Understanding Preventive Health Behavior: A Mixed-Methods Study to Explore Factors Influencing the Practice of Breast Self-Examination Among Indian Medical Students.

INTRODUCTION: Breast cancer (BC) is among the most prevalent oncological cases in the world, and the global burden of the disease is expected to rise further in the coming years. Strategies aiming at early diagnosis, backed by research and a well-trained healthcare cadre, can aid low- and middle-income countries (LMIC) in tackling the possible cancer-caused strain on healthcare systems. Our study aimed to evaluate the level of knowledge of medical students concerning BC and explore barriers and facilitators of breast self-examination (BSE). METHODS: A sequential explanatory mixed-methods study approach to better understand factors and beliefs influencing preventive health practice in BSE was conducted among students at a medical college in rural Maharashtra, India. One hundred and two female medical students completed the quantitative phase, and 15 of them gave in-depth interviews (IDIs) for the qualitative aspect. RESULTS: Among the participants, 67.6% had good knowledge of risk factors, but only 10% knew the recommendations for BSE, clinical breast examination (CBE), and mammography. We found that being taught BSE by a trusted source and knowing a BC patient were significant facilitators. In contrast, lack of self-efficacy and two fear factors were found to be acting as barriers for BSE, one being the absence of fear of ever getting BC and the other fear of detecting a lump. CONCLUSION: This study reveals a gap between knowledge of risk factors and their translation to disease prevention practice. The barriers elicited are modifiable by planning and implementing an appropriate training program covering risk factors and recommending all available screening and preventative modalities. A well-trained medical staff will be instrumental in improving the health status of our community and country.

Speech-Language Therapy Through Telepractice During COVID-19 and Its Way Forward: A Scoping Review.

The overall burden of voice disorders is vast, and speech-language therapy has been in use for long to prevent, assess, diagnose, and treat different speech and language disorders. Due to the COVID-19 outbreak, these services are not readily accessible because of various precautionary measures that have been laid down by the government to check the blowout of infection; as a solution to this, there has been a rise in telepractice. The purpose of this review article is to study the usefulness of telepractice for speech-language therapy during the COVID-19 pandemic and its way forward. Search was performed in the PubMed database. A total of 102 articles were found, out of which 32 articles were included through a comprehensive inclusion and exclusion criteria. This study analyzes various papers on the use of telepractice during COVID-19 for speech-language therapy. The satisfaction was greater among women as compared to men because women could get the appointment done at home and they could easily manage their household chores. It has been recognized as an "attend anywhere" web-based platform that provides us with the 5 C's, namely, easy-to-access care, increased comfort, increased convenience, reduced cost, and higher confidentiality. Patients look for such sessions in the future, even when the pandemic is over. Telepractice has now been accepted as the new healthcare delivery model with multiple advantages and disadvantages. However, more research needs to be done on the moral and environmental aspects related to its use.

Self-Care Practices and Their Role in the Control of Diabetes: A Narrative Review.

Diabetes mellitus (DM) is a long-standing, continuously growing metabolic ailment in which levels of glucose in the blood increase due to a total (DM of type 1) or incomplete (DM of type 2) decrease in the level of the hormone insulin. Diabetes mellitus affects a large number of individuals worldwide, and as more people develop the disease, the burden will double from what it is now. The requirements of people suffering from diabetes are not only confined to the control of blood glucose; there is also a need to prevent disabilities, side effects, and difficulties in rehabilitation. Studies suggest that seven self-care practices for individuals suffering from this disease have shown good outcomes. Those practices include assessment of sugar levels in the blood, consuming healthy foods, remaining physically active, taking medications regularly and on time, maintaining healthy behavior, and decreasing risk factors. All of these practices collectively have shown good results in maintaining blood glucose levels, decreasing side effects, and increasing life expectancy in people with diabetes mellitus. Those who have DM and practice self-care have shown positive results by reducing the complications of DM, decreasing its progression, and leading to a huge reduction in the burden due to DM. Despite these positive changes, people sticking to these self-care practices are very few, specifically when we see broad and chronic changes. There are many positive contributing factors, such as social factors, demographic factors, and various socio-economic factors, but the role of physicians in increasing the practices associated with personal care for people with this disease is crucial and most important for the desired outcome. Keeping in mind the burden and multidimensional nature of the disorder, proper systematic and combined efforts are needed to increase these self-care practices in patients with diabetes to reduce any chronic side effects and complications.

Public Health Importance of Emporiatrics: A Review.

