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Introduction: The most reliable indicator for anaemia diagnosis at the population level is haemoglobin (Hb) estimation. The direct cyanmethaemoglobin method is considered the gold standard method for haemoglobin estimation. However, for resource constraint areas like primary health care (PHC) level, either blood samples are transported on filter paper for Hb testing (indirect cyanmethaemoglobin method) in laboratory or point of care testing is commonly used. Therefore, a comparative analysis of haemoglobin estimation of direct with indirect cyanmethaemoglobin method and also with TrueHb (Wrig Nanosystems Pvt. Ltd.) haemometer was done to strengthen anaemia diagnosis at the PHC level. Materials and Methods: This was a cross‑sectional study. A total of 90 participants above 9 years of age, who visited the outpatient department (OPD) of health centre, Kheri and gave consent were included. Comparative analysis was done between Hb concentration assessed by indirect cyanmethaemoglobin method and TrueHb haemometer device against the gold standard method. Results: The mean Hb value estimated by direct method, TrueHb haemometer and indirect methods (filter paper A, B and C) was 11.42 ± 1.59 g/dl, 11.52 ± 1.54 g/dl, 10.66 ± 1.52 g/dl, 9.84 ± 1.50 g/ dl and 10.19 ± 1.62 g/dl, respectively. There was no significant difference found between the mean Hb concentration estimated by the direct method and the TrueHb haemometer device. However, there was a significant difference in mean Hb values between the direct method and the indirect method. Therefore, regression analysis was done to estimate the correction factor for the indirect method. Conclusion: TrueHb metre device gave promising results in comparison to the gold standard method and can be used if resource permits in PHC centres. Indirect methods of haemoglobin estimation can be an alternative in resource‑constraint settings, specifically for surveys. However, further studies are required for the validation of the indirect method. [ABSTRACT FROM AUTHOR]

Basic computer skills are essential for authors writing research papers as it has the potential to make the task easier for a researcher. This article provides a glimpse about the essential software programs for a novice author writing a research paper. These software applications help streamline the writing process, improve the quality of work, and ensure that papers are formatted correctly. It covers word processing software, grammar correction software, bibliography management software, paraphrasing tool, writing tools, and statistical software. All of the tools described are free to use. Hence, it would help researchers from resource-limited settings or busy physicians who get lesser time for research writing. We presume this review paper would help provide valuable insights and guidance for novice authors looking to write a high-quality research paper. [ABSTRACT FROM AUTHOR]

The entire world seems to have responded to COVID-19 pandemic in a knee-jerk manner with a short mindset without building on the existing strengths of public health infrastructure. National governments cannot be blamed for this as we are dealing with a crisis that comes once in a lifetime. Realising this, the Organized Medicine Academic Guild (OMAG) an association of major health associations in this country has suggested measures for long-term solutions to COVID-19-like pandemics in the form of a policy paper by OMAG. [ABSTRACT FROM AUTHOR]

Diabetes Mellitus (DM) causes global exhaustion, consumes economic resources, and has several risk factors. The bibliometric studies re-evaluate the research efforts on this illness using mathematical and statistical tools to indicate current research and future trends. This study examines KSA's DM research during 2010-2021. Data were acquired from Scopus and analyzed using VOSviewer and MS Excel. Several characteristics were examined to measure the quantity and quality of KSA-related DM articles. In total, 1,919 journal and conference papers were published. DM research included researchers from multidisciplinary sectors. Thirty-seven percent of them have ten or more scientific publications. Al-Daghri, N.M. (King Saud University) leads the pack. In total, 757 (39.44%) research projects got funding from 159 sources within and outside KSA. Memish, Z.A. is the most cited author. The Saudi Medical Journal has the most citations (1214). Al-Daghri, N.M. (KSU) collaborates the most. One hundred forty-one nations aided KSA's diabetes research. Egypt's High Institute of Public Health has the most scientific collaboration with KSA. Authors' and all Keywords analyses indicated a rich knowledge structure. Diabetes Care Journal has the most cocitations with 2,220 and a total link strength of 19,283, followed by The New England Journal of Medicine. The study results will be helpful to stakeholders to understand better the trends and performance of diabetes-related regional research, which will be beneficial. [ABSTRACT FROM AUTHOR]

Zoonotic diseases are an important public health problem. Keeping this in way, a panel reviewed the discussion around "one health" strategy of the WHO in combating zoonotic diseases during Seventh annual conference of Consortium Against Rabies (CAR) with the theme of "Zoonoses: Thinking beyond Rabies" held on 14th and 15th June 2019. The panel came out a manuscript discussing the need, background, and rationale for basic framework of possible roadmap for one health. Background —About CAR: CAR has been established with the aim to serve as a platform for the control of the rabies menace in India. It will evolve into a full fledged struggle against rabies in the country. The association comprises of medical professionals, veterinary doctors, and public health persons. The idea behind CAR is to bring the best minds in the country for research and information dissemination in the field of rabies. About Academy of Family Physicians of India (AFPI): AFPI is the official association of family physicians in India. Dedicated to provide professional leadership, conduct healthcare advocacy, policy development and a change in health system within the domain of family medicine, and larger public health system in the country, the academy is the recipient of the Healthcare Leadership Award 2012 in the category of Healthcare Governance and Public Administration. The white paper development Process: More than 100 medical experts, veterinary doctors, and public health persons from across the country and belonging to the fields of internal medicine, family medicine, public health, veterinary sciences, nursing science and environmental science and representing reputed medical institutions, government funded research institutions, and policy making bodies participated in discussions on topic of "one health" made during 7th Annual national conference of CAR with the theme of "Zoonoses: Thinking beyond Rabies" held on 14th and 15th June 2019. The panel steering the discussion included leading expert from ICMR, medical colleges, veterinary college, family medicine, private practitioners, and health program managers. The panel committee had prepared a draft document well in advance of the conference, which was communicated to all participants for feedback and comments. The panel was steered by ICMR expert. The discussion of the panellist was presented to the consensus group and unanimously adopted. A writing group worked on the manuscript, which was again circulated by email to all for any comments and suggestions before final publication. [ABSTRACT FROM AUTHOR]

Family medicine is the internationally recognized nomenclature for the academic discipline, knowledge domain, and medical specialty of primary care doctors, working in the community setting. Family medicine is defined as a specialty of medicine which is concerned with providing comprehensive care to individuals and families by integrating biomedical, behavioral, and social sciences in the community setting. The distinction of family medicine lies in the tradition of medical generalism, promoting whole person care, in a life cycle mode; providing optimal preventive, promotive, and curative healthcare services in a wide spectrum of setting from home to hospital. In 2016, 92nd report of the department‑related parliamentary standing committee on health and family welfare on the “Functioning of the Medical Council of India” has emphasized the need for postgraduate in family medicine. The committee report has noted that “the medical education system is designed in a way that the concept of family physicians has been ignored. The committee recommends that the Government of India in coordination with State Governments should establish robust PG Programs in Family Medicine and facilitate introduction of Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous healthcare for the individuals and families. The successive National Health Policies of Government of India–NHP 2002 and 2017 have emphasized the need of family medicine training in India. The recently enacted National Medical Commission Act 2019 has mandated NMC to promote training in family medicine at both undergraduate and postgraduate levels. Therefore, in the background of the stated policies of the Government of India the concept of family doctors, which was earlier neglected should be institutionalized within the mainstream medical education system of India. It is now time to accelerate and upgrade family medicine training and thereby strengthen the concept of comprehensive primary care in India. This white paper presents the review of family medicine training in India and proposes a way forward. [ABSTRACT FROM AUTHOR]

