Category: Nevin Manimala

J Family Med Prim Care. 2024 Oct;13(10):4462-4468. doi: 10.4103/jfmpc.jfmpc_283_24. Epub 2024 Oct 18.

ABSTRACT

INTRODUCTION: Undergraduate medical students often lack the soft skill of empathy which is considered as an important attribute for doctors. Hence, this study was conducted to improve the empathy skills among undergraduate students of a medical college in Kolkata.

METHODS: A quasi-experimental study was conducted in the Rural Health Training Centre of a medical college in Kolkata among the undergraduate medical students during community medicine posting. Students were assessed for baseline empathy by Jefferson’s Scale of Empathy (student’s version) (JSE-S). Baseline perception was taken from geriatric persons about the empathy level of medical undergraduates using Jefferson’s Scale of Patient’s Perception about Physician’s Empathy (JSPPE). Training module was prepared, validated and imparted. Post-training score was obtained using the scales for students as well as geriatric persons. Data were entered in MS Excel and analysed using STATA MP16.

RESULTS: Total of 93 students participated. Overall Mean ± SD of pre-score of JES-S was 102.03 ± 13.02, and post-score was 109.03 ± 14.57; the difference was found to be statistically significant (P < 0.001). With respect to JSPPE, score difference was found to be statistically significant (P < 0.001). Significant difference was present in scores between the students who prefer people-oriented specialities compared to the technology-oriented specialities (P < 0.05). Increase in mean empathy score was significantly higher among female students than their male counterparts (P = 0.01).

CONCLUSIONS: The study shows the effectiveness of training module in increasing empathy score among medical undergraduates which is the need of the hour to establish the proper building block of doctor-patient relationship.

PMID:39629439 | PMC:PMC11610830 | DOI:10.4103/jfmpc.jfmpc_283_24

J Family Med Prim Care. 2024 Oct;13(10):4678-4683. doi: 10.4103/jfmpc.jfmpc_787_24. Epub 2024 Oct 18.

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has presented an unprecedented challenge to the global healthcare system, prompting an urgent need to understand the factors influencing patient outcomes. Critical to improving treatment protocols and reducing mortality rates is an in-depth assessment of the clinical profile, laboratory findings, and management strategies employed in treating COVID-19 patients. This research provides valuable insights that could influence future therapeutic approaches and public health strategies, ultimately aiming to reduce the morbidity and mortality associated with COVID-19. The study aimed to assess mortality predictors in patients admitted to the intensive care unit (ICU) due to COVID-19.

METHODS: This study employed a retrospective approach, utilizing patient data from medical records. The collected data encompassed demographic and clinical profiles and details regarding the duration of admission and treatment. The evaluation focused on patients admitted to the ICU for COVID-19 between March 2020 and July 2021, with confirmation through real-time reverse transcriptase polymerase chain reaction (RT-PCR). Rigorous statistical analysis was conducted to compare outcomes between discharged and deceased patients.

RESULTS: The study included a total of 202 ICU patients admitted for COVID-19. Among the cases, 147 (72.8%) were males and 55 (27.2%) were females. The mean age was 58.42 years, with a standard deviation of 15.59 years. Fever (92%) emerged as the most frequently encountered symptom, followed by cough (48.5%) and dyspnea (35%). Patients with underlying comorbidities exhibited a higher susceptibility to developing a severe or critical disease. Hypertension (n = 38) was identified as the most prevalent comorbidity, followed by type 2 diabetes mellitus (n = 36). Hypertension has demonstrated a significant association with disease outcomes. Body temperature, respiratory rate, oxygen saturation, and mechanical ventilation played substantial roles in patient outcomes.

CONCLUSION: The study revealed that underlying comorbidities and complications, such as acute respiratory distress syndrome (ARDS), were linked to significantly higher mortality rates among COVID-19 patients. Abnormal laboratory parameters also exhibited significant differences in the outcomes of ICU patients.

PMID:39629435 | PMC:PMC11610858 | DOI:10.4103/jfmpc.jfmpc_787_24

J Family Med Prim Care. 2024 Oct;13(10):4208-4216. doi: 10.4103/jfmpc.jfmpc_167_24. Epub 2024 Oct 18.

ABSTRACT

INTRODUCTION: By scrutinizing the impact of job schedules, workplace culture and stress levels, our study aims to determine the prevalence of sleep disorders among various occupations and its associated factors. The findings promise to enhance the overall well-being, sleep quality and productivity in various occupational settings.

METHODS: This is an analytical cross-sectional study involving secondary data from the nationally representative Longitudinal Ageing Study in India (LASI Wave I 2017-18) of 35 Indian states and union territories with exception of Sikkim. The study included 59441 Indian volunteers who older than 45 years. Multivariable logistic regression analysis was conducted to study the association of sleep disorders among various occupations while accounting for other associated factors.

