Perspective of Arguments in Public Health

Recently, an argument was put forth because a symptomatic and positive patient for CoVID-19 turned tested negative after 7 days, so discharged from the hospital. Both at the time of admission and discharge real-time reverse transcriptase Polymerase Chain Reaction (RT-PCR) was done for testing of CoVID-19. Immediately, patient again developed respiratory symptoms and was admitted to hospital again. Amidst of current CoVID-19 pandemic, a question was asked “What is the specificity of the Real Time-Polymerase Chain Reaction (RT-PCR) test for COVID-19?” with an assumption that what if at the time of discharge the disease is present in patient but test turned out to be negative? In response to that a counter statement was posed that “It is the sensitivity that should be asked rather than specificity”. It was based on the implication of primary question that was implying false negative report of the RT-PCR. It means, since patient was discharged with negative result that could be false negative.

Anxiety Levels of Doctors Working in Kolkata during COVID-19 Pandemic: A Cross-sectional Study

Introduction: Doctors are amongst the major frontline health-care providers combating the ongoing COVID-19 pandemic situation. This overwhelming burden has not only resulted in physical exhaustion but also taken a toll on their mental health. It is thus important to determine the anxiety levels among doctors working in Kolkata and identify its associated factors which can serve as important evidence for promotion of mental well-being among them. Methodology: This cross-sectional study was done through online social media platform-based survey from August to October 2020, in Kolkata, among 313 doctors. Levels of anxiety was assessed by the Generalized Anxiety Disorder-7 scale (modified for COVID-19 pandemic). Univariate and multivariable logistic regression was done to find out the association of risk factors with high anxiety levels among the study participants. Results: Among 313 study participants,31.9% had mild, 22% moderate and 6.4% had severe anxiety levels. Multivariable logistic regression analysis showed that younger age, female gender, working in government sector, presence of associated co-morbid medical condition, working as designated frontline COVID-19 health-care worker, working in increasing number of high-risk areas in the health facility, poor quality of available personal protective equipment and increasing number of difficulties faced while working had significant association with high anxiety levels. Conclusion: Present study showed that considerable proportion (28.4%) of doctors had high anxiety levels. Maintaining appropriate COVID-19 protocols at the workplace, periodic health check-up to detect co-morbidity at the earliest, counseling services with particular attention to female providers would add on to betterment of their mental health.

A Cross-Sectional Study on Prevalence of Post-Natal Depression and its Associates among Women in a Rural Community in Hooghly District, West Bengal

Background:Post-natal depression, aserious mental health problem experienced by mothers 4 to 6 weeks after delivery. Patients suffering from post- natal depression are at higher risk of developing major depressive illness in future life. Objectives: To assess the prevalence of post-natal depression and its associates among women in a rural community in Hooghly district, West Bengal. Methodology: A cross-sectional study was conducted among 83 post-natal mothers (period of 6th to 10th week after delivery) in a rural community in Hooghly district, West Bengal, selected by simple random sampling technique from the list of mothers attending the immunization clinic in a health centreduring the period of April 2019 to September 2019. Data was collected by face-to-face interview and review of records by house to house visits. Depression was assessed by Edinburgh post-natal depression scale (EPDS).Statistical analysis was done using Microsoft Excel and SPSS version 16. Results: Prevalence of post-natal depression among study participants came out to be 28.9%. Poor socio-economic status (p=0.000). Unplanned pregnancy (p=0.025), Pre-term delivery (p=0.011) and increase in number of parity (p=0.025) were found to be statistically significantly associated with post-natal depression. Conclusion: Post-natal depression is a major public health problem which should be dealt with great concern while making policy for betterment of maternal and child health especially in low income countries like India. This can be detected early by health care providers in primary health care set up using simple screening tools. Special care and counselling should be provided to them.

Overcoming Mental Health Challenges during Pandemic: Arguing in favour of Incorporation of Community Mental Health in Undergraduate Medical Curriculum

The rapid and progressing Covid-19 pandemic is building an upsurge of fear, anxiety and stress globally. Repeated episodes of lock down, physical distancing norms, work from home culture in the new normal scenario, travel restrictions, school shutdown, home isolation and quarantine, bed and oxygen crisis, prolonged hospitalization, post Covid morbidities and deaths, Covid orphans, loss of job, lack of recreation, loneliness and the others cumulatively are contributing to tremendous stress on individual mental health. Though by definition ‘Health’ includes “mental wellbeing” apart from physical and social wellbeing but the mental health issues have largely been pushed into backstage in this current pandemic conundrum.

Journey of Tuberculosis Control in India: From then till now

The history of Tuberculosis control in India dates back to 1951 with mass vaccination with BCG and it started as a National Programme in 1962. Radical changes in the form of DOTS were incorporated with the start of Revised National Tuberculosis Control Programme (RNTCP) in 1997. Since then, TB control efforts have witnessed many changes in the form of daily DOTS, Injection free regimen for both drug sensitive & drug resistant TB, moving from fixed Categories of treatment regimen to Individualized treatment regimen based on prior Universal Drug susceptibility testing. Flexibility has been incorporated in the programme to accommodate Private practitioners in the form of various incentives. Introduction of Active case finding strategy has helped in early diagnosis leading to prompt treatments. Engagement of Community and leaders from all sectors and various organizations has helped to reach all communities in this fight against TB. India hopes to End TB by 2025 with rechristening the programme to National TB Elimination Programme (NTEP) and bringing in the much needed changes & flexibilities in the programme.