Covid-19 has once again brought into focus our limited preparedness to deal with epidemics. Most nations, across the globe, have responded with a resolve to come stronger out of this crisis and leaderships across the world have shown great commitment to protecting its people from Covid-19. Covid-19 has also taught us a few things for the future. One such learning has been that a strong shift in focus towards non-communicable diseases driving health infrastructure across the globe for the last few decades has come at neglect of communicable diseases. In that sense, therefore, the current pandemic has been a wake-up call. Organised Medicine Academic Guild (OMAG), an umbrella organization of professional associations gathered a group of health experts to develop a policy document on epidemic preparedness to limit the influence of epidemics like Covid-19. [ABSTRACT FROM AUTHOR]

Urgent care practice (UCP) is a novel concept for India. Urgent care primarily deals with injuries or illnesses requiring immediate care. Medical emergency and urgency can happen anywhere unannounced. Research has shown that 90% of the morbidities can be resolved within the community by primary care physicians lead teams. Given the changing professional demands, non-specialists tend to refer away far too many cases to specialists, undermining generalist medical care, particularly in Indian settings. The spillover of the patient load from the primary care setting to the tertiary care centers is enormous leading to resource mismatch. Family physicians and other primary care providers are best positioned to develop practices and provide good quality urgent care to society. Family physicians, general practitioners, and medical officers are already functioning as the frontline care providers for any emergency or medical urgency arising within communities. Urgent care is essentially ambulatory care or outpatient care outside of a traditional hospital emergency room. "UCP aims to provide timely support, which is easily accessible with a focus on good clinical outcomes, e.g. survival, recovery, lack of adverse events, and complications. Core interventions of urgent care are centered on the 4Rs - Rescue, Resuscitate, Relate, and Refer. At present, there are no available, established training model for future faculty, residents, and medical students on "UCP" in India. [ABSTRACT FROM AUTHOR]

Half the world’s people currently live in rural and remote areas. About 70% of the world’s 1.4 billion people who are extremely poor live in rural areas. The problem is that the majority of healthcare providers prefer to serve in urban areas. Only a comprehensive and systematic approach can address these inequities. India, the largest democratic republic in the world, possesses 2.4% of the world’s land area and supports 16% of the world’s population. According to census 2011, 68.84% of population resides in rural areas. Nearly 86% of all the medical visits in India are made by rural inhabitants with a majority still traveling more than 100 km to avail healthcare facility, of which 70%–80% is born out of pocket landing them in poverty. A country’s approach must systematically and simultaneously address legal coverage and rights, health worker shortages, extension of healthcare protection, and quality of care. Only then can equitable access for all be fully achieved. Those living in rural areas have access to health protection and services that meet the criteria of availability, affordability, accessibility, acceptability, and quality. Family medicine as a broad specialty has its role from womb till tomb. Family medicine is defined as a specialty of medicine which is concerned with providing comprehensive care to individuals and families by integrating biomedical, behavioral, and social sciences. As an academic discipline, it includes comprehensive healthcare services, education, and research. A family doctor provides primary and continuing care to the entire family within the communities; addresses physical, psychological, and social problems; and coordinates comprehensive healthcare services with other specialists, as needed. The practitioners in family medicine can play an important role in providing healthcare services to the suffering humanity. The general practitioner’s responsibility in Medicare includes management of emergencies, treatment of problems relating to various medical and surgical specialties, care of entire family in its environment, appropriate referrals, and follow-up. He or she is the first-level contact for the patients and his or her family. Family medicine is the ideal solution to growing rural healthcare challenges. This article is a formal position paper of the Academy of Family Physicians of India. [ABSTRACT FROM AUTHOR]

Introduction: Daily use of public restrooms may have a significant impact on spreading infectious diseases. Human society could be affected by spreading of transitional infectious diseases through feces, urinary tract infection and poor personal hygiene. According to the World Health Organization reports, plenty of people's developed diseases caused by contaminated public restrooms that may result in severe health problems. Methods: This descriptive cross-sectional study was conducted on 7,482 samples that were collected randomly in 6 months (spring and summer 2019) in different regions of Tehran. The Data were obtained by analyzing 804 restroom's indoor and outdoor handles, 1062 toilet faucet, 826 washbasin taps, 1,062 toilet hoses, 804 flush tank levers, 643 soap dispenser bottoms, 643 liquid soaps, 99 bar soaps, 169 toilet papers and paper towels, and 50 hand dryer machines. Samples which were tested, based on bacteriology standard methods. Result: 7,482 samples were gathered of which 6,678 contaminated cases (89.25%) were observed and 804 cases (10.75%) were found non-contaminated. Escherichia coli with 28.48% and Pseudomonas with 0.39% were the most and the least common bacteria, respectively, in this study. Conclusion: The required tests to identify the bacteria that cause contamination through the use of public restrooms have been done. It is essential to inform the public of the mentioned items and teach how to prevent infectious diseases. [ABSTRACT FROM AUTHOR]

The world is passing through a global pandemic of COVID 19. The number of positive cases has crossed over twenty thousand as of April 2020. Like everyone else, it is indeed a very challenging situation for family physicians and primary care providers as most of the guidelines presently have focused on screening, quarantine, isolation, and hospital-based management. Limited information or clarity is available on running small private clinics during pandemic times. The key concern is professional obligation versus risks of community transmission. Family physicians see routine flu-like illnesses throughout the year with seasonal variation within their practices. This document is intended to develop consensus and standard practices for the family physicians and other primary care providers during the pandemic, ensuring optimal continuity of care. This document was reviewed by the national executive of the Academy of Family Physicians of India and approved for dissemination among members. However, due to the dynamic status of the pandemic, all practitioners are advised to closely follow the instructions, guidelines, and advisories of national, state and local health authorities as well. [ABSTRACT FROM AUTHOR]

