Community Health Immersion Programs in Medical Institutions.

Exposure to the local community is crucial and pivotal to deliver contextual learning to medical students and thereby aid in the process of attaining subject-specific competencies. In the field of medical education, community health immersion refers to a set of systematic and immersive educational experiences for medical students to expose them to sociocultural and health-related attributes of the general population. Community health immersion has been linked with multiple merits that are crucial in the making of a competent medical graduate, who is well equipped to deliver patient-centered care. Even though there are multiple benefits to community health immersion nevertheless, its implementation in the community might vary based on institutional support and local community-related factors. There is an immense need to overcome these challenges to ensure optimal benefit, and this will essentially require the adoption of a multipronged approach with the help of all the concerned stakeholders.

Cultural Competency Training of Medical Students among Trauma Patients: Training and Assessment Strategies.

In the field of health care, cultural competency refers to the ability of healthcare professionals to acknowledge, respect, and accordingly respond to the varied needs, beliefs, values, and practices followed by persons and the communities they serve. The purpose of the current review is to explore the role of cultural factors and trauma experience, and identify the strategies that can be employed to train and assess medical students in cultural competency pertaining to trauma patients. An extensive search of all materials related to the topic was carried out on the PubMed and Google Scholar search engines and a total of 21 articles were selected based on their suitability with the current review objectives. Cultural factors play a defining role in determining the experiences of trauma patients, and how these patients and family members perceive, cope, and recover from such traumatic events. To meet the diverse needs of the community, the medical curriculum has to be flexible and must include the component of cultural competency. Like any other domain, medical educators must plan for the assessment of cultural competencies while delivering trauma education, as it will provide insights into the readiness of the students to deliver culturally sensitive and effective care to trauma patients. In conclusion, the inclusion of cultural competency training within trauma care in the medical curriculum carries immense utility as it can help healthcare professionals to effectively communicate and respond to the varied needs of trauma patients, regardless of their cultural backgrounds. This calls for the adoption of a combination of teaching-learning methods and assessment methods by medical educators so that medical students can be empowered to deliver culturally sensitive medical care to trauma patients.

Revitalizing Medical Education Delivery through Teacher-Led Curriculum Critiques: A Narrative Review.

A teacher in a medical college is like a compass who has the responsibility and the power to guide budding medical students in their educational journey to become effective and efficient members of the healthcare team. The purpose of the current review is to justify the significance of curriculum evaluation, explore the role of teacher in the capacity of curriculum evaluator, enlist various methods and tools to perform curriculum evaluation, and identify the challenges and suggest potential solutions to overcome them. An extensive search of all materials related to the topic was carried out on the PubMed and Google Scholar search engines and a total of 16 articles were selected based upon their suitability with the current review objectives and analyzed. Keywords used in the search include curriculum evaluation in the title alone only (viz. curriculum [ti] AND medical [ti]; curriculum evaluation [ti] AND methods [ti]; curriculum evaluation [ti] AND approaches [ti]; curriculum evaluation [ti]). A number of strategies can be employed to perform the evaluation of the medical curriculum, ranging from obtaining feedback from medical students at the end of each professional phase to assessing content, teaching methods, assessment, and attainment of learning outcomes. The process of evaluation of medical curriculum by teachers is a complex and challenging one and needs careful planning and execution of different aspects. These identified challenges clearly provide evidence that teachers have to be given the necessary training, resources, and institutional support to enable them to conduct effective medical curriculum evaluation. In conclusion, teachers in their capacity as curriculum evaluators remain the most important stakeholder in ensuring continuous improvement in the quality of education delivered to students. Owing to their in-depth awareness of classroom dynamics, the learning process, and the awareness about unique needs of students, their involvement in curriculum evaluation can ensure alignment between the delivered curriculum and the needs of the society.

Application of Artificial Intelligence in the Management of Drinking Water: A Narrative Review.

Waterborne illnesses are a significant concern worldwide. The management of water resources can be facilitated by artificial intelligence (AI) with the help of data analytics, regression models, and algorithms. Achieving the Sustainable Development Goals (SDGs) of the 2030 Agenda for Sustainable Development of the United Nations depends on understanding, communicating, and measuring the value of water and incorporating it into decision-making. Various barriers are used from the source to the consumer to prevent microbiological contamination of drinking water sources or reduce contamination to levels safe for human health. Infrastructure development and capacity-building policies should be integrated with guidelines on applying AI to problems relating to water to ensure good development outcomes. Communities can live healthily with such technology if they can provide clean, economical, and sustainable water to the ecosystem as a whole. Quick and accurate identification of waterborne pathogens in drinking and recreational water sources is essential for treating and controlling the spread of water-related diseases, especially in resource-constrained situations. To ensure successful development outcomes, policies on infrastructure development and capacity building should be combined with those on applying AI to water-related problems. The primary focus of this study is the use of AI in managing drinking water and preventing waterborne illness.

