Prevalence of diabetes distress among type 2 diabetes mellitus patients in India: a systematic review and meta-analysis.

Introduction: The burden of type 2 diabetes mellitus (T2DM) in India is on the rise, with projections indicating a staggering 134 million cases by 2045. Managing T2DM demands strict adherence, often resulting in mental strain and burnout. Diabetes distress (DD), a unique psychological burden, significantly affects motivation and self-care, contributing to increased morbidity and mortality. Material and Methods: This study was conducted by doing a comprehensive literature search using PubMed (MEDLINE) and EMBASE databases for studies published from their inception to 14th August 2023 by using relevant keywords. The protocol is registered in PROSPERO and adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Selected articles were meticulously screened based on predetermined inclusion and exclusion criteria. Joanna Briggs Institute (JBI) Critical Appraisal scale for cross-sectional study was used for assessing the study quality. Data analysis was done by using Jamovi 2.3.24 software. Results: Following the systematic search and screening process, 10 cross-sectional studies were identified, comprising a total of 2,107 Type 2 Diabetes Mellitus patients. All studies employed the Diabetes Distress Scale-17 (DDS-17) for measurement. The prevalence of DD varied, ranging from 8.45% to 61.48%. The pooled prevalence of DD in T2DM patients in India was estimated at 33% (95% CI: 21%-45%) with substantial heterogeneity observed (I2 = 97.33%, P < 0.001). While an asymmetric funnel plot suggested potential publication bias, sensitivity analysis reinforced the robustness of our findings. Conclusion: Policymakers, clinicians, and researchers can leverage these insights to prioritize the psychological well-being of T2DM patients, ultimately improving their overall health outcomes. This study aligns with the Sustainable Development Goals (SDGs) and India's national health policy, emphasizing the urgency of screening and treating diabetes-related distress by 2025.

Barriers to healthcare utilization among married women in Afghanistan: the role of asset ownership and women's autonomy.

Women face multiple socio-economic, cultural, contextual, and perceived barriers in health service utilization. Moreover, poor autonomy and financial constraints act as crucial factors to their healthcare accessibility. Therefore, the objective of the present study is to study the association between health care utilization barriers and women empowerment, including asset ownership among currently married women in Afghanistan. Data of 28,661 currently married women from Afghanistan demographic health survey (2015) was used to carry out this study. Barriers to access healthcare were computed based on problems related to permission, money, distance, and companionship, whereas women empowerment and asset ownership were computed as potential covariates along with other socio-economic risk factors. Bivariate and logistic analysis was carried out to study the association and odds of explanatory variables. Our results confirm the significant and strong association between the barriers to access healthcare and various explanatory variables. Women having any decision-making autonomy are less likely to face any odds [(AOR = 0.56, p < 0.001), CI: 0.51-0.61] among the currently married women than those who don't have any decision-making authority. Similarly, women who justify their beating for some specific reasons face the greater difficulty of accessing health care [(AOR = 1.76, p < 0.001), CI: 1.61-1.93]. In terms of asset ownership, women having any asset ownership (land or household) are less likely to face any barriers in health services utilization given the lower odds [(AOR = 0.91, p < 0.001), CI: 0.90-0.98]. Accessing maternal health is a crucial policy challenge in Afghanistan. A substantial proportion of women face barriers related to approval, money, distance, and companionship while accessing the health services utilization in Afghanistan. Similarly, women empowerment and asset ownership are significantly associated with health service accessibility. This paper therefore suggests for some policy interventions to strengthen the healthcare needs of women and ensure healthcare accessibility by scaling down these potential barriers like poor autonomy, asset ownership and domestic violence.

Study on Sociodemographic Profiles and Health-Seeking Behaviour in Cervical Cancer Patients in a Tertiary Healthcare Centre in Central India.

