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The ultrasound identification of fetal gender at the gestational age of 11–12 weeks
Farideh Gharekhanloo
January-February 2018, 7(1):210-212
DOI:10.4103/jfmpc.jfmpc_180_17  PMID:29915761
Introduction: The early prenatal identification of fetal gender is of great importance. Accurate prenatal identification is currently only possible through invasive procedures. The present study was conducted to determine the accuracy and sensitivity of ultrasound fetal gender identification. Materials and Methods: The present cross-sectional study was conducted on 150 women in their 11th and 12th weeks of pregnancy in Hamadan in 2014. Ultrasound imaging performed in the 11th and 12th weeks of pregnancy for fetal gender identification identified the fetus either as a girl, a boy, or as a “gender not assigned.” Frequency, sensitivity, specificity, positive and negative predictive values, and accuracy of the gender identification was assessed using SPSS version 20. The significant level was 0.05 in all analyses. Results: Of the total of 150 women, the gender was identified as female in 32 (21.3%), as male in 65 (43.3%), and not assigned in 53 (35.3%); overall, gender identification was made in 64.6% of the cases. A total of 57 male fetuses were correctly identified as boys, and 8 female fetuses were wrongly identified as boys. As for the female fetuses, 31 were correctly identified as girls, and 1 was wrongly identified as a boy. The positive predictive value for the ultrasound imaging gender identification was 87.6% for the male fetuses and 96.8% for the female fetuses. Conclusion: The present study had a much higher gender identification accuracy compared to other studies. The final success of fetal gender identification was about 91% in the 11th and 12th weeks of pregnancy.
  671,748 1,937 1
Childhood obesity: causes and consequences
Krushnapriya Sahoo, Bishnupriya Sahoo, Ashok Kumar Choudhury, Nighat Yasin Sofi, Raman Kumar, Ajeet Singh Bhadoria
April-June 2015, 4(2):187-192
DOI:10.4103/2249-4863.154628  PMID:25949965
Childhood obesity has reached epidemic levels in developed as well as in developing countries. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. Overweight and obese children are likely to stay obese into adulthood and more likely to develop non-communicable diseases like diabetes and cardiovascular diseases at a younger age. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Childhood obesity can profoundly affect children's physical health, social, and emotional well-being, and self esteem. It is also associated with poor academic performance and a lower quality of life experienced by the child. Many co-morbid conditions like metabolic, cardiovascular, orthopedic, neurological, hepatic, pulmonary, and renal disorders are also seen in association with childhood obesity.
  88,419 10,865 456
Importance of effective communication during COVID-19 infodemic
B Venkatashiva Reddy, Arti Gupta
August 2020, 9(8):3793-3796
The impact of COVID-19 on vulnerable groups would rely in part on the quality of communication regarding health risk and danger. Strategic planning should take full account of the way life conditions, cultural values, and risk experience affect actions during a pandemic. Concept of information education communication, Social behaviour change communication, social marketing usually technology and media is recapitulation. Ignorance with sociocultural, economic, psychological, and health factors can jeopardize effective communication at all levels. We summarized the framework for effective communication during pandemic. Understanding and practicing various communication strategies is crucial for physicians and health care workers to develop therapeutic relationships with COVID-19 patients. Addressing psychology in all people is vital during a pandemic and effective communication network is key to it. Effective communication, if ignored, will generate gaps for vulnerable populations and result in added difficulty in combating COVID-19 pandemic.
  82,072 2,554 10
Validity, reliability, and generalizability in qualitative research
Lawrence Leung
July-September 2015, 4(3):324-327
DOI:10.4103/2249-4863.161306  PMID:26288766
In general practice, qualitative research contributes as significantly as quantitative research, in particular regarding psycho-social aspects of patient-care, health services provision, policy setting, and health administrations. In contrast to quantitative research, qualitative research as a whole has been constantly critiqued, if not disparaged, by the lack of consensus for assessing its quality and robustness. This article illustrates with five published studies how qualitative research can impact and reshape the discipline of primary care, spiraling out from clinic-based health screening to community-based disease monitoring, evaluation of out-of-hours triage services to provincial psychiatric care pathways model and finally, national legislation of core measures for children's healthcare insurance. Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are then addressed with an update on the current views and controversies.
