Role of Community Medicine during COVID-19 Pandemic

Pandemics have significantly affected economy of each country. Health & political system have been also drastically affected in each part of the country. To fight against pandemic, it demands multidimensional approaches comprising of various measures like surveillance, containment, isolation & quarantine, border restriction as well as various socio-political and community measures. Though the entire health workforce is involved at multiple levels, the role of a community medicine/public health expert is maximum in controlling the spread in the community and managing the situation. The community medicine specialists can contribute to the public health as well as health-care services in combating the pandemic. This review has been done for giving an insight of proper utilisation of public health services and existing manpower of community medicine. Also this will channelize our health system and give a direction for combating future public health crisis.  So Government should utilise the experiences and expertise to manage the pandemic very well

Awareness regarding Janani Shishu Suraksha Karyakram (JSSK) among mothers: a community based cross-sectional study in rural area of Raipur district, Chhattisgarh

Background: In order to increase accessibility of health care services for pregnant women and sick infants and to reduce out-of-pocket expenditure, Ministry of Health and Family welfare, Government of India has launched a nationwide initiative- Janani Shishu Suraksha Karyakram on June 01, 2011. The objective of the study was to find out the awareness level about the entitlements of JSSK among mothers with child less than one year and its association with different socio-demographic variables.Methods: A community based cross-sectional study was conducted in rural block of Raipur district, Chhattisgarh, India, among 352 mothers having child less than one year using multistage random sampling using predesigned, pretested proforma from July 2015 to June 2016. Chi-square test was applied to find out the association between awareness level and different socio-demographic variables. P <0.05 was considered significant.Results: Among 352 mothers, good awareness were found in only 207 mothers (58.80%). Maximum awareness (89.20%) regarding entitlements among mothers was seen for free transport services from home to health institution followed by the drop back transport facility from hospital to home (85.22%). None of the mothers know about free diagnostic services for mothers and for sick infants and for free provision of blood for sick infants. Increasing parity was significantly associated with good awareness regarding JSSK.Conclusions: Level of awareness regarding JSSK entitlements for pregnant mothers and sick infants was found to be low. Extensive IEC needed to further increase the awareness regarding JSSK entitlements to increase utilization among beneficiaries

Prevalence, awareness, treatment and control of hypertension among adults of Raipur city, Chhattisgarh, India: a cross sectional study

Background: Hypertension is prevalent all over the world. Usually it is readily detectable, easily treatable condition and if left untreated may leads to serious complications. In considerable proportion of cases the disease tends to be asymptomatic for prolonged time, hence also labelled as ‘Silent killer’. High blood pressure (BP) is a major risk factor for cardiovascular disease and better control can lead to prevention of 300,000 of the 1.5 million annual deaths from cardiovascular diseases in India. The objective of the study was to find the prevalence, awareness, treatment and control status of hypertension among adults of Raipur city.Methods: A community based cross sectional study was carried out in 768 subjects of age 25-59 years residing in Raipur city, Chhattisgarh, India. A predesigned, pretested questionnaire was used for data collection. To classify blood pressure JNC VII criteria was used.Results: The prevalence of hypertension was 29.0 %. Out of 223 hypertensive (223/768), 59.2% were aware about their hypertensive status, in them 76.9% were on treatment and 49.5% were under control.Conclusions: There was striking lack of awareness of the condition and a suboptimal rate of control among those treated. These finding emphasize public health importance of hypertension in Raipur city and there is urgent need to address this through targeted intervention

A study of parasympathetic autonomic function in different phases of the menstrual cycle among young adult females

Background: The sex hormones, estrogen, and progesterone, as well as the gonadotropins, luteinizing hormone, and follicle-stimulating hormone produced from the anterior pituitary, govern the three stages of the menstrual cycle: menstrual, follicular, and luteal. Hormone fluctuations cause changes in autonomic function. There have been relatively few studies that show autonomic function modification throughout various periods of the menstrual cycle. Aim and Objectives: The current study was undertaken to investigate the difference in mean parasympathetic autonomic characteristics between the proliferative and secretory stages of the menstrual cycle. Materials and Methods: A total of 120 healthy young adult female volunteers were recruited among Kalinga Institute of Medical Sciences, Kalinga Institute of Nursing Sciences, and Kalinga Institute of Dental Sciences students. The study eliminated 20 students who were in the bleeding phase of their cycle. The electrocardiogram was captured, and parasympathetic parameters were determined using the fully automated CANWin instrument in the Department of Physiology. The data of the abovementioned parameters were compiled, tabulated, and entered into Microsoft Excel 2013 and statistically analyzed using STATA software 15.1. Results: The subjects' mean ages, heights, and weights were 18.9 ± 0.70 years, 156.6 ± 5.25 cm, and 53.7 ± 8.63 kg, respectively. The mean resting heart rate in the secretory phase was substantially greater than in the proliferative phase, indicating sympathetic dominance. The 30:15 ratio between proliferative and secretory stages. The mean E: I ratio calculated from the slow deep breathing maneuver reveals a statistically significant difference between the proliferative and secretory phases. Conclusion: During the secretory phase, there is a considerable rise in parasympathetic activity among the individuals in the current study. Changes in parasympathetic activity throughout the follicular and secretory stages of the menstrual cycle may be caused by fluctuations in estrogen and progesterone levels