INTRODUCTION:  Cervical cancer is one of the fourth most common cancers in females. Although screening and early intervention are preventive and a part of national programs, cervical cancer is attributed to a large number of deaths due to late-stage presentation and late diagnosis. To better understand this phenomenon, this study analyzed the sociodemographic characteristics of cervical cancer patients and assessed their health-seeking behaviour. METHODS:  This cross-sectional study included 230 cervical cancer patients from the cancer ward of a tertiary care hospital. Detailed information about the onset of symptoms and previous gynecological problems along with sociodemographic details were recorded. RESULTS: Of the 230 cervical patients included, 70% were from rural areas and the majority presented at Stage III and IV. Additionally, 173 out of 230 patients previously had gynaecological problems, of which more than 50% did not initially seek any treatment. The common reasons for not seeking treatment were embarrassment, loss of daily wages, and the thought that it would heal by itself. The majority of those who took treatment went to traditional healers, and a Papanicolaou smear was not conducted on any patient. CONCLUSION:  Lack of awareness about the importance of screening programs along with the embarrassment of addressing any problems leads to unwillingness to access health care for cervical health.

Risk of Silico-Tuberculosis in Miners: A Systematic Review and Meta-Analysis.

Context: Tuberculosis (TB) and Silicosis are public health problems with high morbidity and mortality. They also exist as comorbidities and are highly prevalent among mine workers. Aims: This study aims to estimate the risk of TB in miners with silicosis than in miners not having silicosis. Methods and Material: This systematic review was conducted by literature search using PubMed, and EMBASE for studies published from 1st Jan 2017 till 20th July 2022. From the data obtained using relevant keywords for the search, a total of 345 articles were selected for screening after applying our inclusion-exclusion criteria and removing duplicates. PRISMA guidelines were followed. items JBI critical appraisal checklist for cross-sectional studies was used for assessment of the risk of bias. The odds ratio was used to estimate the strength of the association. Results: After extensive screening, four studies have met our selection criteria. The meta-analysis of those studies revealed that the prevalence of TB in miners with silicosis is 27.11% while the prevalence of TB in miners with non-silicosis is 16.75%. The estimated pooled odds ratio (fixed effect model) is 1.34 (95% CI 1.01 - 1.76). Conclusions: The present study reveals that there is an increased risk of TB in miners with Silicosis. Newer initiatives must be taken to prevent TB in miners.

Rapid Assessment of Low Utilisation of sexually transmitted infection Services amongst High Risk Groups in Designated sexually transmitted infection Clinics of Bhopal" - A Qualitative Study.

INTRODUCTION: High-risk groups (HRGs) have limited access to appropriate information and sexual and reproductive health services. They are a highly marginalized subgroup and their social stigma is a barrier for the use of health care and treatment. OBJECTIVES: (1) To assess the knowledge regarding sexually transmitted infection (STI) infections among HRGs. (2) To identify the reasons and barriers associated with low utilization of services among HRGs. MATERIALS AND METHODS: Qualitative study conducted in three HRGs of Bhopal for 3 months. Six focus group discussions were done among three HRGs namely intravenous drug users (IDUs), commercial sex workers (CSWs), and men having sex with men (MSM). Issues related to STIs were asked to all the respondents and detailed responses were recorded by the voice recorders and noted down. The audio recordings were translated and transcribed into English. Transcribed data content were analyzed manually in various themes. RESULTS: Knowledge regarding STI/reproductive tract infection: The knowledge of HRGs regarding STDs was assessed. Almost all the CSWs of the group were having considerable knowledge regarding signs and symptoms about STI. MSM were having good knowledge about STIs. Most of the IDUs had a very limited and scarce knowledge about STI. Most of the CSWs shared their problems regarding STI with family members followed by doctor. Almost all the MSMs approached the counselor first before approaching a doctor and preferred to consult a doctor in a government hospital. Majority of IDUs said that they prefer to go to government hospital for getting treated for such conditions while a few prefer for private hospitals. CONCLUSION: Majority of HRGs are seeking health care from government health facilities while the MSMs and transgender faced discrimination at these facilities and nongovernmental organizations (NGOs) played a major role in promoting better health-seeking behavior among them. The HRGs freely discussed their problems with the NGOs.