Global Journal of Medicine & Public Health

Socio-Demographic and Lifestyle Factors Influencing Adherence to AntiHypertensive Treatment in a Rural Area of Ludhiana, India

Sangeeta Girdhar — 2025-02-09

Background

Epidemiological transition has caused increase in burden of non-communicable diseases like hypertension

especially in developing countries like India which are further responsible for significant number of deaths among

patients.Untreated hypertension can lead to numerous complications in patients However, there is inadequate

adherence to therapeutical regimen observed among hypertensives with range varying from 19-96% in our country.

Hence, this study was done in a rural area of Ludhiana to determine adherence to anti-hypertensive treatment

among hypertensive patients and explore various socio-demographic and lifestyle factors associated with

adherence

Methodology

A cross-sectional study was conducted among clinically diagnosed cases of hypertension attending OPD at Rural

health Training centre, Pohir over 3-month period, aged above 18 years of age and were on treatment for at least 6

months. A pre-designed semi-structured questionnaire was used to assess the patient’s socio-demographic profile,

treatment seeking behaviour, duration and type of treatment and presence of any complication of hypertension.

Life style related habits like consumption of junk food, extra salt and alcohol, smoking and daily physical exercise

were also assessed. The patients who took medication for less than 80% of week (?5days) were considered as non

adherent. Weight and Height of the patients were measured and Body mass index (BMI) was calculated by using

formula (weight/height2 ). For categorization of BMI, Asia Pacific Classification was used.

Results

Of the 203 total diagnosed cases of hypertension, 184 patients were enrolled in the study, consisting of 104 males

(56.5%) and 80 females (43.5%). The mean age of the subjects was 59.9±11.75 years. Among 184 patients, 128

(69.5%) were adherent to treatment regimen and 56 (30.5%) were non adherent. Medication adherence was

significantly more among literate as compared to illiterate subjects. On assessing lifestyle related habits of the

subjects, it was observed that adherence was significantly higher in patients not consuming alcohol and no extra

salt intake and ones with no junk food preference. Also, complications were significantly higher among non

adherent patients (82.8%) as compared to ones who took their medication regularly (45.2%). Among reasons for

non-adherence to treatment, the most frequent reasons were discontinuation of medication when feeling well

followed by forgetfulness and financial issues amongst others.

Conclusions

Hypertension is becoming a global health issue and is yet a preventable disease if timely and adequately treated.

Non-adherence to drug therapy among anti-hypertensives is a matter worth concern. Improving adherence will not

only reduce complications and mortality among patients but also improve their quality of life and reduce financial

burden. Hence, certain interventions in this regard like health education and behaviour change communication are

utmost essential at community level.

A Comparative Study between outcome of 25% glucose in glycerin and submucosal human placental extract injection in the management of Primary Atrophic Rhinitis

Amlan Debbarma, — 2025-02-09

Background

Atrophic rhinitis is a chronic disease of the nose. Progressive atrophy of nasal mucosa and underlying turbinates,

formation of scanty viscid secretion and crusts causing foul odor are the cardinal features of this disease. Treatment

can be conservative as well as surgical. This study aimed to compare the outcome of 25% glucose in glycerin

solution and Sub-mucosal human placental extract injection in the management of primary atrophic rhinitis.

Methodology

This study was conducted at Tripura Medical College and Dr. BRAM Teaching Hospital, Tripura, India, from January

2024 to June 2024 with a sample size of 10 after satisfying inclusion and exclusion criteria. Patients who had been

diagnosed with primary atrophic rhinitis were divided into 2 groups, i.e., Group A and Group B. Group A was

administered submucosal human placental extract injection, once a week for 6 months and Group B was advised

25% glucose in glycerin nasal drop, 10 drops in each nostril twice daily for 6 months following which the response

of both the groups was recorded. Collected data was analyzed using Microsoft Excel and SPSS 25.0 software.

Results

Group A (submucosal human placental extract injection) had shown 60% good response while Group B (25%

glucose in glycerin nasal drop) had shown 40% good response after 6 months of treatment. Fair response was

equal in both the groups. Group A had shown 33% poor response while Group B had shown 67% poor response

after 6 months. Out of a total of 10 patients, irrespective of groups, 50% of the patients had shown good response

after 6 months of treatment, combining both the modalities. 20% of patients had shown fair response and the

rest of 30% had shown poor response.

