Search

The paper presents a quantitative and qualitative profile of Thrombosis research in India, based on 4026 publications indexed in Scopus database during 2000-19. Indian research output on Thrombosis registered 11.64% annual growth, averaged 13.54 citations per paper and contributed 2.26% global share (with 13th rank) and 14.13% share devoted to international collaborative papers. Thrombosis research applications across subjects were the largest in medicine (87.93%), followed for other subjects with contribution from 5.84% to 10.08%), etc. The distribution by type revealed that Venous Thrombosis accounted for the highest share (52.36% share), followed by Arterial Thrombosis (29.01% share), Limb ischemia (1.49%) and Hepatic artery thrombosis (0.72%) during 2000-19. AIIMS- New Delhi (374 papers) and PGIMER-Chandigarh (280 papers) lead the country as the most productive organizations. Besides, GMCH-Chandigarh (66.80 and 4.93) and Fortis Healthcare Limited (47.82 and 3.53) lead the country as the most impactful organizations in terms of citation per paper and relative citation index. K. Ghosh (61 papers) and R. Saxena (51 papers) lead the contry as most productive authors and K. Sarin (115.32 and 8.52) and D. Dash (44.29 and 3.27) lead as the most impactful authors. Indian Heart Journal (with 160 papers), BMJ Case Reports (133 papers) and Neurology India (115 papers) topped the list of most productive journals. [ABSTRACT FROM AUTHOR]

The paper presents a quantitative and qualitative dimensions of congenital heart defect (CHD) research output in India, based on publications data (1335) indexed in Scopus database during 2000-19. CHD research registered 10.0% growth, averaged 7.07 citations per paper, contributed 3.04% share to the global output and constitute 13.48% share of India's research as international collaborative. CHD research is skewed as top 10 countries account for 83.23% of global output. India ranks as the 10th most productive country in the world. The distribution of CHD research by type of research reveal that Tetralogy of Fallout accounted for the highest share (34.31% share), followed by Aortic Stenosis (30.41%), Atrial Septal Defects (28.16%), Ventricular Septal Defects (26.22%), etc. AIIMS - New Delhi, Amrita Institute of Medical Sciences, Coimbatore and PGIMER - Chandigarh lead the country as the most productive organizations (with 222, 73 and 64 papers). Besides, Amrita Institute of Medical Sciences, Coimbatore (33.88 and 4.79), SCTIMST - Trivandrum (30.73 and 4.35) and Institute of Medical Sciences, BHU, Varanasi (17.20 and 2.43) lead the country as the most impactful organizations in terms of citation per paper and relative citation index. B. Airan, A. Saxena and S. Talwar have been the most productive authors (with 63, 63 and 59 papers) and P. Khairy (16.31 and 2.31), B. Vaidyanathan (14.3 and 2.03) and R.K. Kumar (10.53 and 1.49) have been the most impactful authors. Indian Heart Journal, Annals of Pediatric Cardiology (84 papers) and Annals of Cardiac Anaesian (53 papers) topped the list of most productive journals (with 110, 84 and 53 papers). International Journal of Cardiology (18.62), Catheterization and Cardiovascular Interventions (16.64) and Journal of Cardiothoracic and Vascular Anesthesia (11.65) leads in ranking in terms of citation per paper. [ABSTRACT FROM AUTHOR]

Objectives: The present study examines the publication output of authors from India on the topic of "Covid-19 and Psychology" using bibliometric methods. Methods: The publications as listed in Scopus database were identified by using "Covid-19" and its synonyms keywords in "Keyword" and "Title" tags. The results obtained were further restricted to subject "Psychology" under subject tag and country to India. Results: 372 publications emerged in the last 2 years on the topic of "Covid-19 and Psychology", accounting to 4.63% share of global output. About 9.95% and 25.81% share of Indian publications received external funding support and involved international collaboration, respectively. The author's from 277 organizations and 416 authors participated unevenly in the research in this area. The highest number of publications emerged from National Institute of Mental Health and Allied Sciences (NIMHANS), Bangaluru, followed by Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, All India Institute of Medical Sciences (AIIMS), New Delhi and All India Institute of Medical Sciences (AIIMS), Bhubaneswar. Authors from Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry had highest impact in terms of citations per paper and relative citation index, followed by authors from King George's Medical University (KGMU), Lucknow, and Manipal Academy of Higher Education (MAHE), Manipal. The journals that published the highest number of publications were Asian Journal of Psychiatry (158 papers), Indian Journal of Psychological Medicine (44 papers), and Frontier in Psychology (18 papers). The most commonly investigated topics in terms of frequency of appearances of keywords were mental health (93), followed by anxiety (80), mental disease (68), depression (64), mental stress (34), and social isolation. Conclusion: Over the last 2 years a large number of publications have emerged in the area of COVID-19 and psychology from India. [ABSTRACT FROM AUTHOR]

Analyses the 1293 Indian publications in cataract research during 2002-2011, with a focus on contribution and citation impact of 15 most productive countries, India's overall contribution, its growth, citation impact, the share of international collaborative papers, identification of significant countries in India's international collaboration, different types of cataract research, analyses of research by subfields and different population age groups, productivity, and impact of leading Indian institutions and authors and pattern of communication of Indian output in most productive journals. The Scopus Citation Database has been used to retrieve the data for 10 years (2002-2011). Indian publications increased from 87 papers in 2002 to 195 papers in 2011, witnessing an annual average growth rate of 10.03%, registering an average citation impact per paper of 3.26 and international collaborative share of 21.58% during 2002-2011. Suggest that the government should encourage the decision makers and ophthalmologists and allied persons involved in ophthalmic services to make serious efforts in reducing the burden of cataract disease by increasing the R&D, strengthening of national and international collaboration and improve the existing training programs for ophthalmologic professionals. [ABSTRACT FROM AUTHOR]

