common in rural Indian communities, often due to occupational hazards and accidents. Although evidence-based acute wound care guidelines exist, local beliefs, limited resources, and low awareness often lead to traditional remedies of uncertain safety and efficacy. Proper wound care is essential to prevent infection, delayed healing, and complications. This study aimed to assess wound care knowledge and practices among rural adults in Aligarh district and examine their association with educational status.

Methods: A community-based cross-sectional study was conducted from April to June 2026 among 378 adults aged ≥18 years in a village served by the Rural Health Training Centre of J. N. Medical College, Aligarh. Participants were selected by systematic random sampling. A pretested semi-structured questionnaire assessed sociodemographic characteristics, wound care knowledge, and practices. Descriptive statistics and chi-square tests were used, with p<0.05 considered significant.

Results: Of the participants, 55.3% were female and 62.2% were illiterate or educated up to primary level. Nearly half (49%) used traditional substances such as turmeric, ash, or toothpaste on wounds. Only 19.8% cleaned wounds with plain water, 19.0% with soap and water, 38% knew about tetanus prophylaxis, and 30.9% sought medical consultation within 24 hours. Higher education was significantly associated with correct wound care practices (p<0.001).

Conclusions: The study shows major gaps in wound care knowledge and practices among rural adults in Aligarh, with education influencing safer practices. Community-based education and integration of WHO wound care guidance into primary healthcare are needed to improve outcomes.

Nutritional assessment and prevalence of anaemia in adolescents

Fri, 30 Oct 2026 00:00:00 +0000

Background: Anaemia is a major public health problem especially in adolescents due to increased nutritional requirements, rapid growth, menstrual blood loss, poor dietary practices and limited awareness. In this study anaemia was classified according to the WHO age and sex specific haemoglobin cut-offs. The study aimed to evaluate knowledge, dietary practices and haemoglobin status among adolescents and to determine factors associated with its prevention.

Methods: A cross-sectional study was conducted among 400 adolescents using a structured questionnaire to collect information on demographic characteristics, awareness of anaemia, dietary habits, health-seeking behaviour, and related risk factors. Estimation of haemoglobin and anthropometric measurements were done. The factors between male and female participants were compared and significant relationships were identified by statistical analysis.

Results: Anaemia was found in 15.0% of the 400 adolescents. Haemoglobin level <11g/dL was significantly more common in female adolescents than in male adolescents (18.0% vs. 9.0%). Stomach upset (21.3%) was a commonly reported symptom. Anaemia awareness was poor; 66.2% had never heard about anaemia, and 63.3% were not aware of the causes. There were significant differences in anaemia education, dietary practices. Menstruating adolescents reported irregular menstrual cycles (42.4%) and heavy menstrual bleeding (40.0%).

Conclusions: Poor dietary practices, inadequate awareness and limited preventive health behaviour are still major challenges in reducing the burden of anaemia among adolescents. Comprehensive school and community-based nutrition education, regular screening, promotion of balanced diets with iron and other micronutrients, and early preventive measures are necessary for better adolescent health and reducing prevalence of nutritional anaemia.

Determinants of geriatric giants among the geriatric population of north India: a community-based cross-sectional study in Kanpur Nagar

Sonam, Tanu Midha, S. K. Barman, Seema Nigam, Samarjeet Kaur — Fri, 30 Oct 2026 00:00:00 +0000

Background: The "geriatric giants," or the "5 I's," in geriatrics, refer to common problems in older adults: Immobility, Instability, Incontinence, Intellectual Impairment and Iatrogenesis (other disorders). The present study was done with objective to estimate the prevalence and determinants of geriatric giants among the geriatric population residing in Kanpur Nagar district.

Methods: Geriatric people (>60 years) residing for more than 1 year in Kanpur Nagar's urban and rural areas participated in a community-based cross-sectional study. In each area, 256 participants were directly interviewed by using a pre-structured questionnaire for sociodemographic variables and history of morbidities. Microsoft Excel was used to enter and compile the collected data. Data was analysed using the SPSS, trial version 29.0.2.0(20).

Results: In this study, intellectual problems were the most prevalent geriatric giant (30%), followed by chronic complications/iatrogenic problems (24%), immobility (21%), incontinence (13%) and instability (12%). Nearly four-fifths of the geriatric had at least one geriatric giant, while 43.2% had more than two, highlighting a substantial burden of cumulative geriatric morbidity. Multivariable logistic regression analysis shows that Geriatric addicted to chewing tobacco, smocking, alcohol shows significant association and higher risk with geriatric giant syndrome.

Conclusions: The study highlights the need to integrate routine geriatric screening into primary healthcare under the National Programme for Health Care of the Geriatric. A multidisciplinary team involving geriatricians, physiotherapists, occupational therapists and pharmacists can work together to assess fall risk factors, implement preventive measures and promote safe mobility.

Immediate effect of positional stretches of hamstring muscles on hamstring tightness in desk job workers: an experimental study

Megha H. Sable, Siddhi Tendulkar — Fri, 30 Oct 2026 00:00:00 +0000

Background: Prolonged sitting and limited movement during desk work may contribute to reduced hamstring flexibility. This study examined the immediate effect of positional hamstring stretching in desk job workers and compared stretching performed in standing and sitting positions.

Methods: An experimental study was conducted among 60 desk job workers aged 30-45 years in Pune, Maharashtra, India, from 11 April 2025 to 9 October 2025. Participants were selected by convenience sampling. Hamstring tightness was assessed on both sides using the active knee extension (AKE) test with a universal goniometer. Participants performed hamstring stretches in standing and sitting positions, with each stretch held for 30 seconds, followed by 15 seconds of rest, for three repetitions on each leg. Paired t-tests were used to compare pre- and post-stretching values within each condition, and unpaired t-tests were used for comparison of post-standing and post-sitting values. Data were analysed using Microsoft Excel, with p<0.05 considered statistically significant.

Results: Standing stretching reduced the measured hamstring tightness angle on the right from 53.73±10.33° to 37.41±10.43° (t=26.47, p<0.0001) and on the left from 53.05±8.46° to 35.55±9.17° (t=27.15, p<0.0001). Sitting stretching reduced the right-side value from 53.73±10.33° to 37.80±10.57° (t=25.63, p<0.0001) and the left-side value from 53.05±8.46° to 35.38±9.25° (t=28.55, p<0.0001). The difference between post-standing and post-sitting values was not statistically significant on either side (right: t=0.19, p=0.84; left: t=0.099, p=0.92).

Conclusions: Both positional stretching approaches produced a significant immediate change in the measured hamstring tightness angle. Neither standing nor sitting stretching showed a clear advantage over the other in the present sample.

Knowledge retention after a single iron and folic acid training session among accredited social health activists in rural West Bengal, India: a quasi-experimental study

Vibhuti Vaibhav, Jayita Pal, Sanjoy Kumar Sadhukhan, Lamabam Harit Singh — Fri, 30 Oct 2026 00:00:00 +0000

Background: Accredited social health activists (ASHAs) distribute iron and folic acid (IFA) tablets and counsel beneficiaries under the Anemia Mukt Bharat strategy, so their knowledge shapes delivery at village level. Training is the usual remedy for knowledge gaps, but how long the gains last is rarely measured. This study assessed a single training session and re-measured knowledge three months later.

Methods: An institution-based, single-group, before-and-after quasi-experimental study was conducted among ASHAs of the rural field practice area of the All India Institute of Hygiene and Public Health, Singur, West Bengal. All 97 ASHAs were approached and 82 completed all three assessments. A pre-tested, investigator-developed 10-item questionnaire was administered immediately before training, immediately after, and at three months. Scores were compared using the Friedman test with Durbin-Conover post hoc comparisons.

Results: Median knowledge rose from 6 (interquartile range, IQR 4-7) before training to 8 (IQR 7-9) immediately afterwards and was 7 (IQR 5-8) at three months; means were 5.50±2.19, 8.00±1.72 and 6.60±1.69. The Friedman test was significant (χ²=64.55, df=2, p<0.001; Kendall’s W=0.394), as were all three pairwise comparisons (p≤0.002). The immediate gain of 2.50 points, a 45.5% improvement, fell by 1.40 points over three months, leaving 44% retained. Baseline knowledge varied by age group (p=0.012) but not by education or length of service.

Conclusions: A single session improved IFA knowledge substantially, but over half the improvement was lost within three months. Periodic refreshers, supportive supervision and job aids are likely needed to sustain the knowledge underpinning IFA distribution.

Stage-wise analysis of outpatient department patient flow and waiting time at a government tertiary teaching hospital in North India: a mixed-method study

Komal Kumari — Fri, 30 Oct 2026 00:00:00 +0000

Background: Outpatient department (OPD) waiting time is a recognised indicator of hospital service quality. There are few studies from large Indian government tertiary hospitals combine direct time-motion observation with patient reported timing within a single design. This study measured stage-wise OPD patient flow at a large tertiary teaching hospital in North India to identify the primary contributor(s) to patient delay.

Methods: A descriptive, cross-sectional, mixed-method study was conducted from May 2026 to June 2026 among 255 OPD patients selected by convenience sampling. Patient reported timing was used for the arrival to consultation stages, and direct time-motion observation for the pharmacy stage. Data were analysed descriptively, and examined using Pareto analysis and fishbone (Ishikawa) root cause analysis.

Results: Mean total patient journey time was 260.4 minutes (arrival to consultation) and 318.6 minutes (arrival to pharmacy completion), of which consultation itself accounted for only 12.8 minutes (under 5% of total time). Waiting time from arrival to being called by the doctor was the primary bottleneck (242.8 minutes; 76.2% relative contribution), followed by pharmacy dispensing time (119.4 minutes; 37.5%). Root cause analysis identified registration-counter misallocation, absence of patient-guidance infrastructure and centralised, multi-stop pharmacy layout as the primary structural causes, rather than clinical staffing or patient volume.

Conclusions: OPD delay at this tertiary hospital is driven predominantly by process and layout design rather than from insufficient service points, although staffing and patient volume were not measured here. Target interventions are registration reallocation, patient-guidance infrastructure, digital queue systems, and decentralised dispensing of generic medicines offer a practical, low-resource pathway to measurable improvement.

Prevalence of adult pulmonary tuberculosis in rural community adjacent to an oil industry, Assam

Dhruba Jyoti Bora, Anuja Baruah, Annamika Hakmaosa, Anuradha Hazarika Medhi — Fri, 30 Oct 2026 00:00:00 +0000

Background: To estimate the prevalence of adult pulmonary tuberculosis among rural community residing adjacent to Numaligarh Oil Refinery.

Methods: The present study was conducted from July 2019 to June 2020 in a rural area adjacent to Numaligarh Oil Refinery. Total 3600 study participants aged 15 years and above were enrolled by multistage stratified random sampling method and they were interviewed for PTB symptoms. Two sputum samples were taken from eachsymptomatic individual for microscopic examination in DMC and positive cases were taken as sputum smear positive PTB. Sputum smear negative presumptive cases had undergone CXR and CB-NAAT examination.

Results: Total 27 sputum smear positive cases revealing prevalence of smear positive cases 750 per lakh population. 12 CXR positive were found in the present study among them three cases were microbiologically positive by CB-NAAT exam. Overall prevalence of adult pulmonary TB was found as 1083.3 per lakh population.

Conclusions: The overall prevalence of adult pulmonary tuberculosis in our study was much higher than the national average and it might be due to for delayed diagnosis of cases which leads to continuation of the transmission chain in the community.

Impact of online food delivery applications on eating habits of medical undergraduates in district Ludhiana: a cross-sectional study

Fri, 30 Oct 2026 00:00:00 +0000

Background: Online food delivery applications (OFDAs) have emerged as a popular food-ordering option among young adults, potentially affecting their dietary patterns. This study examined the impact of OFDA usage on eating habits among medical undergraduates in Ludhiana district.