Conclusion

There are various modalities of treatment of primary atrophic rhinitis both surgical and conservative. Treatment

with 25 % glucose in glycerin solution as well as submucosal human placental extract injection both had shown

promising outcomes in various studies. But submucosal placental extract injection had shown better outcome

than 25% glucose in glycerin solution in this study.

A community-based study to estimate the internet usage and its associated factors among elderly residing in an urban slum area in North India

Garima Sangwan — 2025-02-09

Background

There has been tremendous growth in internet usage globally, with an estimated 5 billion users around the world in

2022 (1). In India , there were 840 million internet users in 2022 (2). Internet addiction, defined as the inability to

control one's use of the internet despite negative consequences, often persists over an extended period (3-5). While

internet addiction has been widely studied in adolescents and young adults, there are limited studies to explore

internet addiction among the elderly.

Aims and Objectives

The study aimed to estimate the prevalence of internet addiction among the elderly and to determine the various

factors associated with internet addiction.

Methods

This community-based cross-sectional study was conducted among 200 study participants. A semi-structured

interview schedule was used for data collection. It included the socio-demographic details of the study participants

and a structured schedule for assessing internet addiction using Young's Internet Addiction Test (IAT). Statistical

analysis was performed using descriptive statistics, chi-square test and logistic regression.

Results

The mean age of the study participants was 66.9 years (SD = 6.8), ranging from 60 to 92 years. The distribution of

categories reveals that 49.5% of participants had no internet addiction, while 36.0% had mild internet addiction.

Moderate internet addiction accounted for 9.5% of the total, and severe internet addiction was found in 5.0% of the

individuals. On multivariable analyses, it was found that gender (adjusted OR = 2.35, 95% CI: 1.29-4.25), marital

status (adjusted OR = 2.42, 95% CI: 1.23-4.76) and personal income (adjusted OR = 5.49, 95% CI: 2.45-12.32) were

significantly associated with internet addiction.

Conclusion

The high prevalence of internet addiction, along with its significant associations with gender, marital status, and

personal income, suggests a need for targeted interventions focusing on education about healthy internet use

among older adults. It is also recommended to collaborate with local healthcare providers and youth volunteers to

educate the elderly on internet addiction. Future research should consider longitudinal designs to better understand

the causal pathways and the effectiveness of different intervention strategies.

Assessment of Home Isolation Measures and Factors Associated with Adherence Among Patients During the Pandemic in Nepal: A CrossSectional Study

Lisasha Poudel — 2025-02-09

Introduction

Housing status and behavioral practices of COVID-19 positives during home isolation are crucial to breaking the

transmission chain and rapidly managing cases during emergencies. This study aimed to assess the home isolation

status of COVID-19 patients in Nepal and determine factors associated with adherence to home isolation measures.

Methods

A telephone-based cross-sectional study was conducted from January to May 2021 to assess the home isolation

status among 362 home-isolated COVID-19 patients in Karnali Province. Patients were interviewed to collect socio

demographic characteristics, COVID-19 symptoms, comorbid conditions, and household and behavioral

characteristics. Univariate and multivariate logistic regression analyses were done to determine the association of

the use of masks, social distance, and outside visits during home isolation with socio-demographic and household

characteristics. We reported adjusted odds ratios(aOR) with 95% confidence intervals.

Results:

Of the total, 15% did not have ventilation in their isolation rooms, and only about 30% used separate toilets during

isolation. More than half of the respondents staying at home in isolation were asymptomatic. About 29% of

respondents did not maintain a two-meter distance from their family members. About 76% always wore a mask in

front of their family members and 68% never went outside the house during home isolation. Females were more

likely to stay home during the isolation period (aOR:2.42; 95%CI:1.39-4.21). Young adults were more likely to wear

masks in front of family members(aOR:0.96;95%CI:0.94-0.99). Highly educated participants were more likely to

maintain distance during isolation (aOR:1.19;95% CI:1.10-1.28).