Introduction: Anemia is a major public health problem amongst elderly population in India. Anemia in old age further worsens the age-related decline in functional ability, mobility, fatigue, bone density, and skeletal muscle mass. There is lack of evidence on the prevalence and risk factors of anemia among elderly population. Hence, this study was undertaken. Methodology: A community-based cross-sectional study was conducted during the year 2015–2016 in District Nainital, Uttarakhand state, India. A total of 958 subjects were selected from 30 clusters (villages) identified using population proportional to size methodology. Information on sociodemographic profile, nutritional status, body mass index, and dietary intake was obtained. Blood sample was collected from each subject on the filter paper for estimation of hemoglobin (Hb) level using cyanmethemoglobin method. Results: We found that 92.1% of the elderly subjects were anemic. Moderate and severe anemia was found to be significantly higher among female subjects, unemployed, illiterates, subjects using smoke-producing fuel, subjects belonging to lower socioeconomic status, malnourished and underweight subjects, subjects with self-reported hyperacidity, and subjects who had not utilized health facility and had lower iron and vitamin C intake when compared with subjects with mild anemia and normal hemoglobin levels. Conclusion: High prevalence of anemia exists amongst elderly subjects living at high-altitude region of rural Uttarakhand State, India. There is a need to educate the elderly population about the importance of adequate intake of foods rich in iron and vitamin C to reduce the prevalence of anemia among them. [ABSTRACT FROM AUTHOR]

Background: It is essential for practicing clinicians to have core knowledge of biostatistics. However, surveys indicated that clinicians' attitudes towards biostatistics are negative. Despite its importance, little is known about the knowledge of and attitudes towards statistics among trainees in family medicine, particularly in Saudi Arabia. The current investigation attempts to evaluate knowledge and attitudes held by family medicine trainees in Taif and explore their correlates. Materials and Methods: This was a descriptive, questionnaire-based, cross-sectional study of residents in family medicine training programme in Taif, Saudi Arabia. We used Poisson regression modelling to evaluate the effect of background factors on knowledge and attitudes towards biostatistics. Results: The study included 113 family medicine trainees at different levels of training. Only 36 (31.9%) of the participating trainees expressed positive attitudes towards biostatistics. On the other hand, 30 (26.5%) participating trainees were found to have good biostatistics knowledge, compared to 83 (73.5%) trainees whose knowledge level was found to be poor. Upon adjusting for all background factors simultaneously, only younger age, level R4 training, publishing one or three papers were found to be associated with poorer attitudes towards biostatistics. Older age was associated with worsening of attitudes (adjusted odds = 0.9900, P = 0.00924), and so also was being a senior R4 trainee (adjusted odds = 0.9045, P = 0.01301). Publishing one paper (compared to publishing over three papers) was associated with poorer attitudes towards biostatistics (adjusted odds = 0.8857, P = 0.03525). Also, having published three papers (compared to publishing over three papers) was still associated with worse attitudes towards biostatistics (adjusted odds = 0.8528, P = 0.01318). Conclusion: The main finding of our current study is the poor level of knowledge and overtly negative attitudes held by family medicine trainees in Taif towards biostatics. Knowledge was particularly poor about advanced statistical concepts such as survival analysis and linear regression modelling. However, poor levels of knowledge about biostatistics could be a function of poor research productivity among family medicine trainees. Age, seniority in training and involvement in research also impacted positively on attitudes towards biostatistics. Therefore, it is recommended that the training curriculum for family medicine trainees should first cover essential biostatistics in a creative and accessible way and secondly encourage engagement research and publication from an early stage of training. [ABSTRACT FROM AUTHOR]

The h-index is an author-level scientometric index used to gauge the significance of a researcher's work. The index is determined by taking the number of publications and the number of times these publications have been cited by others. Although it is widely used in academia, many authors find its calculation confusing. There are websites such as Google Scholar, Scopus, Web of Science (WOS), and Vidwan that provide the h-index of an author. As this metrics is frequently used by recruiting agency and grant approving authority to see the output of researchers, the authors need to know in-depth about it. In this article, we describe both the manual calculation method of the h-index and the details of websites that provide an automated calculation. We discuss the advantages and disadvantages of the h-index and the factors that determine the h-index of an author. Overall, this article serves as a comprehensive guide for novice authors seeking to understand the h-index and its significance in academia. [ABSTRACT FROM AUTHOR]

Introduction : The volume and quality of biomedical research publications from an institution are considered adequate indicators of the quality of medical care in that institute. King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia (KSA), is one of the oldest and most distinguished medical centers in the country. Methods: In this study, we analyzed the number of publications from the Critical Care Unit of the hospital in the past two decades, from 1996 to 2016. The research publications were evaluated on various parameters. Moreover, the impact of their study on global medicine was determined. Results: Our results indicate a steady progression in the number of publications from the institute in the past two decades. An average of 17.3 papers was published each year during this time. Out of the 283 publications from KAMC included in this study, the majority of the publications were original articles, 61 were review articles, 66 were multicenter trial studies and 28 were randomized control trials. The citation profile of the publications was good indicating global impact of the studies. Conclusion: The global impact of research as evaluated through published manuscripts in KAMC is overall good. This was deduced from both the increase in the number of publications each year and also the quality of papers as evidenced by the citation index of the papers published between 1996 and 2016. [ABSTRACT FROM AUTHOR]

There is a rare subset of patients with a genetically abnormal hemoglobin structure initially discovered in the Volga region of Europe known as Volga anemia. Key features of this condition include compromised delivery of oxygen to peripheral tissues and altered red blood cells that have a higher likelihood of being broken down or hemolyzed, which can lead to significant hemolytic anemia. Methylene blue is a dye that acts as a reducing agent of oxygen and is commonly used in toxic states that lead to methemoglobin build‑up. This paper explores the pathophysiology of this genetic condition and documents three cases across two patients—a father and son—when methylene blue was used during an anemic crisis. [ABSTRACT FROM AUTHOR]

Background: There are few reliable Iranian‑induced abortion data. The aim of this paper was to investigate the prevalence and socioeconomic characteristics of women and men who report having had or been a partner in an abortion. Materials and Methods: A cross‑sectional survey of women and men aged 15–49 years referred to the health center that randomly selected from 110 health center that was used. Results: Data from 1520 women and men surveys were analyzed. One in 10 women and one in 12 men had experienced or been a partner in an abortion. In adjusted analyses, women and men in the 34–49 age group [adjusted odds ratio (AOR) 0.62, 95% (CI) 0.41, 0.96], the importance of religion in fertility (AOR = 0.42; 95% CI 0.26, 0.67), dissatisfied general health (AOR = 0.52; 95% CI 0.32, 0.87), and history of unwanted pregnancy for twice (AOR = 2.32; 95% CI 1.43, 3.77) and history of unwanted pregnancy for three‑time or more (AOR = 2.69; 95% CI 1.59, 5.49) were associated with significantly increased odds of abortion. Haven’t heard of medication abortion, that is, abortion with tablets (AOR = 0.43; 95% CI 0.29, 0.67) was associated with significantly reduced odds of abortion. Conclusions: The findings contribute to scarce information about abortion in Iranian. Due to the high prevalence of abortion and the country’s population growth policy, Iranian women need a full range of sexual and reproductive health services, including contraceptive counseling and accessible abortion care. [ABSTRACT FROM AUTHOR]

