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   Table of Contents - Current issue
Coverpage
September-December 2022
Volume 3 | Issue 3
Page Nos. 49-95

Online since Wednesday, September 14, 2022

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EDITORIAL  

Over-the-top platform: A boon or bane during COVID-19 lockdown p. 49
Prem Sagar Panda, Sania Salim
DOI:10.4103/jphpc.jphpc_23_21  
COVID-19, an unprecedented global pandemic, has changed the way of media consumption by the audience. A new trend surfaced during this period – prioritizing over the tops (OTTs) over normal ongoing media channels. This points to the growing market and consumer appetite for content of choice available on OTT platforms. OTTs offer a naïve and consumer-friendly advantage – choice of content, simple access, and choice of device/mediums (hand phone, laptop, tablet, or TV screen). However, its rampant usage has also affected the mental and physical health of people of all generations. It is imperative to know the impact of growing content consumption on psychological behaviors across generations (children, adults, and elderlies) as there is limited censorship within the OTT space. As the mental health issues are on rise, the primary care physicians are the key role players to address this issue as they meet number of subjects as a primary contact. Hence, to find out the impact of OTT, an extensive literature search was done from PubMed and Google Scholar, and the relevant findings were noted down.
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REVIEW ARTICLE Top

How to set up your google scholar profile: A brief technical guide p. 53
Himel Mondal, Sarika Mondal, Shaikat Mondal
DOI:10.4103/jphpc.jphpc_1_22  
Google Scholar is a free search engine that provides information about scholarly articles available on the Internet. An author can track the citations and other author-level metrics such as the h-index and i10-index in the Google Scholar profile. Opening an account in Google Scholar is free. An author can open the account with the Google account (e. g., Gmail account credential) details. If an institutional e-mail address is available, the author can verify the e-mail address. However, this is not a prerequisite for opening an account. In this article, we provide a brief technical guide on the creation of a Google Scholar profile.
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ORIGINAL ARTICLES Top

