INDIan Consensus on the mAnagemenT of cOugh at pRimary care setting (INDICATOR).

BACKGROUND: Cough has a prevalence of 9.6% globally and 5-10% in India. Though it is a reflex action, it affects an individual's quality of life (QoL) when uncontrolled. There was a need to create an integrated guidance document on managing cough focused on primary care physicians in the Indian setting. This consensus intends to bridge this gap by providing clinical recommendations to diagnose and manage cough in primary healthcare in India. MATERIALS AND METHODS: The modified Delphi method was used to arrive at a consensus on clinical statements. The panel comprised 10 experts, including pulmonologists, otolaryngologists, a pediatrician, and a general physician. The statements were discussed under the following domains: definition, etiology, diagnosis, and treatment. RESULTS: A total of 109 clinical statements were framed, with 75 reaching consensus, 13 reaching near consensus, and 21 reaching no consensus. The experts recommended empiric use of nonopioid antitussive agents for symptomatic relief of acute dry cough. The use of oral antihistamines, oral decongestants, or mucoactive agents as a part of fixed-dose combinations (FDCs) in cough associated with rhinitis or upper airway cough syndrome (UACS) can be considered for symptomatic relief. Maintaining good hydration is important to manage a productive cough. Codeine-based preparations are to be considered as a last resort in patients with an unexplained chronic cough when other treatments have failed. Additionally, insights were captured on red flag signs, nonpharmacologic therapy, special populations, and referral to higher centers. Experts have also proposed a management algorithm with an integrated care pathway approach for acute, subacute, and chronic coughs. CONCLUSION: The present consensus fills the existing need and may guide the physician to successfully diagnose and manage cough in the primary healthcare setting in India.

A Statement of Solidarity on COVID-19 Pandemic 2020 by the South Asian Family Physicians.

The World Organization of Family Doctors (WONCA) is a not-for-profit organization and was founded in 1972 by member organizations in 18 countries. WONCA now has 118 Member Organizations in 131 countries and territories with a membership of about 500,000 family doctors and more than 90 percent of the world's population. WONCA has seven regions, each of which has its own regional Council and run their own regional activities including conferences. WONCA South Asia Region is constituted by the national academies and colleges and academic member organizations of this region namely India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan, and the Maldives. In the background of the ongoing COVID 19 pandemic, the office bearers, academic leaders, practitioners, and researchers of primary care from the South Asia Region have issued a solidarity statement articulating the role of primary care physicians.

Domestic violence against women: A hidden and deeply rooted health issue in India.

BACKGROUND: Domestic violence was identified as a major contributor to the global burden of ill health in terms of female morbidity leading to psychological trauma and depression, injuries, sexually transmitted diseases, suicide, and murder. AIMS: The study was conducted to find out the prevalence of different types of lifetime domestic violence against women, factors associated with it, and care-seeking behavior. SETTINGS AND DESIGN: An observational cross-sectional study conducted at a slum of Burdwan district of West Bengal, India. METHODS AND MATERIAL: Study was done among 320 ever-married women of 15-49 years of age using a predesigned pretested proforma from March 2019 to December 2019 by face-to-face interview. STATISTICAL ANALYSIS USED: Data were compiled and analyzed by EpiInfo 6 and SPSS 20 version. RESULTS AND CONCLUSIONS: The overall prevalence of any form of violence during the lifetime among the study population was 35.63%. Verbal/psychological violence was the most common form of domestic violence (91.23%) followed by physical (82.46%) and sexual violence (64.91%). Slapping and/or beating, kicking, and object throwing were the major forms of physical violence; humiliation (88.46%) was the commonest form of psychological violence and most common form of sexual violence was forced sexual intercourse (51.35%). About 20% of the study population faced violence every day. Older age, lower age at marriage, longer duration of marriage, lower education of husband and wife, lower family income, unemployment of the husband, and alcohol consumption of husband were associated with the occurrence of domestic violence. We have found that the prevalence of domestic violence in this group of population is high. The alarming issue is that approximately one-third of women (32.46%) who faced violence in their lifetime had never sought any help. The findings indicate to develop appropriate and culturally relevant public health interventions to increase awareness.

Web-based KAP Intervention on Office Ergonomics: A Unique Technique for Prevention of Musculoskeletal Discomfort in Global Corporate Offices.