The 1978 Alma Ata Declaration established recommendations for health systems, which significantly impacted low‑income countries. These guidelines marked improvements in access to health, coverage and financial equity, especially in Latin American countries. Objectives: This paper focuses on the role of the private sector (including for‑profit and non‑profit organizations) in achieving Universal Health Coverage (UHC). It examines their involvement in the management, service delivery, resource investment and financing of primary health care (PHC) within the sustainable development goals (SDGs). Methods: The study covers a review of health systems, emphasizing the influence of private institutions on public health, and evaluates how private sector experiences contribute to system functions and progress towards UHC. Results: The findings indicate the crucial role of the private sector in global health systems, notably expanded in several countries. Private actors are essential to improve access and coverage, particularly in countries with low health indicators. The article highlights the importance of primary care physicians understanding these dynamics since their management is vital in implementing public policies for UHC. [ABSTRACT FROM AUTHOR]

Background: Menstrual hygiene management is integrally associated with reproductive health of women. Menstrual health and hygiene needs, particularly of tribal women still remain unmet for many reasons. Inappropriate menstrual behaviour leads to adverse health consequences. Objectives: This study aimed to ascertain the menstrual hygiene behaviour of tribal married women aged 15 to 49 years and its correlates. Methods: A descriptive cross‑sectional study was conducted from May 2019 to April 2020 in the Barabani block of Paschim Bardhaman district, West Bengal. A calculated sample of 530 women was selected randomly from 10 tribal villages of the study area; they were interviewed through a pre‑designed schedule for socio‑demographic and menstrual hygiene behaviour characteristics. Menstrual hygiene management score was derived based on five essential components‑ hygienic absorbents, hygienic disposal of absorbents, frequency of changing of absorbents, cleaning of external genitalia and source of water for cleaning; menstrual hygiene behaviour was categorised as favourable and unfavourable. Bivariate and multivariable logistic regression was performed using SPSS v. 20. Results: All 530 women were Hindu and belonged to Santhal ethnicity; 53.4% were illiterate. Sanitary pads were used by 43.8% of women; 63% practised indiscriminate throwing for disposal of absorbents; 86% practised appropriate changing of absorbents. Overall, 63% had favourable menstrual hygiene management behaviour, and the literacy status of women was found to be a significant predictor. Conclusion: Unfavourable menstrual practices are still widely prevalent among tribal women, mainly attributable to lack of knowledge. Awareness generation should be focused on improving those practices, which would also result in the improvement of general health conditions. [ABSTRACT FROM AUTHOR]

Moderate to severe hypertensive retinopathies are more likely to correlate with uncontrolled blood pressure in all ages. Mild microvascular changes are expected with natural aging and are therefore more concerning in patients younger than 40. Risk assessment is subsequently determined based on blood pressure measurements and patient symptoms. The goal of this paper is to discuss current opinions regarding the role of grading hypertensive retinopathy in the risk assessment of systemic cardiovascular disease in the context of a clinical case. Management and referral recommendations for clinicians will be summarized. Emergent referral for hospital-based care is indicated in any patient with severe hypertensive retinopathy; pregnant women with moderate hypertensive retinopathy; patients younger than 55 with blood pressure greater than Grade 2; any patient with blood pressure greater than grade Severe; any patient with symptoms of chest pain, headache, dyspnea, or dizziness; and any patient with a symptomatic retinal plaque. [ABSTRACT FROM AUTHOR]

The National Medical Commission (NMC) of India has issued new guideline for post graduate medical courses in India on 15th January 2024. These Guidelines may be called the "Minimum Standard of Requirements for Postgraduate Courses-2023 (PGMSR-2023)". These guidelines will come into force with immediate effect. Unfortunately, Family Medicine specialty has been entirely excluded from this document, despite clear mandate in the National Medical Commission Act 2019. Previously, the Undergraduate Medical Education Board of NMC did not include the Family Medicine as a mandatory department for training at MBBC Course. In the absence of a specific policy on medical education, a careful planning is required for number of post graduate residency positions across India depending upon population coverage and morbidity patterns. So, far during past three decades the increase in the number of post graduate residency posts/ seats have been random. There has been no clear-cut policy by the government or by the regulator itself. There appears to be no mapping for specialty need across geographical territories and population density in the background of the morbidity pattern. Under section 24(1)(c) of the National Medical Commission Act 2019 The Under-Graduate Medical Education Board shall perform the following functions, namely: -- (c) develop competency-based dynamic curriculum for addressing the needs of primary health services, community medicine and family medicine to ensure healthcare in such areas, in accordance with the provisions of the regulations made under this Act; Under section 25. (1)(j) National Medical Commission Act 2019 The Post-Graduate Medical Education Board shall perform the following functions, namely: -- (j) promote and facilitate postgraduate courses in family medicine. Under section 57. (1) The Commission may, after previous publication, by notification, make regulations consistent with this Act and the rules made thereunder to carry out the provisions of this Act. (2), and without prejudice to the generality of the preceding power, (p) the curriculum for primary medicine, community medicine, and family medicine under clause (c) of sub-section (1) of section 24. It is to be noted that Family Medicine is a community-based clinical discipline, all parameters for the graduate Family Medicine department, training, and faculty eligibility have been kept as per other hospitalist disciplines. It is the mandate of the Post Graduate Board of NMC to promote the PG program in Family Medicine. Suggestions articulated in this paper may be worthy of consideration of the esteemed members of National Medical Commission. [ABSTRACT FROM AUTHOR]

Objective: Vaginal pH has been suggested to be one of the causative factors, responsible for variation in prostaglandin efficacy for induction of labour. The purpose of this study was to analyse the effect of vaginal douching with normal saline before insertion of dinoprostone vaginal insert for induction of labour. Methods: This randomised controlled study was done in the Department of Obstetrics and Gynaecology for a period of 1 year. Using a computer-generated random number table, subjects were allocated in two groups. In group A (study group), vaginal douching was done with 20 cc of sterile 0.9% NaCl and vaginal pH was again measured with pH paper strips just before inserting dinoprostone pessary. Dinoprostone pessary was inserted without douching in group B (control group). Results: There was a significant increase in the vaginal pH after douching with normal saline (4.91 vs 5.52, P < 0.001). Mean intrinsic vaginal pH (pH before inserting dinoprostone insert) in women who delivered vaginally was significantly higher than that of the women who had a caesarean section (5.10 vs 4.63, P < 0.001). Time interval between dinoprostone insertion to active phase of labour, duration of active phase of labour, time interval between dinoprostone insertion, and complete cervical dilatation and mode of delivery were not significantly different between the two groups. Conclusion: Although douching with normal saline increases vaginal pH, douching does not help in increasing the chances of vaginal delivery because it gives a transient effect. Rather, it is intrinsic vaginal pH, which is a better decisive factor for successful vaginal delivery. [ABSTRACT FROM AUTHOR]

Background: Population aging leads to change of population structure and increase care needs. Lack of proper planning in this field will lead to occur increasing problems. In this paper, the review of the elderly care plans at various levels in some European and Asian countries, comparing these countries with Iran with the goal of using their experiences to enhance elderly plans have been done. Methods: This research was a review study of library documents and resources and systematic search. Data were collected using the resources, databases, scientific databases and websites of the Ministry of Health and Welfare of the studied countries. Results: Based on this research in the studied countries, the care services of the elderly is based on the important principle of coordination between different organs of the country, followed by the creation of LTC insurance and provision of health and social services for the elderly and mainly the type of home care. In Iran country, providing appropriate services and cares for the elderly with existing plans and policies is not possible and the need to provide appropriate service packages based on the different systems of successful countries and applying the experiences of these countries is essential. Conclusion: Given the current status of the Iranian elderly population in terms of policies and plans and the types and methods of providing services, quality, access and financial resources allocated to this age group, compared to the studied countries, there is a well and integrated plan is essential. [ABSTRACT FROM AUTHOR]