RESULTS: Prevalence of sleep disorders was higher among the females (12.66%), unemployed (13.34%), ≥ 60-yr age group (13.45%), those who lived in rural areas (12.35%), those who were illiterate (12.80%) and reported themselves to be widowed, separated or divorced (14.54%), people with no health insurance (11.74%), smokers (12.11%), without physical activity (12.67%) and also rated themselves as poor in the self-rated health status (26.77%). Alcohol consumption was not statistically significant factor for sleep disorders.

CONCLUSIONS: There is an emerging need for targeted screening, prompt detection and early management of insomnia and other sleep disorders among the high-risk groups. Provision of accessible and affordable screening tools, training skills for early diagnosis at primary care level and/or proper referral services to higher centres form the cornerstone for adequate management of sleep disorders.

PMID:39629430 | PMC:PMC11610827 | DOI:10.4103/jfmpc.jfmpc_167_24

J Family Med Prim Care. 2024 Oct;13(10):4623-4627. doi: 10.4103/jfmpc.jfmpc_425_24. Epub 2024 Oct 18.

ABSTRACT

BACKGROUND: Immunisation services does not reach over one third of urban poor children. There is clear cut difference of children completely immunised in the low as compared to high standard of living index in urban areas. This difference is more marked in low performing states like Rajasthan and this difference as compared to better performing states like Kerala. Such inter-state differentials indicate the importance of extra focus on low performing states like Rajasthan.

METHODOLOGY: A cross-sectional study was conducted among 550 children aged 12-23 months in an urban slum of a district in southern Rajasthan. Along with the immunisation coverage, determinants associated with incomplete immunisation was assessed. The child’s immunisation was ascertained using the immunisation cards/Mamta cards or in whom cards not available WHO recall method was used. The Chi-square test was used to find out statistical significance.

RESULTS: Of 550 children studied, 417 (75.8%) were fully immunised, 117 (21.3%) were partially immunised and 16 of them were non immunised (2.9%). When the determinants of incomplete immunisation were assessed, all were found statistically significant.

CONCLUSION: The present study concluded that immunisation coverage is lower than that of the target. The factors thought to have influenced immunisation such as religion, family composition, education of mother and gender of child were discovered to be statistically significant.

PMID:39629424 | PMC:PMC11610829 | DOI:10.4103/jfmpc.jfmpc_425_24

J Family Med Prim Care. 2024 Oct;13(10):4217-4224. doi: 10.4103/jfmpc.jfmpc_153_24. Epub 2024 Oct 18.

ABSTRACT

BACKGROUND: Dental care of patients with epilepsy and seizures must be performed by dentists who are familiar with these disorders. Improper training and incapability to manage medical emergencies, including epileptic seizures, may cause thoughtful consequences and legal actions. Therefore, dental students must have a proper knowledge of the disease and its consequences. They should have the ability to provide first-aid measures helping a patient experiencing an epileptic seizure in their clinics. This study aims to evaluate the first-aid knowledge and practices towards patients with epileptic seizures among the dental students in Saudi Arabia.

METHODS: A cross-sectional study was conducted targeting dental students in Saudi Arabia from 15 September 2022 to 15 December 2022 using convenience sampling. An online questionnaire was sent to the students via social media platforms for data collection. The data analysis was conducted using the Statistical Package for the Social Sciences (SPSS) version 16.0.

RESULTS: Of the 499 dental students included, 154 (30.86%) students had ever seen an epileptic patient in the clinics. About 16% of students did not know about performing cardiopulmonary resuscitation (CPR) on patients. The majority (66.5%) would call the ambulance after the patient’s seizure stops. About 82% of students prefer to call an ambulance if the patients face difficulty breathing or waking up after the seizure. More than 60% of students were taking precautions before treating an epilepsy patient. About 58.5% of the students were using local anaesthesia for an epilepsy patient. Nearly 41.9% do not have the confidence to treat an epilepsy patient. About 28.0% would swipe the vagus nerve stimulation (VNS) magnet over the left side of the chest. Of 154 students, who had ever seen epileptic patients, the majority (68.8%) refused to treat patients if they observe noncompliance with medication and follow-up among the patients who had any recent illness or seizures (16.2%).

CONCLUSION: The undergraduate dental students had an intermediate knowledge regarding epilepsy and epileptic seizure first aid. However, some students lacked the confidence to deal with the epileptic cases in their clinics. Educational campaigns on epilepsy and first-aid courses targeting dental students are highly recommended.

PMID:39629417 | PMC:PMC11610869 | DOI:10.4103/jfmpc.jfmpc_153_24

J Family Med Prim Care. 2024 Oct;13(10):4693-4698. doi: 10.4103/jfmpc.jfmpc_48_24. Epub 2024 Oct 18.