AIMS: The purpose of this study was to evaluate web-based Knowledge, Attitude and Practice (KAP) intervention on office ergonomics - a unique method for prevention of musculoskeletal discomfort (MSD) - in corporate offices that influences behavior modification. BACKGROUND: With the increasing use of computers, laptops and hand-held communication devices globally among office employees, creating awareness on office ergonomics has become a top priority. Emphasis needs to be given on maintaining ideal work postures, ergonomic arrangement of workstations, optimizing chair functions, as well as performing desk stretches to reduce MSD arising from the use of these equipment, thereby promoting safe work practices at offices and home, as in the current scenario many employees work from home with flexible work hours. Hence, this justifies the importance of our study. OBJECTIVE: To promote safe working by exploring cost-effective communication methods to achieve behavior change at distant sites when an on-site visit may not be feasible. MATERIALS AND METHODS: An invitation was sent by the Medical and Occupational Health Team of a multinational corporation to all employees at their offices in Sri Lanka, Singapore, and Malaysia to take up an online Nordic questionnaire, a screening tool for musculoskeletal symptoms, shared in local languages on two occasions - baseline evaluation (n = 240) and a follow-up evaluation after 3 months (n = 203). After completing the baseline questionnaire, employees were immediately trained on correct postures and office ergonomics with animation graphics. The same questionnaire was sent again after a 12-week gap only to those employees who responded to the baseline questionnaire on initial assessment. STATISTICAL ANALYSIS USED: Data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software and variables were compared using odds ratio as well as Chi-square test. RESULTS: Of the 203 employees who responded, 47.35% had some musculoskeletal symptoms. Among them 58.7% had lower back pain, 46.9% had upper back pain, 44.1% had wrist pain, 39.5% had shoulder pain, and 37% had knee pain. The percentages are high as some participants had multiple complaints i.e. 2 or 3 complaints. However, only 40% of these employees had ongoing symptoms at the time of evaluation (past 7 days). A subsequent 3-month evaluation after web-based intervention showed a significant 41-50% decline in ongoing symptoms. CONCLUSIONS: We conclude that newer technology using web-based animation graphics is a highly efficient technique to create office ergonomics awareness and has the potential to become a best practice in countries where language is a communication barrier and an on-site visit may not be feasible due to meagre resources.

Effective Office Ergonomics Awareness: Experiences from Global Corporates.

BACKGROUND: Use of laptops and hand-held devices increase the risk of musculoskeletal disorders (MSDs). More time spent on this activity adopting faulty postures, higher the risk of developing such injuries. This study addresses training on office ergonomics with emphasis on sustainable behavior change among employees to work in safe postures, as this is a top priority in the corporate environment, today. AIM: To explore training intervention methods that ensure wider coverage of awareness on office ergonomics, thereby promoting safer working and suggesting sustainable programs for behavior change and job enrichment. MATERIALS AND METHODS: A cross-sectional study was conducted (2012 - 2017), encompassing corporate office employees of multinational corporations selected from India, Dubai (U.A.E), Nairobi (East Africa), Durban (South Africa), South East Asian countries (Philippines, Vietnam, Indonesia, Singapore, Malaysia, Thailand and Sri Lanka).Participant employees (n = 3503) were divided into two groups to study the effect of interventions'; i.e., (a) deep training: 40 minute lecture by the investigator with a power point presentation (n = 1765) using a mock workstation and (b) quick training: live demonstrations of 10 minutes (n = 1738) using a live workstation. RESULTS: While deep training enhanced awareness in 95.51% and quick training in 96.59% globally, the latterwas much appreciated and educated maximum employees. From statistical analysis, quick training was found superior in providing comprehensive training and influencing behavior modification in India, but all over the world it was found highly superior in knowledge enlargement, skills enrichment in addition to providing comprehensive training (P < 0.05). In countries, located to West of India, it significantly influenced behavior modification. CONCLUSION: As because few employees attend deep training lectures, the quick 10-minute program is highly promising as it is practical, replicable, yields increased awareness with wider employee coverage in a much shorter time, instilling a feeling of caring and confidence amongst them towards a robust office ergonomics program. This could lead to propose as a best practice for corporate offices globally.