The present study quantitatively analyze Indian dengue research output during the 10 years from 2003 to 2012, using Scopus international multidisciplinary database. The study focused on global publication output, share, rank, and citation impact of top 15 most productive nations, India's publications output, growth, global publication share and research impact, international collaborative papers share in national output and the share of major international collaborative partner countries in total India's international collaborative papers, contribution of various sub-fi elds and distribution by population age groups, productivity and citation impact of its leading Indian institutions and authors and Indian contribution in most productive journals. Indian contribution in dengue fever research consisted of 910 papers, which increased from 27 papers in 2003 to 193 papers in 2012, witnessing an annual average growth rate of 28.19%.Among the top 15 most productive countries, India holds second position in dengue fever research output, with global publication share of 10.22% during 2003-12. The average citation per paper scored by India was 3.27, the least among the top 15 most productive countries during 2003-12. India's share of international collaborative papers was 10.55% during 2003-12, which increased from 9.12% during 2003-07 to 11.13% during 2008-12. The present India's research efforts in dengue research are low in view of the 50,222 cases of dengue in 2012 alone. The country needs to increase its research output and also increase its research impact substantially particularly through enhanced national and international collaboration, besides evolving a national policy for identifi cation, monitoring and control of dengue cases and also evolving a research strategy with suffi cient funding commitment to solve this growing national problem. [ABSTRACT FROM AUTHOR]

Background: The prevalence of childhood obesity (CHO) has gradually increased in India over the past two decades and has necessitated advanced research to address it. Assessing CHO-related research conducted so far is necessary to guide future research. However, a bibliometric assessment of Indian CHO research is unavailable. Aim: The study aimed to map the CHO research published in India during the last two decades. Materials and Methods: The publication data was retrieved from Elsevier's Scopus database using a predefined search strategy. The quality of publications was assessed using indicators such as citations per paper (CPP), relative citation index (RCI), and Hirsch index (HI). Results: India contributed 705 (1.8%) to a global total of 37,762 publications and is currently ranked 15th in CHO-related research; the top 3 countries are the USA, UK, and Australia with 38.1%, 9.6%, and 6.5% publication share respectively. The annual growth in India's publications was 27.4% compared to the global average of 8.7%. The research quality has declined (average CPP 50.6 during 2002-2011 and 25.4 during 2012-2021). Only 25.2% of publications were internationally collaborative. The most productive organizations were AIIMS, New Delhi, PGIMER, Chandigarh, and St. John's Research Institute, Bengaluru, whereas Amrita Institute of Medical Sciences, Sher-i-Kashmir Institute of Medical Sciences, J&K, and Sitaram Bhartia Institute of Science and Research, New Delhi were the most impactful. CS Yajnik, N Tandon, and V Khadilkar were the most prolific, whereas A Laxmaiah, HPS Sachdev, and V Mohan were the most impactful authors. Seven of the ten top productive journals were Indian, but only three were among the most impactful. Conclusion: India lags in CHO research behind other countries having similar current and future projections for the prevalence of CHO. Its research output, but not impact, has increased over the past two decades. India's international collaboration in CHO research is meager. Our analysis identifies the contributions of various stakeholders in addressing CHO and provides a framework for researchers, policymakers, organizations, and national government for future research to develop interventions for effective prevention and control of CHO. [ABSTRACT FROM AUTHOR]

Introduction: Mucormycosis is a well-researched infection worldwide. The Indian contribution to global Mucormycosis research remains unevaluated. Materials and Methods: Elsevier's Scopus database was used to retrieve Indian publications on mucormycosis during 1998-2021. The extracted data were analyzed in terms of the number of publications, citation metrics, top productive organizations and authors, research collaborations, and active journals, using appropriate bibliometric tools. Results: India produced 799 publications on mucormycosis during 1998-2021. The publications grew at 8.5% annually and 175.1% cumulatively and received on average 9.6 citations per paper (CPP). Only 8.7% of publications involved international collaboration. The most researched types of mucormycosis were pulmonary and gastrointestinal, while diabetes mellitus and diabetic ketoacidosis were the top risk factors studied. Most of the research focused on clinical studies and treatment, while genetics was the least researched aspect of mucormycosis. The top 20 of the 294 organizations and 384 authors that participated in research contributed 59.7% and 29.4% to the total national output, and 97.3% and 76.2% to total citations, respectively. The most productive organizations were PGIMER-Chandigarh, AIIMS-New Delhi, and CMC-Vellore, and the most prolific authors were A. Chakrabarti, M.R. Shivprakash, and J. Chander. Indian Journal of Otolaryngology and Head and Neck Surgery, Mycosis, and BMJ Case Reports were the high-yielding journals, whereas Medical Mycology, Mycosis, and Journal of Postgraduate Medicine were the most impactful. Conclusion: Indian research in mucormycosis has shown consistent growth during 1998-2021. There is, however, a need to improve on collaborative research and focus on emerging areas such as the genetics of mucormycosis. [ABSTRACT FROM AUTHOR]