Conclusion

State and local authorities are recommended to develop specific measures to enhance the knowledge and practice

of the participant groups likely to exhibit low adherence to home isolation measures.

Determining factors for utilisation of employee wellness programme by healthcare workers in Limpopo Province, South Africa

Shirley Davhula — 2025-02-09

Background

The health and well-being of healthcare workers have broader implications for public health. The utilization of

employee wellness programs (EWPs) among healthcare workers poses a significant challenge, as there is a growing

concern regarding the limited engagement and participation in these programs. Despite the well-established

benefits of such initiatives in promoting the well-being of healthcare professionals, a notable gap exists in

understanding the factors influencing their utilization within the healthcare sector. Therefore, this study aimed to

determine factors for utilisation of EWP by healthcare workers (HCWs) in the Limpopo Province of South Africa.

Methods

This was a cross-sectional quantitative study conducted among 325 HCWs who were selected using random

sampling techniques. Data were collected using self-administered questionnaires. Logistic regression analysis was

performed to identify factors for utilisation of EWP among HCWs.

Results

Almost all (96%) had an adequate level of awareness of EWP in their workplace. Participants who were responsible

for their own wellbeing were ten times more likely to participate in an EWP than those who were not responsible

(OR=10.6, p<0.05). Participants who talk to their friends about issues related to healthy eating were 11 times more

likely to participate in an EWP than those who did not talk about healthy eating (OR=10.9, p<0.05). Stressed/burned

out employees were 3.7 times more likely to participate in an EWP than those who did not have these conditions

(OR=3.7, p=0.036).

Conclusion

HCWs are willing to utilise EWP if offered. There is a need for initiating EWP in the study setting. The EWP

programme should be developed and implanted in the health sectors considering the factors found to be significant.

A Prospective Observational Comparative study Between qSOFA and SIRS Scores for Early Prediction of Sepsis Outcome in an Emergency Medicine Department , Kozhencherry, South Central Kerala,India

Rahul Rajeev — 2025-02-09

Background

Sepsis remains a significant challenge in emergency medicine, with early identification crucial for improved

outcomes. The introduction of the quick Sequential Organ Failure Assessment (qSOFA) score has sparked debate

about its efficacy compared to the traditional Systemic Inflammatory Response Syndrome (SIRS) criteria in

predicting sepsis outcomes.

Objective

To compare the performance of qSOFA and SIRS scores in early prediction of sepsis outcomes in an Emergency

Medicine Department.

Methods

A prospective observational study was conducted on 63 patients aged 18-80 years presenting with suspected sepsis

at Muthoot Health Care, Kozhencherry. Patients were assessed using both qSOFA and SIRS criteria. Exclusion

criteria included pregnancy, terminal illness, and severe comorbidities. Participants were followed up to determine

final diagnosis and outcomes. Data analysis compared the effectiveness of qSOFA and SIRS in predicting sepsis

outcomes.

Results

The majority of participants (59.9%) were over 50 years old, with a slight male predominance (54%). qSOFA scores

of 0-1 were observed in 55.6% of patients, while 60.3% had SIRS scores of 3-4. The mean qSOFA and SIRS scores

were 1.59 and 2.75, respectively. A significant correlation was found between qSOFA scores and outcomes

(p=0.007). The in-hospital mortality rate was 30.2%.

Conclusion

While qSOFA demonstrated a slight advantage in predicting in-hospital mortality, SIRS showed higher sensitivity

in sepsis diagnosis. The study suggests that a combined approach using both scoring systems may provide a more

comprehensive assessment of patients with suspected sepsis in the emergency department setting. Further large

scale, multicenter studies are recommended to validate these findings across diverse populations.

A study regarding student satisfaction on medical graduate license examinations and career guiding sessions around the globe including the NEXT (National Exit Test) exam of India using qualitative and quantitative methods in a medical college of North

Bhanupriya Shivshankar Pande — 2025-02-09

Context:The National Medical Commission of India in the year 2019 recommended the National level licenses exam

for medical graduates. Around the world similar exams are getting conducted. The students are usually aware of

foreign license exams and their typology.