Understanding the Factors Contributing to Suicide Among the Geriatric Population: A Narrative Review.

A critical health concern for older adults is suicide, particularly for those above the age of 60 years. Despite this, research on suicide in this age group is relatively scarce compared to studies on younger populations. This article is intended to summarize the existing literature on etiological/risk factors, including problems with one's physical and mental health, social isolation, money, and life changes like retirement and the death of a spouse and methods for preventing suicide specific to the geriatric population. We conducted a comprehensive literature search to identify the original reports and reviewed publications through various databases, including Google Scholar, PubMed, and the CDC. We gathered information on Google from reputable sources such as the WHO and the National Crime Records Bureau (NCRB). Our review found that the risk factor of suicide in the geriatric population includes physical illness, familial issues, financial issues, and hopelessness. The suicide rate for older adults declined, dropping from 16.17 per 100,000 individuals to 14.25 per 100,000 individuals aged 50 to 69 years and from 27.45 per 100,000 individuals to 24.53 per 100,000 individuals for those over 70 years. A more significant proportion of elderly suicide attempters come from rural than urban locations. Young individuals have better professional opportunities in urban areas, but older people are dispersed to underdeveloped or rural areas, where they are more likely to experience social isolation. By systematically identifying these risk factors, we can develop prevention and intervention strategies to decrease the suicide rates among the geriatric population.

Recent Outbreak of Monkeypox: Implications for Public Health Recommendations and Crisis Management in India.

Monkeypox is a rare and self-limiting disease that was eradicated globally through vaccination approximately forty years ago, following the eradication of smallpox. The purpose of this article is to explore the implications of the recent monkeypox outbreak on public health recommendations and crisis management in India. An overview of the consequences of the current monkeypox epidemic on public health, epidemiology, clinical findings, management, challenges, and existing strategies for this disease, along with recommendations are discussed. It is crucial to develop evidence-based recommendations for the diagnosis and treatment of monkeypox, as well as early case identification and contact tracing. To prevent the spread of infection, travelers from affected countries should be subjected to health testing and quarantine. In order to successfully control the outbreak, a multidisciplinary team should be established to manage the monkeypox virus at tertiary care facilities, and health workers with occupational exposure to the virus should be assessed and given management plans.

Assessment of Obesity and Associated Risk Factors of Diabesity in an Urban Population in Central India.

Background Over the past 20 years, the prevalence of adult obesity has doubled. International awareness of the body mass index (BMI) as a benchmark for identifying and categorizing overweight and obesity has grown. This study was conducted to assess the socio-demographic factors of the study participants, assess the prevalence of obesity amongst the study subjects, find an association between risk factors and diabesity, and assess obesity using the percentage body fat and waist-hip ratio of study participants. Methods This study was undertaken among diabetes patients residing in the field practice area of the Urban Health and Training Centre (UHTC), Wadi, affiliated with the Datta Meghe Medical College, Nagpur, from July 2022 to September 2022. Two hundred and seventy-eight diabetic people were included as study participants. Systematic random sampling was used to identify study subjects visiting UHTC, Wadi. The World Health Organization's step-by-step approach to the surveillance of risk factors for chronic diseases served as the model for the questionnaire. Results Among the 278 diabetic study participants, the prevalence of generalized obesity was 76.61%. Obesity was more prevalent in subjects with a family history of diabetes. All hypertensive subjects were obese. Obesity was more prevalent among tobacco chewers. In obesity assessment using body fat percentage when compared with standard BMI, the sensitivity was found to be 84% and specificity was 48%. Conclusion Body fat percentage is a simple estimation that can identify obesity among diabetic individuals who are non-obese by BMI. We can change the behavior amongst non-obese diabetic individuals by giving health education, thereby reducing insulin resistance and improving compliance and adherence to the treatment.

Role of Telemedicine and Digital Technology in Public Health in India: A Narrative Review.

