Community Medicine articles list

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

In this paper, investigations are made to analyze the human body temperature during wound healing process due to surgery. Wound is considered after the skin graft. Skin graft is a technique used in plastic surgery. Skin is the first line of defense between the human and environment, it is very susceptible to damage. Internal body or core temperature (Tb) is one of the clinical vital signs along with pulse and respiratory rates. Any disturbance in body temperature will drive complexities in wound healing process. These studies are important in the mechanism of establishing the limits of thermal regulation of human body during the healing process in different situations and conditions. The Finite element method is used to analyze tissues temperature for normal tissues (donor site) and abnormal tissues (tissues after surgery). Appropriate boundary conditions have been framed. Numerical results are obtained using Crank Nicolson Method.

Manisha Jain

Homoeopathy is one of the latest systems of medicine discovered at the latter part of 18th century, first rose to prominence in the 19th century due to its success in treating epidemics and is currently second largely utilized system of medicine globally. Prophylaxis through Homoeopathy has been strongly promulgated by stalwarts and popular among the general public in the recent times, but still controversy revolves around it. Aim of the study is to review the available literature for analyzing the usefulness of Homoeopathy in prophylaxis of human, animal as well as plant diseases. A comprehensive search has been made in electronic database aimed to target the available literature of various levels of evidence. Examples are summarized under different areas of applicability of homeopathic medicine as prophylactic. Currently there is convincing evidence to support effectiveness of Homoeopathy in prophylaxis, though sparse. More rigorous research studies are warranted to enlarge the horizon of its application.

Dr Deepthi Gilla

Background: Pandemics are known to cause poor mental well-being and an increased risk of mental disorders. The foremost concern emerging from different aspects of COVID-19 is its impact on mental health. There were many surveys conducted on the general population related to the effect of COVID-19 and few studies on its psychological impact but there is sparse literature on how the containment measures affected the psychiatric patients. Objective of the study was to investigate whether the COVID-19 related lockdown affected the subjective mood and behavior of psychiatric patients and their caregivers. The secondary purpose is to assess the difficulties encountered in procuring medicines and the effect of non-availability of homoeopathic medicines if any. Methods: A cross-sectional survey was conducted on mentally ill patients and their care-givers in the Outpatient Department of Psychiatry in National Homoeopathy Research Institute in Mental Health (NHRIMH), Kottayam. Respondents were evaluated with a specially framed questionnaire containing 22 questions to assess the effect of lockdown on psychiatric patients and their caregivers, who attended the OPD after the COVID-19 related lockdown. The data generated through the study are analysed and presented in this article. Results: Out of the total 548 participants (M-65.9%, F-34.1%) who responded to the survey, 290 (53%) cases expressed that they were distressed to be under lockdown. 26.5% of the clients reported worsening of mental health conditions during lockdown compared to pre-lockdown. 54.2% of the patients found difficulty in procuring homoeopathic medicines during Lockdown. Conclusions: Authorities should consider the ways of limiting the effects of confinement on mentally ill patients and their caregivers by developing strategies to mitigate the adverse consequence of the pandemic.

Dr Deepthi Gilla

The choice of the study design is a major determinant of scientific quality and clinical value of a research study. To select an appropriate study design is a perplex task for novice as well as veterans in research. AYUSH systems of medicines have evidence database showing the effectiveness in a wide range of clinical conditions, yet improving the quality of trials by well- designed studies is indispensable to demonstrate widespread utility on more scientific grounds. This article describes the structured classification of research designs done on the basis of a selective literature search concerning medical research. The study design and type that can best answer the particular research question at hand must be determined not only on a scientific basis, but also in view of the available resources, ethical issues and practical feasibility of study.

Dr Deepthi Gilla

Physically unclonable function (PUF) is a hardware security module preferred for hardware feature based random number and secret key generation. Security of a cryptographic system relies on the quality of the challenge-response pair, it is necessary that the key generation mechanism must unpredictable and its response should constant under different operating condition. Metastable state in CMOS latch is undesirable since it response becomes unpredictable, this feature used in this work to generate a unique response. A feedback mechanism is developed which forces the latch into the metastable region; after metastable state, latch settle to high or state depends on circuit internal condition and noise which cannot be predicted. Obtained inter hamming variation for 8 PUF is 51% and average intra hamming distance is 99.76% with supply voltage variation and 96.22% with temperature variation.

