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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]

Camps are a popular approach to deliver medical care in India. While it is usually a one-off event for physical ailments, it is a long-term affair in Psychiatry. One of the first camps in psychiatry was rolled out as early as in 1967 at Mandar, Ranchi, followed by Raipur Rani (Haryana) in 1976 and at Gunjur, Karnataka in 1977. This camp approach became extremely popular and got expanded across India as they were thought to be synonymous with community-based outreach for mental illnesses. In the past 5 years, however, newer models of community care have emerged, necessitating a relook at this traditional approach. In this paper, the authors trace the origin, utility and future directions of these camps, taking data from community psychiatry camps conducted by the National Institute of Mental Health and Neurosciences, Bengaluru, a premier neuropsychiatric tertiary care institute in India. Data have been collated from the annual reports of the Institute, database from the District Mental health Program, Government of Karnataka, India, and compared with published literature on the same field. While camps remain as one of the important avenues to reach the unreached, there is a need to change the approach of their functioning by incorporating training (primary care providers) aspects and collaborative care. The latter may make the initiative more meaningful and sustainable. [ABSTRACT FROM AUTHOR]

Introduction: Common mental disorders (CMD) and cardiovascular diseases (CVD), common health problems among patients seeking primary healthcare, contribute to high economic productivity losses. Collaborative care programs for CMDs and CVDs have shown improvement in clinical outcomes for both conditions; however, data on productivity outcomes are scarce. Objective: Effect of integrated collaborative care on productivity among people with comorbid CMD and CVD in rural Karnataka primary health clinics. Methods: Participants were recruited within a randomized trial in rural South India, where patients received either collaborative or enhanced standard care. In this substudy, 303 participants were followed for 3 months and assessed with the iMTA Productivity Cost Questionnaire (iPCQ). Results: We found a reduction in the proportion of individuals reporting productivity loss at 3 months (66%) compared to baseline (76%; P = 0.002). Productivity losses decreased from INR 30.3 per person per day at baseline to 17.7 at 3 months. Reductions were similar in the two treatment conditions. Conclusion: Medical intervention may foster reduced productivity losses among patients with CMD and CVD. Collaborative care did not translate into higher reductions in productivity losses than "enhanced standard care." [ABSTRACT FROM AUTHOR]

A corollary to industrialization and urbanization is a significant increase in noise levels. In many industrial settings, the noise levels are such that they are potential health hazards. There are many studies which suggest that prolonged exposures to high noise levels have a negative impact on various aspects of human physiology. However, not much work has been conducted in studying the effects of various noise frequencies in the industrial environment. This paper has made an attempt to identify various noise frequency components to which the workers of six major industries in Mysore (Karnataka State, India) are being exposed, and their effects on the physical, physiological, and psychological systems of the working community with respect to their noisy industrial environment. The study results showed that the sampled industrial workers were repeatedly being exposed to noise of dominant low- and mid-octave band center frequencies. It is found that symptoms such as 'eye ball pressure,' 'awakening from sleep,' 'pains in neck,' 'frequent ear vibration,' 'chronic fatigue,' 'repeated headache,' 'backache,' and 'repeated ear pulsation' are observed to be highly associated with low- and mid-octave band center frequency noise exposure among the sampled workers. Furthermore, among the major psychological symptoms identified to be associated with octave band center frequencies, it is evident that 'irritability' is highly associated with low- and mid-octave band noise frequency characteristics. [ABSTRACT FROM AUTHOR]

Introduction: The ongoing Coronavirus disease 2019 (COVID-19) pandemic has had a huge mental health impact on people, especially the infected population. They are at greater risk of developing psychological symptoms due to the fear of death and developing severe disability, lack of proper treatment and social restrictions, stigma, and discrimination. The early psychological symptoms, if ignored, may have long-term consequences on the health and well-being of COVID patients. Due to the COVID-19 pandemic, the mental health services have been impacted negatively, and the need for technology-based psychological interventions has been identified as an alternative treatment method. Hence, the Telephone-Based Brief Psycho-Social interventions (TBPSI) will be developed for COVID-19 patients. Materials and Method: A five-session tele psychosocial intervention including rapport establishment and assessment, supportive counselling, activity scheduling, relaxation technique, and post-assessment will be developed based on the extensive review of the literature. Face and content validation of the intervention package will be done by the mental health experts. Further, the feasibility of the intervention program will be tested on COVID-19 patients in the Dharwad district, and later, the same will be implemented across the COVID hospitals of Karnataka state. Discussion and Conclusion: The study results may bring new insights into the culturally sensitive technology-oriented interventions during this pandemic in the country. The paradigm may be shifted from routine treatment to cost-effective and time-based intervention in the public health system in India. The telephonic brief psychosocial interventions can be utilised as a mainstream treatment during non-emergency situations as well. [ABSTRACT FROM AUTHOR]