Aim:1. To assess student satisfaction after the career counselling session on medical license exams conducted

across the globe.

2. To study the Knowledge, Attitude and Perceptions of students regarding the NEXT exam and USMLE (for USA).

Settings and Design:This mixed method study was conducted in a medical college of North Maharashtra.

Methods and Material:The Qualitative study was conducted using focus group discussions. Total 35 participants

were present in the 5 focus groups. In the cross sectional survey randomly 164 MBBS students were enrolled.

Statistical analysis used:Descriptive analysis and Chi-square test was used. Content analysis was done for

qualitative data.

Results:Lack of knowledge about the legalities, residency rotations, internship rotations for license exams poses a

challenge to students. 44.6% participants think that a competency based medical education pattern will be enough

to appear for the exam. A significant difference was obtained for NEXT exam difficulty level when compared with

foreign medical license exams. (P <0.001, ?² = 24.2, df= 4). A significant difference was also noted when NEXT exam

Marks distribution was compared with the NEXT exam pattern. (P <0.001, ?² = 65.0, df= 4).

Conclusions:The career guiding sessions on license exams including NEXT should be regularly conducted by Health

Universities.

A comparative analysis of the level of out-of-pocket healthcare expenditure in urban and rural communities in Edo state Nigeria

Momoh JA — 2025-02-09

In many low- and middle-income countries, individuals faced with financial hardship cannot afford medical

treatments or even finance the purchase of medicines due to relatively high cost of health care services.In numerous

low- and middle-income countries, individuals experiencing financial difficulties are unable to afford medical

treatments or purchase medicines due to the relatively high cost of healthcare services. High cost of healthcare has

often been recognized as one of the leading barriers to quality healthcare services with the potential to plunge

households into poverty, which affects the type and quality of health services sought for at health facilities between

urban and rural areas.

This cross-sectional descriptive study was among 495 eligible respondents in households in Edo State, Nigeria using

the multi-stage sampling technique. The data collection tool was an interviewer-administered semi-structured

questionnaire. The study found that in both urban and rural areas, 89.8% of respondents accessed care primarily by

‘Out of Pocket Payment (OOPP)’ however, this was higher among the rural households. Also, the purchase of drugs

accounted for the largest proportion (71.9%) of the total expenditure on healthcare services.

Given the economic realities faced by many households, especially in rural areas, urgent measures are warranted

to alleviate the financial strain of healthcare expenses. To address this issue, there is a critical need for the Edo state

government and private sector to prioritize the enhancement of existing healthcare insurance schemes, particularly

in rural regions, by expanding coverage and accessibility. Additionally, subsidizing the cost of medications,

particularly for common illnesses like malaria, could significantly alleviate the burden of out-of-pocket healthcare

expenditure.

Clinical, Radiological and Pathological evaluation of breast lumps: a crosssectional study from a tertiary care hospital of north-east India

Kaushik Datta — 2025-02-09

ABSTRACT

Background

Breast lumps are a frequent clinical finding among women, ranging from benign lesions to malignant conditions.

Differentiating these lesions accurately is critical for timely diagnosis and treatment, especially in resource-limited

settings. In India, breast cancer remains the most common cancer among women, with variable presentations. This

study investigates the clinical, radiological, and pathological features of breast lumps in patients at a tertiary care

hospital in Tripura, northeast India.

Methods

This cross-sectional study included 180 female patients with palpable breast lumps, excluding those previously

diagnosed or unwilling to consent. Each patient underwent clinical examination, imaging (mammography or

ultrasonography based on age), and Fine Needle Aspiration Cytology (FNAC) for preliminary diagnosis. In cases of

atypical or indeterminate FNAC findings, biopsy was conducted for histopathological confirmation.

Results

The mean age of participants was 38.5 years. The cytological findings from Fine Needle Aspiration Cytology (FNAC)

in 180 patients revealed that 76.7% of patients had benign lesions, while 17.2% had malignant lesions. After the

histopathological findings as the final diagnosis, 33 cases were malignant and 147 cases were reported as of benign

origin.Most lumps were located in the upper outer quadrant (42.2%). FNAC findings revealed that 76.7% of cases

were benign, while 17.2% were malignant. Histopathological analysis confirmed fibroadenoma as the most

common benign lesion (45.5%), and invasive ductal carcinoma as the predominant malignant type (15.5%).