  56,517 10,687 225
Socioeconomic status scales-modified Kuppuswamy and Udai Pareekh's scale updated for 2019
Rabbanie Tariq Wani
June 2019, 8(6):1846-1849
DOI:10.4103/jfmpc.jfmpc_288_19  PMID:31334143
Socioeconomic status (SES) is one of the prime factors influencing the health status of a nation. It is the measure of the social standing of the individual or a family and has a wide impact on an individual/family's health, educational attainment, diet, lifestyle, etc., The per capita income of citizens is a major factor that decides the SES of the population. The affordability and utilization of the health facilities depend on the socioeconomic profile of the population. The periodic changes in the consumer price of goods globally as well as nationally due to inflation warrants that it is mandatory to constantly update the income-based socioeconomic scales so as the assessment is made correctly in practice. We are making an attempt to provide an updated Kuppuswamy and Udai Pareekh's socioeconomic scales for 2019.
  49,580 3,575 47
Prediction of ease of laryngoscopy and intubation-role of upper lip bite test, modified mallampati classification, and thyromental distance in various combination
Anjana S Wajekar, Shrividya Chellam, Pratibha V Toal
January-March 2015, 4(1):101-105
DOI:10.4103/2249-4863.152264  PMID:25810998
Background: The incidence of difficult intubation in patients undergoing general anaesthesia is estimated to be approximately 1-18% whereas that of failure to intubate is 0.05-0.35%.1,2,3 Various methods have been used for prediction of difficult laryngoscopy. Although, upper lip bite has been shown to be a promising test in its introductory article, repeated validation in various populations is required for any test to be accepted as a routine test. We have compared upper lip bite test (ULBT), modified Mallampati test (MMC) and thyromental distance (TMD) individually and in various combinations to verify which of these predictor tests are significantly associated with difficult glottic exposure. Methods: After obtaining institutional ethics committee approval, 402 ASA I and II adult patients undergoing elective surgical procedures requiring endotracheal intubation were included. All the three test were performed in all the patients preoperatively and their glottic exposure was recorded by Cormack-Lehane classification during intubation. Sensitivity, specificity, positive predictive value and negative predictive value were used for comparison. Results: In our study, the incidence of difficult laryngoscopy was 11.4% and failure to intubate 0.49%. None of the three are a suitable predictive test when used alone. Combination of tests added incremental diagnostic value. Conclusion: We conclude that all three screening tests for difficult intubation have only poor to moderate discriminative power when used alone. Combinations of individual tests add some incremental diagnostic value.
  41,230 467 10
Attitudes, beliefs, and self-use of Kabasura Kudineer among urban and rural population in Tamil Nadu, India: A comparative cross-sectional study
Dharani Bala
January 2021, 10(1):158-166
Context: During an earlier outbreak of dengue (DENV), chikungunya (CHIKV) and swine flu in Tamil Nadu, India, Kabasura Kudineer and Nilavembu Kudineer were used to control the febrile episodes. No research is conducted in the past to understand the attitude and beliefs of people towards using Kabasura Kudineer as a means to improve immunity in people, especially in Tamil Nadu, the birthplace of Siddha medicine which led the researcher to conduct the study. Aims: The researcher in the present paper aims to understand the attitude, belief and self-use of Kabasura Kudineer among people in Tamil Nadu, India. Settings and Design: A cross-sectional questionnaire survey was conducted among various people in Tamilnadu, India wherein data was collected from 200 participants. Methods and Material: A cross-sectional study involving explanatory/descriptive research design was considered for the study. Statistical Analysis Used: For the analysis of collected data statistical package for SPSS software version 25.0 was used. Results: The urban participants who participated in the study were 80.5% and the rural participants were 19.5%. The significant P value (0.002) indicated that people use kabasura kudineer because allopathic medicine is less effective medicine and the significant P value (0.001) shows that kabasura kudineer is taken as a self-medication among Tamil Nadu people. Conclusions: The findings of the study revealed the better empowerment of people in the select region towards the use of Kabasura Kudineer.