Methods: This cross-sectional study included 420 medical undergraduates between March and May 2026. Data were obtained through a pretested Google Form following informed consent. Statistical analysis was performed using SPSS version 26, employing descriptive statistics, Chi-square/Fisher’s exact tests and multivariable logistic regression. Statistical significance was defined as p<0.05.

Results: Among 420 participants, 407 (96.9%) reported using OFDAs, primarily for convenience (68.6%), cravings (62.1%) and dissatisfaction with hostel food (55.0%). Food was ordered once weekly by 38.6% and 2-3 times weekly by 36.6%, predominantly during evenings (73.5%). Meal skipping was reported by 64.8%, while 54.8% consumed fast food 2-3 times weekly. Increased unhealthy food consumption was perceived by 75.0%. Frequent OFDA usage was significantly associated with meal skipping (AOR=1.75; 95% CI: 1.10-2.79; p=0.018), delayed meals (AOR=2.03; 95% CI: 1.27-3.23; p=0.003), earlier meals (AOR=2.27; 95% CI: 1.06-4.87; p=0.036) and increased snacking (AOR=1.93; 95% CI: 1.05–3.57; p=0.036).

Conclusions: OFDA utilization was highly prevalent and associated with unfavourable eating behaviours among medical undergraduates. Targeted nutritional awareness initiatives and improved access to healthier food choices may encourage better dietary practices.

An observational study on Atiyoga of Vak-Karma with special reference to Atibhashya among teachers: a cross-sectional study

Shivanand Mallappa Ankalagi, Soumya Saraswathi M., Radhika M. S., Shalom Sandesh — Fri, 30 Oct 2026 00:00:00 +0000

Background: Ayurveda describes Atiyoga of Vak Karma, the Karmendriya of speech, as a causative factor for Vata vitiation and impaired vocal function, manifesting as Atibhashya. Teachers are at high risk of voice disorders owing to continuous, prolonged, forceful vocal use. This study evaluated the association between Atiyoga of Vak Karma and Atibhashya Lakshanas among teachers.

Methods: A cross-sectional observational study was conducted among 150 apparently healthy teachers (aged 25-60 years) from private and government schools of Moodubidire, Dakshina Kannada, selected by random sampling. Atiyoga of Vak Karma and Atibhashya Lakshanas were assessed using a structured, validated questionnaire (Cronbach’s α=0.897). Data were analysed in IBM SPSS using descriptive statistics, Spearman’s rank correlation, and exploratory factor analysis (Kaiser-Meyer-Olkin=0.842; Bartlett’s test χ²=1499.00, df=378, p<0.001).

Results: Mukha Shosha and Kantha Shosha were the most frequently reported symptoms, each rated “sometimes” by 52.7% of participants, followed by strain of voice (51.3%) and Shirasthapa (49.3%). A significant positive correlation was observed between Atiyoga of Vak Karma and overall Atibhashya Lakshanas (r=0.148, p=0.036). Pipasa (r=0.245, p=0.001), Mukha Shosha (r=0.184, p=0.012), Kantha Shosha (r=0.179, p=0.014), Shirasthapa (r=0.152, p=0.031), Timira (r=0.135, p=0.049) also showed significant associations.

Conclusions: Atiyoga of Vak Karma is significantly associated with Atibhashya Lakshanas among teachers, particularly dryness- and fatigue-related manifestations. Findings support the classical Ayurvedic concept of Atiyoga as a causative factor in functional vocal disturbance and underscore the need for preventive vocal hygiene measures in voice-intensive occupations.

Multimorbidity, polypharmacy and the clinical profile of adults attending a rural primary care hospital: a retrospective cross-sectional study

Christina Gomes, Merlyn Joseph — Fri, 30 Oct 2026 00:00:00 +0000

Background: Multimorbidity is an increasing challenge in primary care, particularly in rural settings. This study characterized the clinical profile of adults attending a rural primary care hospital and assessed the prevalence of multimorbidity and polypharmacy.

Methods: A retrospective cross-sectional study was conducted using outpatient records generated from January 2023 to December 2025 at St. Francis Hospital, Khatauli, Uttar Pradesh. Adults attending for the first time during the study period with documented blood pressure and at least one of random blood glucose or hemoglobin were included. Sociodemographic characteristics, clinical measurements, diagnoses, medication burden, tobacco and alcohol use were extracted. Binary logistic regression was used to identify factors associated with multimorbidity.

Results: Among 304 participants, the mean age was 47.07±17.70 years and 69.1% were female. Hypertension, diabetes mellitus and anemia were present in 39.6%, 31.6% and 61.5%, respectively. Polypharmacy was present in 9.9%. Participants aged ≥60 years had higher odds of multimorbidity than those aged <60 years (adjusted odds ratio 1.87, 95% confidence interval 1.03-3.40; p=0.040). Polypharmacy was associated with increased odds of multimorbidity, although the adjusted association was not statistically significant (adjusted odds ratio 2.31, 95% confidence interval 0.92-5.81; p=0.076).

Conclusions: Multimorbidity was common among adults attending this setting. The findings support integrated chronic disease management, routine assessment of multimorbidity, and periodic medication review in rural primary care.

Assessment of knowledge and experiences of adverse events following immunization among mothers of under-five children in a tertiary hospital of Arunachal Pradesh

Pepu Jini, Ngilyang Sunya, Rajon Jaishy, Mamum Kartek, Tilling Tani, Tam Tariang — Fri, 30 Oct 2026 00:00:00 +0000

Background: Since mothers are usually the primary decision-makers and caregivers for young children, their knowledge regarding immunization and AEFIs influence healthcare-seeking behaviour and completion of immunization schedules. In Arunachal Pradesh, the complete immunization rate is low and zero dose rate is high in under-five children. Hence, we aimed at assessing the knowledge and practices among mothers of under-five children about AEFIs.

Methods: Data was collected by interviewing the mothers of under-five children using a semi-structured questionnaire. Descriptive statistical analysis of the data was conducted and presented in frequencies and percentages.

Results: A total of 380 mothers were enrolled. Most of the mothers did not know what causes an AEFI but maximum of them were aware of atleast one form of AEFI. More than half of the mothers did not know that AEFI has to be reported. Mothers who were guided about AEFI by healthcare workers had the highest mean knowledge. There was no significant association between the socio-demographic characteristics with mother’s knowledge about AEFI. Fever followed by pain/swelling was the commonest form of AEFI experienced. Vaccines given at 6, 10 and 14 weeks caused the maximum AEFI. Most of the mothers managed the AEFIs at home.

Conclusions: Understanding the knowledge and practices regarding AEFI among mothers helps to understand their health behaviour, especially preventive interventions like childhood vaccinations. This may help in training of healthcare workers and utilization of mass media for dissemination of AEFI information and clarification of misconceptions for better acceptance of vaccines among mothers.

Awareness vaccination gap in Hepatitis B among first-year MBBS students: a cross-sectional study

Rajvee S. Shah, Aarohi A. Acharya — Fri, 30 Oct 2026 00:00:00 +0000

Background: Hepatitis B is a major infectious disease, causing liver inflammation that may progress to fibrosis, cirrhosis or hepatocellular carcinoma. This study aimed to assess the knowledge and vaccination rates for Hepatitis B among medical students, as they are at a higher occupational risk due to frequent patient contact.

Methods: A cross-sectional study was conducted in June 2025 among first-year MBBS students (academic year 2024-2025) at a medical college in Gujarat. Participants completed a structured questionnaire on hepatitis B vaccination history with documentation, modes of transmission routes and prevention, attitudes toward vaccination, reasons for non-compliance and willingness to be vaccinated.

Results: Of the 204 eligible students, 151 participated (74.0%). Most correctly identified major transmission routes, though gaps remained regarding unprotected sex, occupational exposures, tattooing and perinatal spread, with some misconceptions regarding casual contact and airborne transmission. Leading reasons for non-vaccination were lack of awareness (51.7%) and missed doses (26.5%), followed by unavailability, fear of side effects and reported allergy. Awareness for the need for hepatitis B vaccination was high (89.4%), yet only 20.0% had completed the three doses, 22.5% had received at least one dose, 40.0% were unsure of their status and nearly one-third were unvaccinated; none could provide documentation.

Conclusions: Although most students recognized the importance of Hepatitis B virus vaccination and occupational risk, a substantial proportion remained partially vaccinated or unvaccinated, with gaps in awareness regarding modes of transmission. These findings underscore the need for targeted sensitization sessions, accessible institutional vaccination programs and proper documentation of vaccination history.

Effectiveness of scenario-based learning for teaching epidemiological concepts amongst undergraduate medical students: a quasi-experimental study

Parth H. Vyas, Vaibhav Mehta, Hiren B. Patel, Uday Shankar Singh — Fri, 30 Oct 2026 00:00:00 +0000

Background: Epidemiological concepts underpin community medicine and require application in real-life public health contexts. Traditional lectures often limit active engagement. Scenario-based learning (SBL), a learner-centred approach, may improve understanding, critical thinking, and application. This study evaluated the effectiveness of SBL versus conventional lectures for selected epidemiological concepts among MBBS students.

Methods: A quasi-experimental crossover study was conducted among Phase III MBBS students. Study designs and incidence and prevalence were taught using SBL and lecture-based methods. Pre-test and post-test assessments were used to measure learning gains, and student perceptions were assessed using a structured questionnaire.

Results: Both teaching methods significantly improved post-test scores (p<0.001). However, SBL resulted in higher learning gains than lectures. The overall mean gain score was significantly greater in the SBL group (2.85±2.16) compared with the lecture group (1.49±2.90; p<0.001). Students demonstrated favourable perceptions towards SBL, with 88.3% reporting that group discussions clarified concepts, 86.7% expressing overall satisfaction, and 85.0% reporting improved confidence in solving epidemiological problems.

Conclusions: Scenario-based learning was more effective than traditional lectures in improving understanding of selected epidemiological concepts and was well accepted by students. SBL can be considered a useful adjunct to conventional teaching in undergraduate community medicine.

Polypharmacy and potentially inappropriate medication use in hospitalized geriatric patients: a prospective evaluation using the American geriatrics society 2023 Beers criteria

Sarfaraz M., Rizwan R. Biradar, Khuteja Parveen — Fri, 30 Oct 2026 00:00:00 +0000

Background: Elderly inpatients are disproportionately burdened by polypharmacy and potentially inappropriate medication (PIM) use, driven by age-related pharmacokinetic change, multimorbidity, and fragmented prescribing. Systematic Beers criteria-based prescription review is rarely practised in Indian tertiary care settings, and regional economic data on this problem are lacking.

Methods: A prospective observational study was conducted from January-June 2025 at a 1200-bed tertiary care teaching hospital in Raichur, Karnataka, enrolling 100 in-patients aged ≥65 years from general medicine, orthopaedics, ophthalmology, and surgery departments. Prescribed drugs were evaluated against the four categories of the American Geriatrics Society (AGS) 2023 Beers Criteria, and drug costs were used to compute the economic burden of inappropriate prescribing. Descriptive statistics, chi-square, Pearson correlation, and one-way ANOVA were applied.

Results: Female patients constituted 61% of the cohort; 57% were aged 65-70 years. Mean drugs per prescription was 11.13±3.72 (range: 5-22). A total of 293 PIM occurrences were identified in 99 of 100 patients (99%); mean 2.93±1.67 per patient. Proton pump inhibitors (40.3%), non-steroidal anti-inflammatory drugs (14.7%), and tramadol (12.6%) were the most prevalent inappropriate classes. Mean PIM-attributable cost was INR 1021.98±1113.04 per patient (13.64% of total inpatient drug expenditure); one-way ANOVA across three cost strata showed significant differences (F=18.87; p<0.001).

