Exploring the viability of newer technologies in care and management of tribal diabetes and metabolic syndrome in India

With the advancements of digitalization technology in health sector, diabetes care and management have also experienced modifications and betterment. Various newer technologies cater to the individual conditions and needs and provide a personalized treatment. Device based technologies such as continuous glucose monitoring (CGM) linked to closed loop insulin delivery system, insulin pumps, wearable devices linked with mobile apps have made the self-management of diabetes possible on regular basis. In its contrast, the technologies are yet to reach the tribal settings of India, and also very challenging to implement. Studies have shown that the scenario of diabetes prevalence in Indian tribal population is as crucial as urban population. Also, land alienation, lack of health management infrastructure, low connectivity, technological challenges add up to their condition. While various technologies are challenging to implement due to electricity, network connectivity, infrastructure and storage facilities, some technologies can be implemented easily with the joint approach of primary health care staff, governmental and non-governmental organizations and people with diabetes themselves. Digitization of data is needed as it will give a clearer picture of the prevalence, provide easy access for the follow ups and easier to implement intervention-based technologies. The situation demands a tailored multifaceted approach for implementing the technological based remedies in tribal settings of India as it will increase the quality of life in these areas

Pervasiveness of metabolic syndrome and cardiovascular disease in tribal/rural population of India: a review

Diseases classified as non-communicable diseases (NCDs) are those that are often caused by unhealthy behaviors rather than by infection or by contact with others. One of the main NCDs causing many fatalities is cardiovascular disease (CVD). Recent research has shown that the prevalence of metabolic syndrome (Mets) associated CVDs among tribal populations is increasing in rapid pace. In this review, we have included studies investigating the components of Mets and the relationships between Mets and CVDs. From the assessment of studies, we may predict a significant association between Mets and CVDs as a whole. Our evaluation of these studies revealed that carrying at least three Mets risk components, like hyperglycemia, obesity, dyslipidemia, and high blood pressure, significantly enhances the risk of CVDs. Undernutrition, smoking, and a low intake of fruits and vegetables in the Indian tribal population are the main risk factors for managing Mets associated CVDs. Furthermore, various studies have also shown that Mets may be influenced by genetic and environmental factors. Finally, healthy habits such as a balanced diet and frequent exercise should be introduced from a young age in individuals, to prevent Mets progression. In order to combat the Mets associated CVDs, functionally upgraded primary health centers and special IECs (Information, education and communication) programs may play a beneficial role. Furthermore, strengthening public healthcare systems and focusing on prevention, early identification, and treatment using medical and social interventions can be of immense help in managing the metabolic risk factors that can lead to CVDs

Challenges and opportunities in mixed method data collection on mental health issues of health care workers during COVID-19 pandemic in India

Background: The present paper describes the key challenges and opportunities of mixed method telephonic data collection for mental health research using field notes and the experiences of the investigators in a multicenter study in ten sites of India. The study was conducted in public and private hospitals to understand the mental health status, social stigma and coping strategies of different healthcare personnel during the COVID-19 pandemic in India.Methods: Qualitative and quantitative interviews were conducted telephonically. The experiences of data collection were noted as a field notes/diary by the data collectors and principal investigators.Results: The interviewers reported challenges such as network issues, lack of transfer of visual cues and sensitive content of data. Although the telephonic interviews present various challenges in mixed method data collection, it can be used as an alternative to face-to-face data collection using available technology.Conclusions: It is important that the investigators are well trained keeping these challenges in mind so that their capacity is built to deal with these challenges and good quality data is obtained

Factors associated with stigma and manifestations experienced by Indian health care workers involved in COVID-19 management in India: A qualitative study

Healthcare personnel who deal with COVID-19 experience stigma. There is a lack of national-level representative qualitative data to study COVID-19-related stigma among healthcare workers in India. The present study explores factors associated with stigma and manifestations experienced by Indian healthcare workers involved in COVID-19 management. We conducted in-depth interviews across 10 centres in India, which were analysed using NVivo software version 12. Thematic and sentiment analysis was performed to gain deep insights into the complex phenomenon by categorising the qualitative data into meaningful and related categories. Healthcare workers (HCW) usually addressed the stigma they encountered when doing their COVID duties under the superordinate theme of stigma. Among them, 77.42% said they had been stigmatised in some way. Analyses revealed seven interrelated themes surrounding stigma among healthcare workers. It can be seen that the majority of the stigma and coping sentiments fall into the mixed category, followed by the negative sentiment category. This study contributes to our understanding of stigma and discrimination in low- and middle-income settings. Our data show that the emergence of fear of the virus has quickly turned into a stigma against healthcare workers

Bone Deformity due to Excess Fluoride and Relation with Food Nutrients

63-67Fluorosis has emerged as a new public health problem in specific areas of India during the last few years. Fluorosis is a form of fluoride poisoning based on intake of excessive fluoride for a longer period through drinking water. Prior to this study Mandala distt. of Madhya Pradesh had no place in the fluoride marked map. In 1995 for the first time in Madhya Pradesh this centre identified this disease. With a view to have an estimation of the alarming range of fluorisis as a result of excessive fluoride, Regional Centre for Tribal Medical Research, Jabalpur investigated 2263 people of 5 villages of Madhya Pradesh. This paper comprises the details of the study undertaken