  36,543 325 -
Systematic reviews and meta-analysis: Understanding the best evidence in primary healthcare
S Gopalakrishnan, P Ganeshkumar
January-March 2013, 2(1):9-14
DOI:10.4103/2249-4863.109934  PMID:24479036
Healthcare decisions for individual patients and for public health policies should be informed by the best available research evidence. The practice of evidence-based medicine is the integration of individual clinical expertise with the best available external clinical evidence from systematic research and patient's values and expectations. Primary care physicians need evidence for both clinical practice and for public health decision making. The evidence comes from good reviews which is a state-of-the-art synthesis of current evidence on a given research question. Given the explosion of medical literature, and the fact that time is always scarce, review articles play a vital role in decision making in evidence-based medical practice. Given that most clinicians and public health professionals do not have the time to track down all the original articles, critically read them, and obtain the evidence they need for their questions, systematic reviews and clinical practice guidelines may be their best source of evidence. Systematic reviews aim to identify, evaluate, and summarize the findings of all relevant individual studies over a health-related issue, thereby making the available evidence more accessible to decision makers. The objective of this article is to introduce the primary care physicians about the concept of systematic reviews and meta-analysis, outlining why they are important, describing their methods and terminologies used, and thereby helping them with the skills to recognize and understand a reliable review which will be helpful for their day-to-day clinical practice and research activities.
  26,339 6,473 143
Internet addiction and psychological well-being among college students: A cross-sectional study from Central India
Arvind Sharma, Richa Sharma
January-February 2018, 7(1):147-151
DOI:10.4103/jfmpc.jfmpc_189_17  PMID:29915749
Background: Internet provides tremendous educational benefits for college students and also provided better opportunities for communication, information, and social interaction for young adults; however, excessive internet use can lead to negative psychological well-being (PWB). Objective: The present study was conducted with the objective to find out the relationship between internet addiction and PWB of college students. Materials and Methods: A multicenter cross-sectional study was carried out in college students of Jabalpur city of Madhya Pradesh, India. A total of 461 college students, using internet for at least past 6 months were included in this study. Young's Internet addiction scale, consisting of 20-item, based on five-point Likert scale was used to calculate internet addiction scores and 42-item version of the Ryff's PWB scale based on six-point scale was used in this study. Results: A total of 440 questionnaire forms were analyzed. The mean age of students was 19.11 (±1.540) years, and 62.3% were male. Internet addiction was significantly negatively correlated to PWB (r = –0.572, P < 0.01) and subdimensions of PWB. Students with higher levels of internet addiction are more likely to be low in PWB. Simple linear regression showed that internet addiction was a significant negative predictor of PWB. Conclusion: PWB of college students negatively affected by internet addiction. Hence, it is essential to develop strategies for prevention of internet addiction which is very important for promoting PWB of college students.
  26,246 5,249 13
Innovative mental health initiatives in India: A scope for strengthening primary healthcare services
Apurvakumar Pandya, Komal Shah, Ajay Chauhan, Somen Saha
February 2020, 9(2):502-507
Mental health burden is a major health concern worldwide. In the last few decades, we are witnessing innovations that are successfully addressing gaps in the mental health service delivery in Indian context. This is an opportune time to explore existing innovative mental health initiatives in the country and integrate viable interventions to primary healthcare facilities to strengthen public mental healthcare delivery. The descriptive review of literature on innovative mental health programs in India was carried out. The initial search from google scholar and PubMed database yielded 1152 articles, of which 1114 were excluded that did not meet inclusion criteria. Full texts of 38 articles were reviewed and finally 22 studies were included for the study. Based on the review, most innovations are broadly summarized into five categories: (1) quality improvement mental health programs; (2) community-based mental health programs; 3) non-specialist mental health programs, 4) mobile-technology based mental health programs, 5) tele-mental health programs. These promising innovations in treatment and care can be customized as per the context for scale up and integrated into the primary healthcare system through District Mental Health Programme.The innovative approach not only makes mental health services more accessible and affordable but also empowering in nature by encouraging community members in early detection, prevention of mental illness and appropriate treatment referral to existing primary health care services.
  30,203 946 4
India achieves WHO recommended doctor population ratio: A call for paradigm shift in public health discourse!
Raman Kumar, Ranabir Pal
September-October 2018, 7(5):841-844
DOI:10.4103/jfmpc.jfmpc_218_18  PMID:30598921
The Indian medical education system has been able to pull through a major turnaround and has been successfully able to double the numbers of MBBS graduate (modern medicine training) positions during recent decades. With more than 479 medical schools, India has reached the capacity of an annual intake of 67,218 MBBS students at medical colleges regulated by the Medical Council of India. Additionally, India produces medical graduates in the “traditional Indian system of medicine,” regulated through Central Council for Indian Medicine. Considering the number of registered medical practitioners of both modern medicine (MBBS) and traditional medicine (AYUSH), India has already achieved the World Health Organization recommended doctor to population ratio of 1:1,000 the “Golden Finishing Line” in the year 2018 by most conservative estimates. It is indeed a matter of jubilation and celebration! Now, the time has come to critically analyze the whole premise of doctor–population ratio and its value. Public health experts and policy makers now need to move forward from the fixation and excuse of scarcity of doctors. There is an urgent need to focus on augmenting the fiscal capacity as well as development of infrastructure both in public and private health sectors toward addressing pressing healthcare needs of the growing population. It is also an opportunity to call for change in the public health discourse in India in the background of aspirations of attaining sustainable development goals by 2030.