Conclusions: PIM use was observed in a substantial proportion of elderly inpatients, with proton pump inhibitors, NSAIDs, and opioids frequently identified. The findings support continued individualized medication review, Beers Criteria integration, and physician–pharmacist collaboration to optimize safe, effective, and patient-centered geriatric pharmacotherapy.

Central adiposity, lifestyle behaviours and utility of the Ashwell String test among urban working women: a pilot study

Anuja A. Bhise, Anuja A. Kinikar, Harshada K. Thakur, Aakanksha A. Salve — Fri, 30 Oct 2026 00:00:00 +0000

Background: Central adiposity and sedentary lifestyle behaviours contribute to cardiometabolic risk among working women. Simple tools such as the Ashwell String Test can aid in early identification of central adiposity. This study assessed central adiposity, lifestyle risk factors, KAP, and the utility of the Ashwell String Test among urban working women.

Methods: A cross-sectional pilot study included 50 urban working women in Pune, India. Data were collected using a structured questionnaire, a Knowledge, Attitude, and Practice (KAP) assessment, the International Physical Activity Questionnaire (IPAQ), 24-hour dietary recall, bioelectrical impedance analysis, and the Ashwell String Test. Central adiposity was assessed using waist circumference, waist-to-hip ratio, and waist-to-height ratio (WHtR).

Results: Mean age of participants was 31.38±5.19 years, BMI was 26.52±4.77 kg/m², and WHtR was 0.54±0.08. Obesity was observed in 62% of participants, while 66% had a WHtR >0.5. The Ashwell String Test identified 64% as being at risk of central adiposity and was significantly associated with WHtR. Mean screen time was 6.80 hours/day and sitting duration 6.1 hours/day; only 10% achieved health-enhancing physical activity (HEPA) levels. Elevated blood pressure or hypertension was observed in 32% of participants. A knowledge-practice gap was identified despite good knowledge and positive attitudes.

Conclusions: Urban working women exhibited a high prevalence of central obesity, sedentary lifestyle behaviours, and early cardiometabolic risk factors. Ashwell String Test demonstrated potential as a simple, practical screening tool for central adiposity. Large longitudinal studies are warranted to validate these findings and inform workplace lifestyle interventions.

Implementation and participant profile of a lifestyle medicine clinic at an urban health training centre in India: a prospective observational program evaluation

Faiz Ali, Kajal Davara, Sunil Nayak, Kunal Pandya, Sridevi — Fri, 30 Oct 2026 00:00:00 +0000

Background: Non-communicable diseases (NCDs) pose a public health challenge in urban India. Lifestyle medicine may complement primary care. Objectives were to describe the implementation and participant profile of a Lifestyle Medicine Outpatient Department (OPD) at Urban Health Training Centre (UHTC) in India and to assess follow-up retention.

Methods: This prospective observational program evaluation study was conducted at UHTC in India from December 2025 to May 2026 (6 months). Adults aged with ³18 years with known or newly detected NCDs were enrolled consecutively. The intervention comprised individualized lifestyle counselling, fortnightly group education on hypertension and diabetes, and behavioural counselling for substance use. Anthropometric measurements, blood pressure, and HbA1c were assessed at enrolment, while retention was assessed through attendance at scheduled follow-up visits.

Results: The mean age was 62.75±10.45 years; 64.4% were aged ≥60 years. Hypertension was the most prevalent comorbidity (55.0%), followed by diabetes mellitus (21.5%). Using Asian Indian BMI cutoffs, 75.8% were overweight or obese. HbA1c assessment revealed diabetic values in 37.6% and prediabetic values in 6.7% of participants. First follow-up attendance was 22.1%, declining progressively to 1.3% by the fifth visit.

Conclusions: A lifestyle medicine program can be incorporated into the UHTC framework and reach a population with substantial cardiometabolic risk. However, very low follow-up retention limits the potential for sustained behavioural support and evaluation of clinical outcomes. Strategies including community outreach, digital follow-up, and community health worker support should be incorporated into future program implementation.

Determinants and prevalence of insomnia among security personnel of a tertiary care hospital in Bengaluru city: a cross-sectional study

Fri, 30 Oct 2026 00:00:00 +0000

Background: Insomnia is an important public health concern and may be particularly relevant among security personnel because of irregular work schedules, occupational demands, sustained vigilance, and inadequate rest. This study was conducted to determine the prevalence of insomnia and its association with selected sociodemographic and health-related factors among security personnel in a tertiary care government hospital in south India.

Methods: A cross-sectional study was conducted among 100 security personnel. Sociodemographic characteristics, including age, gender, income, education, and marital status, and health-related characteristics, including body mass index, diabetes, and hypertension, were assessed using a structured questionnaire. Insomnia was assessed using the Insomnia Severity Index (ISI). Associations between insomnia and selected variables were examined using the chi-square test.

Results: Sub-threshold insomnia was present in 32% of participants, while no cases of moderate or severe insomnia were identified. Significant associations were observed between insomnia and gender (p=0.019) and income level (p=0.020). No significant associations were observed with age, education, marital status, or metabolic health status. Self-reported Diabetes and Hypertension were present in 10% and 4% of participants, respectively, while 74% were classified as obese.

Conclusions: Although moderate or severe insomnia was not observed, nearly one-third of security personnel had sub-threshold insomnia. Workplace-based sleep hygiene interventions may be beneficial, particularly among women and lower-income employees. Further studies incorporating objective sleep assessments and detailed evaluation of shift schedules are warranted.

Effectiveness of a novel subcutaneous enoxaparin injection technique in reducing injection-related pain and ecchymosis: a quasi-experimental study

Fri, 30 Oct 2026 00:00:00 +0000

Background: Subcutaneous injections frequently cause local complications like pain and ecchymosis. Pre-injection ice application is a simple, non-pharmacological nursing intervention that may reduce these complications. To evaluate the effectiveness and clinical applicability of pre-injection ice application.

Methods: A quantitative, true experimental post-test-only control group design was used. Through purposive sampling, 100 patients aged 20–50 years were randomly assigned to an experimental group (n=50, receiving pre-injection ice application) or a control group (n=50, receiving standard protocol). Post-test pain was assessed via the numeric pain rating scale (0–10), and ecchymosis was evaluated using a graded observational scale.

Results: In the experimental group, 40% reported no pain, 24% mild, and 36% moderate pain; none experienced severe pain. In the control group, 86% reported severe pain and 14% moderate pain. The mean pain score was significantly lower in the experimental group (2.38±2.24) than the control group (8.32±1.50), with a mean difference of 5.94 (t=15.57, p<0.001). For ecchymosis, 60% of the experimental group had no bruising (0% Grade III), whereas only 4% of the control group was bruise-free (52% Grade III). The mean ecchymosis score was significantly reduced in the experimental group (1.76±0.96) versus the control group (3.18±0.96; t=7.39, p<0.001). Sociodemographic variables showed no significant associations with outcomes.

Conclusion: Pre-injection ice application effectively minimizes pain and ecchymosis, offering a practical, resource-efficient technique to enhance clinical nursing care quality.

Mahila Arogya Samitis: a community interface for reducing out-of-pocket expenditure and strengthening public-sector uptake in non-communicable disease management

Dhananjay Kakade, Vaishali P. Patil, Jyoti Ghogre, Trupti Malti — Fri, 30 Oct 2026 00:00:00 +0000

Background: Recurring out-of-pocket expenditure (OOPE) for managing non-communicable diseases (NCD) such as diabetes mellitus (DM) and hypertension (HT) is a reality for poorer households in India. The OOPE is primarily driven by reliance on the fee-for-service private healthcare sector in the absence of reliable public sector provisioning. SATHI’s community intervention project focuses on activating Mahila Arogya Samitis (MAS) as a community-level interface to support the management of NCDs through the public health system.

Methods: This action-research data is generated through routine programmatic monitoring in which identified patients were tracked at baseline (November 2024) and across three monitoring cycles (July 2025, November 2025, and March 2026), recording the source of treatment (Private vs. ‘Government+’ (government+ trust+ other NGOs+ generic sources)).

Results: The private sector's share of treatment fell by roughly 32-40 percentage points between baseline and Cycle 3 (DM 86.8% to 48.3%; HT 80.3% to 48.0%; both conditions 76.0% to 44.2%), with a corresponding rise in patients seeking treatment from the public health system. In total, the migration to the public health system led to savings of approximately ₹6,57,675 over nine months for the combined cohort.

Conclusions: Empowered MAS triggered migration of NCD patients from the private to the public health system through three interrelated functions: information facilitation, trust transfer to the public health system, and reliable feedback between communities and the public system. Scaling participatory forums like MAS is a useful strategy to reduce OOPE and contribute to the elusive goal of household financial protection from health expenditures.

Knowledge, coverage and willingness to enrol in health insurance schemes among rural households: a community-based cross-sectional study

Fri, 30 Oct 2026 00:00:00 +0000

Background: Rural households remain vulnerable to catastrophic health expenditure despite the expansion of publicly financed health insurance schemes. This study assessed awareness, coverage and willingness to enrol in health insurance among rural households.

Methods: A community-based cross-sectional study was conducted in Singanagudem village, Krishna district, Andhra Pradesh, from September to November 2021. One village was randomly selected from the rural field-practice area. All 413 households were approached, and 384 participated (response rate, 93%). Data were collected using a pretested interviewer-administered schedule and analysed descriptively.

Results: Overall, 70.3% of households were aware of health insurance, whereas 91.1% held a valid insurance card. Dr YSR Aarogyasri was the predominant scheme among insured households (95.1%), and 85.7% reported family coverage. Among 34 uninsured households, 52.9% were willing to enrol. Fear of medical expenses was the most common reason for willingness (38.9%), whereas lack of trust was the most common reason for unwillingness (50%).

Conclusions: Health insurance coverage was high, but awareness was lower than card possession. Strengthening insurance literacy through frontline health workers may improve informed and equitable use of benefits.

Health-related quality of life and treatment adherence in tuberculosis–diabetes comorbidity in urban India

Dinesh Asokan, Anjali Mall, Geeta Pardeshi — Fri, 30 Oct 2026 00:00:00 +0000

Background: Tuberculosis (TB) and diabetes mellitus (DM) form a growing syndemic that adversely affects treatment outcomes and patient well-being. While clinical consequences are well documented, patient-centred outcomes such as health-related quality of life (HRQoL) and treatment adherence remain inadequately explored in high-burden settings. This study aimed to assess HRQoL and treatment adherence among patients with TB–DM comorbidity receiving anti-tubercular therapy in an urban tertiary care hospital.

Methods: A hospital-based cross-sectional study was conducted among adult patients with TB–DM comorbidity receiving anti-tubercular therapy. HRQoL was assessed using the WHOQOL-BREF across physical, psychological, social, and environmental domains. Treatment adherence was measured using the Tuberculosis Medication Adherence Scale (TBMAS). Data were analysed using appropriate statistical tests, with p<0.05 considered statistically significant.

Results: The majority of participants were aged 26-40 years, male, and urban residents. Poor HRQoL was most pronounced in the psychological and environmental domains, while nearly one-third had poor physical HRQoL. Social HRQoL was impaired in a substantial proportion of participants. High-risk behaviours were common, including tobacco use and alcohol consumption. Despite high treatment adherence observed in 166 (89.2%) participants, HRQoL remained poor, particularly in the psychological [132 (71.0%)] and environmental domains [141 (75.8%)].

Conclusions: Although most participants demonstrated good treatment adherence, substantial impairment in HRQoL persisted, particularly in psychological and environmental domains.