Abhishek Kumar

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

Recently studies showed that globally, more than 1.8 billion adults are overweight and in that around 650 million are obese. India is one among the most widely recognised countries which are identified with way of life today as being overweight. Obesity or overweight leads to heart diseases, Diabetes Mellitus, Hypertension etc. Objectives: Adulthood is a period where we have to pay at most attention tohealthy nutritional diet. Preventive measures through assuring the nutritional status of adults such as anthropometric, dietary survey, food consumption pattern, nutritional awareness, physical activity and alertness about diseases will assist the community from being overweight and thus the occurrences of metabolic disorders. Methods: zone chosen for the conduct of the study was Tirupati and based on the number of subjects required, their age profile; willingness to participate in the study; their health condition etc,. a private company which was willing was selected. The subjects chosen were in the age group of over 30-40 years. The selection was carried out using the purposive sampling technique. Results: The data indicates that some adults are in the border line of non-communicable diseases such as overweight or obesity, cardio vascular diseases, Type 2 diabetes and hypertension. Conclusion: This could be rectified through regular practice of consuming a nutritious and appropriate diet in conjunction with physical exercise routine.

Kimeera Ambati

COVID-19 is associate communicable disease caused by severe acute respiratory syndrome coronavirus. It's currently a virulent disease unfold moving several countries globally. The aim of this study is to assess the knowledge and practices of COVID-19 among general public at the selected setting, Chennai. The main objective was to assess the knowledge and practice on COVID-19, correlate the knowledge with practice on COVID-19, and associate the knowledge and practice on COVID-19 with the demographic variables among the public. A Quantitative non-experimental analysis style was used to assess the knowledge and practice of COVID-19. Sixty individuals were chosen through the non-probability convenience sampling technique. The findings of the analysis disclosed that the majority (40%) of the samples had a high level of knowledge and 43.3% of them had a good practice, 33.3% of them had a moderate level of knowledge and 30% of them had moderate practice, whereas 26.7% of them had a low level of knowledge and 26.7% of them had poor practice on COVID 19. Keywords:- COVID-19, Knowledge, Practice, Pandemic, General Public.

Elsi Queen

Background: Quality of life (QOL) is an important determinant in assessing the health status. It includes physical, psychological, and social well being. The aim of this research was to identify the intrinsic and extrinsic factors of QOL; and the association of QOL with socio-demographic, anthropometric variables and lifestyle variables. Methods: This cross sectional study was conducted in Tamil Nadu among 327 adults during July 2020 through online using standardized WHOQOL-BREF tool to assess the quality of life along with socio-demographic variables, anthropometric variables and lifestyle variables. Principal component analysis method was used to identify the factors which influence the QOL of adults. The association between socio-demographic variables, anthropometric variables and lifestyle variables with quality of life was also assessed. Among the selected samples 165 were female and 162 were male. The structured questionnaire included Section A- socio-demographic variables such as age, gender, occupation, educational qualification, place of residence, marital status; Section B - anthropometric variables such as height, weight and BMI; Section C lifestyle variables such as type of diet and physical activity pattern; and Section D -consisted of Standardized WHO-BREF tool to assess the quality of life. Results: The identified intrinsic factors include Life style approach, Emotional stability and Health status; Safety & accomplishment, Financial support with societal information were identified as extrinsic factors. These factors played an influential role in QOL of the adults during pandemic crisis. The association between the type of residence (p=0.001), occupation (p=0.000) and marital status (p=0.022) with QOL was highly significant at 1 % and 5 % respectively. Conclusion: The identified factors during covid-19 pandemic had influenced the quality of life domains namely physical health, psychological, social relationship and environment. Intrinsic factors were dependent on individual’s perception towards accepting the new normal during the pandemic. Whereas, extrinsic factors were greatly influenced by the environment and society in which the study participants were exposed. One of the identified extrinsic factors (residence), showed high significant association with QOL.

Athina Deepa Prasanna

This paper found that 35% of Adivasis have health problems, and 73% said that they are getting treatment with RMP. 87% have toilet facility and more than 12% still defecate openly. 18.3% said that they faced different problems at open defecation, and 50% of women not using sanitary napkins. Nearly 90% of respondents wash their hands after toilets and coming from outside of the home. Ten per cent of respondents said that they do not have an awareness of sanitation. Therefore, the study confirmed that the sanitation facilities considerably made the women's dignity and quality of life better in the study area. Moreover, four case studies also focused on open defecation problems in the study area.