  28,054 918 -
The leadership crisis of medical profession in India: ongoing impact on the health system
Raman Kumar
April-June 2015, 4(2):159-161
DOI:10.4103/2249-4863.154621  PMID:25949958
By 2030 India will have one million additional MBBS doctors; currently being produced @50,000 per year. Contrary to perception of scarcity of medical doctors, a large section of newly qualified physicians are spending considerable years in dysfunctional status due to mismanagement in human resource in health in India. There are very few employment opportunities for qualified doctors in public sector; at the same time the average salary of MBBS doctors in urban private hospitals is very low. Paradoxically, in a country of 1.3 billion populations there is no actual demand for medical professionals. While the popular perception is that young doctors are not willing for community service, a reality check is required on the count of intent and capacity of public sector as well as industry towards engagement of medical doctors in the process of service delivery. The visible leaders of medical profession are unable to reflect the ground reality. There is a leadership crisis among medical doctors in India.
  25,428 952 2
Short Term Home Oxygen Therapy for COVID-19 patients: The COVID-HOT algorithm
Indrani Sardesai, Joydeep Grover, Manish Garg, P W B Nanayakkara, Salvatore Di Somma, Lorenzo Paladino, Harry L Anderson III, David Gaieski, Sagar C Galwankar, Stanislaw P Stawicki
July 2020, 9(7):3209-3219
Innovative solutions are required to effectively address the unprecedented surge of demand on our healthcare systems created by the COVID-19 pandemic. Home treatment and monitoring of patients who are asymptomatic or mildly symptomatic can be readily implemented to ameliorate the health system burden while maintaining safety and effectiveness of care. Such endeavor requires careful triage and coordination, telemedicine and technology support, workforce and education, as well as robust infrastructure. In the understandable paucity of evidence-based, protocolized approaches toward HOT for COVID-19 patients, our group has created the current document based on the cumulative experience of members of the Joint ACAIM-WACEM COVID-19 Clinical Management Taskforce. Utilizing available evidence-based resources and extensive front-line experience, the authors have suggested a pragmatic pathway for providing safe and effective home oxygen therapy in the community setting.
  24,974 972 3
Comparison of sensitivity, specificity, and accuracy of Wilson's score and intubation prediction score for prediction of difficult airway in an eastern Indian population—A prospective single-blind study
Sri Vidhya, Brahmanand Sharma, Bhanu P Swain, UK Singh
March 2020, 9(3):1436-1441
Introduction: Unidentified difficult airway leads to significant adverse events and therefore prediction of a difficult airway is of importance. Independent bedside tests for the prediction of a difficult airway have poor accuracy. The airway assessment scores have not gained popularity as they are cumbersome to perform at the bedside. They also have a varying degree of interobserver variability because of their subjective parameters. Therefore, there is a need to search for a simple score with objective parameters that can be performed at the bedside. Aim: To determine the diagnostic accuracy of the Wilson score andiIntubation prediction score for predicting difficult airway in the Eastern Indian population. Material and Method: A prospective single-blind study was done including 150 consecutive patients, ASA grade I and II between the ages of 18 and 70 years, undergoing surgery requiring general anesthesia with endotracheal intubation. Preoperatively, the airway was assessed in all patients using Wilson Score and Intubation Prediction Score. General anesthesia with endotracheal intubation was done in all patients. The airway was assessed for ease laryngoscopy and intubation using the Intubation Difficulty Scale. An IDS >5 was taken as difficult airway. The sensitivity, specificity, PPV, NPV, and accuracy of the two predictive tests to predict a difficult was calculated. Results: The sensitivity, positive predictive value and accuracy of Intubation Prediction Score was 77.8%, 58.3%and 90.7% respectively as compared to 38.9%, 25.95% and 78.33% respectively of Wilsons score. Conclusion: Intubation Prediction score with its objective parameters can be preferred as a simple and accurate bedside test to predict a difficult airway in an Eastern Indian population.