Household contact investigation coverage and barriers among pulmonary tb index cases in bidar district, Karnataka: a Nikshay-based cross-sectional study

Shivani Chauhan, Dhananjay B. Naik, Pallavi M. Kesari — Fri, 30 Oct 2026 00:00:00 +0000

Background: This study aimed to assess household contact investigation (HCI) completion, contact examination, tuberculosis preventive treatment (TPT) initiation, and barriers to HCI implementation among pulmonary tuberculosis (TB) index cases in Bidar district, Karnataka.

Methods: A cross-sectional programmatic study was conducted using Nikshay records of pulmonary TB cases registered from July to December 2025, supplemented by structured telephonic interviews from January to June 2026. Eligible index cases were approached consecutively. Descriptive statistics, tests of association, and binomial logistic regression were used for analysis.

Results: Among 267 index cases, HCI was completed in 162 (60.7%), while 105 (39.3%) had no completed HCI. Of 418 household contacts identified among cases with completed HCI, 380 (90.9%) were examined. Although 147 contacts reportedly initiated TPT, 175 (65.5%) index cases reported no household contact initiating TPT. Among cases without completed HCI, the most frequently reported barriers were absence of a health-worker visit (65.7%) and fear/stigma (23.8%). HCI completion was not significantly associated with gender, residence, taluk, type of TB, or mode of detection.

Conclusions: HCI completion was suboptimal in Bidar, despite high examination coverage among identified household contacts. The absence of health-worker visits and fear/stigma were prominent reported barriers. Strengthening health-worker-led contact investigation and stigma-reduction efforts may improve HCI implementation.

Socio-demographic and cultural determinants of high fertility among women residing in an urban metropolitan slum: a comparative cross-sectional study

Rutuja R. Chavan, Abhiram M. Kasbe — Fri, 30 Oct 2026 00:00:00 +0000

Background: High fertility (three or more children) remains a public health concern in socioeconomically vulnerable urban populations. This study compared socio-demographic, reproductive, and cultural factors associated with low and high fertility among women residing in an urban metropolitan slum.

Methods: A community-based comparative cross-sectional study was conducted from January 2021 to April 2022 among 322 women in an urban slum of a metropolitan city in India. Women were equally categorized into low-fertility (1-2 children) and high-fertility (≥3 children) groups. Participants were selected by systematic random sampling. Data were collected using a pre-tested structured interview schedule and analysed using Chi-square tests and multivariable logistic regression.

Results: Women with high fertility were more likely to have lower maternal and paternal education, lower socioeconomic status, earlier marriage and first pregnancy, more conceptions, lower mass-media exposure, and greater desire for additional children. Contraceptive use was lower among women with high fertility than those with low fertility (87.5% versus 96.3%). In adjusted analysis, higher paternal education was associated with lower odds of high fertility (AOR 0.52), while an unplanned last pregnancy was associated with higher odds (AOR 3.56). Having a male first child and the husband’s desire for another child were also independently associated with fertility status (AOR 0.27 and 0.22, respectively).

Conclusions: High fertility in this urban slum was associated with gender preference, spousal fertility intentions, pregnancy planning, and lower paternal education. Couple-centred family-planning counselling, male involvement, delayed marriage, improved education, and access to effective modern contraception should be prioritised.

Effectiveness of an interactive Zotero training session on knowledge and practice of reference management among nursing students in selected institutions of Kamrup, Assam: a quasi-experimental study

Akoijam Mamata Devi, Jahnabee Kalita, Maidul Islam, Sajina Begum — Fri, 30 Oct 2026 00:00:00 +0000

Background: Reference management software such as Zotero improves accuracy and efficiency of citation, yet many nursing students do not fully adopt such tools due to limited exposure and training. Objectives were to assess knowledge and practice regarding the compiling reference tool Zotero (CRTz), evaluate an interactive training session’s effectiveness, and determine associations of post-test scores with demographic variables among nursing students.

Methods: A quasi-experimental, non-equivalent control group design was used. Two-hundred final-year nursing students (100 experimental, 100 control) from two institutions in Kamrup, Assam were enrolled by total enumerative sampling. The experimental group received a 30-minute interactive Zotero session; the control group received no intervention. A 15-item knowledge questionnaire and 20-item practice checklist were administered pre- and post-intervention and analysed using descriptive statistics, paired t-test and chi-square test (p<0.05).

Results: At pre-test, most students showed poor-to-moderate knowledge and average practice in both groups. The experimental group showed a significant rise in mean knowledge (5.34±2.31 to 8.97±2.32; t=16.71, p<0.001) and practice (13.53±4.41 to 17.01±2.63; t=11.1, p<0.001), while the control group showed no significant change (p>0.05). Post-test knowledge was significantly associated with age, religion and residence (experimental group) and gender (control group); post-test practice was significantly associated with prior tool knowledge (experimental group) and course type (control group).

Conclusions: A brief interactive session substantially improves nursing students' knowledge and practice regarding Zotero, supporting integration of structured, hands-on reference-management training into nursing curricula.

Prevalence of hypertension in high school children in urban and rural regions of Telangana: a cross-sectional comparative study

Alina Husain, Kshitija Singh, Nagoor Khadervali, Koena Dixit — Fri, 30 Oct 2026 00:00:00 +0000

Background: Hypertension (HTN) is increasingly recognised as a paediatric concern with significant long-term cardiovascular implications. This study aimed to assess and compare the prevalence of HTN among high school children in the urban and rural settings of Telangana and to identify associated modifiable risk factors.

Methods: A cross-sectional, school-based study was conducted from January to December 2025 across four government and four private high schools each in urban (Hyderabad) and rural (Sadasivapet) regions. A total of 1200 students aged 13-15 years were enrolled using multistage random sampling. Data were collected through a pretested structured questionnaire and standardised anthropometric and blood pressure measurements. Statistical analysis was performed using statistical package for the social sciences (SPSS) version 26.

Results: The overall prevalence of hypertension was 11.5%. Urban prevalence (14.2%) was significantly higher than rural prevalence (8.2%). A significant association was observed between elevated blood pressure and higher BMI (p<0.01), reduced physical activity (p<0.05), and frequent junk food consumption (p<0.05).

Conclusions: Hypertension is a prevalent, under-recognised condition among Telangana adolescents, with a disproportionate urban burden. Preventive strategies targeting modifiable risk factors through school-based screening and health education are warranted.

Digital eye strain among undergraduate medical students: a cross-sectional study at a tertiary care centre

Srushti D. Pimple, Mahavir P. Nakel, Bharat B. Chavan — Fri, 30 Oct 2026 00:00:00 +0000

Background: Digital devices have become very important in education. Students are increasingly spending their time on screen for education and other use. However, prolonged screen exposure has led to increasing complaints of digital eye strain, an emerging public health concern.

Methods: A cross-sectional study was conducted among 165 undergraduate medical students in a tertiary care centre. A pilot studied; semi-structured questionnaire was used for data collection. Data was entered in Microsoft excel and analysed.

Results: The prevalence of digital eye strain among undergraduate medical students was found to be 52.7%. Most common symptom noted were Headache (68.5%), Itching (60.6%), tearing of eyes (58.1%). There was a significant association between the duration of mobile screen usage (>4 hours) and digital eye strain (p value=0.0303).

Conclusions: Digital eye strain is a common health concern among medical students. Higher the hours of mobile screen use, greater is the risk of digital eye strain.

Patient perspectives and satisfaction with outpatient healthcare services at a tertiary-care public hospital in Chandigarh, India: a cross-sectional study

Dinesh Kumar, Naveen K. Goel, Deepak Sharma — Fri, 30 Oct 2026 00:00:00 +0000

Background: Patient satisfaction is an important indicator of the quality, effectiveness, and patient-centeredness of healthcare services. Assessing patients’ perspectives can help identify service gaps and guide quality improvement. Objective was to assess patients’ perspectives and satisfaction with outpatient department (OPD) healthcare services and to explore their suggestions for improving patient care at a tertiary-care public hospital in Chandigarh, India.

Methods: A cross-sectional study was conducted among patients attending OPDs of a tertiary-care government hospital in Chandigarh from April to December 2025. Patients who consented to participate or their attendants were interviewed using a self-designed semi-structured interview schedule to collect information on socio-demographic characteristics, waiting time, patient experiences, satisfaction, problems encountered, staff behaviour, and suggestions.

Results: A total of 1069 respondents including 53.6% females and 46.4% males were interviewed. Overall, 70.9% respondents were satisfied with OPD healthcare services, 16.6% were less satisfied, and 12.5% were not satisfied. Overcrowding (53.8%) and long waiting time (49.0%) were the most frequently reported problems. Overall, 72.8% reported at least one undesired experience, whereas 80.4% reported positive experiences. Good behaviour of doctors was the most commonly reported positive experience (29.8%), followed by quality patient care (14.4%). Importantly, 85.8% respondents reported that they would recommend the hospital’s services to others.

Conclusions: System-level limitations continue to be significant obstacles to a better OPD experience, despite the fact that overall patient satisfaction was encouraging. To maintain patient satisfaction, it is important to prioritize reducing crowding and waiting times, enhancing waiting places, parking, medicine availability, diagnostic services, and organizational management.

Non-communicable diseases and cognitive impairment among older adults in East Delhi: a cross-sectional study

Sugadev Balan, Jyoti Khandekar, Anita Shankar Acharya, Shiv Prasad — Fri, 30 Oct 2026 00:00:00 +0000

Background: Non-communicable diseases (NCDs) are a leading cause of morbidity among older adults and are increasingly recognized as being associated with cognitive decline. Cognitive impairment can adversely affect treatment adherence, self-management, and overall quality of life. This study aimed to assess the prevalence of cognitive impairment among elderly individuals with NCDs attending an urban health facility in east Delhi.

Methods: A clinic-based cross-sectional study was conducted among adults aged 60 years and above attending the NCD clinic of the urban health centre, Kalyanpuri, east Delhi. Data were collected through face-to-face interviews using a predesigned questionnaire. Cognitive function was assessed using the Montreal cognitive assessment (MoCA) scale, with a score of less than 26 indicating cognitive impairment. Data were entered and analysed using SPSS and Microsoft Excel.

Results: Cognitive impairment was found to be common among elderly patients with NCDs; more than half (55.1%) of the study participants showed some degree of cognitive impairment (mild to severe). Normal cognition was seen in less than half (44.9%) of the study participants. The prevalence of cognitive impairment was 57.2% among participants with hypertension, 60.5% among those with diabetes mellitus, 44.1% among individuals with thyroid disorders, 64.3% among those with chronic respiratory diseases, 50.0% among participants with coronary artery disease, and 38.9% among those with dyslipidaemia and other chronic conditions.

Conclusions: A considerable proportion of older adults living with NCDs demonstrated cognitive impairment. These findings underscore the importance of incorporating routine cognitive screening into NCD care services for the elderly. Early identification of cognitive decline may facilitate timely interventions, improve disease management, enhance treatment adherence, and promote healthy ageing.

Psychological distress among ASHA workers serving zero-dose and non-zero-dose UPHC catchments in Malegaon, Maharashtra: a cross-sectional study

Tejas N. Kadam, Swanand D. Tilekar, Sudhakar M. More — Fri, 30 Oct 2026 00:00:00 +0000

Background: ASHA workers support immunization and community outreach, yet evidence on their psychological well-being in zero-dose programme settings is limited. This study compared psychological distress among ASHA workers serving zero-dose and non-zero-dose UPHC catchments in Malegaon Municipal Corporation, Maharashtra.

Methods: A cross-sectional analytical study included 184 ASHA workers nested within 14 UPHCs (88 in six zero-dose and 96 in eight non-zero-dose catchments). DASS-21 scores were reconstructed directly from the 21 questionnaire items. Group differences were assessed using Welch tests with Mann-Whitney sensitivity analyses; mean differences, 95% confidence intervals and Cohen’s d were reported. Adjusted linear models used family type and religion, with small-sample cluster-robust CR2 inference at UPHC level.