Floods are the most common natural disasters in the world. Currently Pakistan is in an acute emergency situation due to the recent flood that occurred as a result of the monsoon rains in July–August 2022. Unfortunately, the country was already under an economic crisis and was just recovering from the COVID pandemic when this devastating calamity struck. Almost one-third of the country's land was affected, with millions of houses damaged and property lost. As the victims are displaced and local health units are flooded, their medical needs are being met through medical flood relief camps arranged by public and private sector welfare organizations. Due to a lack of disaster preparedness and policies, most of the healthcare workers are untrained to manage medical flood relief camps and are hence learning from experience rather than following any standardized policy guidelines. We did not find any guidelines for organization and management of a flood relief camp in previous literature. As natural disasters continue to cause mass destruction every few years, there is a need to devise policies and procedures for disaster preparedness and hazard reduction. This paper is thus an effort to provide the best possible delivery of acute health services in a developing country during and after a flood in the transit phase, while the government and other non-governmental organizations (NGOs) help communities rebuild their health system. [ABSTRACT FROM AUTHOR]

Background: The fundamental principles of healthcare practices and policies are derived from good quality research. Doctors collectively are a source of vast sums of invaluable information. This information if effectively utilized can improve and strengthen the healthcare system. Our study provides a comprehensive overview of the ecosystem of an Indian medical researcher. Objectives: To understand (1) the obstacles faced by medical professionals (2) the challenges encountered at various steps (3) the gaps in research knowledge and (4) the means to rectify them. Method: Doctors from medical schools, hospitals, and in private practices were approached. Data were collected through online and physical questionnaire. Data were analyzed and studied. Results: The total number of participants in this study is 212. Case reports (51.9%) and case-control studies (51.14%) are the most frequently conducted types of research. Lack of access to research journals (43.9%) and absence of proper guidance or mentorship (37.39%) are the commonly faced challenges among individuals who have pursued research, whereas busy schedule is the top-cited reason for not pursuing research (34.24%) and discontinuing research (57.4%). Coordinating time schedule with mentees is a challenge for mentors (49.2%). Doctors also face the greatest difficulty (48.12%) and delay (47.4%) in the publication process. On the other hand, personal interest (60.15%) and job requirement (46.61%) are the top facilitators for research. A small percentage has or knows someone that has plagiarized (21.32%) or falsified data (33.49%). Most of the doctors agree that research experience should be a mandatory part of undergrad training (81.6%). Conclusion: We believe interest, impact and importance of research can be the best developed and emphasized in the training years. Institutional support, adequate mentorship and an uplifting research environment can go a long way in motivating the doctors and tackling the challenges they face. [ABSTRACT FROM AUTHOR]

The role of the Academy of Family Physicians of India (AFPI) has been vital in promoting family medicine in India. Through its various initiatives, the AFPI has worked to enhance the quality of healthcare services, support the professional development of family physicians, and advocate for policies that recognize and strengthen the role of primary care in the healthcare system. By fostering education, research, and collaboration, the AFPI is working toward a healthcare system where everyone can access comprehensive and continuous primary care. This paper summarizes the vision, mission, goals, and objectives of AFPI. [ABSTRACT FROM AUTHOR]

Background: Breast cancer awareness is vital to enhance early detection and treatment, thus improving women’s quality of life and reducing the breast cancer burden in a country. This paper describes breast cancer awareness among women in the Alappuzha district, Kerala. Methods: A community-based cross-sectional survey was conducted among 320 women aged 35-65 using a multi-stage cluster-sampling method. The data were collected using a structured interview schedule and analysed using IBM SPSS Statistics-25. The Chi-square test was used to test associations, and binary logistic regression was used to estimate odds ratios and 95% confidence intervals. Results: The most reported risk factor and symptoms were unhealthy food habits (29.6%) and breast lumps (91.7%), respectively. Nearly half of the women spoke about at least one risk factor (53.8%), and 39.8% mentioned at least two symptoms of breast cancer. Awareness of breast self-examination and mammography were 85.7% and 39.5%, respectively. Compared to women with a primary level of education, women with a higher secondary or above level of education were more likely to report at least one risk factor (AOR = 8.96; 95%CI: 3.44-23.36), more than two symptoms (AOR = 4.73; 95%CI: 1.82-12.27) and mammogram as a screening method (AOR = 61.1; 95%CI: 6.56-394.63). Women detected with breast cancer (n = 6) were excluded from the analysis. Conclusion: Women are unaware of most of the risk factors and symptoms of breast cancer, and breast cancer awareness are highly associated with women’s education. Breast cancer awareness creation is essential to improve the early detection of breast cancer among women, especially in the low socioeconomic strata. [ABSTRACT FROM AUTHOR]

Background: Cancer is often detected much later to its onset, resulting in poor prognosis. This makes cancer the second most common cause of death globally. Looking for cancers much before any symptoms occur is termed "cancer screening" and is a powerful strategy for prevention, early diagnosis, and better management of several cancers. This paper examines the status of cancer screening in India from the National Family Health Survey (NFHS)-5 report for the period of 2019–2021. Methods: Secondary data on participation in screening for cervical, breast, and oral cancer were extracted from the NFHS-5 report. Participation status for all the above cancer types is represented as percentages and compared across 28 states and eight union territories in India. Results: The percentages of women who have ever undergone cervical, breast, and oral cavity screening were 1.9%, 0.9%, and 0.9%, respectively. About 1.2% of men participated in oral cavity screening. The highest percentage of cervical and breast cancer screening participation was reported in Tamil Nadu (9.8% and 5.6%, respectively), followed by Puducherry (7.4% and 4.2%) and Mizoram (6.9% and 2.7%). Andaman and Nicobar Islands reported the highest oral cancer screening among women (10.1%) while Andhra Pradesh (6.3%) reported the highest participation among men. Conclusion: Cancer screening participation in India is extremely inadequate and calls for the immediate attention of national and state governments. Additional efforts are warranted to improve public awareness of cancer screening, and appropriate measures should be implemented to conduct well-organized screening programs across the country to ensure maximum participation. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is a chronic condition that can lead to a variety of consequences. Diabetes is a condition that is caused by factors such as age, lack of exercise, sedentary lifestyle, family history of diabetes, high blood pressure, depression and stress, poor food, and so on. Diabetics are at a higher risk of developing diseases such as heart disease, nerve damage (diabetic neuropathy), eye problems (diabetic retinopathy), kidney disease (diabetic nephropathy), stroke, and so on. According to the International Diabetes Federation, 382 million people worldwide suffer from diabetes. By 2035, this number will have risen to 592 million. Every day, a large number of people become victims, and many are ignorant whether they have it or not. It primarily affects individuals between the ages of 25 and 74 years. If diabetes is left untreated and undiagnosed, it can lead to a slew of complications. The emergence of machine learning approaches, on the other hand, solves this crucial issue. Aims and Objectives: The aim was to study the DM and analyze how machine learning algorithms are used to identify the diabetes mellitus at an early stage, which is one of the most serious metabolic disorders in the world today. Methods and Materials: Data was obtained from databases such as Pubmed, IEEE xplore, and INSPEC,and from other secondary sources and primary sources in which methods based on machine learning approaches used in healthcare to predict diabetes at an early stage are reported. Results: After surveying various research papers, it was found that machine learning classification algorithms like Support Vector Machine (SVM), K-Nearest Neighbor (KNN), and Random Forest (RF) etc shows the best accuracy for predicting diabetes at an early stage. Conclusion: Early detection of diabetes is critical for effective therapy. Many people have no idea whether or not they have it. The full assessment of Machine learning approaches for early diabetes prediction and how to apply a variety of supervised and unsupervised machine learning algorithms to the dataset to achieve the best accuracy are addressed in this paper.. Furthermore, the work will be expanded and refined to create a more precise and general predictive model for diabetes risk prediction at an early stage. Different metrics can be used to assess performance and for accurate diabetic diagnosis. [ABSTRACT FROM AUTHOR]