  22,995 185 1
The family and family structure classification redefined for the current times
Rahul Sharma
October-December 2013, 2(4):306-310
The family is a basic unit of study in many medical and social science disciplines. Definitions of family have varied from country to country, and also within country. Because of this and the changing realities of the current times, there is a felt need for redefining the family and the common family structure types, for the purpose of study of the family as a factor in health and other variables of interest. A redefinition of a ''family'' has been proposed and various nuances of the definition are also discussed in detail. A classification scheme for the various types of family has also been put forward. A few exceptional case scenarios have been envisaged and their classification as per the new scheme is discussed, in a bid to clarify the classification scheme further. The proposed scheme should prove to be of use across various countries and cultures, for broadly classifying the family structure. The unique scenarios of particular cultures can be taken into account by defining region or culture-specific subtypes of the overall types of family structure.
  19,052 3,752 11
Disability and rehabilitation services in India: Issues and challenges
S Ganesh Kumar, Gautam Roy, Sitanshu Sekhar Kar
January-June 2012, 1(1):69-73
DOI:10.4103/2249-4863.94458  PMID:24479007
Disability is an important public health problem especially in developing countries like India. The problem will increase in future because of increase in trend of non-communicable diseases and change in age structure with an increase in life expectancy. The issues are different in developed and developing countries, and rehabilitation measures should be targeted according the needs of the disabled with community participation. In India, a majority of the disabled resides in rural areas where accessibility, availability, and utilization of rehabilitation services and its cost-effectiveness are the major issues to be considered. Research on disability burden, appropriate intervention strategies and their implementation to the present context in India is a big challenge. Recent data was collected from Medline and various other sources and analyzed. The paper discusses various issues and challenges related to disability and rehabilitation services in India and emphasize to strengthen health care and service delivery to disabled in the community.
  20,405 2,281 23
Selfies: A boon or bane?
Agam Bansal, Chandan Garg, Abhijith Pakhare, Samiksha Gupta
July-August 2018, 7(4):828-831
DOI:10.4103/jfmpc.jfmpc_109_18  PMID:30234062
Background: Selfie deaths have become an emerging problem and we performed this study to assess the epidemiology of selfie-related deaths across the globe. Subject and Methods: We performed a comprehensive search for keywords such as “selfie deaths; selfie accidents; selfie mortality; self photography deaths; koolfie deaths; mobile death/accidents” from news reports to gather information regarding selfie deaths. Results: From October 2011 to November 2017, there have been 259 deaths while clicking selfies in 137 incidents. The mean age was 22.94 years. About 72.5% of the total deaths occurred in males and 27.5% in females. The highest number of incidents and selfie-deaths has been reported in India followed by Russia, United States, and Pakistan. Drowning, transport, and fall form the topmost reasons for deaths caused by selfies. We also classified reasons for deaths due to selfie as risky behavior or non-risky behavior. Risky behavior caused more deaths and incidents due to selfies than non-risky behavior. The number of deaths in females is less due to risky behavior than non-risky behavior while it is approximately three times in males. Conclusion: “No selfie zones” areas should be declared across tourist areas especially places such as water bodies, mountain peaks, and over tall buildings to decrease the incidence of selfie-related deaths.
  18,499 1,252 12
Socio-economic impact of coronavirus disease 2019 (COVID-19) – An Indian outlook
Dinesh Dhamodhar Mathevan Pillai, Nagappan Nagappan, Sekar Veena Dharani, Kalaivani Subramanian, Bharath Champakesan, Thomson Maridasan D'Cruz
October 2020, 9(10):5103-5106
It took only days to a few months, for the coronavirus to spread across the globe from it's place of origin, Wuhan city, China. Though, India is not among the worst affected countries of coronavirus, it is still a major Public Health emergency which pose a serious threat of crippling the nation's economy. A densely populated country like India, cannot afford getting it's population infected with coronavirus, as that will have an enormous strain in existing healthcare facilities. Although the government of India has implemented complete lockdown, there are many economic concerns to be addressed. Even though, relief fund was announced, the nation's huge population could use additional financial support, to take care of their essential needs like groceries, provisions and medicines. The livelihood, employment and income of many citizens remains questionable. This article attempts to give a socio-economic perspective of the coronavirus pandemic in India.