There are still many areas of India without proper medical facilities. In such a setting, technology can play a facilitating role, particularly in reaching out to remote locations and offering a greater standard of care at a lower cost. The method of treating and diagnosing patients remotely through communication networks is known as telemedicine. When more patients get access to telemedicine, payers take more notice of how much less expensive it is than traditional medicine, and doctors are aware of its benefits. Telemedicine is a more beneficial technology that can expand access to preventive treatment and may lead to long-term health. Telemedicine has the potential to greatly affect public health. This paper reviews the current state of the art of telemedicine in India. Nearly 50 years ago, telemedicine was shrugged off as a complicated, expensive, and inefficient technology. Because of how quickly the information technology and telecommunications disciplines are advancing, telemedicine is today a viable, dependable, and useful technique. Practitioners and medical experts from a variety of fields have experienced success with telemedicine. The COVID-19 pandemic highlighted the need for strong primary healthcare networks for a more effective public health response during health emergencies and exposed the fragmentation of healthcare delivery systems. Although primary care is the first point of contact between the general public and the healthcare system, it has not recently grown much focus or funding. Even in the post-COVID-19 environment, telemedicine offers the potential to get through enduring barriers to primary care in India, such as a shortage of qualified medical professionals, issues with access, and the cost of in-person care. Telemedicine has the power to speed up the delivery of universal health coverage while strengthening primary care. There is a widening gap between people and those who offer basic health services as the population in India has grown, and the average lifespan has increased. Telemedicine helps with palliative care, early identification, a better cure, prevention, and rehabilitation in the treatment of cancer. Due to a shortage of primary care delivery networks and referral units, secondary and tertiary care facilities' health systems are overworked. To successfully use telemedicine, proper planning and operating processes are required. Thus, the development and implementation of telemedicine will improve patient care and India's primary healthcare system in the future. Finally, telemedicine's cost-effectiveness will likely be its most significant outcome.

Study of Menstrual Hygiene Practices Among Adolescent Girls in a Tribal Area of Central India.

Introduction Menstruation is an essential phenomenon in an adolescent girl's life. In India, females who are menstruating are considered impure and teenage girls are not allowed to undertake home chores or engage in religious or cultural events during their period. Up-to-date knowledge about menstruation, beginning in early adolescence, would improve safe practices and relieve the distress of millions of women. Material and methods A cross-sectional study was conducted among adolescent girls (10-19 years) residing in a tribal area of Nagpur District from January to March 2022. Three tribal residential schools (Ashram Shala) were selected from a total of six in Hingana Taluka of Nagpur District, using simple random sampling to fulfill the required sample size of 272. Demographic details, age at menarche, awareness of menstruation, sources of information about menstruation, menstrual hygiene practices, and restrictions observed during menstruation were assessed. Results The average age at menarche was 13.04+0.96 years (range 11-16 years). Only 45.17% of girls were aware of the menarche and menstrual cycle before its onset. The duration of the menstrual cycle ranged from 21-35 days in most of the girls (90.69%), and it was regular in 85.86% of girls. Duration of bleeding was two to six days for the majority of the girls (87.93%). Around 73.79% of girls were using sanitary pads, while 26.21% of girls were using clothes. The most important restrictions imposed on the girls during menstruation were not being allowed to attend religious functions (97.93%), followed by not being allowed to attend classes (65.86%). The use of sanitary pads was significantly more in late adolescent girls than in early adolescent girls (ꭓ2=14.97, p=0.0001), girls who have literate mothers than girls with illiterate mothers (ꭓ2=5.17, p=0.02), and girls belonging to higher socioeconomic classes (class I, II, III) than lower ones (class IV, V) (ꭓ2=44.23, p<0.0001). Conclusion The tribal adolescent girls still don't exercise proper hygiene throughout their periods. During menstruation, the majority of girls are still subjected to various restrictions.

Universal Health Insurance coverage and utilization among women in urban slum of Rajnandgaon, Chhattisgarh.

BACKGROUND: Universal Health Coverage refers to health care system that provides health care and financial protection to all the citizen. Rashtriya Swasthya Bima Yojna as National Health Insurance Scheme initiated in Chhattisgarh State in 2009 for below poverty line families. Second scheme is Mukhyamantri Swasthya Bima Yojna initiated in 2012, which covers non below poverty line families. OBJECTIVES: To assess socio demographic factors among women residing in slum of Rajnandgaon, to find their universal health insurance coverage under RSBY/ MSBY and to assess the extent of concerned treatment under RSBY/MSBY. METHODS: It was a community based cross sectional study, conducted in the urban slum area of Rajnandgaon amongst 188 women above 18 years of age who were hospitalized 6 months prior to the study using snow ball technique as a sampling method. They were interviewed using semi structured questionnaires by the investigator with the help of anganwadi worker. RESULT: 77.65% respondents/study subjects were enrolled under the universal health insurance (RSBY card/ MSBY card). Subjects belonging to Lower socio-economic status and having BPL card were enrolled under scheme more than upper socio-economic group. Out of 146 smart card holders, a mere 1.36% subjects incurred catastrophic OOPE. Out of 42 respondents not having smart card, 40.47% subjects incurred catastrophic OOPE. CONCLUSION: The RSBY card reduced the inpatient OOPE. RSBY card prevented catastrophic OOP in most of the respondent. RSBY has made health services accessible to all sections of community at minimal cost.

