Tarundeep Singh | PGIMER,CHD,India - Academia.edu (original) (raw)

Papers by Tarundeep Singh

Journal of Family Medicine and Primary Care

Introduction: Decentralization through introduction of Village Health Sanitation and Nutrition Co... more Introduction: Decentralization through introduction of Village Health Sanitation and Nutrition Committees (VHSNCs) was a key initiative introduced in 2007 under the National Health Mission (NHM), India to address local health and sanitation issues. This study was done to assess the functioning of the VHSNCs. Aims and Objectives: 1. To assess the level of awareness among the VHSNC members about their roles and responsibilities 2. To assess the level of awareness among the community members about the committee and its functions. 3. To assess the pattern of disbursement and utilization of untied funds under VHSNCs. Methodology: A cross-sectional study of 30 VHSNCs conducted in district Kangra of state Himachal Pradesh. Information was collected through a review of records and in-depth interviews with community and VHSNC members. Results: All committee members knew about VHSNCs but the level of awareness among community members was comparatively less (67%). Some members were confused about their roles and responsibilities. Most active members were the FHWs, AWWs, ASHAs, Mahila mandal representatives, and the female ward panch. A major chunk (65%) of the funds is utilized on the cleanliness activities. For the nutritional part, the majority of the work is already being undertaken by the AWCs so there is no clarity regarding the functioning of the committee on this aspect.

Indian Journal of Community Health

During the COVID-19 pandemic times, non-COVID patients faced many difficulties to access health c... more During the COVID-19 pandemic times, non-COVID patients faced many difficulties to access health care because of diversion of health resources to manage the pandemic, partial or complete closure of routine OPD services and travel restrictions due to lockdown. Increased use of technology enhanced the effectiveness of the healthcare system to maintain treatment avenues in this challenging time. Also, the pandemic accelerated diffusion of technological innovations like teleconsultation among healthcare workers and patients. The present case study is about a young, breast cancer, female patient from rural India who was diagnosed with the disease just before the pandemic times. She was put on neo-adjuvent chemotherapy in a tertiary care hospital about 150 kms away from her native place but meanwhile lockdown was imposed in India to control COVID-19 spread. She was maintained on follow up through teleconsultation services. She was facilitated through travel restrictions for chemotherapy cy...

Indian Journal of Psychological Medicine

Background: Little is known about elder abuse in the domestic environment. In lower-middle income... more Background: Little is known about elder abuse in the domestic environment. In lower-middle income countries like India, the demographic transition is throwing novel challenges. The older adults are relatively more vulnerable because of coexisting medical and psychological problems. Any form of abuse affects mental health and increases the chances of anxiety and depression among the older adults. The study aimed to assess the burden of abuse amongst older adults visiting a primary health care center of north India. Methods: This is secondary data analysis conducted on the data collected in the primary study between September 2017 and June 2018 in northern India among 311 older adult patients attending the noncommunicable disease clinic. Diabetes mellitus and hypertension were diagnosed as per standard guidelines. Vulnerability to Abuse Screening Scale (VASS) was used to assess elder abuse. Depression, anxiety, and loneliness were assessed by using the Patient Health Questionnaire (PH...

Indian Journal of Psychological Medicine, 2021

Background: Little is known about elder abuse in the domestic environment. In lower-middle income... more Background: Little is known about elder abuse in the domestic environment. In lower-middle income countries like India, the demographic transition is throwing novel challenges. The older adults are relatively more vulnerable because of coexisting medical and psychological problems. Any form of abuse affects mental health and increases the chances of anxiety and depression among the older adults. The study aimed to assess the burden of abuse amongst older adults visiting a primary health care center of north India. Methods: This is secondary data analysis conducted on the data collected in the primary study between September 2017 and June 2018 in northern India among 311 older adult patients attending the noncommunicable disease clinic. Diabetes mellitus and hypertension were diagnosed as per standard guidelines. Vulnerability to Abuse Screening Scale (VASS) was used to assess elder abuse. Depression, anxiety, and loneliness were assessed by using the Patient Health Questionnaire (PH...