  18,982 604 2
Asian BMI criteria are better than WHO criteria in predicting Hypertension: A cross-sectional study from rural India
Madhur Verma, Meena Rajput, Kamal Kishore, Soundappan Kathirvel
June 2019, 8(6):2095-2100
DOI:10.4103/jfmpc.jfmpc_257_19  PMID:31334186
Background: International Obesity Task Force proposed lower body mass index (BMI) cut-off values for defining overweight and obesity in Asian population. However, there is an absence of unanimity regarding the definition of overweight and obesity that is confusing while estimating disease burden, resource allocation, and priority setting. Therefore, the primary aim of the study was to assess the prevalence of overweight and obesity and its predictors as per different criteria (WHO criteria, Modified Asian criteria of BMI classification and BF% estimation by bioelectric impedance analysis technique). The secondary aim was to assess the concordance of overweight and obesity as diagnosed using these three methods. Methodology: A community-based cross-sectional study was conducted in a rural area of Rohtak, north India over a period of 1 year with a sample size of 1080. Anthropometric measurements including height, weight, blood pressure, body fat % analysis were recorded using standard protocols. Results: The prevalence of overweight and obesity were observed to be 49.62% (N = 536) as per the modified criteria for the Asian Indians (BMI ≥23 kg/m2) and 34.62% (N = 374) according to WHO criteria (BMI ≥25 kg/m2). A total of 18.3% of the study population were hypertensive. Modified criteria of BMI classification for Asian Indians had high sensitivity (67%) as compared to WHO criteria (55%) in predicting, diagnosing hypertension, and resembled sensitivity estimate obtained through direct body fat percentage estimation (69%). Conclusion: Modified criteria of overweight and obesity classification are better in terms of reducing comorbid dysmetabolic conditions, as exemplified by hypertension.
  18,071 981 5
Overview of artificial intelligence in medicine
Amisha , Paras Malik, Monika Pathania, Vyas Kumar Rathaur
July 2019, 8(7):2328-2331
DOI:10.4103/jfmpc.jfmpc_440_19  PMID:31463251
Background: Artificial intelligence (AI) is the term used to describe the use of computers and technology to simulate intelligent behavior and critical thinking comparable to a human being. John McCarthy first described the term AI in 1956 as the science and engineering of making intelligent machines. Objective: This descriptive article gives a broad overview of AI in medicine, dealing with the terms and concepts as well as the current and future applications of AI. It aims to develop knowledge and familiarity of AI among primary care physicians. Materials and Methods: PubMed and Google searches were performed using the key words 'artificial intelligence'. Further references were obtained by cross-referencing the key articles. Results: Recent advances in AI technology and its current applications in the field of medicine have been discussed in detail. Conclusions: AI promises to change the practice of medicine in hitherto unknown ways, but many of its practical applications are still in their infancy and need to be explored and developed better. Medical professionals also need to understand and acclimatize themselves with these advances for better healthcare delivery to the masses.
  14,086 2,802 44
Family medicine at AIIMS (all India institute of medical sciences) like institutes
Raman Kumar
July-December 2012, 1(2):81-83
DOI:10.4103/2249-4863.104925  PMID:24479011
  6,248 9,897 2
Biopsychosocial model of illnesses in primary care: A hermeneutic literature review
Hari Kusnanto, Dwi Agustian, Dany Hilmanto
May-June 2018, 7(3):497-500
DOI:10.4103/jfmpc.jfmpc_145_17  PMID:30112296
Biopsychosocial model is a useful worldview for primary care or family doctors. However, it is often considered as impractical or too complicated. The objective of this study is to review the implementation of the biopsychosocial model in clinical practice, and its contributions to clinical outcomes. Hermeneutic circle literature review was conducted to provide experiential learning in an attempt to understand biopscyhosocial model, first developed by George Engel. Literature search started with review articles in Medline and Scopus as search engines. Citations from previous articles, editorials, and research articles were identified and interpreted in the context of the knowledge derived from all identified relevant articles. The progress of biopsychosocial model has been slow, and primary care doctors do not implement biopsychosocial medicine in their practice, while biomedical thinking and approach are still the dominant model. Biopsychosocial research addressed chronic illnesses and functional disorders as conditions in need for biopsychosocial model implementation. As payment scheme, clinical guidelines and clinical performance indicators are biomedically oriented, there is no incentive for primary care doctors to adopt biopsychosocial model in their practice. Workload and lack of competence in primary care may hinder the implementation of biopsychosocial model. Biopsychosocial model helps primary care doctors to understand interactions among biological and psychosocial components of illnesses to improve the dyadic relationship between clinicians and their patients and multidisciplinary approaches in patient care. Biopsychosocial model potentially improves clinical outcomes for chronic diseases and functional illnesses seen in primary care.