The dream of universal health care demands a much larger and wider approach, engaging not just the public but also the private sector. This paper has attempted mapping the present public-private partnership scenario in India using the WHO health system functions framework, giving an insight into the nature and extent ofchallenge of the present dominant model. A systematic review methodology was adopted to identify published literature on private-public partnership in India. From an initial pool of 785 articles were identifi ed. Finally a total of 29 published articles meeting the inclusion criteria were included. The descriptive framework of Health system functions by WHO (2000), were used to analyze the data. All papers which were considered for the study were segregated based on the 4 prime health system functions: Financing; Management of non-fi nancial inputs; Health service delivery and Oversight. The literature review reveals that more than half of the papers (51.72%) selected for the study were focused on health service delivery functions and quite thin literature were available for other 3 functions, which includes fi nancing, management of non-fi nancial inputs and oversight functions as per WHO. This fi nding raise an important question if the genesis of most of the public-private partnerships is out of the inability of the public sector in reaching out to a particular target group by virtue of its geographical position or diffi culty in working with high risk groups. Considering the limitations of the present model of engagement of private and public sectors, it demands for an alternative model of engagement where the mutual strength that exists with each one of the partners, could be harnessed and complemented. An alternate model is to engage in tri-partite partnership (TPP) between the government, non-government and the corporates. [ABSTRACT FROM AUTHOR]

Introduction: The world's second most populous country-India, witnesses 20-30% pregnancies that belong to the high-risk category out of the total pregnancies in the country. 12% of the global maternal deaths are attributed to India. The Rural areas of the country are further vulnerable to high maternal and infant mortality rates due to a rural-urban divide and unavailability of health resources. Objectives: The rationale of this paper is to understand and illustrate common High Risk Pregnancies (HRPs) in the rural area of Shorapur and to gauge the preparedness of the health facility in the area to help deliver safe child birth for the mother and the child. Materials and Methods: A cross-sectional study was conducted in pregnant women attending the Antenatal Care (ANC) clinic in sub-district hospital of northern Karnataka over a period of 03 months. Results: A total of 601 high risk conditions were identified in ANC women. Of the total ANC women with HRP 44.1% (n= 265) had previous Caesarean Section, 15.1% (n=91) had RH incompatibility, 12.6% (n=76) were observed to be Short Primi, 9.7% (n= 58) experienced Bad Obstetric History/Antepartum Haemorrhage, 8.2%% (n=49) had Gestational Hypertension, 5.8%% (n=35), were severely Anaemic, 4.2% (n= 25) had Multiple pregnancy and the remaining 0.3% (n=3) had tumour, Gestational DM and Rheumatoid Arthritis. Discussion: As per the observed HRPs and respective health facility preparedness, two main barriers to safe pregnancy and childbirth emanated during the study - inadequate infrastructure and services for blood transfusion, dearth of trained health professionals. Conclusion: Direct referral of high risk cases to appropriate facilities that have the required capacity to support such cases must be made. Tele-medicine can be considered as an efficient alternative to connect the ANC women with the specialist doctor remotely for evaluation of HRPs. A blood storage unit must be established in all SDH hospitals as a minimum requirement. [ABSTRACT FROM AUTHOR]

Background: Medical undergraduates having lack of interpersonal skills may lead to severe deficiencies in health services. Currently these were not being trained or assessed at workplace for their behavior and communication skills during their medical curriculum. During this study, mini-CEX (mini clinical evaluation exercise) was used as a work place based assessment (WPBA) tool to assess the interpersonal skills of interns and providing them concurrent feedback. The aim of this study was to evaluate and improving the interpersonal skills of interns posted in orthopedic department during their rotatory internship while assessing the acceptability, feasibility and effectiveness of mini-CEX assessment as a tool. Materials and Methods: This prospective and interventional study was conducted in department of orthopedics of our hospital settings between July to November of 2022. The forty interns who participated in this study were on rotatory internship in our department and 06 volunteered faculty members were also included. The mini-CEX form as assessment tool structured by American Board of Internal Medicine was used in this study. Each intern undergone six rotatory assessment sessions, on mini-CEX forms with each of the faculty comprising a total of 240 sessions. Participants at the end of their internship submitted their perceptions on an anonymous validated questionnaire which contains both open ended and closed ended questions (Likert 5-point scale). Statistical Analysis: The descriptive data having frequencies were analyzed using Microsoft Excel software. Thematic analysis was used for qualitative data of open ended questions. Results: Most of interns (36/90%) and all included faculty members had shown that mini-CEX assessment tool has encouraged them and helpful in improving their communication skills. On comparison of their first through 6th encounters, interns had shown improvement in their mean min-CEX score for skill development and competencies with improvement in communication skills. This improvement was statistically significant. (p<0.05). Conclusion: Our study had shown that mini-CEX as WBPA too is an acceptable, effective as well as feasible method for assessing the interpersonal skills of interns in clinical settings. [ABSTRACT FROM AUTHOR]

This paper analyzes 1078 India's publications on suicide research during 10 years, i.e., 2005-2014, as indexed in Scopus International Multidisciplinary Database. The study focuses on the various aspects of performance of India's suicide research, such as the publication growth, citation impact, international collaboration, subject-wise distribution of publications, contribution and citation impact of Indian organizations and authors, medium of communication, and characteristics of its high-cited papers. This study reveals that India's research output on suicides research witnessed an annual average growth rate of 10.49%, registered an average citation impact per paper of 9.75, and a share of 16.23% of international collaborative publications. India's global publication and share to world suicide research was 2.47% during 1999-2014. Medicine contributed the largest publication share of 84.32%, followed by pharmacology, toxicology, and pharmaceutics and social sciences (19.94%), environment science (9.37%), biochemistry, genetics and molecular biology (8.35% share), psychology (7.05% share), neuroscience (4.36% share), economics, econometrics, and finance (2.23% share), and immunology and microbiology (1.95% share) during 2005-2014. About 294 organizations and 356 authors participated in 1078 Indian papers in suicide research, of which the top 15 most productive Indian organizations and authors together contributed 36.18% and 17.44% publications share and 49.58% and 56.06% citation share to the India's publications and citation output on suicide research during 2005-2014. This study also suggests the need for taking up of measures at population, sub-population, and individual levels to prevent suicide and suicide attempts. Suicide is a complex issue and therefore suicide prevention efforts require coordination and collaboration among multiple sectors of society. [ABSTRACT FROM AUTHOR]

