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Background: Acute respiratory infections (ARIs) are the single greatest cause of death among children throughout the world. They are responsible every year for the deaths of 4.3 million children under 5 years of age worldwide. Community‑ or hospital‑based surveys for finding out the prevalence and various factors associated with ARI are very few, especially in urban areas. Also, surveys to study the use of vaccines in preventing ARIs are scarce. Hence, we studied ARI in children aged 1 year to 5 years in a tertiary care hospital in Kerala. The aim was to determine the frequency of ARIs in the last 1 year in children aged 1 year to 5 years, attending the immunization clinic at Lourdes Hospital, Kochi, and assess the selected epidemiological, socio‑demographic, nutritional and immunization factors associated with ARIs in the study group. Methods: Children attending the immunization clinic at a tertiary care hospital, Kochi, in the age group of 1 year to 5 years were selected. A brief introduction was given to the mother/caregiver of the child regarding the purpose of the study and was asked to fill out the questionnaire. Informed consent was taken. For the study, ARI is defined as the presence of one or more of the following: cough, running nose, blocked nose, sore throat, difficulty breathing, or ear problems; with or without fever. Results were analyzed. Results: Mother was the caregiver in 67% of the cases. When the caregiver was the mother, ARI is found to be less. Among those mothers who had no formal education, 100% of their children got ARI. Children whose caregivers were 30 years and older had lesser ARI. The proportion of children with ARIs was more with a history of respiratory infection among family members (parents/siblings) compared to those with no such history. The occurrence of ARI was more frequent in rural compared to urban areas. There is a significant proportion of ARI in non‑exclusively breastfed infants, bottle feeding, and early initiation of complementary feeding. Children with a history of exposure to cigarette smoke had an increased occurrence of ARI. Similar results followed for exposure to biomass fuel and exposure to cold and rain. Children who were not immunized to vaccines‑pneumococcal, Hib, measles, vitamin A, showed a higher occurrence of ARI compared to immunization. Conclusion: The studies regarding factors influencing ARI are relatively rare in an urban setting, thus this calls for more studies in urban areas. Health education can change the healthcare‑seeking behavior and attitude of parents for preventing ARI‑related deaths. Family physicians can play a significant role by educating caregivers of children and giving timely services. Promoting and ensuring exclusive breastfeeding practices, timely weaning after 6 months, and avoidance of bottle feeds can dramatically decrease the episodes of ARI. [ABSTRACT FROM AUTHOR]

Introduction: Menarche is an important biological milestone in a woman’s life as it marks the onset of the reproductive phase of her life. It is, often considered an impure phenomenon in Indian society owing to cultural taboos and insufficient and incorrect information and causes unnecessary restrictions in the day‑to‑day normal activities of menstruating girls. Aim: To assess the perception and practices related to menstruation and reproductive health among school‑going adolescent girls in the urban population in Kochi, Kerala. Objectives: To elicit the practices regarding menstruation and reproductive health among the school‑going, adolescent girls. i. To elicit the beliefs, perceptions, and sources of information regarding menstruation and reproductive health among the school going, adolescent girls. ii. To find out the relation between perceptions/practices and other factors. Methodology: A cross‑sectional study was conducted among 100 adolescent girls of a secondary school situated in Ernakulam, Kerala, with the help of a pre‑designed and pre‑tested questionnaire. Data were analyzed statistically by simple proportions. Result: 89% of the girls were aware of menstruation before menarche. A major source of information was found to be mothers. More than 70% used sanitary pads and 99% of girls knew menses as a natural phenomenon. 80% of girls with good perception had no menses‑related anxiety. 54% haven’t even heard of Pre‑Menstrual Syndrome. 40% have inhibition talking about menses to their father or brother. Among girls with good practice, 87% had a good perception. Conclusions: Before bringing any change in menstrual practices, Family physicians can play a role in educating the girls about the significance of menstruation and the development of secondary sexual characteristics, the selection of a sanitary menstrual absorbent, and its proper disposal. Trained personnel, school teachers, and knowledgeable parents can play a very important role in imparting menstrual health‑related information to adolescent girls. [ABSTRACT FROM AUTHOR]