COVID-19 pandemic response by India and future directions p. 56
Suraj Kapoor
DOI:10.4103/jphpc.jphpc_31_21  
Introduction: It has been more than a year since COVID-19 was declared Pandemic by WHO on 11 March 20. India with the initial slow rise of cases had a peak of cases at around September 20 followed by a gradual fall in the number of new cases and faced the second wave with the rising number of cases from March 21 to July 21. There is limited literature examining the pandemic response in India considering policies adopted, economic factors, health-care capacity factors of selected states influencing the variation of the spread of infection in various states. Hence, this study is conducted to understand COVID response, policies adopted by India, and lessons learned. Materials and Methods: This is a descriptive study conducted across the country covering important states covering the period from January 2020 to September 2021. States were selected based on high caseload, high test positivity ratio. Data for the study are compiled from the health bulletins, official handles of health ministries, WHO, World bank, Worldometer, John Hopkins University Centre for Science and Engineering, NFHS 5, etc., Results: On comparing key epidemiological indicators of selected states, Maharashtra has the largest number of cases with the highest Case fatality rate (CFR). Kerala has the second-highest cases among selected states but with the least CFR. On comparing key sociodemographic factors, Kerala has a maximum literacy rate and elderly population, while Delhi has maximum Population density. Despite having maximum risk factors such as the prevalence of diabetes, obesity, and hypertension, Kerala managed to have the least CFR. The reason may be due to the robust surveillance system, high literacy rate, and good doctor–patient ratio comparing other states. Maharashtra the worst affected state managed to do better in the second wave in respect of oxygen supply and vaccination drive. Conclusion: Full lockdowns and early border closures appeared to lessen the peak of transmission and thus prevent health system overcapacity. However, these measures had an impact on the lives of people as well as the economy of the countries. Addressing vaccination drive issues such as supply chain and manufacturing capacity, focussing on the young and pediatric population as well as focussed cluster containment strategies seems to be the most effective strategy to combat the anticipated third wave.
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Vaccine hesitancy and risk perception among health-care workers in a tertiary hospital in North-East India p. 63
Bishwalata Rajkumari, Avinash Keisam, Ningthoukhongjam Shugeta Devi, Samurailatpam Priyanka Devi, Regina Wahengbam, Mangvung Mangboi Haokip
DOI:10.4103/jphpc.jphpc_28_21  
Context: Vaccine hesitancy is an important threat to public health and a major setback for achieving herd immunity especially during the COVID 19 pandemic. Health-care workers are a major reckoning force in making the vaccines acceptable to the general population and the question is why there is vaccine hesitancy among them. Aims: The study plans to determine the reasons of vaccine hesitancy among health-care workers and to assess the association between their risk perception and variables of interest. Settings and Design: A cross-sectional study was conducted among doctors, nurses and other support staff in a tertiary hospital in North-East India, who were hesitant to take the vaccine when it was their turn. Methods and Material: Using convenience sampling method, data collection was done using a pre-tested interview schedule after obtaining informed verbal consent. Ethical clearance was obtained from the Institutional ethics committee. Statistical analysis used: Descriptive statistics like Mean, SD and percentages were used. Chi-square and Fisher's exact tests were used for association. Results: There were 160 participants out of which 30 (18.8%) had low risk perception of COVID-19 infection. Three (1.87 %) of the respondents said they were never going to be vaccinated against the disease and 59 (36.87%) said they may get the vaccine maybe at a later date. While 56 (35%) of the individuals were scared of common AEFI's like fever, chills and rigor; 21 (13.12%) were scared of unknown side effects. Fifteen percent of the respondents had trust issues with the vaccines. Conclusions: Though majority of the respondents had high-risk perception of COVID-19 infection, but almost one-sixth had trust issues with the vaccine. Trust building for the vaccine and information, education, and communication must be in the forefront for making the vaccination drive a success.
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Noncommunicable disease program for blood pressure ontrol in Tamil Nadu, India: Bridging care gaps among patients with hypertension in public health facilities p. 68
Kamaraj Pattabhi, Jerard Selvam, Azhagendran Sivalingam, Piyalee Pal, Savitha Kasivishwanathan, Suresh Arunachalam, TS Selvavinayagam, Prabhdeep Kaur
DOI:10.4103/jphpc.jphpc_4_22  
Background: Despite advances in hypertension care, developing countries have a high burden of uncontrolled blood pressure (BP). The Government of Tamil Nadu, India, initiated a noncommunicable disease program to improve hypertension management in public facilities. Method: We conducted cross-sectional surveys at baseline and follow-up to evaluate BP control after a multipronged intervention among patients with hypertension visiting public health facilities in Tamil Nadu. The intervention included protocol-based hypertension treatment, lifestyle counseling and monitoring by trained nurses, alongside monthly free drug refills. Descriptive statistics and adjusted odds ratio (AOR) for BP control were analyzed. Results: We surveyed 923 patients at baseline and 941 at follow-up. Most patients were over 60 years of age, with female predominance. Proportion of patients dispensed drugs for 30 days increased at follow-up (84.5%) compared to baseline (11.4%) (P < 0.01). Proportion of patients with BP control was 32.4% at baseline and 40.5% at follow-up (P < 0.001). AOR for BP control at follow-up was 1.4 (95% confidence interval 1.1–1.7, P < 0.05) after adjusting for age, sex, type of facility, and the number of drugs. Conclusion: Focussing on accessibility, availability, and affordability, the program facilitated the provision of free drugs and counseling, resulting in optimal BP control. Encouraging physician adherence to protocols and task sharing with nurses can help streamline sustainable hypertension management.
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Knowledge, attitude, and practices pertaining to COVID-19 among pregnant women: A cross-sectional study p. 76
Pallabi Nayak, Abhipsa Rath, Subarna Mitra, Jasmina Begum
DOI:10.4103/jphpc.jphpc_6_22  
Background: Since its emergence in 2019, COVID-19 has affected all groups of people across several countries. Updated information about the disease and its application is the key to halt the spread of infection. Although there have been widespread awareness campaigns on COVID-19, the level of awareness among vulnerable groups such as pregnant women needs to be evaluated. Aims: The aim of this study was to assess the level of knowledge, attitude, and practices toward COVID-19 among pregnant women and its association with various demographic variables. Subjects and Methods: This was a cross-sectional descriptive study conducted between July 1, 2020, and September 30, 2020. Assessment was done using a self-designed questionnaire. Participants scoring more than 50% marks in each section were considered to have adequate knowledge, positive attitude, and good practice. Statistical analysis was done using SPSS version 20. Results: The total number of pregnant women included was 244. About 59% of women had adequate knowledge about COVID transmission and protective measures. All women had a positive attitude toward preventive measures taken by the government. About 98% of women agreed that all preventive measures taken by the government were beneficial. Almost all (98%) women had good practice of safety measures such as social distancing, wearing masks, and frequent handwashing. However, no association was observed between demographic variables and level of knowledge, attitude, or practice. Conclusion: The study showed adequate knowledge and good practice by most pregnant women irrespective of their level of education and socioeconomic status. Targeted health education to pregnant women can further ensure safe practices during pregnancy.
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Family care burden and its association with psychological distress among caregivers of chronic patients with schizophrenia p. 81
Lokesh Kumar Ranjan, Pramod R Gupta, Manisha Kiran, Narendra Kumar Singh
DOI:10.4103/jphpc.jphpc_16_22  
Background: Family burden among caregivers of patients with schizophrenia encounter comprehensive caregiving challenges to maintain their own physical as well as psychological distress and it can deteriorate the family functioning. Aim: The aim of this study is to assess the relationship between family care burden and psychological distress among caregivers of chronic patients with schizophrenia. Methods and Materials: The study was cross-sectional. It was conducted at the outpatient department of the Central Institute of Mental Health and Neuro Sciences, Dewada, Rajnandgoan, Chhattisgarh, India. A total of 260 samples were selected through a purposive sampling technique and informed about the study after giving their informed consent. Sociodemographics, a burden assessment schedule, and depression, anxiety, and stress scale were all part of the interview. Result: The study results showed a high level of care burden (70.8%) in the caregivers of patients with schizophrenia. The majority of the caregivers reported a severe level of stress (59.2%), anxiety (56.2%), and depression (48.5%). The result of the study indicated a significant positive relationship between family care burden and stress, anxiety, and depression among caregivers of chronic patients with schizophrenia. Conclusion: The study suggests the high prevalence of care burden which strongly contributes to psychological distress. These caregivers need psychosocial interventions to enhance the overall family environment to have a better adaptive state among families.
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CASE REPORTS Top