Background: There is some debate concerning the posterior cruciate ligament's function in knee replacement surgeries. In theory, the range of motion can be increased and posterior translation can be prevented by femoral rollback, which is achieved by preserving the PCL. Our hospital's Primary Total Knee Replacement procedure is the focus of this prospective comparison of functional outcomes. The ligament was preserved in cases where the knee was used as a sacrifice. Materials and Methods: Total 25 patients were participated in this study. This study was conducted at the Department of Orthopedics, Kamineni Institute of Medical Sciences, Narketpally, Telangana, India between November 2022 to October 2023. After and before surgery, patients were evaluated using a scoring system that was developed using the WOMAC Score, the Knee Society Knee Score, and the Functional Knee Score. Results: Clinical and functional knee scores improved significantly for all patients in both groups, according to the functional outcome analysis. With a total Knee Score of 85.80 for the PS group and 75.60 for the CR group, statistical analysis showed a statistically significant difference in the p-value favouring the Cruciate Sacrificing Prosthesis, indicating that it has better functional outcomes. A functional knee score of 99.6 for the CS group and 91.6 for the CR group indicated that all patients had a significant improvement. Based on statistical analysis, no significant difference was found. Conclusion: The functional prognosis after total knee arthroplasty was better in patients who had the posterior cruciate ligament sacrificed than in the maintaining group. This difference is likely due to the fact that the flexion deformity persists in the retaining group. [ABSTRACT FROM AUTHOR]

Context: Identification of the effect of valid factors on students' academic performance is of great importance to student counseling and policy making. Aims: This study was carried out to find the predictors of academic performance of 2nd year undergraduate medical students of a renowned Medical College of Kolkata. Materials and Methods: This cross sectional study was carried out in a tertiary care teaching hospital of Kolkata. The information on factors like attendance percentage, sex, place of residence, previous academic performance of the entire batch of 2nd year students was collected from the departments' academic records and through personal interview. The association of the above mentioned factors with students' academic performance was determined through statistical analysis using t-test and multiple linear regression modeling and the results were reported. Results: Academic performance is found to be weakly correlated with attendance. Better academic grade was observed for the group with high attendance percentage compared to the other with low attendance percentage (P < 0.01). Higher percentage of marks was observed to be scored by female students (P < 0.01), local students (P < 0.01) and high performers who were capable of successfully clearing their 1st year's coursework in their first attempt (P < 0.01). Conclusion: All the factors studied in this paper which includes attendance, sex, place of residence and previous academic performance serve as predictors in understanding students' performance. Among the above mentioned, the attendance of the students is an important factor that has to be monitored and regulated through corrective actions to improve the performance of the class. [ABSTRACT FROM AUTHOR]

Context: Postponement of fi rst pregnancy is known to be associated with a variety of interdependent factors such as age, education, income, occupation, religion, caste, and cash incentives. This paper examines the relationship and effects of some of these factors on postponement of fi rst pregnancy among newly married couples in Satara district. Objective: To study the interdependency of age, years of schooling, income, and cash incentive on postponement of fi rst pregnancy among newly married couples. Materials and Methods: This study employed quasi-experimental study design. Duly trained multipurpose workers interviewed husbands and auxiliary nurse midwives (ANMs) interviewed the wives; preferably in separate rooms using pretested semi-open proforma. Statistical analysis was done using STATA®version 12 statistical software. Results: Out of 1,355 participants; 704 couples successfully postponed fi rst pregnancy by 2 years, but 651 couples could not do so. Participants were signifi cantly successful in postponing pregnancy by 569.13 vs. 353.89 days for controls. Age and education of female participants were signifi cantly associated with postponement of fi rst pregnancy; while age, education, and income of male participants were not associated with postponement. Conclusions: Higher age, more education, and higher income appear to be associated with acceptance of postponement of pregnancy and appear to be acting synergistically in both male and female participants as compared to nonparticipants. [ABSTRACT FROM AUTHOR]

Public provisioning of quality health care to make available affordable and reliable health services constitutes the focal point of national health programs and policies. Signifi cant progress has been achieved over the decades during the various 5-year plan periods. The present paper discusses the changes achieved in the key areas of health over the XI 5-year plan period and further proposals for important areas under the XII 5-year plans. [ABSTRACT FROM AUTHOR]

Introduction: The state of Chhattisgarh today faces several challenges in improving the health status of its people. The on-going problems of maternal and child mortality, communicable diseases, and HIV/AIDS pandemic still need greater interventions/support from the already overburdened health systems. In addition, the public health challenges include the escalating burden of chronic noncommunicable diseases. Keeping all these things in mind a study was carried out to have an overview of the public health scenario of Chhattisgarh. Aim: This paper aims to review the different public health indicators of Chhattisgarh. Materials and Methods: This study comprised of reviewing different health indicators of Chhattisgarh adopting three different methods during the period March-April 2013. The methods were: (i) extensive online search, (ii) reviewing the related literatures from different journals and other authentic printed materials, and (iii) information collected from public health experts through e-mail, telephone, or direct interaction. Results: Out of 2.55 crore populations in the state (as per Census 2011), 78% lives in rural areas and 37% of the population is tribal. The sex ratio is 968 and the literacy rate is 65.5% in population above 7 years of age. There is a shortage of trained health care providers in Chhattisgarh. The crude birth rate is 23.5 per 1000 (population Annual Health Survey [AHS] 2011-2012). The infant mortality rate is 48 per 1000 live births (SRS 2012). Malnutrition, anemia, sickle cell hemoglobinopathy, Beta thalassemia trait, and G6 PD enzyme defi ciency are very high among the tribes of Chhattisgarh. Malaria has been a major health problem. Chhattisgarh is one of the states with annual parasite index >5 (MRC report). The other states are Rajasthan, Gujarat, Karnataka, Goa, Southern Madhya Pradesh, Jharkhand, Odisha, and Northeastern states. Conclusion: From a public health point of view, most of the health indicators are below national average and unsatisfactory. The human resources gap, poor physical infrastructure, inadequate health education and awareness, poor health-seeking behavior, and inadequate healthcare utilization compound the problem. Indicators related to health and health care delivery are outcomes of research in diverse fi elds other than the department of health. Putting them together and projecting them in a public health view point encourage others to focus on the neglected indicators/areas. However, further research is needed to have a clear database in this regard. [ABSTRACT FROM AUTHOR]