During the COVID-19 pandemic times, non-COVID patients faced many difficulties to access health c... more During the COVID-19 pandemic times, non-COVID patients faced many difficulties to access health care because of diversion of health resources to manage the pandemic, partial or complete closure of routine OPD services and travel restrictions due to lockdown. Increased use of technology enhanced the effectiveness of the healthcare system to maintain treatment avenues in this challenging time. Also, the pandemic accelerated diffusion of technological innovations like teleconsultation among healthcare workers and patients. The present case study is about a young, breast cancer, female patient from rural India who was diagnosed with the disease just before the pandemic times. She was put on neo-adjuvent chemotherapy in a tertiary care hospital about 150 kms away from her native place but meanwhile lockdown was imposed in India to control COVID-19 spread. She was maintained on follow up through teleconsultation services. She was facilitated through travel restrictions for chemotherapy cy...

Introduction: Physical inactivity in children is a precursor to childhood obesity, which is a maj... more Introduction: Physical inactivity in children is a precursor to childhood obesity, which is a major public health concern due to its increasing prevalence over the years. Aim of this study was to predict physical activity (PA) behavior among upper elementary school children from Northern India through Multi -Theory Model (MTM). Methods: The Multi-Theory Model (MTM) was used to predict PA behavior among 214 upper elementary school children in District Ambala, Haryana, India. A 38-item Physical Activity (PA) questionnaire was used to assess the constructs of MTM. Significant predictors of PA behaviour change (i.e., initiation and sustenance) were assessed by using stepwise multiple regression. Results: Our findings showed that the mean for the intention to initiate engaging in 60 minutes of physical activity every day in the upcoming week was 2.14 units (SD = 1.23, possible range 0-4 units). The initiation model explained 12.5% variance in the intention to start PA behavior change. Su...

Healthcare Informatics Research

Objectives: Health systems are shifting from traditional methods of healthcare delivery to delive... more Objectives: Health systems are shifting from traditional methods of healthcare delivery to delivery using digital applications. This change was introduced at a primary care centre in Chandigarh, India that served a marginalised population. After establishing the digital health system, we explored stakeholders’ perceptions regarding its implementation.Methods: Ethnographic methods were used to explore stakeholders’ perceptions regarding the implementation of the Integrated Health Information System for Primary Health Care (IHIS4PHC), which was developed as a patient-centric digital health application. Data were collected using focus group discussions and in-depth interviews. Participatory observations were made of day-to-day activities including outpatient visits, outreach field visits, and methods of health practice. The collected information was analysed using thematic coding.Results: Healthcare workers highlighted that working with the digital health system was initially arduous, ...

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

Introduction: Health Care Workers (HCWs) can acquire or transmit Corona Virus Disease 2019 (COVID... more Introduction: Health Care Workers (HCWs) can acquire or transmit Corona Virus Disease 2019 (COVID-19) from and to patients respectively. There is limited data on risk factors for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection among HCWs. Aim: To evaluate the risk factors for SARS-CoV-2 infection amongst HCWs of tertiary care hospitals in Mumbai, Maharashtra, India. Materials and Methods: A questionnaire based cross-sectional study was conducted among 801 HCWs from three tertiary care hospitals. Data regarding demography, co-morbidities (hypertension, diabetes, heart disease, cancer, immunosuppressive therapy, asthma), symptoms, contact with confirmed cases of COVID-19 and protective precautions at the work place was collected. Infection diagnosed by Respiratory Tract samples- Reverse Trancriptase Polymerase Chain Reaction (RT-PCR) test was correlated with the above factors. Results: Of the participants, 50.1% were working in designated COVID-19 area; 85.1% ha...

International Journal Of Community Medicine And Public Health

Background: Coronavirus disease 2019 (COVID-19) pandemic has affected more than 200 countries cau... more Background: Coronavirus disease 2019 (COVID-19) pandemic has affected more than 200 countries causing loss of life and livelihood. The accelerated development of the COVID-19 vaccine is a vital development, and early data suggests that it is both, safe and efficacious. However, the acceptance of COVID-19 vaccine depends on various socio-demographic characteristics. The aim of this study was to understand the knowledge and attitude towards COVID-19 vaccine in India. Methods: This is a cross-sectional study done in an urban slum in Mumbai, India. The main outcome variable was the responses related to COVID-19 vaccine acceptance among the study participants.Results: A total of 1342 participants were included in the study. Almost two thirds (64.5%) of the young adults aged between 18 and 40 years were unaware about the COVID-19 vaccine availability, followed by 56.4% person aged between 40 and 60 years and 46.2% of the persons aged more than 60 years were unaware about the vaccine avai...