Head and Neck Myxoma Presenting as Isolated Laryngeal Polyp

Myxoma is a benign tumour with a propensity for local infiltration and recurrence. Laryngeal myxoma presents as a submucosal polyp. Being an uncommon tumour and mimicking vocal cord polyp, only anecdotal evidence is available in the literature. The literature was reviewed from 1986 onwards using the keywords “myxoma” and “larynx.” The databases used were PubMed, Google Scholar, Scopus, and Web of Science. Along with this, we also report our case of vocal fold myxoma. We found a total of 19 studies reporting laryngeal myxoma. Laryngeal myxoma typically affects males in the 6th decade with a history of smoking. Unlike myxomas originating outside the larynx, recurrence is not widely described, and microlaryngeal surgery will usually suffice. Laryngeal myxomas should definitely be kept in the list of differential diagnosis when dealing with a benign-looking vocal fold lesion

Prevalence, awareness, treatment and control of hypertension among adults of Raipur city, Chhattisgarh, India: a cross sectional study

Background: Hypertension is prevalent all over the world. Usually it is readily detectable, easily treatable condition and if left untreated may leads to serious complications. In considerable proportion of cases the disease tends to be asymptomatic for prolonged time, hence also labelled as ‘Silent killer’. High blood pressure (BP) is a major risk factor for cardiovascular disease and better control can lead to prevention of 300,000 of the 1.5 million annual deaths from cardiovascular diseases in India. The objective of the study was to find the prevalence, awareness, treatment and control status of hypertension among adults of Raipur city.Methods: A community based cross sectional study was carried out in 768 subjects of age 25-59 years residing in Raipur city, Chhattisgarh, India. A predesigned, pretested questionnaire was used for data collection. To classify blood pressure JNC VII criteria was used.Results: The prevalence of hypertension was 29.0 %. Out of 223 hypertensive (223/768), 59.2% were aware about their hypertensive status, in them 76.9% were on treatment and 49.5% were under control.Conclusions: There was striking lack of awareness of the condition and a suboptimal rate of control among those treated. These finding emphasize public health importance of hypertension in Raipur city and there is urgent need to address this through targeted intervention

Inventory management of drugs at a secondary level health-care center in Odisha

Introduction: Planning the recurring purchases in the pharmacy results in efficient functioning of a health-care facility. Limited studies have explored the inventory management at secondary-care settings. The objective of this study was to analyze the annual drug expenditure of Community Health Centre (CHC), Tangi during the year 2017-2018. Material and Methods: The annual procurement of, and expenditure incurred on drugs for financial year 2017-2018 drugs was analyzed at the secondary level CHC always, better, control (ABC) analysis, vital, essential, desirable (VED) analysis and combination matrix of ABC-VED which are inventory management techniques based on expenditure, criticality, and combination of both. Results: Total expenditure for the year 2017–2018 on 232 drugs was 4,606,487 rupees. According to ABC analysis, Category A, B and C constituted 8.6%, 19.4%, and 72% accounting for 70%, 20%, and 10% of the total expenditure. VED analysis showed 21%, 66%, 13% items as Vital, Essential, and Desirable, accounting for 14%, 67%, and 19% of annual expenditure. On ABC-VED matrix analysis, 24.1%, 66.8%, and 9.1% drugs were found to be Category A, B and C, accounting for 74.7%, 24.6%, and 0.7% of annual expenditure. Conclusion: ABC-VED matrix analysis can be used for effective management of inventory at a secondary level healthcare centre

Spatial auto-correlation and endemicity pattern analysis of crimes against children in Tamil Nadu from 2017 to 2021

Background: A child is a nation’s supreme asset and future. India homes 444 million children, aged between 0 and 18 years, contributing to 19% of the world’s children. Crime against children is detrimental to their mental and physical health and affects their growth and development. The National Crime Record Bureau recently reported that a crime targeting children happens every 4 minutes. There is a paucity of literature regarding the burden of crime against children. To understand the magnitude and spatial distribution of crime against children, a retrospective surveillance study was conducted in the state of Tamil Nadu, India, from 2017 to 2021. Materials and Methods: This is a cross-sectional analytical type of study conducted in KIMSRC, Chengalpattu, Tamil Nadu. The data from the yearly crime review bulletin of Tamil Nadu from 2017 to 2021 were cleaned, transformed, and analyzed using Python v3.8 and subjected to geospatial auto-correlation and hotspot analysis using the Getis-Ord Gi* in ArcGIS Pro v3.1. The endemicity pattern was studied through cluster analysis with Hierarchical Density Based Scanning in Python and visualization in ArcGIS pro v3.1 in the study area. Results: In Tamil Nadu, only one hotspot district in 2017 [Tiruppattur (95% confidence, P < 0.05)] and one hotspot in 2020 [Villupuram (90% confidence, P < 0.1)] were identified, with others being insignificant. The districts which show very high prevalence of crimes against children are Chennai, Ranipet, Chengalpattu, Viluppuram, Tiruvannamalai, Vellore, Tiruppattur, Krishnagiri, Dharmapuri, Salem, Cuddalore, Thanjavur, Tiruchirappalli, Karur, Tiruppur, Coimbatore, Dindigul, Pudukkottai, Sivaganga, Tenkasi, Thoothukkudi, Tirunelveli, and Kanniyakumari. Conclusion: This study identifies key areas within the state of Tamil Nadu which have a high prevalence of crimes against children and also areas that are hotspots for such crimes. Greater resources and measures can now be targeted toward these areas by stakeholders, which can help in the reduction of crimes against children