  14,092 2,022 13
Psychological impact of the COVID-19 pandemic on healthcare workers in India: An observational study
Rachna Raj, Soujanya Koyalada, Amit Kumar, Stuti Kumari, Pooja Pani, Nishant , Kishore Kumar Singh
Dec 2020, 9(12):5921-5926
Background: The World Health Organization (WHO) in January 2020 declared outbreak of novel coronavirus disease, COVID-19, an international public health emergency. It was stated that there was high COVID-19 spread risk to various other countries across world. According to WHO in March 2020, COVID-19 was characterized as pandemic. However, this sudden crisis is generating great deal of stress, anxiety, and depression throughout the world. Aim: The aim of this study was to assess the psychological impact and various associated factors during the developing COVID-19 situation among both the healthcare and non-healthcare working professionals in India. Materials and Methods: This was an observation-based cross-sectional study conducted during the lockdown period and following the lifting of the lockdown for a total of 3 months duration. A structured questionnaire was send via the (email) electronic mail system to a target population of 350 people. Out of which 300 responded. The questionnaire was comprised of study variables: (a) Gender; (b) age-group range which was categorized into- (i) Between 30 snf 50 years and (ii) More than 50 years; (c) Presence of any comorbid medical condition; psychological symptoms of- (d) insomnia; (e) anxiety; and (f) depression. Statistical analysis was performed using the Chi-square test for determining significance. Results: Mean ± SD values for age were found to be 35.54 ± 6.09; 33.84 ± 7.87; 32.16 ± 5.89 and 55.76 ± 8.98 for physicians, nurses, technical staff, and non-healthcare professionals while the percentages of male study participants was found to be 37.2%, 15%, 57%, and 65% and female study participants was 62.8%, 85%, 43%, and 35% for the physicians, nursing staff, technicians, and non-healthcare professionals. Depression, insomnia, and anxiety between healthcare and non-healthcare professional workers, demonstrated significant P values of 0.05, 0.03, and 0.02, respectively. Conclusion: The present study has shown a significant psychological impact arising from this crisis.
  14,760 1,069 2
Menstruation related myths in India: strategies for combating it
Suneela Garg, Tanu Anand
April-June 2015, 4(2):184-186
DOI:10.4103/2249-4863.154627  PMID:25949964
Menstruation is a phenomenon unique to girls. However, it has always been surrounded by taboos and myths that exclude women from many aspects of socio-cultural life. In India, the topic has been a taboo until date. Such taboos about menstruation present in many societies impact on girls' and women's emotional state, mentality and lifestyle and most importantly, health. The challenge, of addressing the socio-cultural taboos and beliefs in menstruation, is further compounded by the low girls' knowledge levels and understandings of puberty, menstruation, and reproductive health. Thus, there is the need to follow a strategic approach in combating these issues. The current paper aims to discuss menstruation related myths prevalent in India, their impact on women's life, relevance of addressing these issues in primary care and a brief description about various strategies to combat them.
  14,339 1,403 21
Nurse-to-patient ratio and nurse staffing norms for hospitals in India: A critical analysis of national benchmarks
Suresh K Sharma, Ritu Rani
June 2020, 9(6):2631-2637
Optimum nurse-to-patient ratio is the concern of most of the nurse leaders globally. It has benefits both for nurses and patients; which is essential for patient's safety and quality of care. Some parts of the world such as California, USA, and Queensland, Australia has passed the law for the minimum nurse-to-patient ratio, which has scientifically found to be beneficial for the patients and healthcare system. Indian nurse staffing norms given by the Staff Inspection Unit, Indian Nursing Council, and Medical Council of India are developed through professional judgement models and are not updated. Five electronic databases were considered for literature search; in addition, grey literature and books were also searched. The primary outcome was to summarise exiting national nurse-to-patient norms and to find out the ideal nurse-to-patient ratio and nurse staffing norms as per Indian resources. It is concluded that nurse staffing norms must be immediately revised in the light of international norms and research evidence available in this regard. Further, there is a need for workload analysis based research evidence to have true nurse-to-patient ratio estimation for hospitals in India.
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