Background: This paper investigates a swift gastrointestinal outbreak in central India and further explores environmental, agent, and host interactions culminating into outbreak. Materials and Methods: Epidemic investigation was launched as per the standard protocol laid by Center for Disease Control to capture the clinico-microbiological pattern of disease. Descriptive and observational epidemiological analysis was performed. Results: This cholera like watery diarrheal episode presented along with vomiting and abdominal cramps had an attack rate of 45.11%. The mean duration of illness was 61 h with a predilection to pediatric age group. Clinico-microbiological picture probed the enterotoxicogenic Escherichia coli contaminated well-water as a source for the outbreak initiated by geo-environmental stimulation. Conclusion: The findings endorse the need of serviceable environmental sanitation strategies in order to prevent the disease transmission through water. [ABSTRACT FROM AUTHOR]

Background: In 2011, in an effort to increase focus on newborn care and survival, the Ministry of Health and Family Welfare, Government of India, formally introduced the three-tier Facility Based Newborn Care (FBNC) system at various levels of health facilities. This study evaluates the functional status of newborn care facilities in a northern state of India. Materials and Methods: A cross sectional, mixed methods, descriptive study was conducted during the months of May to July 2021. Six districts were selected for the study representing each of the six administrative divisions of the state. A total of 31 facility based newborn care units were assessed, including six Special Newborn Care Units (SNCU), six Newborn Stabilization Units (NBSU) and 19 Newborn Care Corners (NBCC). Human resources availability and training, infrastructure, equipment and supplies, adherence to standard operating procedures, infection control protocols and regular maintenance of records were assessed. Overall functional status was ascertained using five criteria: Equipment, Human resources, Protocol, Infrastructure and Recordkeeping. Results: Though the prescribed strength of manpower was available at almost all facilities, most reported that they had not received specific on-the-job training on newborn care. Infrastructure and biomedical waste disposal facility was found to be adequate at all levels. However, the complete set of prescribed essential neonatal care equipment was not available and functional in any of the NBSUs and in a very small number of SNCUs and NBCCs. Most of the SNCUs and NBCCs were found to be partially functional according to the set criteria. Conclusion: Adequate functionality of NBSUs needs to be ensured in order to maximize the benefits of the three-tier system of FBNC. [ABSTRACT FROM AUTHOR]

Introduction: Responding to raised demand for health services during the COVID-19 pandemic, many countries turned to private healthcare providers to augment public capacities. In India, to deal with price inflation by private hospitals, many state governments implemented regulation of rates for COVID-19 treatment. Materials and Methods: In Maharashtra which pioneered the hospital rate regulation among Indian states, we conducted a mixed-methods study to examine the impact of rate regulation. Using purposive sampling, we interviewed 100 previously hospitalised COVID patients or their relatives, along with 12 health sector stakeholders. Results: Analysis shows that in 82.5% of hospitalisation episodes, patients were overcharged compared to official packages The majority of private hospitals utilised diverse stratagems to circumvent rate regulations, including double charging on items included in official packages. Conclusion: With a background of commercialisation of healthcare and pre-existing regulatory hiatus in India, gaps in design and implementation of COVID-period regulatory measures and state's inadequate regulatory capacity formed the context for the limited effectiveness of regulatory measures. India and other LMICs with large private healthcare sectors should develop comprehensive yet pragmatic frameworks for regulating private healthcare, including standardisation of rates, which can strengthen regulatory efforts, enabling equitable and affordable access to healthcare for all. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review is firstly to critically appraise and summarize the peer-reviewed published evidence on the relationship between the caste system and risk factors for poor health status in India and secondly, to discuss the concept of the social gradient and policies that have been developed to address social inequalities of healthcare in India. Studies explored the relationship between caste membership and health-related risk factors such as mortality, health behaviors, and nutritional status. Review revealed odds of mortality; poor health behaviors and poor nutritional status were higher and in some cases were significantly higher in lower caste groups in comparison to reference groups. Odds ratios reported for mortality and poor health behaviors were significantly higher in older populations. Odds ratios reported for nutritional status and mortality were significantly higher in younger populations. Further research on the independent effects of wealth and education would broaden the scope of the social gradient health equation in India. [ABSTRACT FROM AUTHOR]