B Suresh Lal

Community pharmacies not only act as sites of drug purchase but also as healthcare setting. The aim of this study is to examine the extent of public’s use of community pharmacy and their reasons of visiting to Sabha, South part of Libya. Thus, a descriptive, cross-sectional survey with self-administered questionnaire was developed and validated. Data was collected during 2019 by registered pharmacists using the self-designed prepared questionnaire for community pharmacies in Sebha. Of all 600 questionnaires were handed during 2020, 462 forms were returned (77%, response rate). The majority of the respondents reported they had visited the community pharmacies at least once in a month (n = 343, 74%). The highest reason of visiting reported by the respondents was dispensing their prescription medications (n = 304, 65%) while purchasing medication without prescriptions was accounted with n = 162, (35%). The highest rate of the respondents was given advice about antibiotic use (n = 224, 48%) followed by physical exercises (n = 178, 39%) and healthy eating (n = 173, 37%). The majority of the respondents preferred to visit community pharmacy over other healthcare centers because of minor health problems (n = 358, 77%). The major factors influence the consumers choose any particular pharmacy were the professionalism of pharmacy staff (n = 254, 55%) and the availability of the medical products (n = 221, 48%). The respondents incline to choose community pharmacy as a primary health center when they faced drug related problem (n = 248, 54%). In conclusion, the current study revealed that the majority of Libyan people are regular users of community pharmacies and various services and topics of advice have been given by their staff. However, shortage of professional pharmacists in community pharmacies can undermine the opportunity of given reliable pharmaceutical care from these communications.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hypoglycemia is a common complication of intensive diabetes mellitus therapy. This study was aimed to review the profile of admitted Libyan cases of non-pregnant adults and adolescents. A retrospective study for patients admitted to Tripoli Diabetes Hospital, Tripoli, Libya. Data were collected from medical files of diabetic patients with hypoglycemia from January 2017 to July 2018. Thus, during this period, a total of 29 cases with hypoglycemia were admitted to the hospital. Their age was ranged from 18 to 86 years in which 76.0% were female, 25.0% were non-smokers, 59.0% were married and 55.0% were non-employers. Patients with diabetes mellitus (86%) showed hypoglycemia attack per month of 3.90 ± 2.25. From the 25 cases with diabetes mellitus, 7.0% were newly diagnosed (> one year), 45.0% their duration of diabetes mellitus were more than 9 years and 35.0% were less than nine years. Their Hemoglobin A1C was on target (6.5–7.0%) in 21.0% of the cases, in which 17.0% were on below target range (< 6> 7.0%). 14.0% were on glibenclamide, 3.0% on glimepiride and 69.0% on insulin. Patients on insulin therapy twice daily in 28.0%, triple in 17.0% and basal bolus regime in 24.0%. Hypoglycemia unawareness was presented in 17.0%, hypoglycemia was major in 45.0% of the cases, and in 38.0% were in daytime. Insulin induced hypoglycemia were in 66.0%, and suicidal attempt were in 10.0%. Exercise induced hypoglycemia 10.0% and 3.0% of cases with malignancy induced hypoglycemia. Co-exist systemic illness was mainly absent in 69.0% but cardiovascular diseases in 14.0% and renal diseases in 7.0%. Majority of cases were discharged in good condition (86.0%) and 14.0% discharged against medical advice. Hypoglycemia mostly occurs in patients with diabetes mellitus treated with insulin and in most the cases were reversible and saved with good management. Thus, patient education is a fundamental issue in prevention and reducing complications of hypoglycemia in patients with diabetes mellitus.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Postpartum depression is a major maternal health problem after childbirth. It can start at any time within the first year after delivery and continue for several years. It is characterized by an inability to experience pleasure, anxiety symptoms, panic attacks, spontaneous crying and depressed mood. Some women with postpartum depression even have thoughts of harming their child and self-harm. The aim of this study is to find out the status of postpartum depression and the associated factors among postnatal mothers at first-, fourth- and sixth-month. This study is a prospective descriptive study, carried out in three major health facilities in Misurata. This study consists of three-part questionnaire. Part 1 covers demographic characteristics of the participants, while part 2 explores the associated risk factors according to the variables used. Part 3 constitutes for the psychological evaluation of the participants. Hundred mothers (age are between 15 and 43 years) were enrolled in this study. The findings revealed that prevalence of depression is 60% and 22% are suffering from borderline depression. Development of depression was strongly correlated with the sleeping disturbances, state of the neonate after birth, excess consumption of stimulants, less weight acceptance by mothers during pregnancy and infant illness. There was a weak relation between depression and delivery state, maternal admission to hospital during current pregnancy, and infant gender dissatisfaction. No correlation was found with development of depression regarding miscarriage, maternal medical problems after delivery, previous child sex, maternal age, education, parity or neonate weight. Thus, this study shows that a chance of having miscarriage and unhealthy neonate increases with advanced maternal age. It also shows that caesarean section is associated with bad neonatal outcomes, more weight gain and having gestational diabetes or preeclampsia during pregnancy. Maternal sleeping problems are more pronounced in the first month, attributing for the baby care, compared with fourth and sixth months. The study indicates that depression is a common state of psychiatric disorders among Libyan women and should have an appropriate attention by physicians and gynecologists.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Among the consequences of armed conflict, the effect on the mental health of the civilian population is one of the most significant aspect of psychiatric disorders. Studies of the general population show a positive increase in the incidence and prevalence of mental disorders. This study is aimed to determine the relationship of the national crisis on the mental health conditions of university students and their academic performance. Specifically, this study was aimed to evaluate the national crisis effects on the mental health and the academic performance as well as the association of the national crisis, mental health and academic performance. 40 sample size of pharmacy students at the academic year 2019-2020 at Attahadi University, Tripoli, Libya were used in this study and a survey of validated questionare for mental health was considered. The findings revealed that the effects of national crisis on the mental health of the students disclosed the verbal interpretation of rarely grade. Indeed it can be found that mental health of the students was not of greatly affected in this sample. The academic performance of the students disclosed that academic year levels one and three have verbal interpretation of good and academic year level two has fair. Though the academic performance of the students did not show a verbal interpretation of weak or very weak. It is still worthwhile to note that none of them has reached the very good and the excellent performance. It can be concluded that a need for the students coping strategies be enhanced for them to reach their maximum potential with their academic performance. This study shows also that a weak positive relationship among the variables. Though it’s not that high, indeed, the mental health of the students can be a predictor to their academic performance.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Patent foramen ovale (PFO) is an embryonic interatrialdefect potentially associated withischemic cerebralstrokes. One option is the occlusion of the atrial shunt byendovascular means. This procedure is recommendedfor patients with a history of cryptogenic strokes.Patent foramen ovales (PFOs) are common in the general population (prevalence 20-30%) and do not constitute a pathology in their own terms. Nevertheless, a association has been established between the occurrence of certain cryptogenic ischemic strokes and the presence of a PFO. The risk appears higher when septal patency is associated with atrial septal aneurysm (ASA). The aim of this presentation is to study the association between the PFO and the occurrence of ischemic stroke, and the benefits of its closure.