People travel all around the world to explore, trade, sojourn, etc. Millions of individuals cross national and international borders. Travel medicine services are offered by general practitioners, specialized travel clinics, or immunization centers. Epidemiology, illness prevention, and travel-related self-treatment are all included in the interdisciplinary field of travel medicine. The main objective is to keep travelers alive and in good health, by reducing the effects of illness and accidents through preventative measures and self-care. The danger to a traveler's health and well-being must be understood, and the travel medicine practitioner's job is to help their patient or client recognize and manage those risks. The absence of any disease or symptom does not always indicate good health. Chronic illness sufferers, including those with cancer, diabetes, and hypertension, can maintain a reasonable level of health and mobility. Travel medicine is a rapidly developing, extremely dynamic, multidisciplinary field that calls for knowledge of a range of travel-related illnesses as well as current information on the global epidemiology of infectious and non-infectious health risks, immunization laws and requirements around the world, and the shifting trends in drug-resistant infections. Pre-travel consultation aims to reduce the traveler's risk of disease and harm while on the road through preventive counseling, education, recommended drugs, and essential vaccines. Specialized medical guidance can help reduce the potential health risks of travel. Emporiatrics is not only used for traveling advice or things to be done during the period of the journey but it also creates room in implementing the interdisciplinary subject with new methods or development of new policies, technologies, and various programs to reduce unnecessary problems of the travelers, which will boost tourism.

Out-of-Pocket Health Expenditure Among Migrant Workers in India: A Narrative Review.

Migrant workers make significant contributions to host regions and economies in many nations, frequently working in vulnerable situations in crucial sectors like agricultural and food processing, transportation, health care, and construction sectors. India has one of the world's highest out-of-pocket spending rates, with a cost making up about 62.6% of total health expenses. Migrant workers face healthcare financing burdens due to medical expenses resulting in large out-of-pocket payments. This narrative review aims to gain insight into why migrant workers face out-of-pocket expenditures on health and explore the inclusion of migrant workers in the existing healthcare system in India. For the literature search, databases like PubMed and Google Scholar were used to find relevant articles. This review will be helpful from the public health perspective in illustrating the need for studies and research on the health rights of migrant workers, their healthcare finances, and the social protection of such vulnerable populations who are poor and marginalized. Due to various health disparities, migrant workers may incur unforeseen out-of-pocket costs for the household healthcare system. Health insurance enhances the likelihood of accessing healthcare and minimizes out-of-pocket expenses on inpatient services. Patients' visits to primary healthcare facilities are not increased by health insurance; hospitals remain the primary healthcare provider. Most interstate migrant workers remain unprotected and burdened by the cost of healthcare due to OOP payments in case of medical emergencies. The legal status is a crucial predictor of migrants' access to affordable and adequate health care in a country.

The Effect of Parenting and the Parent-Child Relationship on a Child's Cognitive Development: A Literature Review.

Various studies have been done on subjects such as parenting, parent-child relationships, parenting style, effortful parenting, the concept of parenting, the cognitive development of children, and the cognition of parents. This research is mainly based on parenting practice, child development, and maturation. Children's cognitive development starts in the first year of life and then progresses gradually. Children require positive parenting in painful and different situations. Parenting gives a child the confidence to face crucial, challenging problems. Sensitive parenting and caregiving are required for the child's maturity and cognitive development. Media has been observed to be essential in improving parenting practices. Children exhibit internalizing and externalizing symptoms as a result of harsh, aggressive, and intrusive parenting. According to the data, it is seen that the risk of depression increases in adolescence. The main reason for the rise in depression in children is the non-cooperation and support of mothers and fathers. The risk of depression decreases in children whose mothers and fathers are cooperative and supportive. While family and social stress increase the chances of depression in children, a negative parenting style means children face family and social anxiety. Due to the high level of hostile parenting and low level of positive parenting, they experience stress, peer pressure, and social and family relationship problems. Another excellent term for effortful control parenting is required for children's cognitive development. Parenting is necessary for the regulation of emotions and behavior. There are many problems seen in infancy, early childhood, and late childhood. There are four types of parenting styles seen: authoritative parenting, authoritarian parenting/controlling parenting, permissive parenting/indulgent parenting, and uninvolved parenting/neglecting to parent. Good parenting requires one to know the concept of good parenting, the idea of parenting, the importance of parenting and children's needs, the components of parenting, and the consequences of parenting.

Vitiligo: A Narrative Review.