Background: The private health sector has a significant role in the delivery of health services in India. However, given fast changing COVID-19 pandemic, it is critical to understand the role of the private health sector in delivery of services going forward. The supply of COVID-19 vaccines is firmly regulated by the Government of India and the private sector received unrestricted access to vaccine supply directly from manufacturers from June 2021 onwards. Materials and Methods: PATH carried out a rapid assessment of private health facilities in the state of Maharashtra to understand the challenges faced by private facilities in providing COVID-19 vaccination. Results: During the assessment it was found that 100% of the private health facilities have a robust cold chain system which is essential for safe storage of COVID-19 vaccines and delivery of immunization services. The in-charges of the health facilities reported difficulty in estimating requirement of COVID-19 vaccines doses, as 67% of the beneficiaries in Mumbai and Nashik were direct walk-ins. During the assessment 93.3% of the facilities were observed to have adequate availability of COVID-19 vaccines doses, based on the beneficiary registration data for the day. Ministry of Health, Government of India, recommends a trained 5-member vaccination team for providing services at each vaccination site. Conclusion: The key challenges faced by private health facilities during delivery of COVID-19 immunization were associated with differential vaccine pricing, time taken to receive supply of vaccines, difficulties in accurately estimating vaccine demand, multiple record keeping at the facility level and declining vaccine demand. [ABSTRACT FROM AUTHOR]

Background: Quality of care is central to current efforts under National Rural Health Mission (NRHM) in India to sustain gains in utilization of institutional maternal and newborn care. For effective planning around institutionalizing quality improvement systems, it is important to critically evaluate India's maternal health policy and services in historical perspective. Objectives: The narrative review was conducted (i) to trace the evolution of concern with quality in maternal health in the context of health system development in India from independence (1947) to the present; and (ii) identify quality-related issues and areas for further action to improve maternal and infant survival outcomes. Materials and Methods: Peer reviewed scientifi c publications were identifi ed through systematic searches of scientifi c databases, grey literature and policy documents. Altogether 174 documents were reviewed. Prospectively designed forms extracted data on (i) health system and quality development; (ii) service performance; (iii) health and safe delivery outcomes. Results: In the fi rst four decades after independence, concerns with infrastructure expansion and vertical disease eradication programmes neglected quality of maternal healthcare in India. With growing concern for quality, strategies addressing this were incorporated in NRHM launched in 2005, including public health standards and quality assurance system in reproductive and child health services. Conclusion: Focus on quality in maternal health in India has increased in recent years, especially under NRHM, and this has helped accelerate progress in maternal and neonatal outcomes. Further action areas include the need to increase funding, match rising demand with quality services and enhance functioning of quality assurance system. [ABSTRACT FROM AUTHOR]

Aim: "Swachh Bharat Summer Internship programme" is an initiative of Indian government to involve the youth of the country for cleanliness activity in the community. It was utilized by MBBS students of a university in Bathinda, India as a source of opportunity for community medicine learning and service in the community. Materials and Methods: A mixed method study was planned in the month of June 2019 to assess attitude of the community towards solid and liquid waste disposal, provide community service related with this and arrange health education sessions for waste disposal. Nukkad natak, focus group discussion and video clipping were used to educate community and data were collected. Cleaning of roads and market area were done as service to the community. Feedback from the community about different activities and from the students about the whole programme was collected & analyzed. Results: Findings of the study have shown that villagers had a huge interest for different newer methods which were utilized for community health educational session. Similarly students had also liked the community service sessions however finding shows that requires some improvement in qualitative research techniques. Conclusion: Community's positive attitude towards waste disposal should be utilized judiciously for improving environmental cleanliness of the village. Similarly Positive feedback by the students' necessities that authority should conduct more and more community service and learning exercise involving different education model. [ABSTRACT FROM AUTHOR]

Context: Information related to COVID-19 has been copiously accessible by almost everyone through various modes since its emergence in December 2019 with possible divergence in beliefs about the sources of infection and the actions to take to reduce morbidities and mortality, giving rise to the COVID-19 infodemic. Aim: (i) to report on the variability in the comprehension of COVID-19 related mortality information (ii) to document how varied the sources of information that a population relies on are (iii) to understand the motivation behind implementation of social distancing norms amongst this population (iv) to suggest methods to reduce the burden of an infodemic within a pandemic by creating herd immunity against misinform ants. Settings and Design: An online survey was conducted amongst urban educated individuals on 19 April 2020. Methods and Materials: The survey was conducted using Google forms and sent via WhatsApp chat messages to 949 individuals belonging to various chat groups, of whom 96 replied voluntarily. Results: Even though most (92.71%) of the participants derived their information from 'trustworthy' sources, there was a large amount of variation in their interpretation of that data. Conclusion: We demonstrated that educated urban professionals have been negatively affected by the infodemic around the COVID-19 pandemic and suggest broad guidelines for future information flow to be better handled through programmes such as "information vaccination" and "modified herd immunity" so that an infodemic is controlled and leads to better outcomes from any epidemic. [ABSTRACT FROM AUTHOR]

Introduction: Dietary diversity has been universally identified as a key element of high quality diets. The tendency among undergraduate students with poor dietary patterns is high, due to lack of parental supervision, incorrect knowledge regarding food habits, stress of academic, professional and social life. This study was carried out to assess the diet diversity and eating pattern of undergraduate students of various colleges in India. Methods: This was a descriptive cross-sectional study conducted among 3046 undergraduate students across India by filling the online questionnaire shared through social media. The data on dietary diversity was collected by asking the number of consumed food groups in previous 24hr from the total food groups described by FAO, with anthropometric measurements. Data analysis was done using SPSS version 21. Results: Mean age of participants was 20.7±1.9 years, the majority being females. About 42.2% student's skipped breakfast 1-2 times per week and another 28.5% skipped 3 or more times. About 34.7% had poor DDS (Dietary Diversity Score) whereas 28.5% had good DDS. Higher DDS mean was found in males (3.67) than females (3.23), overall mean being 3.4. Among 869 people with good DDS, 63.1% had normal BMI and 57.1% availed their meals from mess. There is significant distribution of DDS among different regions (p=0.0007), graduation streams (p=0.0014) and source of meals (p<0.001). Conclusion: In this study, the diet diversity of about three-fourth participants was inadequate, showing their improper habit of food consumption and results also indicated their unhealthy eating pattern. Adequate dietary practice is recommended. [ABSTRACT FROM AUTHOR]