Asia Pacific Journal of Public Health

Journal of Neurosciences in Rural Practice

Objectives This study aimed to estimate the prevalence of depression and anxiety, and assess the ... more Objectives This study aimed to estimate the prevalence of depression and anxiety, and assess the knowledge, practice, and concerns regarding coronavirus disease 2019 (COVID-19) among the residents of an urban slum in Chandigarh, India. Materials and Methods Participants were screened using Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales. Results The mean (standard deviation) age of 200 enrolled participants was 33 (13) years with 83% (n = 166) being females. The prevalence of depression and anxiety was 3.5% (95% confidence interval [CI]: 0.95–6.05) and 2.5% (95% CI: 0.34–4.66), respectively. Of total, 46% (n = 92) knew that COVID-19 can transmit through droplets and 30.5% (n = 61) were concerned that they might get infected with disease. Half of the participants (n = 100) believed that there was unnecessary worry regarding COVID-19 and 78% (n = 156) covered mouth while coughing or sneezing. Conclusion To cope with this critical situation, it is necessary to ...

Asia Pacific Journal of Public Health

The widely agreed upon routes of transmission of severe acute respiratory syndrome coronavirus 2 ... more The widely agreed upon routes of transmission of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) are droplet infection, aerosols, and close contact. However, the rate of spread, disease load, and the symptom pattern of the corona virus disease 2019 (COVID-19) have raised the probability of other routes of transmission, such as feco-oral. A significant proportion of persons infected with SARS CoV-2 had diarrhea. Similar to earlier coronaviruses, SARS CoV-2 has also been reported to be found in fecal samples. 1 Plausible explanation for its presence in stool is that the ACE-2 receptors to which SARS CoV-2 binds are present in gastrointestinal mucosa as well. 2 Hence, in order to ascertain whether transmission through feco-oral route of SARS CoV-2 does occur or not, we conducted a review of literature in PubMed and the World Health Organization's collection of COVID-19 literature. The search terms used were "COVID-19," "SARS CoV-2," "Fecal-Oral route," "FecoOral transmission," "Sewage," and "Wastewater." Literature search revealed the presence of infectious SARS CoV-2 in feces of COVID-19 patient. 3,4 Stool samples tested positive for SARS CoV-2 RNA even up to 5 weeks after the respiratory samples tested negative for COVID-19. 3 These findings establish the presence of SARS CoV-2 in stools. Feco-oral transmission, if it is happening, can be very significant in developing and underdeveloped countries, where open defecation is common, and poor water sanitation and hygiene (WASH) practices are followed. In addition, reports have attributed SARS transmission from aerosol plumes of SARS CoV-1 patient with diarrhea, in 2003. Hence, as a precaution, it should be ensured that COVID-19 patients are provided with separate toilets, cleaned at least twice daily. The lid should be down while flushing, to avoid bio-aerosolization or water splashes. If the feco-oral route contributes to transmission of COVID-19 cases, then it is an issue of serious consideration with regard to modifying or adding the public health recommendation for COVID-19 prevention. However, further research is warranted to confirm the feco-oral transmission. 4 Isolation of SARS CoV-2 in sewage water has also been demonstrated. 5 This raises the possibility of SARS CoV-2 transmission through sewage-contaminated water sources. The detection of the virus in sewage, even when the reported COVID-19 prevalence is low or none in the community, indicates that a considerable proportion of COVID-19 cases are asymptomatic, and a sewage surveillance could be used to monitor the circulation of the virus in the population. 5 They