A proposed ABCD scoring system for better triage of patients with COVID-19: Use of clinical features and radiopathological findings.

BACKGROUND AND AIMS: Currently there are limited tools available for triage of patients with COVID -19. We propose a new ABCD scoring system for patients who have been tested positive for COVID-19. METHODS: The ABCD score is for patients who have been tested positive for COVID-19 and admitted in a hospital. This score includes age of the patient, blood tests included leukopenia, lymphocytopenia, CRP level, LDH level,D-Dimer, Chest radiograph and CT Scan, Comorbidities and Dyspnea. RESULTS: The triage score had letters from alphabets which included A, B, C, D. The score was developed using these variables which outputs a value from 0 to 1. We had used the code according to traffic signal system; green(mild), yellow moderate) and red(severe). The suggestions for mild (green)category: symptomatic treatment in ward, in moderate (yellow) category: active treatment, semi critical care and oxygen supplementation, in severe (red) category: critical care and intensive care. CONCLUSIONS: This study is, to our knowledge, is the first scoring tool that has been prepared by Indian health care processional's and used alphabets A, B,C,D as variables for evaluation of admitted patients with COVID-19. This triage tool will be helpful in better management of patients with COVID-19. This score component includes clinical and radiopathological findings.A multi-centre study is required to validate all available scoring systems.

Supportive supervision of routine immunization in Rajnandgaon district of Chhattisgarh.

BACKGROUND: Immunization coverage in Chhattisgarh has never been abysmal but the improvement is rather insignificant over the years. Some more interventions are essential to strengthen different aspects of immunization services such as micro-planning, cold-chain and logistics management, monitoring/supportive supervision, and community mobilization. The present study was considered as a part of ongoing UNICEF funded Project on Supportive Supervision of Routine Immunization in Rajnandgaon district undertaken by the Department of Community Medicine, Government Medical College, and Rajnandgaon CG with the objectives to observe key quality parameters at Ice Lined Refrigerator (ILR) points and to assess knowledge and practice of Vaccine Cold Chain Handler (VCCH). METHODS: A facility-based, cross-sectional study (repeat survey) was conducted from May 2017 to June 2018 in the Rajnandgaon district of Chhattisgarh. First phase of the study was conducted from May 2017 to November 2017 and repeat survey was conducted from December 2017 to June 2018. Structured questionnaires as a part of standard tool prescribed by Government of India was used for the collection of required data. RESULTS: The cumulative score status out of all the 50 centres in Rajnandgaon district showed improvement in 35 centres. The score of important components such as vaccine management, equipment maintenance, temperature monitoring, and monitoring and supervision information improved, but that of background information and human resource component decreased. CONCLUSION: Supportive supervision strategy can be more beneficial in improving the cold chain maintenance process provided that components such as logistic, infrastructure, and manpower are in place to enhance service delivery. Supportive supervision is a continuous process, so regular follow-up and monitoring visits are essential to achieve the targets.

Cold chain maintenance in Rajnandgaon and Bilaspur districts of Chhattisgarh: A process evaluation.

BACKGROUND: Cold chain and vaccine logistic is a key driver of immunization program. It has been observed that besides intensification of routine immunization, more strategic interventions are essential to strengthen the different aspects of immunization services like cold-chain management and monitoring/supportive supervision. The present study was considered as a part of ongoing UNICEF funded Project on Supportive Supervision of Routine Immunization in Rajnandgaon and Bilaspur districts undertaken by the Department of Community Medicine, Government Medical College, and Rajnandgaon with the objectives to assess the background information about cold chain points (CCPs), to observe the vaccine storage and handling practices, and to study the knowledge and practices of VCCH. MATERIALS AND METHODS: A cross-sectional facility based study was conducted from August 2017 to February 2018. Among60 CCPs, 48 from Rajnandgaon and 12 from Bilaspur district were considered for analysis. Structured questionnaires as a part of standard tool prescribed by Government of India was used for the collection of required data. RESULT: In 92% CCPs, the temperature of cold chain equipment (CCE) was recorded twice a day. In 93% CCPs, vaccines were correctly stored in ILR. In 75% CCPs, icepacks were correctly stored in DF, 90% vaccine cold chain handler (VCCH) could correctly demonstrate temperature reading from thermometer, 91% could tell about stages of VVM correctly. CONCLUSION: Most CCPs in both districts are doing good enough, and there is a scope of improvement in all the parameters by means of ongoing project of Strengthening of Supportive Supervision of Routine Immunization in both districts. It was evident that Rajnandgaon district scored more than Bilaspur in some parameters related to vaccine storage and handling practices.