Since the pandemic of the coronavirus disease 2019 (COVID-19) infection, many people have been affected in different ways. The majority of infected people experience mild to moderate symptoms and recover without the need for hospitalization. However, in some affected people, it may lead to catastrophic disease. The severity of COVID-19 infection is widely influenced by co-morbidities, immune system functions, and extra-pulmonary organ injuries. Since the emergence of COVID-19, multi-organ involvement has been documented. In order to implement preventative and protective measures, full attention to potential organ injuries is required. Most existing articles and review papers are focused on a specific organ system, and their numbers are growing. In this review paper, attempts were made to collect review papers and articles published on seven organ system involvements in COVID-19 infection published till 15 July and highlight conclusions and managements of all affected organs. We tried to add to the medical knowledge on COVID-19, pointing out its multi-organ system impact. Finally, we tried to facilitate access to organized information and optimum conclusion by representing review tables for each organ system. Besides, this review article can clarify and magnify the empty research space easily for future investigations. [ABSTRACT FROM AUTHOR]

Background: During the process of the treatment of COVID-19 hospitalized patients, physicians still face a lot of unknowns and problems. Despite the application of the treatment protocol, it is still unknown why the medical status of a certain number of patients worsens and ends with death. Many factors were analyzed for the prediction of the clinical outcome of the patients using different methods. The aim of this paper was to develop a prediction model based on initial laboratory blood test results, accompanying comorbidities, and demographics to help physicians to better understand the medical state of patients with respect to possible clinical outcomes using neural networks, hypothesis testing, and confidence intervals. Methods: The research had retrospective-prospective, descriptive, and analytical character. As inputs for this research, 12 components of laboratory blood test results, six accompanying comorbidities, and demographics (age and gender) data were collected from hospital information system in Sarajevo for each patient from a sample of 634 hospitalized patients. Clinical outcome of the hospitalized patients, survival or death, was recorded 30 days after admission to the hospital. The prediction model was designed using a neural network. In addition, formal hypothesis tests were performed to investigate whether there were significant differences in laboratory blood test results and age between patients who died and those who survived, including the construction of 95% confidence intervals. Results: In this paper, 11 neural networks were developed with different threshold values to determine the optimal neural network with the highest prediction performance. The performances of the neural networks were evaluated by accuracy, precision, sensitivity, and specificity. Optimal neural network model evaluation metrics are: accuracy = 87.78%, precision = 96.37%, sensitivity = 90.07%, and specificity = 62.16%. Significantly higher values (P < 0.05) of blood laboratory result components and age were detected in patients who died. Conclusion: Optimal neural network model, results of hypothesis tests, and confidence intervals could help to predict, analyze, and better understand the medical state of COVID-19 hospitalized patients and thus reduce the mortality rate. [ABSTRACT FROM AUTHOR]

Introduction: Patients with advanced cancer often suffer from complex symptoms necessitating constant supervision and management. Primary care/family physicians act as an important bridge between the patients in the community and the specialists in the hospital ensuring continuity of care. Materials and Methods: The present paper explored the facilitators and challenges in providing home-based palliative care as perceived by the primary care/family physicians (PCP/FP). Results: 62 physicians reported that they were involved in palliative management of at least one cancer patient in the previous year. A significant number of GPs (34%) lacked confidence in providing this care because of patient complexity, inadequate training and insufficient resources. Other barriers included poor communication from specialists and treating teams. Factors facilitating provision of home-based palliative care included their willingness to help palliative care patients, their inclination to train in palliative care and enthusiasm to refer to guidelines while caring for patients. Conclusion: It is explicit in the paper that resources with respect to information sharing and communication, technical support and training are essential to empower the PCP/FP in providing community-based palliative care. [ABSTRACT FROM AUTHOR]

The National Health Family Survey (NFHS) is one of the largest cross-sectional surveys in the world and plays a very important role in seeing the health sector's growth in India. Its comprehensiveness in data points serves as a baseline for policymakers to amend or continue the health policy at the national and state levels. It is also imperative to look up the survey's major findings and compare the same with the previous survey finding to obtain a trend (positive/negative) of the placed data indicators. In writing this information, we aim to provide a researched paper to undergraduates and postgraduates in medical education to identify the trends or gap pockets in NFHS-4 and NFHS-5. These findings might help them as an educational piece of work and further research evidence in their local community. Also, the present work is the compilation of demographic characteristics and major health indicators. [ABSTRACT FROM AUTHOR]

The article discusses a study conducted by Kulkarni et al. on the changing trends in COVID-19 publications in India. The researchers used bibliometric analysis to analyze the pattern of publications related to the pandemic. The study found that an increase in the number of scientific publications can improve the overall scientific environment. However, the article also highlights the potential negative consequences of prioritizing quantity over quality in research. The author suggests adding additional keywords to the analysis and raises questions about the inclusion of certain types of articles in the results. [Extracted from the article]

Introduction: Quality improvement and performance evaluation have become today's mainstream medical issues, whereas in many areas of medical care, the quality of care services is less than desirable. Objective: To determine a conceptual model for practice-based learning and improvement (PBLI) competency in medicine. Methods: This study was conducted using Walker and Avant's theoretical synthesis method. Articles related to the concept of PBLI were searched using the keywords of practice-based learning and improvement, quality improvement, core competency, medical education, practice-based learning in English, separately and combined in google, google scholar, and Pubmed databases. After identifying the theoretical blocks and variables of each block and communicating them, a visual model of PBLI was presented. After a focused search for each block, a total of 229 full papers were studied and the PBLI model was developed in six conceptual blocks. Results: The visual model that presented in this study shows the relation among six theoretical blocks of PBLI including: Block of approach to PBLI, PBLI process triggers block, gap bridging solutions, PBLI infrastructure block, PBLI sub-competencies block, PBLI academic development block. Conclusions: Nowadays, PBLI is one of the inevitable qualities of medicine that ensures the quality of medical practice, which, in addition to individual requirements, requires a series of technical, strategic, structural, and cultural infrastructures. By utilizing this capability, a physician will be able to discover the knowledge, skills, and performance gaps, and will be able to cope up with their appropriate approaches, thereby improving the quality of their medicine and the care provided and the patient's safety. It can provide satisfaction and trust in society. The model presented in this paper makes it easy to understand the relationships between the various components of this competency. [ABSTRACT FROM AUTHOR]

