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1.
Ind Psychiatry J ; 30(Suppl 1): S52-S55, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34908665

RESUMO

BACKGROUND: Lockdown was implemented to restrict the transmission of COVID-19. This brought upon many unforeseen hurdles, including mental health problems. AIM: The aim of the study is to assess the impact of lockdown on mental health. MATERIALS AND METHODS: A cross-sectional study was conducted using Google Form, which the participants were requested to complete online. The questionnaire included sociodemographic information and general health questionnaire (GHQ)-12, which was used to screen for mental health. RESULTS: A total of 343 participants took part in the study in which 113 participants (32.9%) were having GHQ score of less than or equal to 12. The study showed that people aged less than 41 years were able to concentrate more during lockdown (75.6%) as compared to people aged more than 41 years (65%). Younger participants who were less than 41 years reported sleep disorders associated with late-night entertainment and TV viewing (24.5%). Many experienced stress during lockdown, but it was more in people over 60 years (63.7%). CONCLUSIONS: An appreciable proportion of the participants faced stress during lockdown. Elderly people were more affected. Sleeping disorders were associated with late-night entertainment and TV viewing in younger people.

2.
Ind Psychiatry J ; 30(Suppl 1): S3-S4, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34908655
3.
Indian J Public Health ; 65(3): 256-260, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34558487

RESUMO

BACKGROUND: COVID-19 is a public health concern currently demanding continuous efforts to understand its epidemiology. Pimpri-Chinchwad township with a population of over 25 lakhs is located in Maharashtra, one of the worst affected states in India. After the incidence peaked in the township in mid-September 2020, cases started declining even as lockdown restrictions were eased. OBJECTIVES: A seroprevalence study was conducted to understand the transmission dynamics of the pandemic in this region. METHODS: We carried out a population-based seroprevalence study for IgG antibodies for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) among 5000 residents 12 years and above selected by the cluster random sampling. We selected 50 clusters in slums, 80 clusters in tenements, and 70 clusters from housing societies. The field work for collection of samples was carried out from October 07 to October 17, 2020. We used kit from Abbott (SARS-CoV-2 IgG), which employs chemiluminescent microparticle immunoassay technology. The prevalence of IgG antibodies was expressed as point estimates with 95% confidence intervals (CIs). These were weighted for areas and cluster effect and further adjusted for test performance. RESULTS: The overall seropositivity for IgG was 34.04% (95% CIl 31.3%-36.8%). Slum dwellers had 40.9% positivity rate (95% CI 37.0%-44.7%), those in tenements 41.2% (95% CI 37.7%-44.8%) and people living in housing societies had 29.8% positivity (95% CI 25.8%-33.8%). CONCLUSION: A considerable proportion of population had encountered the novel coronavirus approaching partial, if not complete, herd immunity, which may partly explain the declining trend in spite of easing of lockdown restrictions.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/diagnóstico , COVID-19/imunologia , SARS-CoV-2 , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , Criança , Controle de Doenças Transmissíveis , Humanos , Imunidade Coletiva , Imunoglobulina G/sangue , Índia/epidemiologia , Pessoa de Meia-Idade , Características de Residência , Estudos Soroepidemiológicos , Adulto Jovem
4.
Ind Psychiatry J ; 30(1): 96-101, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34483531

RESUMO

BACKGROUND: Depression is a significant public health issue that needs to be taken care of, as it poses a great economic burden on the society at large. Early identification and treatment of the patients will reduce mental morbidity and disability. AIM: The aim is to study the prevalence and functional status of subjects with major depressive disorder in the community. MATERIALS AND METHODS: After identification of the sample population, the sociodemographic details were recorded. Subsequently, assessment was carried out by General Health Questionnaire (GHQ), Patient Health Questionnaire-9 (PHQ-9), Functional Status Questionnaire (FSQ), and Mini Mental State examination (MMSE). RESULTS: A total of 2000 subjects were screened using the GHQ and PHQ and 544 subjects were selected. These 544 subjects were further assessed with FSQ and MMSE. Out of the 544 subjects, 65.1% had a GHQ score of <14, 22.1% had a score between 15 and 19, and 12.9% had a score of >20. The PHQ-9 score was found to be <5 in 28.9% subjects, 5-14 in 64.3% subjects, and >14 in 6.8% subjects. Majority of the sample population was in the warning zone according to the FSQ. The MMSE scores were ≥23 in 86% and ≤22 in 14% of the patients. Over 65% of the subjects were relatively mentally healthy. Out of the remaining 35%, 22% of the subjects required screening for psychiatric disorders and 13% of them did require active psychiatric intervention. CONCLUSIONS: It would be beneficial to the community if a database is created regarding the psychiatric disorders such as depression prevalent in the community and their functional status so that the effective measures can be implemented to minimize the suffering by providing effective psychiatric care at the earliest and follow them up in the long run.