Objectives: The primary aim of this study was to assess the impact of systematically induced health education on physical activity over control of hypertension, diabetes. The secondary aim of this study was to assess the changed pattern of physical activity among hypertensives and diabetics with continuous follow-up. Methods: This is part of a larger study A community trial in coastal Karnataka with three villages where one village was introduced with physical activity alone. A total of 105 participants who are known hypertensives with SBP more than 130 mm Hg or DBP more than 90 mm Hg and diabetics with Hb1Ac more than 7% were included. A specific module for physical activity was prepared, introduced to participants with involvement of family members, followed up for 1 year, and survey was done. The outcomes of median SBP, DBP, and RBS with Physical activity introduction as compared to baseline were done. Statistical analysis––Median, Interquartile range, and Wilcoxon sign rank test––was used. Results: There was 9–15 mm Hg change before and after intervention reduction in SBP and DBP. The median RBS reduced from 264 mg/dL to 205 mg/dL. Moderate activities time markedly increased & sitting hours decreased to half. Conclusion: There is an impact of systematically induced health education on physical activity over control of hypertension and diabetes & change in the pattern of physical activity with continuous health education module and follow-up. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to analyze and determine the factors associated with dental caries experience contains many zeros by zero inflated models. Design: A cross sectional design was employed using clinical examination and questionnaire with interview method. Materials and Methods: A study was conducted during March-August 2007 in Dharwad, Karnataka, India, involved a systematic random samples of 1760 individuals aged 18-40 years. The dental caries examination was carried out by using DMFT index (i.e. Decayed (D), Missing (M), Filled (F)). The DMFT index data contains many zeros were analyzed with Zero Inflated Poisson (ZIP) and Zero Inflated Negative Binomial (ZINB) models. Results: The study findings indicated, the variables such as family size, frequency of brushing and duration of change of toothbrush were positively associated with dental caries. But the variable the frequency of sweet consumption is negatively associated with dental caries experience in Zero Inflated Poisson (ZIP) and Zero Inflated Negative Binomial (ZINB) models. Conclusions: The ZIP model is a very good fit over the standard Poisson model and the ZINB is the better statistical fit compared to the Negative Binomial model. The Zero Inflated Negative Binomial model is better fit over the Zero Inflated Poisson model for modeling the DMF count data. [ABSTRACT FROM AUTHOR]

Context: Oral and maxillofacial pathology (OMFP) is a subspecialization having a masters course in India. Due to lesser number of oral pathologists in the country, the biopsy material from the head and neck is catered to by the general pathologist. Aim: This survey was conducted to acquire responses from general pathologists and gathering knowledge on their perspective of oral pathology. Methods: Pathologists at various medical institutions and at laboratories all over Karnataka were requested to answer a questionnaire comprising 13 questions pertaining to the need and scope of oral pathology. Results: In total, 37 (57%) general pathologists completed the questionnaire, of whom 97% (36) were aware of the specialty and 30 (81%) perceived a need for it. Eleven (30%) of them referred oral biopsy specimens to oral pathologists. The most common sources of diagnostic difficulty were identified as odontogenic tumors and cysts. Twenty-six (70%) pathologists felt the need for a short-term posting for their postgraduates in oral pathology, while 28 (76%) of them expressed their opinion about considering an oral pathologist as a part of their team when diagnosing complex head and neck pathologies. Twelve (71%) of them mentioned that they sometimes found that head and neck lesions took longer time to diagnose. Conclusion: Although the utilization of OMFP specialists' services in the state is quite low, general pathologists strongly feel the need for OMFP training as head and neck specimens form a considerable proportion of biopsies received by them. [ABSTRACT FROM AUTHOR]