Conclusion

Fibroadenoma and invasive ductal carcinoma were the most common benign and malignant breast lesions,

respectively. Early detection and accurate differentiation of breast lumps are essential, particularly in limited

resource settings, to reduce morbidity and mortality. These findings emphasize the importance of structured

diagnostic protocols to optimize patient outcomes.

Prevalence and determinants of Acute Respiratory Infections in children under five in rural mysuru: insights from a cross-sectional study

Nayanabhai Shabad — 2025-02-09

Background

Acute Respiratory Infections (ARIs) remain a leading cause of morbidity and mortality in children under five years

of age, particularly in rural regions. Understanding the prevalence and determinants of ARIs in such settings is

essential for developing targeted interventions. This study aimed to assess the prevalence and identify the key

determinants of ARIs in children under five in rural Mysuru, Karnataka, India.

Materials & methods

A community-based cross-sectional study was conducted in rural areas of Mysuru from January to June 2024. A

sample of 400 children under five years old was selected using a convenience sampling method. Data on

sociodemographic characteristics, clinical characteristics and family background, breastfeeding practices and ARI

symptoms and episodes were collected through a semi-structured questionnaire by interviewing the mother of the

child. Descriptive statistics like frequency and percentages were used and inferential statistics like the Chi-square

test and Fisher’s Exact test were used to find the factors associated with ARIs.

Results

The overall prevalence of ARI in the rural area was found to be 46.8 % in the study. Exclusive breastfeeding for six

months showed a statistically significant association with acute respiratory infections (ARI) (p = 0.001). 48.3% of

exclusively breastfed children experienced ARI. Gender (p = 0.001) and a history of hospital admission (p= 0.000)

were also significantly associated with ARI, with female children and previously hospitalized children more affected.

Other factors, including age, birth weight, family type, and breastfeeding duration, showed no significant

association.

Conclusion

The study demonstrates a clear association between exclusive breastfeeding for six months and a reduced incidence

of acute respiratory infections (ARI) among children under five. Additionally, gender and prior hospital admissions

were also identified as significant risk factors for ARI, indicating that females and previously hospitalized children

are more vulnerable to these infections. These findings suggest the need for enhanced breastfeeding support and

targeted interventions to mitigate ARI prevalence in young children.

COVID-19 vaccination: Knowledge and perception of beneficiaries at a tertiary care center in Haryana, India

Garima Sangwan — 2025-02-09

Introduction

COVID-19 is an infectious and contagious disease caused by the SARS-CoV-2 virus. Despite the availability of vaccines,

there were reports of vaccine hesitancy among people, including healthcare workers. The study aims to assess the level of

knowledge about vaccines available in India, the perception of people towards COVID-19 vaccine and the experiences of

people who took the vaccine.

Methods

The study was carried out over a period of four months from 15th July 2021 to 15th November 2021. The sample size taken

was 500. It was an institution-based cross-sectional, non-interventional study carried out among the people visiting the

COVID-19 vaccination centre. The data collected using self-administered questionnaire was analysed using descriptive

statistics and nonparametric statistics in SPSS version 29.

Results

It was observed that only 6.3% (30) participants had adequate knowledge about COVID-19 vaccination, and the majority

(58.1%, 271) participants had poor knowledge. More than 60% of participants (61.6%, 294) reported having hesitancy to

take up the COVID-19 vaccination. Besides hesitancy, many factors like access to vaccines, protection from COVID-19

disease, fear of increasing COVID-19 cases and deaths etc. were the facilitating factors reported by participants for

COVID-19 vaccination uptake

Conclusion

More than half (61.6%) of the participants reported hesitancy towards uptake of vaccination owing to various side effects.

However, people also believed that vaccination could prevent the disease, and its free availability facilitated people to get

vaccinated. Various barriers leading to vaccine hesitancy and facilitators for a vaccination program should be identified

and addressed for the successful implementation of the program.