5.
8.
Indian J Community Med ; 45(1): 4-7, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32029975

RESUMO

The development in the country's health status has not kept pace with its economic development. Although India along with most countries of the world was a signatory to the Alma Ata Declaration of 1978, its performance particularly on health equity and quality issues, so far, has been far from satisfactory. There are vast variations in health-care status by states, by ethnic groups, gender, and urban-rural difference. Till recently, government policies and people's perceptions also seemed to be on the wrong track. Our priorities seemed to be all wrong - we seemed to prefer setting up of high-cost tertiary health institutions at the expense of the primary health centers. The recently launched Swachh Bharat and Ayushman Bharat schemes offer hope of addressing these asymmetries. This paper briefly dwells on these issues.

9.
Indian J Public Health ; 63(3): 215-219, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31552851

RESUMO

Background: With the rapid rolling out of the information highway, an increasing number of patients are accessing the Internet for medical information. Against this background, the present study was undertaken. Objectives: To ascertain patients' use and opinion on impact of Internet on doctor-patient relationship. Methods: A cross-sectional study was done. A total of 709 patients was interviewed, 307 from urban and 402 from rural field practice areas. Institutional ethical approval was obtained before data collection. Categorical data were summarized by percentages with 95% confidence intervals (CIs). Quantitative data were summarized by mean and standard deviation. Associations were explored using odds ratio (OR) with 95% CI for categorical data and two sample t-test for quantitative data. Results: Internet for medical information was used by 50.35% of the patients (95% CI = 46.68, 54.02). More urban patients, i.e., 79.48% used Internet compared to rural patients, i.e., 28.11%. This difference was significant, OR = 9.9 (95% CI = 6.9, 14.0; P < 0.0001). Users of Internet had about 4 years more schooling than nonusers. This was significant, P < 0.0001. More users believed that this trend will improve the doctor-patient relations (51.26%), compared to nonusers (17.05%). This difference was significant, OR = 5.11, 95% CI = 3.61, 7.22, P < 0.0001. Conclusions: A large proportion of patients used Internet to get medical information, significantly more urban patients compared to rural patients. The implication of this is that doctors in times to come will be dealing with patients empowered by online health information.


Assuntos
Informação de Saúde ao Consumidor/métodos , Internet , Relações Médico-Paciente , Adulto , Estudos Transversais , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Características de Residência
10.
Ind Psychiatry J ; 26(2): 128-133, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-30089958

RESUMO

Background: Anti-tobacco policies are focused on curbing smoking. Less attention is given to the use of smokeless tobacco use. This raises the concern whether these policies lead to increased use of smokeless tobacco use. The present study addresses this issue. Materials and Methods: A stratified random sample of 399 participants over 18 years and both genders were part of this cross-sectional study. They included an interview of urban and rural residents by house-to-house survey including outpatients, inpatients, and college students. Information was collected by face-to-face interview on a standard instrument for recording tobacco use. Additional questions were added to elicit switch from smoking to smokeless forms of tobacco. In-depth interviews were also held with some tobacco vendors. Statistical Analysis: Data were summarized in percentages and with mean and standard deviation. Chi-square and two sample t-tests were used to explore associations. Results: Prevalence of smokeless tobacco use was 36.59% (95% confidence interval: 31.97%-41.41%). Smokeless tobacco use was highest in rural community at 60.20% compared to urban community in which it was 40%. Unskilled workers had the highest prevalence of smokeless tobacco use at 48.57% compared to lowest prevalence among professionals (12.50%). Years of schooling was inversely related to both smoking and smokeless tobacco use. Prevalence of smoking at 20.55% was much less than use of smokeless tobacco use. Awareness of adverse health effects and ban in public places were the main reasons for quitting smoking. About 10% of those who quitted smoking took smokeless tobacco. Conclusion: There was a tendency among tobacco users to switch over to smokeless tobacco use due to awareness of health effects and ban on smoking in public places. A much higher prevalence of smokeless tobacco use compared to smoking suggests that the problem of smokeless tobacco use is receiving less attention from policymakers vis-à -vis smoking control policies.