International Journal Of Community Medicine And Public Health

Background: A seroprevalence study for COVID-19 antibodies was conducted amongst health workers i... more Background: A seroprevalence study for COVID-19 antibodies was conducted amongst health workers in Mumbai, India, in June 2020.Methods: Healthcare workers (n=801) underwent a cross sectional survey through electrochemiluminescence immunoassay (Roche diagnostics’ Elecsys anti-SARS-CoV-2 assay, Roche diagnostics, Rotkreuz, Switzerland).Results: Of the 801 healthcare workers, 62 who had been previously diagnosed with a real time-polymerase chain reaction (RT-PCR) proven SARS-CoV-2 infection, 45 (73.6%) were found to be seronegative during the study. The duration between the positive RT-PCR test and the serological testing ranged from 15 to 49 days for 34 (54.8%), and was >50 days in 28 subjects. Up to 28 days after a positive PCR test, 90% of the subjects were found to be seropositive, but this reduced to less than half over the next two weeks (38.5% between 29 and 42 days).Conclusions: Our findings are in agreement with previous reports that demonstrate a peak antibody formation af...

Asian Journal of Social Science Studies

Background: With the increase in the elderly population in India, state and central government ha... more Background: With the increase in the elderly population in India, state and central government have initiated many schemes for the welfare of the elderly. The current study ascertained the pattern and extent of utilization of social welfare services by the elderly in the rural area of Punjab, a north Indian state.Results: Out of 400 participants, most (72%) of the respondents were females. About 99.5% had an awareness about and 91% were utilizing at least one social welfare scheme. A statistically significant difference was found between the utilization of schemes for availing healthcare services and medicines (p=0.001) and fulfilling basic needs (p=0.01) among rural and urban participants. A significant difference was seen in the number of schemes utilized with economic dependence, source of income, and social class (p<0.05). Lack of knowledge for a scheme was the most common reason for the non-utilization of schemes.Conclusion: The study concluded that the utilization of social...

Asia Pacific Journal of Public Health

Health care systems across the world are facing the challenge of coronavirus disease-2019 (COVID-... more Health care systems across the world are facing the challenge of coronavirus disease-2019 (COVID-19) caused by a novel β-coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Even though patients with COVID-19 majorly report pulmonary symptoms, gastrointestinal (GI) involvement in COVID-19 constitutes a significant component of the extrapulmonary disease spectrum. A systematic review of 29 studies (n = 6064) reported a 15% pooled prevalence of GI symptoms, with nausea/vomiting, diarrhea, and loss of appetite being the 3 most common symptoms.1 Presence of GI symptoms has been associated with an increased risk of acute respiratory distress syndrome (ARDS), but not with mortality.2 The management of GI manifestations remains supportive and no beneficial targeted therapies have been reported to date. The precise influence of COVID-19 on preexisting GI disorders (inflammatory bowel disease [IBD] and celiac disease) is undetermined. Although IBD, via its immunesuppressive properties, theoretically affects the risk of acquiring and suffering from COVID-19, currently available evidence does not suggest so. As of July 7, 2020, only 1696 out of approximately 7 million IBD patients across the globe were reported to be diagnosed with COVID-19 in the collaborative voluntary online registry, Surveillance Epidemiology of Coronavirus (COVID-19) Under Research Exclusion—IBD (SECURE-IBD). Majority (70%) of these patients had minimal symptoms and did not require hospitalization. The mortality rates were comparable with non-IBD patients (4%).3 Similarly, only 48 patients with celiac disease have been reported to develop COVID-19 till July 10, 2020. Surprisingly, 56% of these patients did not have GI symptoms at COVID-19 diagnosis. Akin to IBD, majority of the patients did not require hospitalization.4 A greater challenge, however, for patients with celiac disease is availability and access to gluten-free diet, especially in the backdrop of lockdown orders by the authorities. The impact of COVID-19 on new diagnosis of GI diseases, disease-related symptoms, and quality of life remains an uncharted territory and needs further analysis. The viral genome has been detected in the anal swabs as well as feces. The presence of virus in the GI tract might be responsible for nosocomial spread of COVID-19, particularly in endoscopy suites, though this hypothesis needs corroboration. Fecal shedding of virus begins before the onset of symptoms and can persist for up to 5 weeks after the respiratory samples test negative for COVID-19.5 The fecal viral excretion raises a concern for feco-oral transmission of infection, especially in developing and underdeveloped countries where open defecation is practiced. Mixing of SARS-CoV-2 infected untreated sewage with water bodies may be another probable source of infection, just as it is for cholera, typhoid, hepatitis A, and poliomyelitis. Therefore, testing for the virus in sewage could be helpful in disease monitoring and surveillance. Although the evidence for direct feco-oral transmission of SARS-CoV-2 is lacking at the moment and further evaluation is warranted, extra precaution is indicated if a COVID-19 patient reports diarrhea to mitigate the risk of health care–associated infection. Whether feco-oral transmission emerges as a significant player or not, it is, nevertheless, a good reason to maintain and propagate personal hygiene.