Nutritional status of adolescents of Baiga - A primitive tribe of Central India

149-157Adolescents constitute about 25% of population and form an important physiological group whose nutritional need demands a special attention. Due to increased physical activity, caloric and protein requirements are maximal. Moreover, because of poor eating habits and other factors like menstruation and pregnancy contribute in accentuating the potential risk for poor nutrition among adolescent girls. Baigas are listed as one of the primitive tribes of Central India. There is no data regarding diet and nutritional status of adolescents of tribe. A cross sectional study was carried out in 2002 in the Baigachak area of Dindori District, Madhya Pradesh. Eight villages were selected randomly and four hundred households consisting of 434 adolescents between the age of 10 and 18 years were included for this study. Diet survey was carried out by 24 hours recall method. The extent of underweight and stunting was assessed using standard deviation classification. Statistical significance between rural and tribal data was evaluated by Students 't'-test. The average daily intake of cereals was significantly higher among tribal adolescents as compared to rural adolescents. Intake of Fat, Iron, Carotene, Riboflavin and Vitamin-C were 60% lower than the Recommended Dietary Allowances (RDA). About 62% of tribal adolescents in both genders were underweight (< median to -2 SD) and 52% stunted. This was higher than the rural adolescents at 42% and 39%, respectively. High prevalence of underweight and stunting observed among tribal adolescents than rural adolescents. Hence special nutrition supplementation programme aimed at adolescents should be launched to improve their nutritional status

Psychosocial health and stigma among health-care workers involved in COVID19 management during the first wave of the pandemic in Mumbai: A qualitative study

Background: The unprecedented onset of coronavirus disease 2019 (COVID-19) had a huge impact on health-care facilities, leading to different psychosocial challenges among health-care workers (HCWs) during this pandemic. Aim: This study aimed to explore the impact of COVID-19 on the work, family, and personal life of HCWs engaged in COVID-19 duties during the first wave in India and gain insights on the coping strategies. Materials and Methods: The findings from 12 qualitative in-depth interviews were analyzed and presented in this article. This study is a part of a mix-method design study conducted at two hospitals and one community site in Mumbai, Maharashtra. The present qualitative sample was drawn conveniently from the randomly selected quantitative sample chosen from the three sites. Results: This study highlights that in the early stage of the COVID-19 pandemic, HCWs experienced transition in work life, burnout, disruption in family life, negative emotions such as fear, and experiences of stigma. The findings also reveal that while institutional workers faced discrimination and stigma outside their workplace, noninstitutional workers faced discrimination at multiple sites during traveling and at in their residential places and additionally faced harassment while working in the community. The findings also suggest that despite numerous challenges faced by HCWs, they were driven by a sense of responsibility and displayed resilience. Conclusion: Considering the HCWs as the backbone of the health-care system, it is crucial to boost and maintain the mental well-being of HCWs by providing timely and tailored interventions to sustain their resilience and build better responses to future pandemic

Data_Sheet_1_Health profile of people living in the Gare Palma mining area of Tamnar block, Raigarh, Chhattisgarh, India.docx

IntroductionA community-based health survey was conducted in Tamnar block, Raigarh district of Chhattisgarh, India.MethodologyA total of 909 individuals (adults) were selected from 909 households from 33 sampled villages from March 2019 to February 2020. All individuals were clinically examined, and observations were recorded.ResultsAmong adults older than 18 years, hypertension was observed in 21.7%. Type II diabetes was observed in only 4.0% of individuals. Tuberculosis was seen in 23 (2.5%) individuals.DiscussionCommon morbidities were similar in tribal and non-tribal communities living in the same area. For communicable diseases, being male, having nutritional deficiencies, and smoking were independent risk factors. For non-communicable diseases, the independent significant risk factors identified were being male, an altered body mass index, disturbed sleep, smoking, and nutritional deficiencies.</p

Psychosocial impact of COVID-19 pandemic on healthcare workers in India & their perceptions on the way forward - A qualitative study

Background & objectives: The healthcare system across the world has been overburdened due to the COVID-19 pandemic impacting healthcare workers (HCWs) in different ways. The present study provides an insight into the psychosocial challenges faced by the HCWs related to their work, family and personal well-being and the associated stigmas. Additionally, the coping mechanisms adopted by them and their perceptions on the interventions to address these challenges were also explored. Methods: A qualitative study was conducted between September and December 2020 through in-depth telephonic interviews using an interview guide among 111 HCWs who were involved in COVID-19 management across 10 States in India. Results: HCWs report major changes in work-life environment that included excessive workload with erratic timings accentuated with the extended duration of inconvenient personal protection equipment usage, periods of quarantine and long durations of separation from family. Family-related issues were manifold; the main challenge being separated from family, the challenge of caregiving, especially for females with infants and children, and fears around infecting family. Stigma from the community and peers fuelled by the fear of infection was manifested through avoidance and rejection. Coping strategies included peer, family support and the positive experiences manifested as appreciation and recognition for their contribution during the pandemic. Interpretation & conclusions: The study demonstrates the psychological burden of HCWs engaged with COVID-19 care services. The study findings point to need-based psychosocial interventions at the organizational, societal and individual levels. This includes a conducive working environment involving periodic evaluation of the HCW problems, rotation of workforce by engaging more staff, debunking of false information, community and HCW involvement in COVID sensitization to allay fears and prevent stigma associated with COVID-19 infection/transmission and finally need-based psychological support for them and their families