Results: Mean stress was 15.34 versus 8.96 (difference 6.38, 95% CI 3.95-8.82; d=0.78), anxiety 13.89 versus 8.98 (difference 4.91, 95% CI 2.59-7.22; d=0.62), and depression 8.66 versus 6.00 (difference 2.66, 95% CI 0.49-4.83; d=0.37) in zero-dose versus non-zero-dose groups. Adjusted CR2 coefficients were +7.47 for stress (p=0.033), +6.01 for anxiety (p=0.068) and +3.20 for depression (p=0.305).

Conclusions: ASHA workers serving zero-dose catchments had higher observed stress and anxiety scores. Stress showed the most consistent evidence across analyses, whereas anxiety was less precise at cluster level and depression remained exploratory. The findings represent cross-sectional associations, not causal effects, and should be interpreted in light of only 14 UPHC clusters and fieldwork conducted after programme expansion.

Digital health literacy and its association with cyberchondria among non- medical undergraduate students in Malappuram district, Kerala

Fri, 30 Oct 2026 00:00:00 +0000

Background: The increasing use of the internet for health information may influence health behaviour and anxiety among young adults. Digital health literacy may shape how individual access and evaluate online health information, while excessive searching may contribute to cyberchondria. This study assessed digital health literacy and cyberchondria and examined their association among non-medical undergraduate students in Malappuram district, Kerala.

Methods: A cross-sectional study was conducted among 209 students of MES Arts and Science College, Perinthalmanna, from March 2 to April 2, 2026. Participants were selected by simple random sampling. Data were collected using a questionnaire, the 8-item eHealth literacy scale (eHEALS), and the cyberchondria severity scale-12 (CSS-12). Descriptive statistics, chi-square test, multivariate logistic regression and Spearman correlation were used; p<0.05 was considered statistically significant.

Results: Participants’ mean age was 20.05±1.55 years, and 51.2% were male. The median eHEALS score was 27 (IQR 24-31); 53.1% had higher perceived digital health literacy. The median CSS-12 score was 34 (IQR 26-39), with 56.5% having low, 37.8% moderate, and 5.7% high cyberchondria. Higher perceived digital health literacy (p=0.03) and female gender (p=0.03) were significantly associated with moderate/high cyberchondria severity (p=0.005). Positive correlations were observed with compulsion (ρ=0.354, p<0.001), distress (ρ=0.136, p=0.049), excessiveness (ρ=0.235, p=0.001), and reassurance-seeking (ρ=0.220, p=0.001).

Conclusions: Higher perceived digital health literacy was associated with cyberchondria and its domains, particularly compulsion. Promoting responsible online health-information seeking may help reduce excessive searching and its psychological consequences among young adults.

Association of neonatal anthropometry with maternal anthropometry and demographics: a hospital-based cross-sectional study from Northern India

Kunj Bihari, Ekansh Rathoria, Mridula Srivastava, Richa Rathoria, Utkarsh Bansal — Fri, 30 Oct 2026 00:00:00 +0000

Background: Identifying simple maternal physical predictors of neonatal growth is essential for early risk stratification in resource-constrained settings. This study evaluated the associations between third-trimester maternal physical parameters and neonatal anthropometrics.

Methods: A prospective, hospital-based cross-sectional study was conducted among 160 healthy term mother-neonate dyads at a tertiary care center in Sitapur, Uttar Pradesh. Maternal third-trimester weight, height, body mass index (BMI), and mid-upper arm circumference (MUAC), along with sociodemographic factors, were recorded. Neonatal birth weight, crown-heel length, and head circumference were measured within 24 hours of delivery. Data were analyzed using Chi-square tests and Pearson correlation coefficients (p<0.05).

Results: Mean maternal age was 26.34±3.53 years and gestational age was 38.46±1.06 weeks. Mean neonatal birth weight, crown-heel length, and head circumference were 2.79±0.24 Kg, 46.08±1.15 cm, and 33.79±0.79 cm, respectively. Low birth weight (<2.5 kg) was observed in 6.3% (n=10). Maternal third-trimester weight, MUAC, and BMI demonstrated highly significant categorical associations with all neonatal parameters (p<0.001). Specifically, maternal weight and MUAC showed positive correlations with birth weight (r=0.516 and r=0.439, respectively), length (r=0.668 and r=0.485), and head circumference (r=0.664 and r=0.461; all p<0.001). Gestational age also correlated positively with all three neonatal measurements (p<0.05). Conversely, maternal height, age, parity, delivery mode, and socioeconomic status showed no statistically significant correlations with birth weight or head circumference (p>0.05).

Conclusions: Maternal third-trimester weight, BMI, and particularly MUAC demonstrate positive associations with neonatal birth dimensions. MUAC serves as a practical, low-cost screening tool for antenatal nutritional surveillance in rural healthcare settings.

Occupational health hazards, knowledge and preventive practices among manual scavengers in Kanpur, Uttar Pradesh: a cross-sectional study

Ayusheeka Krishnan Patel, Namita Batra — Fri, 30 Oct 2026 00:00:00 +0000

Background: Manual scavenging continues to expose workers to serious chemical, physical, and biological hazards despite legal restrictions in India. These risks are intensified by poor protective practices and limited occupational health support. Aim was to assess occupational health hazards, knowledge, and preventive practices among manual scavengers and to examine their association with selected demographic variables.

Methods: A descriptive cross-sectional study was conducted among 100 manual scavengers in Kanpur using purposive sampling. Data were collected through a structured interview schedule including self-reported occupational health hazards assessment, knowledge, and preventive practices. Data were analysed using descriptive statistics, Pearson’s correlation, and chi-square test.

Results: Chemical, physical, and biological hazards were commonly reported. Moderate knowledge was found in 61% of participants with mean knowledge score of 15.1±3.21, while poor preventive practices were observed in 49%. Biological hazards showed a significant negative correlation with knowledge (r=−0.201, p=0.044) while knowledge and preventive practices were significantly associated with age, education, type of work, work experience, family size, and gender.

Conclusions: Manual scavengers in Kanpur experience substantial occupational risk with inadequate preventive practices. Targeted occupational health education, provision of protective equipment, and policy-level support are urgently needed.

Beyond safe delivery: integrating maternal anaemia management, Janani Suraksha Yojana and girl child promotion – a rural facility experience from Northern India

Anurag Gautam, Vinit Yajurvedi — Fri, 30 Oct 2026 00:00:00 +0000

Maternal and newborn health requires a continuum of care extending from early pregnancy registration to the postnatal period, particularly in rural settings. This case report describes an integrated maternal healthcare experience at Community Health Centre (CHC) Faridpur, Bareilly, Uttar Pradesh, India, combining routine antenatal care, maternal anaemia screening and prevention, Janani Suraksha Yojana (JSY) facilitation, respectful maternity care, skilled institutional delivery, essential newborn care, and postnatal counselling. A 25-year-old pregnant woman from a rural area registered during the first trimester and received multidisciplinary antenatal care, haemoglobin screening, iron-folic acid and calcium supplementation, nutritional counselling, birth-preparedness counselling, and assistance with JSY documentation. On 19 July 2026, she presented at term with spontaneous labour and underwent an uncomplicated normal vaginal delivery. A healthy female infant weighing 2690 g was delivered with immediate spontaneous cry. Evidence-based intrapartum and newborn practices included labour monitoring, delayed cord clamping, skin-to-skin contact, thermal protection, early initiation of breastfeeding, and postpartum counselling. The family positively celebrated the birth of the daughter with the message “Mere Ghar Lakshmi Aayi Hai,” providing an opportunity for gender-equity messaging within routine maternity care. This case illustrates the feasibility of integrating clinical care, maternal nutrition, government maternity schemes, respectful care, newborn practices, and community engagement within an existing rural government facility. Such an approach may provide a practical and replicable framework for strengthening maternal and newborn healthcare while promoting positive attitudes toward the girl child.

Clinical and surgical management of congenital cervical outflow obstruction variants in adolescents

Aishwarya K. Nichani, Pramila Yadav, Balaji Jadhav — Fri, 30 Oct 2026 00:00:00 +0000

Congenital anomalies of the uterine cervix are rare Müllerian duct development disorders that present significant management challenges. Obstruction of menstrual outflow typically leads to hematometra, causing cyclical pelvic pain and primary amenorrhea. However, presentation can vary greatly depending on uterine anatomy and collection volume. This series reports two distinct presentations of congenital cervical obstruction managed at a tertiary municipal hospital in Mumbai. Case 1 describes a 14-year-old female presenting with primary amenorrhea, severe cyclical abdominal pain, and an anatomical variant featuring a blind vaginal canal, single-sided hematometra with a contralateral rudimentary horn, massive right-sided hematosalpinx, and extensive secondary pelvic endometriosis. She successfully underwent an isthmo-vaginal anastomosis, right salpingectomy, and deposit excision. Case 2 presents a 16-year-old female with primary amenorrhea who was notably asymptomatic for cyclical pain. Pelvic MRI confirmed a subseptate uterus with two non-communicating, asymmetrical endometrial cavities containing restricted blood products, separated from the cervix by a 3–4 mm fibrous tissue band. She successfully underwent surgical resection via an isthmo-cervical anastomosis, intraoperative drainage of dual mucoceles, and fimbrial adhesiolysis. These cases illustrate the diverse clinical spectrum of congenital cervical obstruction. While Case 1 showcases severe retrograde complications, Case 2 demonstrates that small-volume, non-communicating septate cavities can present asymptomatically without cyclical distress. Meticulous multiplanar MRI evaluation and individualized reconstructive surgery are vital to preserving anatomy and long-term fertility.

From a suspected rabies death to definitive diagnosis: the crucial role of forensic medicine in a rural setting

Fri, 30 Oct 2026 00:00:00 +0000

This case report highlights a rabies mortality confirmed through post- mortem analysis in a 43-year-old man in a rural area of Himachal Pradesh, India. The deceased didn’t seek post-exposure prophylaxis following a dog scratch, on his right hand, which was ignored by him. The post- mortem analysis included different diagnostic tests for confirming rabies along with histopathology investigation. The case demonstrates a unique and critical convergence of forensic medicine and disease prevention, as the confirmed post-mortem diagnosis led to the timely public health action in terms of mass animal immunization. This particular case also highlights the importance of timely access to anti-rabies vaccine (ARV) and public health education in terms of information, education and communication (IEC). Concurrently, it signifies the critical medico-legal role of forensic medicine in facilitating the deceased's underprivileged family's eligibility for financial compensation under the ongoing government scheme for accidental deaths.

Preventing non-steroidal anti-inflammatory drug-associated acute kidney injury in young adults: a medication safety and public health perspective

Priyanshi Swain — Fri, 30 Oct 2026 00:00:00 +0000

Acute kidney injury (AKI) following short-term over-the-counter (OTC) non-steroidal anti-inflammatory drug (NSAID) use is an increasingly recognized yet under-recognized complication in otherwise healthy young adults. Young adults frequently self-medicate for headaches, sports injuries, dysmenorrhoea, musculoskeletal pain, and viral illnesses without medical advice. Because patients often present with non-specific symptoms, AKI may initially be mistaken for dehydration or viral illness, delaying withdrawal of the offending agent and worsening renal outcomes. This diagnostic delay may also result in unnecessary investigations before medication induced nephrotoxicity is considered.

Mortality trends and risk factors among tribal children in India

Taranand Singh, Dinesh Kumar — Fri, 30 Oct 2026 00:00:00 +0000

These scientific interpretations focused on highlighting the underlying risks with new-borns, particularly during the neonatal period, among the tribal population. The reason behind neonatal mortality rates among the tribal population has been higher than the national average since long. Majorly preterm birth, low birth weight, and infections are associated with neonatal mortality. Maternal anaemia, inadequate antenatal and perinatal risk are identified as prenatal risk factors, followed by poor socioeconomic status. Home child birth, preterm birth, low birth weight children, and neonatal infections contribute to the postnatal risk.