Background: Conducting research requires the integration of certain levels of practice and knowledge, together with the right attitude. This study aimed to investigate the attitude, knowledge, and barriers regarding research analysis and writing among medical residents in Saudi Arabia. Methods: This was an online-based cross-sectional study that was conducted in Saudi Arabia. Our targeted population was Saudi medical residents who were enrolled in the Saudi Commission for Health Specialties. Data were analyzed and compared to determine associations between the patients' demographics and attitude, knowledge, and barriers. Results: A total of 218 participants were ultimately included in the present study, with a mean age of 29 (± 2.6) years, and most participants (63.3%) had a previous research publication. Specialty and level of residency were the only significant factors that were associated with attitude (P = 0.023 and 0.046, respectively). Specialty and having previously published a research paper were the only factors that were associated with the knowledge scores (P = 0.001 and 0.0001, respectively). On the contrary, specialty was the only significant factor that was associated with barriers scores (P = 0.001). Regarding attitude scores, most residents (60.1%) had 26%–50%, while only 0.9% had >75% of the total score. Regarding knowledge scores, 38.1% of residents had ≤25% and only 7.8% had >75% of the total scores. Regarding barriers, most residents (73.4%) had 26%–50%, while none had >75% of the total scores. Conclusion: Reduced awareness regarding research methodology in our population implies that further education measures should be undertaken. [ABSTRACT FROM AUTHOR]

The Alma‑Ata Declaration of 1978 was a historic hallmark in the history of public health of the 20th century. It stressed on comprehensive primary health care and led to the slogan of “Health for All by 2000 A.D.” The Conference documents made it clear that primary health care was essential health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country could afford to maintain at every stage of their development in the spirit of self‑reliance and self‑determination. It was proclaimed to form an integral part of a country’s health system. In addition, as a consequence, the overall social and economic development of the community depended on its survival. It was regarded as the first level of contact of individuals, the family, and community with the national health system bringing health care as close as possible to where people live and work. Instead of disease‑centred vertical programs, it emphasised to adopt the horizontal community‑based programs. Though the worldwide stir caused by the historic Alma‑Ata Conference (1978), giant MNCs of the world remained hibernated for some time but never gave up to turn “health” into “health care” as commodity. Intriguingly enough, health was “forgotten” when the Covenant of the League of Nations was drafted after the First World War. Only at the last moment, world health was included, leading to the Health Section of the League of Nations. Recently, Intergovernmental Negotiating Body has drafted a new Pandemic Treaty which might become disastrous for general well‑being and rightful living for citizens in future. All these observations are very much relevant if family medicine and primary care are given due importance at the present moment. [ABSTRACT FROM AUTHOR]

Dr. Prakash Chand (PC) Bhatla MBBS was one of the illustrious past presidents (1975-76) of Indian Medical Association (IMA). He was a General Practitioner by vocation and a towering professional leader. He made an immense contribution to the discipline of Family Medicine -- the academic discipline, medical specialty, and the knowledge domain of Family Physicians/Family Doctors within India as well as the global level. He was a brilliant human being and professional par excellence. He was probably one of the greatest leaders of the medical profession in India and a rightful successor to Dr BC Roy's legacy. As a rare achievement, he received the Dr BC Roy National Award from the President of India twice. He received this prestigious recognition award in 1977 for socio-medical relief in India and again in 1982 for the promotion of Specialty of General Practice. He founded IMA CGP (Indian Medical College of General Practitioners), and his foundational work led to the recognition of Family Medicine as a specialty in India. Due to his efforts, Family Medicine was included in the list of recognized specialties by the National Board of Examinations (NBE) as well by the Medical Council of India (MCI). His contribution to medicine at a global level is also remarkable. He is also considered one of the founding forefathers of WONCA -- World Organization of Family Doctors. He was associated with the foundation process of WONCA from the beginning (1964). The International Liaison Committee organized the first World meeting of General Practice in Montreal (Canada) in 1964 and the second meeting in Salsburg in 1966. Dr Bhatla was the convenor of the Third World Conference on General Practice in New Delhi, India, in 1968. A global representative body of Family Medicine/General Practice was launched in 1972 in Melbourne, Australia. Due to contribution to WONCA, he was elected for the first ever WONCA fellowship, the most prestigious global Family Medicine award. He was contemporary to other world leaders of Family Medicine and Primary Care such as Ian McWhinney and Barbara Starfeild. He is rightfully recognized and remembered as Father of Family Medicine. Dr Bhatla's intellectual, professional, and administrative contribution laid down the sound background for the foundation of a Specialty body of Family Medicine in India called the Academy of Family Physicians of India. Life and work of Dr PC Bhatla continues to inspire family doctors, family physicians, general practitioners, and Family Medicine specialists across India, South Asia, and the World in the 21st century. [ABSTRACT FROM AUTHOR]

I "You can't cross the sea merely by standing and staring at the water." i - Rabindranath Tagore, Nobel Laureate in Literature 1913 Dear Editor, Raina I et al i .[[1]] emphasise on India's need for long-term solutions to coronavirus disease-2019 (COVID-19) like pandemics and they draft a policy paper by Organized Medicine Academic Guild in April 2021 issue of the Journal. India's need for long-term solutions to COVID-19-like pandemics: A policy paper by Organized Medicine Academic Guild. 3 Banerjee A, Mukherjee K, Bhattacharjee D, Garai D, Chakraborty R. Status of health-care workers in relation to COVID-19 infection: A retrospective study in a level 4 COVID hospital in Eastern India. [Extracted from the article]

Evidence-based health care is gaining prominence since the past many decades. The ultimate goal of evidence-based medicine is providing the best available treatment to patients. The boom in pharmacy sector has seen a rapid rise in randomised controlled clinical trials. Novel medicines or diagnostic tests must be tested before introducing to the target population. Randomised controlled trials are at the top hierarchy of evidence-based health care, especially for testing newly invented drugs. The results obtained from randomised controlled trials cannot be generalised to the entire population. This has led to the evolvement of multi-centre trials in evidence-based research. Multi-centre trials can overcome the barriers associated with single-centre clinical trials. The conduct of multi-centre trials is still in a budding stage in India. Although there are many ongoing multi-centre trials in India, very few trials are conducted among the dental fraternity. The conduct of such trials has its own set of challenges involving funding, ethical committee approval, and logistic requirements. This paper will discuss the growth of multi-centre research, steps involved in conduct of multi-centre trials, and the challenges faced in conducting these trials by the dental specialists in India. [ABSTRACT FROM AUTHOR]