Immunization among Healthcare Workers in India: A Need or a Want

Immunization is a highly effective way for prevention of some major infectious diseases. Healthcare workers (HCWs) are at greater risk of exposure as well as spread of vaccine preventable diseases, as they are in constant contact with patients and infectious materials. Many of these diseases still carry a potential for resurgence and can lead to outbreaks. Hence, vaccination programs among HCWs form an integral part of infection prevention & control practices, thereby protecting the healthcare personnel from infection and protecting the patients from getting infected. [1] Even in countries with specific vaccination programs for HCWs, the coverage remains very low and the majority are susceptible for vaccine preventable diseases. So, it becomes imperative for a developing country like India and other countries in low-resource settings to have a national vaccination plan for HCWs. [Table 1]. shows the list of vaccines recommended for HCWs by World Health Organization and Center for Disease Control and Prevention. [2,3]

Resilience among Undergraduate Medical Students of a Medical College of Eastern India

Background: Resilience is a dynamic capability which helps people to survive on challenges given appropriate social and personal contexts. Objective: To determine the resilience and to find out the association between resilience and selected socio-demographic variables, if any. Methodology: An institution based mixed method study was conducted among MBBS students from April to May, 2018 at IQ City Medical College by using Child and Youth Resilience Measures Questionnaire (CYRM-28). Multivariate analysis of variance (MANOVA) was performed using SPSS-21software.Results: Older students, Males, 8th semester batch, and day boarder were more resilient in certain areas. In individual and contextual domain, score gradually increased with increase in age groups. Resilience score were more or less similar among both the sexes. 8th semester students were found to be more resilient in all the domains. Personal skills, social skills, psychological care giving, education, played much larger role in differences across the sex, age, semester, and accommodation. Conclusion:Thus counselling and more teacher student bonding are required to propagate the resilience of the medical students. More emphasis has to be given on identified areas so as to make our future doctors more strong and resilient.

A Mixed Method Study to Assess the Effect of Training of Adolescents on Perception and Practices regarding Unintentional Childhood Injuries

Background: Adolescents are the future citizens of any society, who can be trained to become responsible members and also function as change agents in the community to improve children’s health. Child-To-Child Approach is an innovative technique which was used in the present study to improve perception and practices regarding unintentional childhood injuries, by training the adolescent population. Methodology: An intervention study was conducted in two villages of Delhi from April 2017 to July 2019, to test the Child-To-Child Approach in preventing childhood injuries, by training the eldest adolescent in each family of intervention area and encouraging them to disseminate the knowledge to other family members. Present study is a part of the main study and analyses improvement in Perception and Practice (PP) regarding injuries after intervention, as assessed from PP scores of adolescents eligible for training, other adolescents and adult women. Focus group discussions (FGD) for assessing perception were also conducted with adolescents and adult women, at the beginning and end of study. Results: During pre-intervention period, PP scores of all three groups of subjects showed no significant difference between the two areas. Statistically significant improvement was observed in PP scores of all three groups of subjects in the intervention area during the post-intervention phase, in comparison to pre-intervention phase as well as in comparison to scores of control area in post-intervention phase. Findings from the FGD showed that perception of both groups regarding types and reasons of injuries was low in the beginning, but increased markedly in the second FGD in both the groups, compared to the first FGD. Conclusion: These findings indicate that training adolescents and encouraging them to disseminate messages to their siblings and to the adult women of their families, which is the essence of Child-To-Child Approach, is effective in improving the perception and practices regarding unintentional childhood injuries.

Envisaging the Role of Residents as Teachers in the Training of Medical Undergraduate Students

The ideal way to improve the competence level of medical students is via teaching them and giving adequate exposure to the various clinical and ethical scenarios and supporting the same with reflection and constructive feedback.[1,2] In the current era of medical education, where a teacher finds it difficult to maintain equilibrium between their primary role of teaching and patient care, there is a definite scope and adequate evidence which calls for the use of students as peer educators for the mutual benefit of both the learners and the student teacher.[1,3] A near-peer teacher refers to those students who are senior to other trainees, nevertheless play an active role in teaching the junior students regardless of the fact that they are still not qualified content expert.[1-4]

1000 Versus 635 Days Approach for Prevention of Undernutrition in Children

Since the pre-independence era, India is dealing with a variety of health problems that have been eliminated in developed nations. As we prepare to enter post covid era, a problem which we are dealing since ages is child promotion and child survival. India is a nuclear weapon-affiliated country now but it still has a long way to go as far as child malnutrition is concerned. It is a surprising fact to know that the prevalence of malnutrition in India is double that of sub-Saharan country.[1] It has been 45 years since the launch of the Integrated Child Development Scheme (ICDS) and we still have 35.8% of undernourished children in our country makes one think about the drawbacks in our current approach. [2] There are a wide variety of reasons for decreased weight inchildren under the age of 5. Interestingly inadequate food security is considered as one of the primary reasons, however,it does not justify the 20.1% of underweight children belonging to high socioeconomic status.[2] Other reasons include infections i.e. diarrhea and acute respiratory infections in children and it could be attributed to a moderate rate (approximately 62%) of immunization in the under 5 age group.[2]