Effect of acupuncture at LU9, LI11 and UB17 on hemodynamic parameters in hypertensive patients: a case series

Fri, 30 Oct 2026 00:00:00 +0000

Hypertension is a prevalent cardiovascular disorder associated with substantial morbidity and mortality, and complementary approaches such as acupuncture have gained attention as potential adjunctive interventions for blood pressure regulation. This case series describes the effects of acupuncture at LU9, LI11, and UB17 on blood pressure and selected cardiovascular hemodynamic parameters in three patients with hypertension aged 55-65 years. Participants received acupuncture treatment at the three specified points for five consecutive days. Sterile disposable needles were manually stimulated and retained for 30 minutes during each session. We assessed blood pressure and cardiovascular hemodynamic parameters, including pulse pressure, mean arterial pressure, rate pressure product, and double product, at baseline, immediately after the first treatment session, and after completion of the five-day intervention. All three participants demonstrated reductions in systolic and diastolic blood pressure following the intervention. Favorable changes were also observed in pulse pressure, mean arterial pressure, rate pressure product, and double product, suggesting improved cardiovascular hemodynamics and reduced myocardial workload. The treatment was well tolerated, with no adverse events reported. These findings suggest that acupuncture at LU9, LI11, and UB17 may be an integrative approach to improving blood pressure control and cardiovascular hemodynamic function in individuals with hypertension. Larger, rigorously designed clinical studies are warranted to confirm these preliminary findings and clarify the underlying mechanisms.

Patient and healthcare provider satisfaction in the era of electronic health records and electronic medical records: a systematic review

Badr A. Albenhasan, Fatimah Y. Alshaikhsaleh, Hasan A. Almutawah, Mona A. Asiri — Fri, 30 Oct 2026 00:00:00 +0000

Electronic health records (EHRs) and electronic medical records (EMRs) are now central to clinical practice worldwide, including in low-and middle-income health systems, yet their effect on patient and healthcare provider satisfaction remains uncertain. Objectives to synthesize evidence published between 2015 and 2025 on how EHR and EMR use relates to patient satisfaction, provider satisfaction, patient-provider communication, workflow and burnout, and to identify the factors that shape these outcomes across different health-system contexts. A systematic review of primary studies was conducted by searching PubMed, Scopus, Web of Science, MEDLINE and Google Scholar. Studies were eligible if they reported patient or provider satisfaction, communication, quality, workflow or burnout in real-world clinical settings. Two reviewers independently screened records and extracted data. Methodological quality was appraised using the mixed methods appraisal tool (MMAT), version 2018. Thirty-six studies were included and synthesized narratively. Patients generally reported moderate to high satisfaction, particularly in primary care and outpatient settings, citing shorter waiting times and clearer explanations. Provider experience diverged by role: nurses and allied health professionals reported benefits in legibility and coordination, whereas physicians reported documentation burden, workflow disruption and burnout. Usability, training quality and organizational support, rather than adoption itself, were the consistent determinants of satisfaction. Evidence from low-and middle-income settings showed that provider-side efficiency gains did not automatically translate into patient benefit. EHR adoption alone does not improve satisfaction. Investment in usability, role-specific training, documentation relief, and patient-centered communication is required.

Accuracy of artificial intelligence versus eyecare practitioners in detecting diabetic retinopathy using retinal fundus images: a systematic literature review

Peter K. Mutuma, Warren Ayonga, Domnic Marera — Fri, 30 Oct 2026 00:00:00 +0000

Diabetic retinopathy (DR) prevalence rises among low- and middle-income countries where access to appropriate eye care services is lacking. Detecting DR requires retinal fundus imaging, but interpretation conventionally depends on eye-care practitioners, who are affected by shortcomings like inter-observer variability. Artificial Intelligence (AI), a promising technology for automated image examination and interpretation, enables wider, faster screening coverage and consistency. The review compares the diagnostic accuracy of AI and practitioners in detecting DR using retinal images. We conducted a systematic literature review using PRISMA 2020, searching major electronic databases with search terms: diabetic retinopathy, artificial intelligence, eye-care practitioners, and diagnostic accuracy. Eligible studies were published in English, peer-reviewed, and met the inclusion and exclusion criteria. Data extraction, organization, and accuracy were enabled through an Excel data form. The review included 15 of 540 identified studies. AI diagnostic tools like Google’s ARDA show equal or higher accuracy than humans in detecting DR, in some instances, in categorizing images. AI brings hope and assurance in prompt identification, management, and referral. Its performance is limited by the tendency to flag images as false positives; however, this depends on image quality, disease severity, datasets used, and overall grading criteria. Human strength remains in clinical judgement, contextualised interpretation of ungradable or low-quality images, and patient-specific management approach. AI implementation to complement care should be steered by local validation through comparison with eye care givers and approval through standardized protocols, quality control, ethical considerations, and data security.

Community-based interventions to address food insecurity and nutritional health in India: a systematic review

Sudhir, Deepa Krishna, B. Nagaraja Goud, Susmiyhaa Nagarajan — Fri, 30 Oct 2026 00:00:00 +0000

Food insecurity and undernutrition remain major challenges in India, significantly impacting growth, development, and public health among vulnerable populations. Community-based interventions (CBIs) have increasingly been recognized as promising strategies to address food insecurity by employing locally adapted, participatory, and multisectoral approaches. Following PRISMA guidelines, we conducted a systematic review synthesizing quantitative evidence from peer-reviewed studies published between 2000 and August 2025. Eligible studies were conducted in India, focused on CBIs targeting food security and/or nutritional outcomes, and employed RCT, quasi-experimental, or cohort designs. Multiple databases including PubMed, Scopus, Web of Science, EMBASE, and Google Scholar were searched. Data extraction focused on population, intervention characteristics, food security/nutritional outcomes, duration, and methodological quality. Fifteen studies across 11 states met inclusion criteria. Interventions encompassed nutrition education, agricultural support, food supplementation, income generation, and integrated multisectoral models. Integrated CBIs consistently demonstrated the strongest improvements in dietary diversity, reductions in child stunting (8% to 15%), and declines in anemia prevalence (10% to 28%) compared to singular approaches. Critical elements contributing to success included active community participation, contextual tailoring, and continuous monitoring. Nonetheless, study quality varied, follow-up periods were typically short, and the dimension of food security stability remained the least addressed. Well-designed CBIs meaningfully enhance food security and nutritional health outcomes in India. Future programs should prioritize participatory design, incorporate sustainability metrics, and adopt rigorous evaluation frameworks. Enhanced policy engagement and further research focused on the stability aspect of food security are recommended.

Motivators and barriers to physical activity: a systematic review of qualitative studies

Ishita Barot, Arushi Patel, Muskan Kella, Ankur Panchal, Arti Muley — Fri, 30 Oct 2026 00:00:00 +0000

Physical activity is significant for both mental and physical health. It is lacking in routine lives. This study aimed to identify and synthesise the motivators and barriers to physical activity reported across qualitative studies. This systematic review searched PubMed, Embase, Scopus, and Trip Database up to November 2025 using terms related to physical activity, motivators, and barriers. Studies involving participants aged under 18 years and those with physical limitations precluding activity were excluded. Nine qualitative studies published in English that examined motivators, barriers, or both were included. Study quality was appraised using the critical appraisal skills programme (CASP) checklist. Data on study year, setting, population characteristics, and perceived motivators and barriers were extracted and analysed to identify themes common across studies as well as those specific to age, gender, or geographic location.

Perceived physical and psychological benefits (improved fitness, energy, and confidence), social support (from family, peers, and instructors), programme flexibility, structured routines, and environmental facilitators (walkable neighbourhoods, favourable weather) emerged as the principal motivators. Barriers were identified at the individual (fatigue, poor goal-setting, comorbidities), interpersonal (lack of peer support, cultural responsibilities), organisational (workload, unsupportive workplace policies), and environmental (adverse weather, unsafe surroundings, limited facilities) levels. Motivators and barriers to physical activity vary according to personal, social, and environmental circumstances. Effective interventions should therefore address these determinants concurrently-through flexible scheduling, safe exercise environments, workplace accommodations, and community support-to promote physical activity and improve population health.

Barriers to quality post-abortion care in low and middle-income countries: a systematic review

Hem Lata, Latha Venkatesan, Raksha Yadav — Fri, 30 Oct 2026 00:00:00 +0000

Post-abortion care (PAC) is a vital component of reproductive healthcare and essential for reducing abortion-related morbidity and mortality. Despite improvements in service availability, barriers affecting the quality and utilization of PAC services remain common across low-and middle-income countries (LMICs). The review was conducted using PubMed, Scopus, Google scholar and Open search database by following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement (PROSPERO registration: CRD420261425414). The peer-reviewed studies published between 2010 and 2026 were screened according to inclusion criteria. Study selection was performed using Rayyan Software, and methodological quality was assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Five major categories of barriers were identified; Knowledge and awareness barriers; Socio-cultural, financial, and geographic barriers; provider-related and quality -of-care barriers; health-system and facility-level barriers; and policy and legal barriers. The common challenges included abortion-related stigma, limited awareness of services, financial hardship, inadequate counselling, shortage of trained providers, weak referral systems, and insufficient infrastructure. Barriers to quality post -abortion care are multidimensional, and addressing these barriers through coordinated interventions may improve access, quality and utilization of post-abortion care services and help bridge the persistent access-quality gap in LMICs.

Integration of mental health services into primary health care in India: scope and challenges

Mehvish Siddique, Weam Ahmed Mohammad Mari, Pooja Sharma — Fri, 30 Oct 2026 00:00:00 +0000

Mental health disorders are a major concern with millions of people living with mental illnesses, but only a small fraction of them have access to treatment due to stigma attached, lack of resources and trained personnel. Therefore, the inclusion of mental healthcare services in primary health care (PHC) is essential for improving its accessibility. The present review investigates the effectiveness, the different models, and the barriers in integrating mental health services into primary health care in India. The review was conducted following the PRISMA protocol using database like PubMed and Scopus between January 2016 and January 2026. The systematic search yielded 62 results, of which 23 were selected based on established inclusion criteria and were subsequently analyzed thematically. Successful integration of mental health services into primary healthcare was identified as including, but not limited to, task-sharing, use of digital technologies, use of telepsychiatry, and creating an improved policy-driven system. Task-sharing with lay personnel was found to greatly increase the identification and management of people with mental illnesses, while digital technology and telepsychiatry led to better access to mental health services, especially in rural areas. Barriers to implementing integrated mental health services included a lack of training, stigma, insufficient workforce, and limited infrastructure. Integrated mental health services into primary healthcare exist and demonstrate positive results, but to sustain successful implementation, the identified barriers to integration must be eliminated or mitigated to reduce the existing treatment gap for mental illness in India.

Development and evaluation of a culturally adapted birth preparedness and complication readiness training among Hehe pregnant women in rural Tanzania: exploratory sequential mixed-methods study

Rosalia B. Mwenda, Saada A. Seif, Rehema O. Stephano, Fabiola V. Moshi — Fri, 30 Oct 2026 00:00:00 +0000

Background: Birth preparedness and complication readiness (BPCR) education promotes childbirth preparation, recognition of danger signs, and timely care-seeking. However, translation alone may not ensure that BPCR messages are culturally and conceptually meaningful. The objective of the study is to develop and evaluate culturally adapted BPCR training guided by Cultural Equivalence Theory among Hehe pregnant women in rural Iringa, Tanzania, and assess its effects on knowledge, attitudes, and practices compared with standard Kiswahili-translated training.