ABSTRACT

BACKGROUND: Insomnia affects both quality of life and productivity at work, and it raises the risk of other diseases, such as depression, that coexist with insomnia. Nowadays, it is highly advised to treat insomnia with behavioral and psychological therapeutic methods to ensure the quality of your sleep.

AIM: This study aimed to find the efficacy of sleep hygiene techniques in improving sleep quality and mental ability among insomnia clients.

METHODS: Self-structured questionnaires used to evaluate sleep quality and the McQuaig Mental Ability Test to test mental ability were used to collect data during the study’s six-week duration, which involved the recruitment of 50 participants using a purposive sample technique. A paired sample t-test and Pearson correlation were used for the statistical analysis.

RESULTS: Data analysis shows that sleep quality (t = 33.35) (P = 0.0000) and mental ability (t = 35.33) (P = 0.0001) are both highly significant at P =0.0001. Correlation regression data of sleep hygiene elements such as schedule, avoiding caffeine and beverages, relaxation routine, and sleep-stimulating environment shows that there is a positive correlation with the quality of sleep at r = 0.9, 0.89, 0.75, and 0.68, whereas P = 0.000, 0.01, and 0.023, respectively. Similar to this, there is a positive association between mental ability and good sleep habits such as a relaxing routine, a sleep-promoting environment, and a schedule with r = 0.91, 0.88, and 0.92, respectively, with P values of 0.0001, 0.001, and 0.001.

CONCLUSION: The results of the study provide compelling evidence that good sleep hygiene can help enhance insomniacs’ mental ability and sleep quality. Furthermore, those with moderate levels of sleep quality, those between the ages of 18 and 38, and those with higher education benefited more than others.

PMID:39629415 | PMC:PMC11610801 | DOI:10.4103/jfmpc.jfmpc_48_24

J Family Med Prim Care. 2024 Oct;13(10):4499-4504. doi: 10.4103/jfmpc.jfmpc_221_24. Epub 2024 Oct 18.

ABSTRACT

CONTEXT: Over-medicalization of normal pregnancy is associated with unnecessary inductions of labor leading to operative deliveries. In a busy outpatient department (OPD) or low-resource setup where ultrasound availability, experience, and cost will be a concern, routine ultrasound at term can be avoided if the clinical estimation of fetal weight is more or less equal to the actual birth weight.

AIMS: To assess the reliability and validity of fetal weight estimation at term by ultrasound and clinical estimation.

SETTINGS AND DESIGN: A prospective study of diagnostic accuracy was done over a period of 1.5 years in a tertiary hospital, which included 100 women with term singleton pregnancies admitted in obstetric wards or labor room.

METHODS AND MATERIAL: To find out the agreement between actual birthweight and ultrasound fetal weight interclass correlation coefficient (ICC) was used. Mean difference plots (Bland-Altman plots) were done. The mean percentage error was compared with the consultant estimate and registrar estimate across groups. The sensitivity, specificity, and predictive values by clinical and ultrasound estimate were calculated for actual birth weight ≤ 2.5 kg.

RESULTS: Both methods of fetal weight estimation have moderate reliability in predicting the actual birth weight. The sensitivity of identifying birthweight < 2.5 kg babies by ultrasound was slightly higher. For birth weight less than 2.5 kg, there was an overestimation of fetal weight by clinical estimation done by postgraduate with mean percentage error being statistically significant as compared with ultrasound estimation.

CONCLUSIONS: In a developing country like ours where ultrasound is not readily available in all healthcare setups, the clinical method is an easy, cost-effective, simple one that can be used by all medical professionals after adequate training.

PMID:39629413 | PMC:PMC11610859 | DOI:10.4103/jfmpc.jfmpc_221_24

J Family Med Prim Care. 2024 Oct;13(10):4569-4574. doi: 10.4103/jfmpc.jfmpc_409_24. Epub 2024 Oct 18.

ABSTRACT

BACKGROUND: Recurrent pregnancy loss (RPL) is a common problem affecting many women. This study aimed to investigate the baseline characteristics of 400 women with RPL and to examine any differences in baseline characteristics of the recruited women with RPL throughout the years.

METHODS: This study used retrospective data, which included the records of patients with RPL who visited King Khalid University Hospital’s obstetric clinic between 2019 and 2022. The records of 400 patients who met the inclusion criteria were reviewed and analyzed.

RESULTS: The mean age of enrolled women was 36.5 ± 5.4 years, and the mean RPL was 3.8 ± 2.5. The study also revealed that there were significant statistical differences in obesity and vitamin D deficiency among women with RPL based on year (P = 0.013 and P = 0.036, respectively), whereas no significant statistical differences were found between women with RPL in terms of age, parity, diabetes, hypothyroidism, hyperprolactinemia, antiphospholipid antibodies (APLs), uterine malformation, or consanguinity.