The indoor 222Rn and 220Rn were measured by using deposition progeny sensors and single-entry pinhole dosimeter around Kolar Gold Fields of Karnataka state, India. The thirty different places were identified and fixed the dosimetry cups for the determination. The 222Rn and 220Rn concentrations of indoor environment range from 26.2 ± 1.3 to 138.4 ± 1.6 and 21.2 ± 0.8 to 133.3 ± 1.5 Bq/m3 with a mean value of 68.8 ± 1.6 and 61.8 ± 1.5 Bq/m3, respectively. The equivalent concentrations of 222Rn and 220Rn values vary from 0.9 ± 0.4 to 7.6 ± 1.1 and 6.8 ± 0.8 to 19.8 ± 1.8 Bq/m3 with a standard value of 4.3 ± 0.8 and 14.2 ± 1.3 Bq/m3, respectively. The values between the equilibrium factor between 222Rn, 220Rn, and their daughter were also calculated and found to be 0.23 and 0.07, respectively. The average annual intake of 222Rn, 220Rn, and their daughters' products is 2.28 mSv/y1, slightly below the global average of 2.4 mSv/y1 from all components. The data obtained compare average values in the world. [ABSTRACT FROM AUTHOR]

Background: Children with disabilities are expected to have poor nutritional status in comparison to children without disabilities. However, limited data on nutritional status of children with and without disabilities in rural settings in India. Objective: To assess and compare the nutritional status of children with and without disability. Methods: A cross-sectional study among children aged 5–15 years was conducted in the rural practise area of a medical college in Karnataka. 290 children (145 with and 145 children without disability) of similar age and sex were studied. Age and sex-specific World Health Organization (WHO) BMI centiles, 24 h dietary calorie and protein intakes were assessed and compared. Median and interquartile ranges were calculated for quantitative variables. Mann–Whitney U test was used to assess the differences in quantitative variables among the two groups. Results: As per WHO BMI centiles, 33.1% with and 37.20% without disabilities were undernourished. The median calorie consumed by children with disabilities was 1169.0 (946.5–1586.0) significantly lower compared to that of children without disability, that is, 1362.0 (1167.0–1641.0). The median protein consumed by children with disabilities was 28.0 (22.5–38.0) significantly lower compared to that of children without disability, that is, 32.0 (28.0–40.0). Conclusions: Children with disabilities had similar rates of undernutrition as that of their non-disabled peers and their lesser dietary intake in terms of calories and proteins. [ABSTRACT FROM AUTHOR]

Background: In April 2018, the Government of India launched 'Nikshay Poshan Yojana' (NPY), a cash assistance scheme (500 Indian rupees [~8 USD] per month) intended to provide nutritional support and improve treatment outcomes among tuberculosis (TB) patients. Objective: To compare the treatment outcomes of HIV-infected TB patients initiated on first-line anti-TB treatment in five selected districts of Karnataka, India before (April–September 2017) and after (April–September 2018) implementation of NPY. Methods: This was a cohort study using secondary data routinely collected by the national TB and HIV programmes. Results: A total of 630 patients were initiated on ATT before NPY and 591 patients after NPY implementation. Of the latter, 464 (78.5%, 95% CI: 75.0%–81.8%) received at least one installment of cash incentive. Among those received, the median (inter-quartile range) duration between treatment initiation and receipt of first installment was 74 days (41–165) and only 16% received within the first month of treatment. In 117 (25.2%) patients, the first installment was received after declaration of their treatment outcome. Treatment success (cured and treatment completed) in 'before NPY' cohort was 69.2% (95% CI: 65.6%–72.8%), while it was 65.0% (95% CI: 61.2%–68.8%) in 'after NPY' cohort. On adjusted analysis using modified Poisson regression we did not find a statistically significant association between NPY and unsuccessful treatment outcomes (adjusted relative risk-1.1, 95% CI: 0.9–1.3). Conclusion: Contrary to our hypothesis and previous evidence from systematic reviews, we did not find an association between NPY and improved treatment outcomes. [ABSTRACT FROM AUTHOR]