Methods: An exploratory sequential mixed-methods design will be used. The qualitative phase will explore women’s understanding of BPCR concepts and identify culturally meaningful terminology and explanations. Findings will inform manual adaptation through translation, expert review, community input, cognitive review, and pilot testing. The quantitative phase will use a controlled pretest–posttest quasi-experimental design in two rural districts. BPCR knowledge, attitudes, and practices will be assessed at baseline and approximately four weeks after training. Qualitative data will undergo thematic analysis, while quantitative data will be analyzed using mixed-effects regression and Difference-in-Differences analysis.

Conclusions: The study will assess whether culturally adapted BPCR training provides additional benefits over standard translated training and inform culturally responsive maternal health education in rural Tanzania.

Trial Registration: Pan African Clinical Trials Registry: PACTR202607626025411.

Estimating the effectiveness of nurse led community mental health outreach program on health-related quality of life of elderly at community areas, Chittoor, Andhra Pradesh: a mixed methods approach

Fri, 30 Oct 2026 00:00:00 +0000

Background: India’s ageing population faces rising health issues and reduced family support, with old-age homes being culturally less accepted. The nurse led community mental health outreach program (NL-CoMHOP) uses social prescribing to provide affordable, community-based care. Managed by nurses, it improves health, quality of life (QoL), and reduces loneliness for elderly living at home, while easing family burden. This study will evaluate NL-CoMHOP’s effectiveness and estimates its costs, aligning with National Mental Health Program’s (NMHPs) vision.

Methods: This mixed-methods study (QUAN+qual) adopts an open-label randomized controlled trial with concurrent triangulation in community areas of Chittoor district, Andhra Pradesh. Eligible elderly (≥60 years, residents ≥5 years) will be randomly recruited, excluding those needing emergency care or with acute psychosis. Total 162 participants will be enrolled. Over 6 months, the NL-CoMHOP will deliver individualized physical, psychological, social, and spiritual activities using local resources.

Conclusions: The NL-CoMHOP, a newer concept and an intermediary solution for the elderly to improve their health-related QoL (HRQoL).

Trial registration: CTRI/2025/06/089067 dated 18/06/2025 under clinical trials registry-India.

Work, job satisfaction and role performance among ASHA workers in Karnataka: an overview of existing evidence

Vinutha M. Dsouza, Shashi Joyce Soans — Fri, 30 Oct 2026 00:00:00 +0000

Accredited social health activists (ASHAs) are an important component of community-based health service delivery in India. Their responsibilities have expanded considerably and include maternal and child health, health education, community mobilisation, referral services, disease prevention and support for national health programmes. The conditions under which ASHAs work may influence their job satisfaction and role performance. Evidence from Karnataka is available, but it is dispersed across studies examining workload, incentives, training, motivation, stress, digital reporting and performance. An overview was undertaken of published evidence concerning work environment, job satisfaction, motivation, workload and role performance among ASHA workers in Karnataka. Relevant studies published predominantly from 2020 onwards were identified from electronic databases, journal websites and other academic sources. Studies were examined according to geographical setting, population, study design, major variables and findings. The evidence was narratively synthesised under the themes of work environment, training, job satisfaction and motivation, role performance, and emerging challenges. Studies from Karnataka indicate that ASHAs perform a wide range of community health activities but face challenges related to workload, extended working hours, additional responsibilities, transportation, incentives, resources, training and organisational support. Digital systems have created opportunities for improved documentation and monitoring but may also add reporting responsibilities. Recent studies have increasingly examined job motivation, occupational stress, quality of life and job satisfaction. Performance studies indicate generally active participation in several maternal, child and community health activities, although gaps remain in selected areas of knowledge and service delivery. Existing evidence suggests that work environment is an important context for understanding job satisfaction and role performance among ASHAs in Karnataka. However, evidence integrating all three constructs remains limited. Future studies using standardised measures should examine their interrelationships and determine whether work environment modifies the relationship between job satisfaction and role performance.

ART in HIV and factors affecting adherence to ART among HIV-positive individuals: a review

Hemant Kharkwal, Jhuma Samanta, Srishti Kharkwal — Fri, 30 Oct 2026 00:00:00 +0000

Anti-Retroviral Therapy (ART) has greatly enhanced the quality of life for individuals living with Human Immunodeficiency Virus (HIV) globally. In regions where ART is widely accessible, there has been a noticeable decline in HIV-related illness and death, making Acquired Immune Deficiency Syndrome (AIDS) a manageable chronic condition. For ART to be most effective, patients must maintain a high level of adherence. Consistent adherence is essential to achieve the full benefits of treatment and to prevent the development of drug resistance. Despite this, numerous barriers to adherence exist in both developed and developing countries. This review aims to examine the impact of HIV, evaluate adherence rates, and identify factors that influence adherence to ART among people living with HIV. It highlights the importance of providing intensive adherence counseling before starting therapy. Healthcare providers should also identify potential obstacles to adherence early and implement appropriate strategies to address them.

Artificial intelligence and computational tools in drug repurposing: a new frontier in therapeutic discovery

Amtul Muqeet Rafia, Fathima Begum, Billa Yashaswi, C. Sai Manasa, Durgam Akshaya — Fri, 30 Oct 2026 00:00:00 +0000

Drug repurposing is the process of identifying novel therapeutic uses for currently available therapies that were initially created for different objectives in order to profit from the established safety and efficacy characteristics of well-known pharmaceuticals. Therefore, by avoiding the first phases of drug development, novel treatments can be introduced to the market more quickly and affordably. Artificial intelligence (AI) is a suitable substitute for conventional experimental approaches, which can be expensive and time-consuming, because of its lesser price, computer benefits, and capacity to reveal underlying trends. The primary subjects of this review include the use of AI algorithms in drug research and their unique and advantageous functions in identifying medicine repurposing, particularly when combined with in silico evaluation of therapeutic compounds. It has been shown that current AI systems are excellent at analyzing massive datasets, identifying intricate drug reaction patterns, and predicting potential medication repurposing. Building on these findings, there are still obstacles to establishing effective AI algorithms and carrying out further research, like expanding customized medicine, enhancing AI computing efficiency, and merging data-related databases for better repurposing.

Contraception beyond access: barriers in uptake, perceived health risk and choice gaps in India

Neha Chhawal, Veena, Kanika Arora, Jitendra Kumar Meena — Fri, 30 Oct 2026 00:00:00 +0000

India has a long-standing family planning programme, yet contraceptive use remains characterised by reliance on female sterilisation, limited uptake of reversible methods, and high discontinuation of temporary contraception. Despite improvements in overall prevalence, access alone has not translated into sustained or equitable use. This narrative review synthesises epidemiological, qualitative, and policy-oriented evidence to examine how contraception-seeking behaviour in India is shaped by social norms, gendered decision-making, health-system practices, and perceptions of health risk, with particular attention to cancer-related fears. The literature indicates that contraceptive decisions are rarely individual choices, being embedded within marital expectations, fertility pressures, and constrained female autonomy. Fear of side effects, especially concerns about long-term health and cancer, deters uptake and continuation of hormonal methods despite evidence of limited, time-bound risks and substantial protection against ovarian and endometrial cancers. These concerns are reinforced by inconsistent counselling and provider bias, highlighting the need for behaviour-centred, rights-based family planning.

Artificial intelligence across community, mental and child health nursing: a future-ready framework for precision, preventive and person centered care

Fri, 30 Oct 2026 00:00:00 +0000

Artificial intelligence (AI) is transforming healthcare by enabling precision, predictive, and person-centered approaches that enhance the quality, accessibility, and efficiency of nursing care. Community, mental, and child health nursing are increasingly benefiting from AI-driven innovations, including machine learning, deep learning, natural language processing, predictive analytics, clinical decision support systems, wearable technologies, conversational AI, and telehealth platforms. These technologies facilitate early disease detection, population health surveillance, risk prediction, personalized interventions, remote patient monitoring, developmental screening, mental health assessment, and evidence-based clinical decision-making. This narrative review synthesizes contemporary evidence on the integration of AI across community, mental, and child health nursing and explores its implications for preventive healthcare, health promotion, and holistic patient management. Relevant literature published between 2018 and 2026 was identified through major electronic databases, including PubMed, Scopus, Web of Science, CINAHL, Embase, PsycINFO, IEEE Xplore, and Google Scholar. The reviewed evidence demonstrates that AI improves healthcare accessibility, strengthens continuity of care, enhances diagnostic accuracy, supports personalized nursing interventions, and optimizes resource utilization. However, successful implementation requires addressing challenges related to ethical governance, algorithmic bias, data privacy, cybersecurity, interoperability, digital infrastructure, and AI competency among nurses. The review concludes that AI should function as a clinical decision-support tool that complements, rather than replaces, professional nursing judgment. Strategic investment in digital health education, interdisciplinary collaboration, and responsible AI governance will be essential for developing future-ready nurses capable of delivering equitable, evidence-based, and compassionate healthcare across diverse populations.

Maternal deaths in Uttar Pradesh – a silent emergency

Fri, 30 Oct 2026 00:00:00 +0000

Any maternal death is actually a silent emergency. A single digit maternal mortality (MM) rate and MM ratio is desirable as there will be circumstances that will be out of reach from the medical care like the case of Smita Patil, the famous Indian actress of Mumbai. She died while giving birth to her son on 13 December 1986. The recent sample registration system (SRS) shows that the MM rate of Uttar Pradesh has decreased but the MM ratio has increased. The denominator of MM rate is 100,000 women in the reproductive age group of 15-49 years. This denominator is unreliable as it includes women who are infertile, unmarried, spinsters and widow and are not related to fertility. The MM rate covers deaths from conception till birth of the child. Hence, the deaths due to complications during pregnancy and abortions are accounted here. Similarly, the MM ratio covers deaths during births till 42 days after delivery. Two-thirds of all maternal deaths take place during intra natal care (INC) and post-natal care (PNC) and especially during PNC. The denominator of MM ratio is 100,000 live births (LB). This is a reliable denominator as we can track the child as well as the mother. Hence in policy making MM ratio is used but not MM rate but both indicators have to be reduced. The article in its conclusion mentions the future steps that are or will be taken up by the Government of Uttar Pradesh.

A public health stalwart who advanced hygiene, equity, education and service through action in rural India: Sant Gadge Maharaj

Umesh G. Kawalkar, Abhay Gaidhane, Amar P. Mankar, Priti Kogade, Sumit Aggarwal — Fri, 30 Oct 2026 00:00:00 +0000

Sant Gadge Maharaj, also known as Gadge Baba, was one of Maharashtra’s most influential saint-reformers and an early advocate of cleanliness, social equality, education, and service to vulnerable populations. Born into a socially and economically marginalized family in rural Maharashtra, he rejected ritualism, caste discrimination, superstition, and extravagant religious practices. Instead, he promoted a practical philosophy centred on cleanliness, compassion, education, dignity of labour, and collective responsibility. His distinctive method was to clean village roads, drains, and public spaces before beginning his kirtan or public discourse. By combining personal example with culturally familiar communication, he sought to reframe sanitation from a stigmatized occupation into a shared civic and moral responsibility. Although he worked before the development of modern health-promotion frameworks, his approach anticipated several contemporary principles: community participation, behaviour-change communication, social inclusion, health literacy, intersectoral action, and local ownership. His legacy was institutionalized through the Sant Gadge Baba Gram Swachhata Abhiyan, implemented by the Government of Maharashtra from 2000-2001. This article examines Gadge Maharaj’s life and methods through a public-health perspective and discusses their relevance to present-day sanitation programmes, including the Swachh Bharat Mission and Sustainable Development Goal 6. His example demonstrates that sustainable public-health improvement requires infrastructure to be accompanied by community mobilization, social dignity, behavioural change, and visible leadership.