CONCLUSION: Advanced maternal age, number of previous miscarriages, parity, diabetes, hypothyroidism, APLs, uterine malformations, first-degree consanguinity, and vitamin D deficiency were found to be significant risk factors associated with RPL among women in Saudi Arabia.

PMID:39629412 | PMC:PMC11610887 | DOI:10.4103/jfmpc.jfmpc_409_24

J Family Med Prim Care. 2024 Oct;13(10):4539-4544. doi: 10.4103/jfmpc.jfmpc_91_24. Epub 2024 Oct 18.

ABSTRACT

INTRODUCTION: Water, sanitation, and hygiene (WASH)-related infectious diseases contribute to approximately 5% of the global disease burden. Despite sanitation being a human right, 673 million people worldwide had limited access to toilets. To tackle the same, Swachh Bharat Mission-Gramin (SBM-G) was launched in 2014 to facilitate the construction of over 100 million individual household latrines (IHHLs) across India. However, literature evidence on acceptance of SBM-G in Tamil Nadu, particularly in Coimbatore, is scarce.

OBJECTIVES: The primary objective was to investigate the utilisation of the SBM-G scheme and its associated factors in rural Coimbatore.

MATERIALS AND METHODS: In 2022, a mixed-methods study incorporating quantitative (using a purpose-designed questionnaire) and qualitative (using in-depth interviews and focus group discussions) components was conducted among 60 SBM-G beneficiaries in Kovai Medical Center and Hospital Institute of Health Sciences and Research (KMCH IHSR)’s rural field practice area. Quantitative data were analysed using Statistical Package for the Social Sciences (SPSS) v23 and qualitative data using manual thematic content analysis.

RESULTS: Before IHHL construction, 93.7% of respondents practiced open-air defecation (OAD). The issues perceived with OAD were distance (28.8%) and privacy concerns (12.5%). After SBM-G implementation, 78.3% reported using the IHHL ‘all the time’, reflecting a substantial shift in behaviour. Most respondents received financial aid within about six months (INR 8,000), often in a single instalment. The majority had constructed their IHHLs before 2015. The expenditures incurred varied significantly, with 58.3% spending extra costs ranging between INR 10,000 and 30,000. Water supply to households significantly influenced IHHL usage.

CONCLUSION: While rural villagers appreciate the SBM-G financial assistance for IHHLs, concerns about the inadequacy of the sanctioned amount for proper piped water supply and septic tanks persist. Nonetheless, there is a clear demonstration of positive behavioural change, marked by reduced OAD and increased IHHL usage.

PMID:39629408 | PMC:PMC11610852 | DOI:10.4103/jfmpc.jfmpc_91_24

J Family Med Prim Care. 2024 Oct;13(10):4560-4568. doi: 10.4103/jfmpc.jfmpc_63_24. Epub 2024 Oct 18.

ABSTRACT

INTRODUCTION: Globally, road traffic injuries (RTIs) are the eighth leading cause of death, with an estimated 1.35 million deaths yearly. In India, road traffic accidents (RTAs) are one of the major causes of mortality among the younger generation. We analyzed Tamil Nadu’s comprehensive Road Accident Data Management System (RADMS) data and described the epidemiological indicators of RTI in this setting.

METHODS: We obtained the data from the RADMS database for 2011-2016 and used 2011 population census data to project and standardize for different age groups and genders to calculate incidence. We calculated average annual percentage changes (AAPC) with a 95% confidence interval for the whole period. We computed Joinpoint regression analysis for trends and calculated the age-adjusted incidence rate with standard error (SE) using R statistical computing software.

RESULTS: We included 3,67,094 RTAs and 5,50,447 RTIs. We observed that the incidence of RTAs and RTIs declined between 2011 and 2016. Most injured were males (82%) and aged 20-39 years (49%). The highest number of accidents occurred on the state highways (65.2%) and on Sundays (17%). Age-adjusted incidence (per 1,00,000) declined from 121.87 (SE 0.4) in 2011 to 92.73 (SE 0.34) in 2016 (AAPC = -4.5% (95% CI = -7.8 to -1)). The age groups 30-39 and 20-29 were 9.82 (z = 8.98; P < 0.05) and 9.02 (z = 8.65; P < 0.05) times at a higher risk compared to 0-9 years old. The motorcyclists (14-27 times; P < 0.05) and pedestrians (12-23 times; P < 0.05) had the maximum risk of RTIs.

CONCLUSION: Young adults, drivers, motorcyclists, and pedestrians remain vulnerable populations for RTIs. More accidents occurred in the state highways and on Sundays. The analysis provides insights on RTIs and RTAs, which will be used to reduce the burden of RTIs and save millions of lives.

PMID:39629407 | PMC:PMC11610803 | DOI:10.4103/jfmpc.jfmpc_63_24