Aim: To study the psychological impacts of COVID-19 on family physicians and residents in Kerala. Objectives: 1. To evaluate mental health outcomes among family physicians and residents in Kerala involved in the COVID-19 response. 2. To quantify the symptoms of depression, anxiety, and stress. 3. To assess the potential risk factors associated with the symptoms of anxiety, depression, or stress. Background: Health care professionals dealing with COVID-19 are under increased work pressure and experience high rates of anxiety and depression. This is even more in family physicians as they are the frontline workers and may contract the disease themselves. So, it is imperative to assess and grade the psychological impact of COVID-19 on family physicians. Methodology: The study population included 80% of the family physicians and residents working in Kerala. This is a cross-sectional survey conducted in the month of January 2021 with the help of a predesigned and pretested questionnaire. Sample size: 120. Depression and anxiety were measured using a 14-item Hospital Anxiety and Depression Scale (HADS: 0–21). Stress was computed using Perceived Stress Scale. The data were analyzed statistically by Chi-square and simple proportions. Results: A total of 80% were directly involved in treating/dealing COVID-19 patients. A total of 55.83% had an economic impact due to COVID-19. A total of 95% agreed to be anxious about spreading the disease to people at home. The increased stress was mostly attributed to change in social habits/lifestyles. Residents had a higher PSS score compared to temporary and permanent employees. Compared to other age groups, borderline or abnormal depression scale was seen in the age group of 31–40 years and 21–30 years. Compared to males, more proportion of females had anxiety and depression scores. Conclusions: It is imperative that we evaluate the psychological impact of COVID-19 on family physicians in order to ensure their mental wellbeing and better productivity. [ABSTRACT FROM AUTHOR]

Introduction: Diarrheal disease comes second among the causes of death in children under 5 years of old. We are well aware that this common disease is preventable and treatable. But the practice of preventive strategies is not as efficient as it should be. Aims and Objectives: 1. To determine the frequency of acute diarrheal disease in children aged 6 months to 24 months attending the immunization clinic of Lourdes Hospital, Kochi, Kerala. 2. To assess the associated factors and practices involved with acute diarrheal disease in the study group. Material and Methods: A cross-sectional study was done in children above 6 months attending immunization clinic in Lourdes hospital during the period from 1st October 2017 to 31st March 2019. After receiving their informed consent, a pretested, semistructured, and validated questionnaire was given to the mothers/caregivers to gather data on socio-demographic characteristics and practices. In order to assess the prevalence of diarrhea, details of the diarrheal episode after the 6 months of age were included in the questionnaire. To eliminate repeats, caution was taken not to include previously recorded data on the diarrheal episode. Discussion and Conclusion: The proportion of children with diarrhea in the study population was 38.7% which was high compared with other studies in the same age group. Many of the practices associated were found faulty and needing rectification which is a Family Physician's area of expertise. The study concludes that there is a need for identifying novel risk factors for diarrhea and educating the caregivers regarding the prevention of diarrhea. Primary Care Physicians/Family Physicians can play an effective role in educating the caregivers. [ABSTRACT FROM AUTHOR]

Background: A large number of people are being discharged from the hospital following COVID-19 without assessment of recovery. Systematic follow-up identifies the physical and physiological burden which could be used to inform the need for rehabilitation and/or further investigations. Methodology: A cross-sectional observational study of sample size 103 who were tested positive by TruNAAT in the month of August to September 2020 was conducted, whose data were collected from the medical records. Phone call interviews were conducted 2 months post-COVID-19, after ethical and institutional permission, and they were asked for any persisting symptoms at this point and the risk factors were noted. Data were analysed using various statistical methods. Result: The most common symptoms at onset were fever (49.5%), cough (28.2%), sore throat (18.4%) and loss of smell (17.5%). The most common comorbidities noted were diabetes mellitus (30.1%), hypertension (14.6%) and heart disease (7.8%). The cases with more than 14 days for COVID-19 to be negative are almost the same in cases with comorbidities (11.1%) and no comorbidities (16.3%). Around 43.7% had post-COVID-19 symptoms. The most common post-COVID-19 symptoms noted were fatigue (28.2%), breathing difficulty (12.6%) and body pain (4.9%). The post_COVID_19 symptoms are significantly higher in cases who took treatment from hospital(moderate to severe cases) (54.4%) compared to the cases who took treatment at home (35.7%). Persisting breathing difficulty is significantly higher in cases with pre-COVID-19 asthma/COPD compared to the cases with no pre-COVID-19 asthma/COPD, which makes COPD and asthma patients to be considered high risk for post-COVID-19 sequelae. Conclusion: Follow-up of COVID-19 patients should become an essential part of family physician's clinical practice. [ABSTRACT FROM AUTHOR]