Background: Measles is the public health problem in India, causing mortality and morbidity in children. Measles vaccination is included in the Immunization program but low coverage is still a major problem. There is a lack of data on measles incidence and coverage in vulnerable population for measles. Methodology: A cross-sectional study was carried out to find out the incidence and vaccination coverage based on parents recall in identified 30 slums of Ahmedabad by using cluster sampling method. 3000 children, less than five years of age were included by selecting 100 children from each cluster. Pre-designed and pre-tested standardized questionnaire of UNICEF was used to assess symptoms of measles and history of the Immunization. Result: The measles incidence was found 20.8% based on symptoms and 3.03% based on confirmed diagnosis by doctors as per parents recall in the past six months. The overall vaccination coverage was found at 64.62%. The most common presenting symptom was found fever with rash in children with measles. Conclusion: No gender difference was found in vaccine coverage, measles incidence and status of treatment received. Vaccine efficacy found to be 42% which is very low and high incidence of measles was reported which shows the need for an effective targeted program for the urban slums. [ABSTRACT FROM AUTHOR]

Introduction: The International Diabetes Federation (IDF) showed that nearly 7 crore people in India were suffering from diabetes in 2015 and this number is projected to be 12.5 crore by 2040. India's economic boom has been accompanied by a dramatic upsurge of diabetes. Globalization of unhealthy lifestyles are closing the gap between urban and rural diabetes. So it has become important to estimate the diabetes prevalence and risk factors in rural Agra, India where no community based data was available. Material and Methods: This community based cross-sectional study was carried out in rural Agra from June 2013 to 2014. The sample size was calculated to 1209. Data was collected using a structured and pre-tested questionnaire while fasting blood glucose measured with the help of Glucocard - Vital Glucometer. The data was compiled and statistically analyzed using SPSS-22 software. Results: The prevalence of Diabetes Mellitus in rural Agra was found to be 7% with a diagnostic gap of 37%. Prevalence of Diabetes was observed significantly associated with the age, occupation and socioeconomic status. Prevalence of Diabetes Mellitus was significantly more in people with higher Body mass index (13.3%), centrally obesity (10.3%) and higher Waist Hip Ratio (8.4%) than with normal BMI (4.4%), non-obese (4.2%) and normal WHR category (1.6%). On multiple logistic regression age, hypertension, BMI and WHR contribute as risk factors for developing Diabetes mellitus. Conclusion: As evident from findings diabetes is becoming common in rural population also, adding to the problem is poor awareness. Health care systems should be strengthened for early detection and effective treatment of disease. [ABSTRACT FROM AUTHOR]

Background: In the pluralistic environment of Indian healthcare financing system, community based health insurance (CBHI) holds promise to reduce the share of out of pocket (OOP) expenditure on healthcare by the households. The present study explores the extent to which the mutual model of CBHI could reach the socially and economically marginalized population along with investigating the reasons of drop-outs from the scheme in the city of Mumbai and Pune. Methods: This study used a cross sectional exploratory study method, using simple random method, conducted in slums of Mumbai and Pune. Results: The financial protection provided through health mutual fund (HMF) is still on the lower side when compared with annual OOP expenditure due to health by the household. The enrolment pattern shows that the scheme covers the marginalized people belonging to lower castes and minority community, employed in the unorganized sector. HMF is playing an important role in providing financial protection against the high frequency illness which is not covered under state sponsored schemes. Conclusion: Factors behind the members dropping out of the scheme were found to be no benefit from the scheme, inability to pay a premium, member of Employees State Insurance Scheme, unsatisfactory services from network provider and past negative experiences including claim rejection or low reimbursement. The study holds larger policy implications as there is limited study conducted to know the pattern of enrolment and exploring reasons of low rates of renewals. [ABSTRACT FROM AUTHOR]

Background: Since 2007, Satara district is implementing a pilot project named "Second Honeymoon Package" (SHP). SHP gives cash incentives to encourage postponement of first pregnancy in newly married couples. At the same time, contraception services are also provided under National family welfare program. There requires a significant amount of commitment and expenditure from the beneficiaries to avail the benefits of governmental programs, which is often overlooked by the system. The costs of these two reproductive health interventions are compared in this study. Objective: To calculate the cost of providing and utilizing contraception services for the newly-wed couples in Satara district from the perspective of the Government of Maharashtra and that of beneficiaries'. Materials and Methods: This was a cost-minimization study of two reproductive health interventions in rural part of Satara district. Information about expenditure incurred was calculated from 17th June 2010 to 16th June 2012. Cost analysis was conducted from the perspective of Government of Maharashtra and that of beneficiaries'. Costs of SHP were evaluated in comparison with those of routine family welfare program. Results: One thousand and ninety-five out of 1355 participants (80.8%) have used condoms, 125 participants (9.22%) have used oral pills while only 15 (1.1%) have used safe period method. The average distance of health facility from the homes of participants has been 4.24 km ± 6.54. Annual unit cost of implementation of SHP was Rs. 883 (16.35$/ year) during the study period while the opportunity cost of utilizing the contraception services was Rs. 383.40 (7.1$) per person per year. The annual unit cost of implementation of family planning program was Rs. 323.73 (6$). Conclusions: In districts like Satara that have a strong family planning infrastructure, reorienting the program to provide contraception services for newly married couples may be achieved with minimal additional inputs. [ABSTRACT FROM AUTHOR]