11.
Ind Psychiatry J ; 24(1): 70-5, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26257487

RESUMO

INTRODUCTION AND CONTEXT: Stigma associated with psychiatric disorders and few somatic disorders such as sexually transmitted diseases (STDs), tuberculosis and leprosy, adversely effects treatment seeking behavior, leads to concealment, and poor compliance with treatment. In busy outpatient departments (OPDs), the issue of stigma is likely to be overlooked. MATERIALS AND METHODS: We carried out a cross-sectional study collecting data on an 8-item stigma scale from patients attending psychiatry and other OPDs of a Tertiary Care Teaching Hospital in an industrial township. Information was collected by face to face interview from 400 patients attending psychiatry OPD and 401 patients attending other OPDs. Validations of the scale were done by face, content, and construct validity. Reliability was appraised by Cronbach's alpha and Guttmann split-half coefficients. Significant differences in answers to the 8-item questionnaire were explored by Chi-square test for individual responses and Kruskal-Wallis test for difference in total stigma score. RESULTS: Patients attending psychiatry OPD consistently gave responses indicating a greater degree of perceived stigma than those attending OPD for somatic disorders. This difference was almost 3-4 times more on most of the items (P < 0.001). Among somatic disorders, stigma was highest (even higher than psychiatric disorders) among STDs, tuberculosis and leprosy patients among these and psychiatric disorders the score was almost 3 times more compared to other somatic disorders (P < 0.001). The scale demonstrated good face, content, and construct validity. Reliability was also very high with Cronbach's alpha coefficient and Guttmann split-half reliability coefficient 0.932 and 0.901 indicating very good internal consistency of the 8-item scale. CONCLUSION: Stigma was higher among STD patients, tuberculosis, leprosy, and psychiatry patients as compared to patients suffering from somatic disorders. Assessment of stigma among these groups of patients can help in planning management and intervention to deal with stigma. This in turn can improve patient compliance.

15.
Int J Crit Illn Inj Sci ; 3(1): 8-11, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23724378

RESUMO

BACKGROUND: India has one of the highest road traffic accident rates in the world. To lessen this burden, information on the contributing factors is necessary. MATERIALS AND METHODS: We studied a series of cases of non-fatal road traffic accidents in two tertiary care hospitals in Pimpri, Pune, India. A total of 212 non-fatal road traffic accidents admitted over a period of one year in these two hospitals constituted the study sample. The study variables were, the gender of the accident victims, mode of accident, days of week on which the accident took place, time of day when the injury was sustained, part of the body injured, nature of injury, and self-reported reasons for the accident. STATISTICAL ANALYSIS: data were summarized using percentages. The Chi-square test for goodness of fit was applied, to see whether there was any association between the different weekdays or time of day and the accidents. RESULTS: MALE : female ratio was almost 5 : 1, which was statistically significant (Chi-Square for goodness of fit = 95.11, df = 1, P < 0.0001). The maximum accidents occurred on Sundays and Mondays and the least around midweek (Wednesday). This pattern was also statistically significant (Chi-square for goodness of fit = 30.09, df = 6, P < 0.001). Pedestrians were the most vulnerable group, followed by drivers and pillions of two wheelers. These categories of road users contributed to almost 80% of the cases of Road Traffic Injuries (RTIs). Accidents were more likely in the time zone of 8 pm to midnight, followed by 4 pm to 8 pm (Chi-square for goodness of fit = 89.58, df = 5, P < 0.0001). A majority of the patients sustained multiple injuries followed by injuries to the lower limbs. A majority reported impaired visibility and fatigue as the cause of accident. Almost half (46.22%) of the injured admitted to drinking alcohol on a regular basis. CONCLUSION: Wide pavements and safe zebra crossings should be provided for pedestrians, as the highest casualty in this study were pedestrians. More accidents occurred on Sundays and Mondays and in the late evenings. Extra supervision by traffic police may be considered on Sundays / Holidays and the day following. Roads should be well lit to improve visibility after sunset.

17.
J Family Community Med ; 19(1): 12-9, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22518353

RESUMO

BACKGROUND: The rapid pace of medical advances coupled with specialization and super-specialization, is eroding the traditional doctor-patient relationship. OBJECTIVE: (a) To study the determinants of core dimensions, such as, concordance, trust, and enablement in a doctor-patient relationship; (b) to explore associations, if any, among these core dimensions. MATERIALS AND METHODS: A cross-sectional study design with both quantitative and qualitative methods was employed. One hundred and ninety-eight outdoor patients were interviewed as part of the quantitative study. Three dimensions of the doctor-patient relationship, that is, physician patient concordance, trust in physician, and patient enablement were assessed using validated tools. Focus group interviews using an open-ended format among few physicians was carried out as part of the qualitative study. RESULTS: In the quantitative analysis most of the sociocultural factors did not show any significant association with the doctor-patient relationship. However, gender was significantly and strongly associated with trust in the physician. Female patients showed a much lower trust in the physician (50%) as compared to male patients (75%) (OR = 0.33, 95% CI 0.17 - 0.64, Chi Sq = 12.86, P = 0.0003). A qualitative study revealed language and culture, alternative medicines, commercialization of medicine, and crowding at specialist and super-specialist clinics as barriers to a good doctor-patient relationship. Better concordance was associated with improved trust in the doctor (OR = 5.30, 95% CI 2.06 - 13.98, Chi Sq = 14.46, P = 0.0001), which in turn was associated with improved patient enablement (OR = 3.89, 95% CI = 1.60 - 9.64, Chi Sq = 10.15, P = 0.001). CONCLUSION: Good doctor-patient concordance (agreement) leads to better trust in the physician, which in turn leads to better patient enablement, irrespective of the sociocultural determinants.