Dermatology is an area that appears at the top of general practitioners (GPs)' educational needs. Our curriculum in undergraduate classes is inadequate to equip us for the real clinical scenarios. Pediatric skin conditions pose a special dilemma to primary care practitioners. On the one hand, dermatologic problems are so common in childhood that the primary care physician is forced to become involved with many of them. On the other hand, the scope of dermatologic conditions found in children is so broad as to be beyond the skills of most primary care physicians. The secret to managing dermatologic problems in children within a primary care setting is to recognize that a relatively small group of conditions encompass the vast majority of reasons for which a primary care physician will be consulted. By recognizing those conditions and becoming expert in the treatment of these well-defined areas, the primary care physician can manage these better. Diagnosing pediatric skin conditions and recognizing the importance of early referral of the cases that fall outside one's expertise is an important measure of the primary care physician's competence as seen by patients and their families. In this article, I would like to highlight few pediatric dermatological cases that came to our family medicine clinic, where correct diagnosis and treatment led to good outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Acute respiratory tract infection (ARTI) is an important cause of morbidity and mortality among infants. Exclusive breastfeeding can considerably decrease the incidence as well as mortality due to ARTI. Aims and Objectives: To evaluate the effectiveness of exclusive breast feeding for the first six months of life in preventing acute respiratory tract infection in infants 61-180 days of age. To compare the incidence of acute respiratory tract infection in exclusively breastfed infants (61-180 days of age) and not exclusively breastfed infants. Material and Methods: A prospective cohort study was done among term babies with > 2500g birth weight born in Lourdes hospital during the period from 1st June 2012 to 31st May 2013. Based on feeding habits babies were classified into two groups. Infants were followed up from 61st day to 180th day of life to assess feeding habits and episodes of ARTI. Discussion and conclusion: 232 episodes of ARTI were recorded during the study of which 165 episodes were recorded in not exclusively breastfed infants. Incidence of ARTI was 2.04 in the exclusively breastfed infants group and 5.02 in the other group. Relative risk of developing ARTI in not exclusively breastfed infants was found to be 2.46. Odds ratio of having ARTI due to lack of exclusive breast feeding during the 61st to 180th day of life was 3.863. Data from this study confirmed the protective effect of exclusive breastfeeding against ARTI during the 61st to 180th day of life. [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]

The World Organization of Family Doctors (WONCA) is a not-for-profit organization and was founded in 1972 by member organizations in 18 countries. WONCA now has 118 Member Organizations in 131 countries and territories with a membership of about 500,000 family doctors and more than 90 percent of the world's population. WONCA has seven regions, each of which has its own regional Council and run their own regional activities including conferences. WONCA South Asia Region is constituted by the national academies and colleges and academic member organizations of this region namely India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan, and the Maldives. In the background of the ongoing COVID 19 pandemic, the office bearers, academic leaders, practitioners, and researchers of primary care from the South Asia Region have issued a solidarity statement articulating the role of primary care physicians. [ABSTRACT FROM AUTHOR]

Family physicians (FP) practising in different parts of the world may require different sets of knowledge and skills to satisfy the needs of the communities in which they work as well as the requirements of the professional bodies with which they are registered. This article gives an overview of the strengths and limitations of the FP globally and more specifically within India, South Africa, and the United States of America. The historical context and evolution of FM as a clinical and academic discipline is discussed in this article. The article recommends suggestions for a better future for Family Medicine as a specialty thereby providing quality primary healthcare to the community, based on the needs of the population of each country. [ABSTRACT FROM AUTHOR]