Aim: In India, dental care scenario is unique and unequally available to the general population with both government-run hospitals and private dental clinics catering to the oral healthcare needs of the patients. There is lack of studies to address how periodontal diseases are managed in general dental practice in India. This study aimed to understand the periodontal referral patterns of general dental practitioners (GDP) to a periodontist in Karnataka state, India.Materials and Methods: This study employed a qualitative approach. Purposive samples of 400 referring dentists were interviewed using structured in-depth questionnaire. The questionnaire consists of a combination of selected response to the questions and close-ended questions, which was distributed to the GDPs of Karnataka state.Results: This survey shows deficient delivery of definitive periodontal treatment. Only 2% of the GDP reported that 80%-100% of their patients received scaling. Location of the practice appeared to have a major role in periodontal referral. Farther the location of the practice from district headquarters, poor was the referral. Clinical skill of the specialist appeared to have a major influence on the selection of specialist followed by academic qualification.Conclusion: This survey provides insight into the periodontal referral process by GDPs in India. [ABSTRACT FROM AUTHOR]

Background: Effective and efficient use of technological advances will ease public health interventions and also help in reaching a larger population. Geographic Information System (GIS) and Foldscope are two such technologies, which have promising utilities in public health. Identifying intestinal parasitic infections early through feasible technologies will help in their effective management. With this objective, this study was conducted to assess the prevalence of intestinal parasitic infections among school children in southern districts of Karnataka, India. Methods: This cross-sectional study was conducted among randomly selected 10 urban, 10 rural, and 5 tribal schools of southern districts of Karnataka. A total of 1052 children studying in these schools were selected. Stool samples were collected and examined under Foldscope for parasitic infestation. The schools where children with worm infestations present were plotted in the GIS map. Findings: Among 1052 children included in this study, 139 (13.2%) were found to have an intestinal parasitic infestation. Among these children, 24.6% were in the age group of 5–9 years, 12.2% were males, and 14.4% were females. Urban students had higher odds (2.765) of parasitic infections compared to rural students. Mean age, height, and weight were significantly lesser among subjects with a worm infestation. Interpretation: Utility of Foldscope and GIS was found to be feasible and effective in the detection and mapping of parasitic infestations. The prevalence of parasitic infestation was found to be high among urban school children. Age, weight, height, and urban residence were found to be the major predictors of outcome. [ABSTRACT FROM AUTHOR]

Context: Falls are a major public health problem in the elderly population. Fear of falling (FOF) among elderly persons can compromise quality of life by limiting mobility, diminished sense of well-being and reduced social interactions. India is undergoing a demographic transitional phase with urban elderly population of 6.72% in 2001. The major challenge would be on the prevention of falls among them. Hence there is a need to highlight the problems related to fall faced by the elderly in India. Objective: To study the prevalence of FOF and its correlates among the elderly population in urban area. Materials and Methods: 250 elderly subjects above 60 years were randomly selected from urban area and interviewed for FOF using Short Fall Efficacy Scale-I (FES-I) , history of falls and risk factors. Results: The prevalence of FOF among the elderly was 33.2%. The significant correlates of FOF were educational status, family type, associated health problems, history of fall in past 6 months, worried of fall again among fallers, fearfulness of fall again among fallers, restriction of daily activities and depression among them. The insignificant correlates were gender and socio-economic status. Conclusion: FOF is a health problem among the elderly living in urban India needs urgent attention. It represents a significant threat to socialization, independence and morbidity or mortality. Knowledge of correlates of FOF may be useful in developing multidimensional strategies to reduce it among elderly. [ABSTRACT FROM AUTHOR]

Background: Infectious disease and malnutrition are common in children. Primary health care came into being to decrease the morbidity. Quality assessment is neither clinical research nor technology assessment. It is primarily an administrative device used to monitor performance to determine whether it continues to remain within acceptable bounds. Aims and Objectives: To assess the quality of service in the delivery of child health care in a primary health care setting. To evaluate client satisfaction. To assess utilization of facilities by the community. Materials and Methods: Study Type: Cross-sectional community-based study. Quality assessment was done by taking 30-50%, of the service provider. Client satisfaction was determined with 1 Immunization and child examination-90 clients each. Utilization of services was assessed among 478 households. Statistical Analysis: Proportions, Likert's scale to grade the services and Chi-square. Results: Immunization service: Identification of needed vaccine, preparation and care was average. Vaccination technique, documentation, EPI education, maintenance of cold chain and supplies were excellent. Client satisfaction was good. Growth monitoring: It was excellent except for mother's education and out reach educational session . Acute respiratory tract infection care: History, physical examination, ARI education were poor. Classification, treatment and referral were excellent. Client satisfaction was good. Diarrheal disease care: History taking was excellent. But examination, classification, treatment, ORT education were poor. Conclusion: Mothers education was not stressed by service providers. Service providers' knowledge do not go with the quality of service rendered. Physical examination of the child was not good. Except for immunization other services were average. [ABSTRACT FROM AUTHOR]