The label you can't read: food preservatives, consumer awareness and regulatory accountability in India – preservatives and labelling awareness in India

Venugopal Reddy I. — Fri, 30 Oct 2026 00:00:00 +0000

India's expanding processed-food market relies heavily on chemical preservatives, colourants, and other additives, yet many Indian consumers cannot reliably interpret this information on food labels, and enforcement of labeling and safety standards remains inconsistent for low-cost products. This narrative review synthesises evidence on preservatives commonly used in Indian food, associated health evidence, the regulatory and labeling framework administered by the Food Safety and Standards Authority of India (FSSAI), documented adulteration patterns, and consumer label literacy, drawing on peer-reviewed literature, FSSAI regulatory documents, Codex Alimentarius standards, and recent government and judicial records (2018–2026). Preservatives such as sodium benzoate, sulphites, nitrates/nitrites, and synthetic antioxidants and colourants are broadly recognised as safe within prescribed limits, yet excessive or combined intake has been linked to oxidative stress, endocrine and reproductive effects, and neurobehavioural changes in children. Indian surveillance data show persistently high rates of substandard and adulterated food, disproportionately affecting economically vulnerable consumers. Studies of Indian consumers show that while awareness that food labels exist is high, functional comprehension of ingredient lists, additive codes, and preservative disclosures remains low, and is strongly patterned by education, income, and urban rural residence. India's labelling regulations are comprehensive on paper, but enforcement capacity, front of pack warning systems, and public label literacy lag behind comparable jurisdictions. Strengthening preservative safety oversight, mandating simplified vernacular front-of-pack warnings, and investing in consumer health literacy programmes are identified as priority interventions to close this gap in India.

Incidence and prevalence of sickle cell trait and disease in Madhya Pradesh, with special reference to Eastern Madhya Pradesh and Singrauli district

Rajesh Kumar Vais — Fri, 30 Oct 2026 00:00:00 +0000

Madhya Pradesh carries one of the largest burdens of sickle cell disease (SCD) in India, concentrated largely among its scheduled tribe, scheduled caste, and other backward class communities. This article synthesises published epidemiological and clinical data on sickle cell trait and disease in Madhya Pradesh, with particular attention to the eastern districts of the state-including Singrauli, Sidhi, Shahdol, Rewa, and Anuppur-where tribal concentration and endogamous marriage practices sustain a high carrier frequency. Demographic data from the 2011 Census are used to contextualise the disease burden in Singrauli district, and district-level screening trends are discussed alongside the clinical and haematological profile of sickle cell anaemia (SCA) and sickle-beta thalassaemia (SBT) reported from Central India. In addition, four years (2022-2025) of institutional high-performance liquid chromatography (HPLC)-and solubility-based screening data from the Department of Pathology, District Hospital, Singrauli are presented and interpreted in light of the referral-biased, non-population-representative nature of hospital-based testing.

Exclusive breastfeeding: life’s first nectar

Fri, 30 Oct 2026 00:00:00 +0000

The current article sees the indicator of Exclusive Breast Feeding (EBF) through the National Family Health Surveys in India. It delves into the status of EBF indicator through these surveys. It focuses especially in the first 2-3 days as the Early Initiation of Breast Feeding (EIBF) indicator is crucial for the continuous milk flow in the breast of the mother. Further it moves onto the related challenges related to these indicators. At the other end the article also dwells on the benefits of these practices. Following that the article discusses the steps taken by the health systems regarding improvement in breast feeding practices. Finally, the article touches upon the modalities of the past, present & future steps regarding breastfeeding practices keeping the NFHS 6^th round data in the background.

Evolution of tuberculosis treatment: from the sanatorium era to modern short-course regimens

Kamal Tyagi, Kashish Grover, Rohit Katre — Fri, 30 Oct 2026 00:00:00 +0000

Tuberculosis (TB), which is a bacterial disease caused by Mycobacterium tuberculosis, still remains a prominent global public health challenge though it is both preventable and curable. The disease was historically managed through supportive care like the sanatorium care and collapse therapy. The treatment of TB was transformed in the antibiotic era. This was brought about by the introduction of streptomycin and the subsequent multidrug regimens. As per the World Health Organization (WHO), TB continues to affect a total of 10 million people approximately in a year, and causes 1.5 million deaths. It disproportionately poses a burden on high-incidence countries such as India. Strategies to combat TB include Directly Observed Treatment, Short-course (DOTS), the End TB Strategy, and India’s National Tuberculosis Elimination Programme (NTEP). These have markedly improved diagnosis, adherence to treatment, and subsequently outcomes. Treatment success rates are now reaching nearly 88% for drug-susceptible TB. However, the rise of extensively drug-resistant (XDR-TB) and multidrug-resistant (MDR-TB) tuberculosis poses a significant concern, necessitating the adoption of new, shorter, all-oral regimens like BPaL and BPaLM that include medications like bedaquiline and pretomanid. Recent efforts include plans to make the treatment duration shorter and develop host-directed therapies aimed at enhancing immune response. This review probes into the historical evolution and present therapeutic strategies, and emerging innovations in the management of TB.

Role of family-based support in enabling digital health literacy of the elderly in India: a comprehensive review

Rohit Kumar, Priyanka Yadav — Fri, 30 Oct 2026 00:00:00 +0000

Digital health literacy (DHL), the ability to locate, understand, evaluate, and apply online health information, is becoming increasingly important for older adults. However, many seniors, particularly those in lower-resource settings, face challenges engaging with digital health tools. Recent evidence emphasises the role of family networks as a crucial factor in enhancing elders' DHL. This review synthesises evidence from both international and Indian contexts to examine how family and social support structures enhance older adults’ access to technology, build their confidence, and strengthen their digital health competencies. It identifies key mechanisms that drive these improvements and highlights effective intervention models, such as intergenerational learning programs, which have shown measurable gains in the elderly’s digital engagement. Recognising India's unique socio-cultural landscape, the review further examines the contextual factors that influence family involvement in digital health literacy. Based on these insights, a conceptual framework and policy recommendations are proposed to be integrated within national digital health initiatives.

Ambient heat exposure and heatstroke mortality: a state-level spatio-temporal assessment

Fri, 30 Oct 2026 00:00:00 +0000

Increasing temperatures and subsequent heatwaves are significant public health issues in India. Given region-specific variations, temporal, spatial, and statistical associations between heat exposure and heat-related deaths is key to targeted adaptation and prevention measures. The current longitudinal study using secondary data analysed an unbalanced panel dataset comprising temperature indicators, heatwave days, heatwave deaths, and heatstroke mortality in India between 2013 and 2018. Temporal analyses, spatial parameters and bivariate correlations were used to assess interannual variation, risk, and the relationship between heat exposure and mortality. Fixed-effects negative binomial regression models accounted for state- and year-specific heterogeneity. Slight changes in mean temperatures nationwide and significant variations in the number of heatwave days (>37 degrees Celsius), with the highest mortality around 2015. A moderate positive association between the average number of heatwave days and mortality from heatstroke (ρ=0.55, p=0.006) was identified at the state level. Each additional heatwave day was associated with a 19% increase in heatstroke fatalities (IRR=1.19, p<0.001). The spatial heterogeneity in heatwave exposure indicates the need for state-specific heat action plans, including reducing the duration of high-temperature exposure and enhancing early warning and response networks.

Telemedicine and mobile health interventions for nutrition management in India: a scoping review

Alemtsehay E. Berega, Richa S. — Fri, 30 Oct 2026 00:00:00 +0000

Metabolic health is basis for all health, influencing energy regulation to disease prevention to hormonal balance. The rapid development of digital health technologies has transformed the approach to nutrition and diet management, providing better access to personalized counselling, diet plans, and real-time health monitoring. Nutrition consultations via telemedicine are conducted remotely via video call and chat platforms. Mobile health (mHealth) employs apps, wearable devices and SMS reminders to monitor physical activity and food consumption. This study provides an overview of the impact of telemedicine and mHealth interventions on eating behaviours, nutritional outcomes and overall health in various populations in India regarding dietary adherence, glycaemic control, weight management and implementation challenges. A review was following the guidelines for meta-analysis using PubMed, Scopus, Google Scholar and relevant official reports to select peer-reviewed studies published in the last decade. Studies assessing digital nutrition counselling, mHealth applications, remote dietary monitoring and behavioural interventions among Indian populations were included. Results suggest that mHealth and telemedicine can improve adherence to diet, glycaemic control and weight management. Real-time feedback, AI-powered meal suggestions and virtual coaching improve self-management, especially among people living with diabetes, obesity and cardiovascular diseases. But the digital divide, the limitations of technology and lack of access in resource poor settings remain huge barriers. Capacity building, enabling policies, technological advancement and improved user engagement are needed to optimize these technologies. Improvements in data security and availability can also increase the effectiveness and reach of digital nutrition interventions, especially for remote and underserved populations in India.

Seven years of Surakshit Matritva Aashwasan: a narrative review of implementation and outcomes

Raksha Yadav, Latha Venkatesan, Rajlaxmi Mundhra — Fri, 30 Oct 2026 00:00:00 +0000

The Surakshit Matritva Aashwasan (SUMAN) initiative was launched by India's Ministry of Health and Family Welfare on 10 October 2019. The major objective was to convert maternal and newborn health entitlements into an assured, zero-cost service guarantee with zero tolerance for denial of care. Databases like PubMed/MEDLINE, Scopus, Web of Science, CINAHL, Embase, DOAJ and Google Scholar were searched to carry out this narrative review. This was futher supplemented by government guidelines, Sample Registration System bulletins, and National Family Health Survey rounds three to six. All relevant data and documents published between October 2019 and September 2026 were pooled together to synthesise evidence on SUMAN's design, implementation, and outcomes. SUMAN converges existing maternal health schemes under one charter, but facility notification has proceeded unevenly. India's Maternal Mortality Ratio, already declining before SUMAN's launch (327 in 1999-2001 to 130 in 2014-16). It fell further to 97 in the year 2018-20. Institutional deliveries rose from 78.9% to 90.6% (NFHS-4 to NFHS-6). Respectful maternity care remains inconsistent. Pooled prevalence of disrespect and abuse during childbirth has been estimated between 54.5% and 85% across studies, birth companionship is merely provided despite LaQshya guidelines. Also, beneficiary awareness of SUMAN itself remains low. SUMAN represents a coherent policy architecture for assured maternal and newborn care. However, impact evaluation remains scarce, and implementation and respectful-care gaps warrant sustained monitoring and targeted research.

Emerging disease patterns among migrant workers in India: a scoping review

Soumya Soni, Abhishek Kumar, Bisma Bashir, B. R. Shamanna — Fri, 30 Oct 2026 00:00:00 +0000

Internal migrants consist of a socially disadvantaged community who work under informal and labour-intensive sectors. Due to poor working conditions, lack of health care services, and negative social determinants of health, many health-related issues can occur. This scoping review is going to examine the existing literature regarding the health of internal migrants in India. A scoping review was conducted using the PRISMA-ScR checklist. The literature was searched from 2008 to 2025 across various databases, including PubMed, Scopus, ScienceDirect, and Google Scholar, using predefined search terms on migrant workers and their health outcomes. The quantitative primary studies were included from India. The data were extracted using a pre-defined Excel sheet. The majority of the studies were based on cross-sectional studies conducted on internal migrant laborers in urban and peri-urban areas. The outcomes of these studies showed a heavy burden of occupational hazards, musculoskeletal disorders, respiratory and gastrointestinal diseases, mental disorders, risky sexual behavior, substance abuse, and vector-borne infections. Low maternal healthcare service utilization and limited access to healthcare services due to late seeking were also found. Health challenges that confront migrant laborers in India include the occupational risks they face, their living conditions, and obstacles related to accessing health care services. Occupational safety reforms, portability of health services, and policies aimed at addressing the needs of migrants within public health care are critical towards reducing health disparities.