Background: Morbidities have emerged as major threats to livelihoods of the poor. An estimated 150 million have been reported as spending more than 40% of their income on their health needs. Aim: To identify the determinants of enrolment and experiences of Rashtriya Swasthya Bima Yojana (RSBY) benefi ciaries in Udupi district, India. Materials and Methods: A cross-sectional study was carried out in Udupi district between March and August 2012. A mixed method approach using qualitative and quantitative methods was used. The study included all households who were eligible under the RSBY scheme recognized by the Planning Commission of India as below poverty line (BPL) households and participants recruited above 18 years of age. The sample included in the study was 316 households and took into account 95% confi dence interval and 20% precision. Results: Education of the household head, marital status, household size and awareness of the cost of enrollment to RSBY were seen to be signifi cantly associated with enrollment to RSBY (P < 0.05). Logistic regression analysis of four variables which showed statistical signifi cance including household size, marital status, education, and prior awareness about the cost of enrollment into RSBY showed that prior knowledge of the cost of enrollment into the scheme and household size of less than fi ve were major determinants to enrolling for RSBY. On qualitative analysis, the majority of the scheme users reported that the enrolment under RSBY had benefi tted them and they are willing to renew the scheme again in the next round of enrollment. Conclusions: The awareness on scheme details among those included in the present study was found to be low. Information and education campaigns could improve involvement of both the insurers as well as the local institutions offering care and possibly increase utilization rate of RSBY. [ABSTRACT FROM AUTHOR]

Background: Privatization of medical education can widen its scope and availability via creation of large no of medical professionals in allopathic system for Indian people, but can it be an alternative to create human resources with appropriate skill mix, especially when services in health system involves lives of the human being needs rethinking on an urgent basis. Objectives: To review the issues related with privatization of medical education system of India. Materials and Methods: A systematic review on key search word: "Privatization of medical Education in India" was done from main indexed journals of key medical search engines i.e. Pubmed, Cochrane, Bio-med Central, and Google Scholar etc. in all forms including e-journals till 15th August 2013 since last 20 years. Conclusions: Indian allopathic medical education system is one of the largest in the world. Medical Colleges in India have rapidly progressed in last 25 years, especially in private set ups; there is no doubt that they can help Indian health care system, but the need of hour is, to critically look at the quality of students opting M.B.B.S course, quality of medical faculties in terms of their skill mix for clinical as well as para-clinical services, and quality of medical education imparted by these institutions, which can be achieved by strict implementation of strict Medical Council of India (MCI) norms, in order to ultimately improve the health care system of India in long run. [ABSTRACT FROM AUTHOR]

Objectives: Analyses were done on the Indian publication outputs on liver disorder research during 2003-2012, on several parameters, including contribution and citation impact of the most productive countries, India's overall contribution, its growth pattern, citation impact, the share of international collaboration, identifi cation of the signifi cant participating countries in India's international collaboration, contribution and impact of different types of liver disorders, productivity and impact of leading Indian institutions and authors, and pattern of communication of Indian output in most productive journals. Materials and Methods: The Scopus Citation Database has been used to retrieve the data for 10 years (2003-2012) by searching with the keyword 'liver,' in the combined Title, Abstract, and Keywords fi eld. Results: The Indian publication's output in the liver disorder research consisted of 2380 articles during 2003-2012, which increased from 143 articles in 2003 to 378 articles in 2012, witnessing an annual average growth rate of 11.92%. The average citation impact per article registered by the Indian publications for liver disorder research was 4.68 during 2003-2012, which decreased from 6.43 during 2003-2007 to 3.71 during 2008-2012. The international collaborative share of India in the overall liver disorder research was 15.34% during 2003-2012, which increased from 12.65% during 2003-2007 to 16.84% during 2008-2012. Conclusions: Keeping in view the severity of liver disorders in India, there is a need to increase the investment in Research and Development (R and D) to bring about improvements in supportive care and a need to set up a Hepatitis Registry. Efforts must be made to develop state- and government-supported prevention and control strategies, including conducting mass awareness programs, formulation of universal guidelines for immunization, promotion of partnerships, development of an evidence-based policy, and development of programs for prevention of transmission, along with better fi nancial and social support initiatives. [ABSTRACT FROM AUTHOR]

Background: India has the largest percentage/number of vitamin A defi cient children in the world. However, the effectiveness of a program of vitamin A supplementation at the population level has been rarely examined. We aim to examine the status of vitamin A supplementation among preschool children in India and its association with their socioeconomic and demographic characteristics and the social and economic development level of the State in which they reside. Materials and Methods: Data are from a cross-sectional study of 20,802 children aged 12-35 months whose mothers participated in the National Family Health Survey 3 (NFHS-3) conducted during 2005-2006. The association between the socioeconomic and demographic characteristics of the children, the social and economic development status of the State in which they reside and vitamin A supplementation status was examined by means of unadjusted and adjusted logistic regression models. Results: Only 25% of the children in India received vitamin A supplementation, indicating a poor coverage, and the differences between the States were wide (<10% to >45%). Rural children (OR: 1.20; 95% CI: 1.10-1.30; P < 0.0001) and children of educated mothers (OR: 2.40; 95% CI: 2.04-2.83; P < 0.0001) were more likely to receive vitamin A supplementation than others. Children born in a higher birth order (6+) (OR: 0.54; 95% CI: 0.46-0.63; P < 0.0001) and those residing in states with low levels of social and economic development (OR: 0.51; 95% CI: 0.46-0.57; P < 0.0001) were only about half as likely to receive vitamin A supplementation as their counterparts. Conclusion: The national vitamin A supplementation program in India did not reach a majority of preschool children in 2005. Greater maternal formal education, higher household wealth status and high social development status of their State of residence appears to be an important determinant for receipt of a vitamin A supplementation by preschool children in India [ABSTRACT FROM AUTHOR]