Background: Change in socio-economic status and various health problems adversely affect an individual's way of life during old age. Objectives: To study the health and social problems of the elderly and their attitude towards life. Materials and Methods: Descriptive study carried out in the Field practice area of the Department of Community Medicine in South India. A total of 213 elderly patients (60 years old and above) who attended the outreach clinics were interviewed using a pre-tested schedule. Findings were described in terms of proportions and percentages to study the socio-economic status of the samples and its correlation to social problems. Results: Around 73% of the patients belonged to the age group of 60-69 years old. Nearly half of the respondents were illiterate. Around 48% felt they were not happy in life. A majority of them had health problems such as hypertension followed by arthritis, diabetes, asthma, cataract, and anemia. About 68% of the patients said that the attitude of people towards the elderly was that of neglect. Conclusions: The results of the study showed that there is a need for geriatric counseling centers that can take care of their physical and psychological needs. The stringent rules for eligibility to social security schemes should be made more flexible to cover a larger population. [ABSTRACT FROM AUTHOR]

Background: To determine the prevalence of goiter and to study the factors influencing goiter among people of the rural community in Karnataka state, a community based study. Setting and Study Design: A cross sectional study was carried out to find out the prevalence of goiter in a rural community of Belgaum district. The study was conducted by house-to-house survey for a period of one month. Materials and Methods: Two villages (Handiganur and Gundwad) were selected randomly from Belgaum and Raibag taluks of Belgaum district. All the family members in each household were examined for the presence of goiter using WHO criteria. Iodine content of the salt sample obtained from each household was estimated by using spot testing kits. Information regarding the determinants of goiter was collected and recorded in a pre tested proforma. Data collected was analyzed using SPSS statistical packages. Results: The prevalence of goiter among rural population was found to be 16.6%. Goiter of grade 1 was 15.7% and that of grade 2 was 0.9%. Prevalence among males and females were 7.2% and 21.8%, respectively. The prevalence of goiter was highest among adolescents. Estimation of iodine content in the salt sample revealed that 50% of samples had adequate iodine content (≥15 ppm). Multiple Logistic Regression Analysis revealed that females of the age group 10-49 years were independently associated with goiter. Conclusion: Prevalence of goiter was relatively high and therefore constituted a public health problem in this region. [ABSTRACT FROM AUTHOR]

The aim of this study is to encourage and initiate the application of generalized linear models (GLMs) in the analysis of the covariates of decayed, missing, and filled teeth (DMFT) index data, which is not necessarily normally distributed. GLMs can be performed assuming underlying many distributions; in fact Poisson distribution with log built-in link function and binomial distribution with Logit and Probit built-in link functions are considered. The Poisson model is used for modeling the DMFT index data and the Logit and Probit models are employed to model the dichotomous outcome of DMFT = 0 and DMFT ≠ 0 (caries free/caries present). The data comprised 7188 subjects aged 18-30 years from the study on the oral health status of Karnataka state conducted by SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India. The Poisson model and binomial models (Logit and Probit) displayed dissimilarity in the outcome of results at 5% level of significance (P<0.05). The binomial models were a poor fit, whereas the Poisson model showed a good fit for the DMFT index data. Therefore, a suitable modeling approach for DMFT index data is to use a Poisson model for the DMFT response and a binomial model for the caries free and caries present (DMFT = 0 and DMFT ≠ 0). These GLMs allow separate estimation of those covariates which influence the magnitude of caries. [ABSTRACT FROM AUTHOR]

The article discusses a study on the quality of life among older people conducted at Doctor TMA Pai Hospital Karkala in Karnataka, India from March to April 2003. The study indicated a significant difference in the mean scores between the age groups of 60 to 69 years and greater than 70 years in various domains. It concluded that the overall well-being was significantly affected for those belonging to the 60-69 age group. It also found a significant difference in the overall well-being between singles and married.