Child abuse is harm or neglect toward a child by another person, whether an adult or child. It is common in all cultural, ethnic, and income groups. It can be physical, emotional--verbal, sexual, or even neglect. Abuse may cause serious injury and may even result in the death of the child. The aim of the paper is to review the child abuse laws prevalent in our country. Literatures were collected from the Google Scholar and E-Journals of legal services to get a sight of the child protection laws and to enlighten indigent children. Even though our country has different sections in the Indian penal code and many laws for the protection of children, still at the zeroth hour many corrupt rises. [ABSTRACT FROM AUTHOR]

An effective referral system ensures that there is a close relationship among all levels of health care, and individuals can receive the best possible care. The main purpose of the present study was to summarize studies that have addressed factors affecting the successful implementation of the referral system. A scoping review was performed to identify English and Farsi papers that were indexed in PubMed, Scopus, Science Direct, Trip Database, Cochrane Library, Embase, Google Scholar, SID, and Magiran until November 2020. Data was collected from the included studies by a reviewer and was checked by a second reviewer the collected data was analyzed using narrative methods. About 1245 relevant studies were identified in the first stage. After checking titles and abstracts, 63 studies were included. The factors that affected the referral system were classified in 4 themes and fourteen subthemes including technology (electronic referral, coordination, response and feedback), processes (effectiveness, efficiency), organizational (management, policy and planning, rules and regulations), patient centered individual (insurance coverage, social capital, transportation, awareness, attitude, satisfaction, and social influence). Therefore, a wide range of factors are affecting the performance of referral systems. For implementing an effective referral system, it is necessary to consider these factors. [ABSTRACT FROM AUTHOR]

Nurses form the pillar of India's healthcare system representing 30.5% of the entire health workforce in India. Amidst a significant shortage in the provision of effective primary care, jeopardizing millions of Indians' access to basic healthcare services, especially the poorest, it is very evident that nurse practitioners are the need of the hour in India. The current scenario of nursing in India warrants policy reforms to facilitate nurses as valuable primary care providers. It also shows the path towards making the Health and Wellness Centre operational by creating a pivotal role for the cadre in such centres, and it will also be important for the nurse practitioner to have a public health leadership role in a country like India. With additional training and qualification and also recognition of nurse practitioners as essential healthcare providers, a complete quality healthcare could be provided. In this research paper we assess the need for nurse practitioners as primary contact providers; reflect on the global evidence on nurse practitioners linking to health outcomes, effective coverage and access to services. We also try to contemplate on the training needs, their role in home-based care and as enablers of the referral mechanism, their untapped potential, and a plan for evaluating their effectiveness. This policy research paper focuses to build an argument for a policy towards making nurse practitioners the first contact providers. [ABSTRACT FROM AUTHOR]

Referral is a dynamic process, in which a health worker at one level of the health system, having insufficient resources (drugs, equipment, skills) to manage a clinical condition, seeks the help of a better or differently resourced facility at the same or higher level to assist in. Health care systems of every country are designed in such a way to encourage patients to first attempt to get care at the primary level and then to approach a higher level of care according to the need. This protocol minimizes the costs for the caretaker/patients. However, in most of the countries, patients often bypass primary care facilities and directly go to the higher center thereby, increasing the burden on higher level facilities, the picture is not very different in India also. Health care system in India is plugged by: overpopulation, lack of expert clinicians, skewed distribution of physicians, lack of motivation among existing health care personnel and an ineffective referral mechanism. Due to failure of conventional paper-based referral systems in our country, we can introduce an e-referral system in the era of internet. It is evident from our experiences, that this artificial intelligence enabled e-referral system has many advantages over the traditional paper-based referral system. It will aid health workers for timely management of cases. Most importantly, it will streamline the existing unorganized referral process. Although, for effective e-Referral system, there should be a collaborative platform where easy search and discovery for health care providers is possible and help in decision making. e- Referral should be incorporated in our health system to strengthen it by bridging the access gap may be through Public Private Partnership model. [ABSTRACT FROM AUTHOR]

Background: The second wave of COVID-19 was disastrous and claimed many lives in India and abroad. The most challenging task was to provide the required treatment as per the patient's condition, within a limited span of time. The lack of prognostic predictors at the time of admission led to failure in prioritizing the patient's need for intensive care. Aim: This study was conducted to find out the clinical and laboratory parameters at the time of admission to ICU as predictors of outcomes in COVID-19 patients, which can help in judicious utilization of the available resources for better patient care. Subjects and Methods: Study comprises of 161 ICU admitted patients. Study of clinical traits, comorbidities, test results, and demographic variables were carried out among survivors and non-survivor. Result: Maximum death were patients of age group 21–30 years and male gender. Mortality in hypertensives, diabetics, and patients with sepsis were found to be statistically significant. Patients who developed ARDS and pneumonia or needed ventilation died invariably. High levels of laboratory parameters like IL-6, LDH, PT, INR, aPTT, ferritin, WBC count, and D-dimer were significantly associated with poor outcomes and at a particular cutoff had optimum sensitivity and specificity to predict mortality in ICU admitted COVID-19 patients. At the same time, low lymphocyte count and PaO2/FiO2 ratio was significantly associated with bad prognosis (P < 0.05). Conclusion: This paper will help in prioritizing patients in ICU who need special attention especially at the time of meager supply of resources. [ABSTRACT FROM AUTHOR]

Objective: There has been an observable trend towards developing medical competency frameworks across the globe. These competency frameworks are intended to improve societal trust in the medical education system in developing appropriately competent medical practitioners. A framework developed by the Royal College of Physicians and Surgeons; Canada has been widely accepted by several institutions across the world. Medical Council of India has also published a similar framework of medical competencies. Most of these frameworks does not consider ancient Indian frameworks which have existed for several thousand years. Current paper examines the medical competency frameworks from ancient India and compares it with current frameworks. Method: A review of literature available in reputable libraries and online on the medical competency framework from ancient India has been attempted. Key words including 'competency framework, medical framework, ancient India and fully equipped physician' were used. Results: A medical competency framework was written and implemented more than two thousand years ago. The framework identified key competencies including: Medical expertise, Communication skills, Scholar, Health advocacy and Professionalism. This framework was used for medical practitioners at the time and used during the training and subsequent medical practice. Conclusion: There is striking similarity between ancient Indian and current model of competency framework. Teachings and wisdom from ancient India can prove invaluable while developing future medical competency frameworks. [ABSTRACT FROM AUTHOR]

The article discusses the h-index and its limitations in academia. It explains how the h-index is calculated, where it can be found, and why it varies across different platforms. The article also highlights other numbers and indices used to evaluate a researcher's work. It emphasizes that no single index can fully judge the quality of a research paper. The article provides historical examples to illustrate that recognition and significance of discoveries are not always immediate or universally acknowledged. It concludes by advocating for independent evaluation of research and supporting scientists regardless of their h-index. [Extracted from the article]