18.
J Family Med Prim Care ; 1(1): 20-6, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24478995

RESUMO

CONTEXT: The biggest challenge in implementing the primary health care principles is of equitable distribution of health care to all. The rural masses and urban slum dwellers are most vulnerable to lack of access to health care. AIM: To study access to health services among slum dwellers and rural population. SETTING AND DESIGN: A cross-sectional survey in an urban slum and surrounding rural areas in field practice area of a medical college. MATERIALS AND METHODS: Structured instrument along with qualitative techniques such as focus group discussions, were used to collect information on access and utilization of health services from 865 individuals of both sexes and all ages selected from urban slums, villages, and indoor and outdoor patients. Access to basic determinants of good health such as housing, water, and sanitation was also elicited. Besides, health needs based on self-reported disease conditions were compiled. RESULTS: More than 50% of respondents were living in poor housing and insanitary conditions. Besides the burden of communicable diseases and malnutrition (especially in children), risk of lifestyle diseases as evidenced by high Body mass index in 25% of adults surveyed was found. Private medical practitioners were more accessible than government facilities. More than 60% sought treatment from private medical facilities for their own ailments (for sickness in children this proportion was 74%). People who visited government facilities were more dissatisfied with the services (30.88%) than those who visited private facilities (18.31%). This difference was significant (OR=1.99, 95% confidence interval 1.40 to 2.88; χ(2) =15.95, df=1, P=0.007). The main barriers to health care identified were waiting time long, affordability, poor quality of care, distance, and attitude of health workers. CONCLUSION: The underprivileged in India continue to have poor access to basic determinants of good health as well as to curative services from government sources during illness.

19.
Indian J Ophthalmol ; 59(3): 211-4, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21586842

RESUMO

BACKGROUND: There has been a growing concern among medical educators about the quality of medical graduates trained in various medical colleges in our country. Data based on the faculty and student perceptions of undergraduate curriculum indicate a need for laying more stress on practical skills during their training and assessment. The Objective Structured Clinical Examination (OSCE) is a reliable and an established and effective multistation test for the assessment of practical skills in an objective and a transparent manner. The aim of this article is to sensitize universities, examiners, organizers, faculty, and students across India to OSCE. MATERIALS AND METHODS: We designed an assessment based on 22-station OSCE and administered it to 67 students during their final year, integrating all the domains of learning, that is higher order cognitive domain, psychomotor domain, and affective domain. Data analysis was done using SPSS version 15. RESULTS: The OSCE was feasible to conduct and had high perceived construct validity. There was a significant correlation between the station score and total examination score for 19 stations. The reliability of this OSCE was 0.778. Both students and faculty members expressed a high degree of satisfaction with the format. CONCLUSION: Integrating a range of modalities into an OSCE in ophthalmology appears to represent a valid and reliable method of examination. The biggest limitation with this format was the direct expenditure of time and energy of those organizing an OSCE; therefore, sustaining the motivation of faculty might pose a challenge.


Assuntos
Competência Clínica , Educação Médica/normas , Avaliação Educacional/métodos , Avaliação Educacional/normas , Oftalmologia/educação , Estudantes de Medicina , Estudos de Viabilidade , Humanos , Reprodutibilidade dos Testes , Adulto Jovem
20.
Ind Psychiatry J ; 20(1): 21-4, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22969176

RESUMO

BACKGROUND: Indian society is in a stage of rapid social transition. As more women enter the workforce, stresses vis-à-vis the genders are to be expected in patriarchal society to which most of our population belongs. Earlier studies in Western societies have revealed gender differences in perception of what constitutes sexual harassment. AIM: Elicit gender differences, if any, in the workplace sexual harassment among future professionals. SETTINGS AND DESIGN: A cross-sectional study among the students of professional colleges. MATERIALS AND METHODS: A total of 200 students of both sexes were randomly selected from four professional colleges. Data collection was done on a structured questionnaire by interview. STATISTICAL ANALYSIS: Internal consistency of the questionnaire was tested by Crohnbach's α coefficient. Associations between gender and perceptions were explored with Chi-square, Odds Ratio with 95% confidence interval, where applicable. RESULTS: The differences in perception on what constitutes sexual harassment among the genders were statistically significant on many measures (P<0.01). CONCLUSIONS: Men and women differ in their awareness as to what constitute sexual harassment. Men were more lacking in awareness regarding sexual harassment.

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