Kalkoul hamza

Background: Ending open defecation has been identified as a top priority for reducing global inequalities in water and sanitation (WASH). It is explicitly referenced in sustainable development goals (SDGs) target 6.2 and closely associated with more comprehensive efforts to end extreme poverty by 2030. Since 2000, the global rate of open defecation has decreased from 21% to 9% (0.7 percentage points per year). However, the 673 million people still practicing open defecation in 2017 were increasingly concentrated in a small number of countries, and these will need to be the primary focus of efforts to end open defecation by 2030. Objectives: To study the socio-economic background of Adivasis, to study the status of sanitation in rural areas, to examine whether economic conditions affect open defecation, to examine whether better sanitation facilities improve health conditions and to examine whether improved sanitation facilities impact the quality of life and thereby dignity of tribal women. Methods: Essentially it is an empirical study and a multi-stage random sample design was adopted. Data were collected from 120 sample households from two villages, i.e., Bandarigudem and Nadikudi of Khammam districts in Telangana State through a structured questionnaire. Statistical tools like frequency distribution, percentages, cross-tabulation with Chi-Square test, and a case study method were used. Results & Discussion: This paper found that 35% of Adivasis have health problems, and 73% said that they are getting treatment with RMP. 87% have toilet facility and more than 12% still defecate openly. 18.3% said that they faced different problems at open defecation, and 50% of women not using sanitary napkins. Nearly 90% of respondents wash their hands after toilets and coming from outside of the home. Ten per cent of respondents said that they do not have an awareness of sanitation. Therefore, the study confirmed that the sanitation facilities considerably made the women's dignity and quality of life better in the study area. Moreover, four case studies also focused on open defecation problems in the study area.

B Suresh Lal

Effective communication between patients and doctors is fundamental to high-quality healthcare, patient safety, and overall satisfaction. However, the onset of COVID-19 has prompted significant shifts in communication from in-room and face-to-face interactions to virtual consults. The impact of this pandemic related change on patient-doctor communication goals, processes, attributes, and environment remains unclear. We undertook a scoping review involving the systematic search of seven academic databases for relevant articles published up to and including June 2021. In total, 47 articles were identified that met the inclusion criteria. We applied the patient-doctor communication framework to guide our deductive thematic analysis of articles included, sorting results from reported studies and position papers into themes and sub-themes. The theme of communication goals highlighted sub-themes related to patient safety, convenience, affordability, and satisfaction; preparation included sub-themes on technology interventions, workforce training, and digital literacy; participant attributes included compassion for doctors and rebuilding trust among patients; and communication process included issues related to telemedicine or video conferencing, challenges with diminished patient privacy, and distractions in the patient's home setting. Finally, the environment theme included insights into doctors' workload, isolation, and anxiety and how changes requiring increases in virtual consults iteratively altered confidence in care provision and communication with patients. Results of the scoping review provide important insights for strengthening virtual patient-doctor interactions, including target areas for training and professional development during and beyond the current pandemic.

Mahuapatra1@gmail.com