COVID-19 pandemic and its influence: Case study in North Bengal Medical College, Darjeeling district, West Bengal, India p. 86
Nilanjana Ghosh
DOI:10.4103/jphpc.jphpc_24_20  
COVID-19 pandemic will be the most dreaded public health challenge world has ever faced and health-care workers play a crucial role in combating it, risking their own lives. Health workers serving COVID faced discrimination. Many new set up like COVID-19 screening clinics with complete new set of rules and logistics were set up. In North Bengal Medical College (NBMCH), it was functional round the clock since its inception. Our case that was a chronic smoker, alcoholic, and had records of defiant behavior was posted as a guard here. The anguish and pan of the patients attending, an increased job responsibility thrust on him along with the dependence of patients on his behavior brought about a change. Witnessing able tireless fearless leaderships from major wards, supportive supervision, empathy, and regular counseling sessions are thought to herald the positive behavioral change in him. The role of self-actualization theories and adoption of behaviors with effective health communications and theories of ergonomics were reinstated. Using health belief models, a deep understanding of the preventive behaviors was tried.
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“COVID Arm” in the family medicine setting: Moderna vaccine hypersensitivity reaction p. 90
Lara L Cohen, Antonio J Suarez, Bryan W Pardo
DOI:10.4103/jphpc.jphpc_26_21  
The Moderna COVID-19 vaccination has been widely distributed since authorized for emergency use. Phase 3 clinical trial data reported that 1.5% of recipients experienced hypersensitivity reactions after vaccination. The resulting erythematous rash, termed “COVID arm,” has been described in isolated case reports. To our knowledge, existing literature has not presented this diagnosis in the family medicine setting. This study was exempt from Institutional Review Board approval. An 85-year-old female presented to our family medicine clinic with a rash at injection site 15 days after receiving the Moderna vaccine. She endorsed pruritus and allodynia. She was afebrile. The rash measured 8 cm (height) × 9 cm (width) and was erythematous, without edema or warmth. We determined the rash was a “COVID arm” hypersensitivity reaction. Family medicine physicians are newly responsible for providing education and care related to COVID-19 vaccination. This case provides a unique opportunity to review the suspected pathology of “COVID arm” and describe management in an outpatient setting. Patients without severe allergic reactions should proceed with the second dose in their other arm, anticipating possible repeat “COVID arm.”
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LETTERS TO EDITOR Top

Impact of lifestyle on COVID-19 patients associated with noncommunicable diseases p. 93
Mani Kruthika Mantha, Tarun Kumar Suvvari, Tejaswi Kota, Harmanjot Singh Kalra
DOI:10.4103/jphpc.jphpc_14_21  
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Alternate day iron prophylaxis: Is it time to change policy in India for pregnant and lactating women? p. 95
Suraj Kapoor
DOI:10.4103/jphpc.jphpc_14_22  
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