Vitiligo, a common depigmenting cutaneous condition, is thought to affect 0.5%-2% of the world's population. During this condition, melanocytes are selectively lost, resulting in non-scaly, chalky-white macules. Achromic macules and patches are side effects of the multifaceted disease vitiligo, defined as the absence of epidermal pigmentation. The causes of this disaster are three significant factors. A suppressed reaction to touch allergens is one of many abnormal activities of the hypopigmented epidermis, which has also been observed in hypopigmented rats. The white epidermis of people with albinism, which is the same color as vitiligo, is more vulnerable to skin carcinoma; the white epidermis of people with vitiligo does not develop non-melanoma skin carcinoma. The overall etiology of vitiligo, which is now categorically recognized as an immunological illness, has made significant strides in recent years. Even though vitiligo is frequently dismissed as an esthetic issue, it can have serious mental consequences and significantly interfere with daily life. A global consensus in 2011 classified segmental vitiligo separately from all other types of vitiligo. The term vitiligo has been repurposed to refer to various types of nonsegmental vitiligo. There are numerous pharmaceutical procedures available on the market that aim to stop the development of and induce epidermal repigmentation. Variable levels of skin pigmentation have been observed with such therapies, either alone or in combination, and their predominance was safe and efficient. There are few vitiligo treatments available, and none of them can reliably cause repigmentation in every individual. Individualized management is required depending on geography, physical appearance, and the presence of illness activities. The preceding study aims to provide insight into the potential prospects of vitiligo medication while also summarizing the current body of knowledge on the condition.

Correlation Between Chest CT Severity Scores and Glycosylated Haemoglobin Levels and its Outcome in Patients With COVID-19: A Retrospective Study in a Tertiary Care Hospital.

Background In this study, we aimed to compare the imaging findings between coronavirus disease (COVID-19) patients with well-controlled, poorly-controlled, and non-diabetic patients and subsequently find any relation between haemoglobin A1c (HbA1c) levels and high-resolution chest computed tomography (HRCT) chest score. Methodology A total of 200 individuals with coexisting COVID-19 and type 2 diabetes mellitus were included in this retrospective cohort study. Based on their HbA1c levels, patients were divided into three groups. The imaging data and laboratory values were obtained from the online medical records of the patients. In addition, the chest computed tomography (CT) score was evaluated as the sum of individual scores from five lung lobes: scores of 0, 1, 2, 3, 4, and 5 were assigned to each lobe. Any peripheral opacification pattern was noted. Haemoglobin A1c (HbA1c) levels and HRCT scores were then analysed by multiple linear regression models using R software. Results The prevalence of diabetes in the study population was 71.5%. Of this, 56 patients had well-controlled diabetes (28%) and 87 patients had poorly controlled diabetes (43.5%); 126 (63%) patients were male and the median age was 54.45 years (95% CI: 54.45 ± 15.53). We found that diabetes status, co-presence of ground-glass appearance with mixed consolidation, and consolidation and reverse halo sign in the HRCT findings were significant predictors of the HRCT scores in patients with COVID-19. Conclusions The presence of any co-morbidities should be viewed as a high-risk case of COVID-19. Diabetes status is significantly associated with the severity of HRCT findings in lab-confirmed COVID-19 infection. Therefore, it is important to prioritise the patients who have COVID-19 along with diabetes.

Perceived burden, causes and consequences of adolescent pregnancy in the rural Maharashtra: a cultural domain analysis.

OBJECTIVES: The existing level of the early age pregnancy necessitates in-depth discussions and study. The objective of this study is to explore the perception of rural population regarding adolescent pregnancy with reference to the perceived burden, causes and consequences. METHODS: A cross-sectional study through cultural domain analysis using free listing and participatory learning and action (PLA) tool of ten seed analysis was used for exploring the perceptions of the community. Cognitive salience was estimated using the Sutrop (Su) index. RESULTS: The perceived burden of adolescent pregnancy was around 18%. Early marriage (Su index = 0.274), love/relationship (Su index = 0.246), pre-marital sex (Su index = 0.215), rape/incest (Su index = 0.162), and poor educational status (Su index = 0.152) were the salient causes of adolescent pregnancy. The salient consequences identified were weak baby (Su index = 0.170), social stigma (Su index = 0.124), excessive bleeding during delivery (Su index = 0.114), mother may die (Su index = 0.112) and abortion (Su index = 0.109). CONCLUSIONS: Teenage pregnancy is perceived as a problem by the community. The causes of teenage pregnancy in this setting are multi-dimensional and are deeply embedded in the system of local values, beliefs and practices.