Health Services Insights

Satisfaction with health care services is a desired outcome of health care delivery. Nonetheless,... more Satisfaction with health care services is a desired outcome of health care delivery. Nonetheless, there is scant information on client satisfaction with services provided in public health facilities in India. A cross-sectional study of persons attending public health facilities in Punjab, North India, was carried out in 2016. All district hospitals, subdistrict hospitals, 2 community health centres (CHCs), and 6 primary health centres (PHCs) were randomly selected from each of the 22 districts. A 60-item pre-tested and validated questionnaire was used to collect data. Participants (3278 outpatient department [OPD] and 1614 inpatient department [IPD]) visiting health care facilities were interviewed. Majority of OPD participants were satisfied with registration process, care providers, and personal issues like safety and security at the health facilities. Major domains of dissatisfaction were long waiting time and concern shown for patients during lab tests and x-rays. Most IPD parti...

Applied Biological Research

Asian Journal of Psychiatry

BACKGROUND Amongst all the ailments among the elderly persons, cognitive impairment has significa... more BACKGROUND Amongst all the ailments among the elderly persons, cognitive impairment has significant impact on the quality of life. Non-communicable diseases (NCDs) like diabetes and hypertension increase the risk of cognitive impairment and dementia. Little is known about the prevalence and correlates of cognitive impairment in elderly with NCDs. AIM The present study aimed to evaluate the prevalence and correlates of cognitive impairment among elderly patients living with NCDs. METHODOLOGY 297 patients attending the chronic disease clinic of two Community Health Centres were evaluated using Hindi mini-mental scale (HMSE), University of California Los Angeles Loneliness Scale (UCLA LS), Geriatric Depression Scale, Generalized Anxiety Disorder (GAD-7 scale) and Vulnerability to Abuse Screening Scale. RESULTS More than one-fourth (27.3 %) of participants had cognitive impairment as per the HMSE scores. The mean HMSE score was lowest (23.90+6.61) among patients with hypertension followed by patients with diabetes alone (26.90+4.46). People with hypertension had lower mean scores on all the domains of HMSE. Multivariable binary logistic regression depicted younger age, high education status, per capita income, long duration of diseases, loneliness, and hypertension emerged as the significant risk factors associated with cognitive impairment. CONCLUSION Older adults with non-communicable diseases have high prevalence of cognitive impairment. Physicians should make the patients and their family members aware about the association of non-communicable diseases with cognitive impairments and should encourage these persons to use remedial measures to reduce the risk of future development of dementia.

Journal of Family Medicine and Primary Care

Introduction: Decentralization through introduction of Village Health Sanitation and Nutrition Co... more Introduction: Decentralization through introduction of Village Health Sanitation and Nutrition Committees (VHSNCs) was a key initiative introduced in 2007 under the National Health Mission (NHM), India to address local health and sanitation issues. This study was done to assess the functioning of the VHSNCs. Aims and Objectives: 1. To assess the level of awareness among the VHSNC members about their roles and responsibilities 2. To assess the level of awareness among the community members about the committee and its functions. 3. To assess the pattern of disbursement and utilization of untied funds under VHSNCs. Methodology: A cross-sectional study of 30 VHSNCs conducted in district Kangra of state Himachal Pradesh. Information was collected through a review of records and in-depth interviews with community and VHSNC members. Results: All committee members knew about VHSNCs but the level of awareness among community members was comparatively less (67%). Some members were confused about their roles and responsibilities. Most active members were the FHWs, AWWs, ASHAs, Mahila mandal representatives, and the female ward panch. A major chunk (65%) of the funds is utilized on the cleanliness activities. For the nutritional part, the majority of the work is already being undertaken by the AWCs so there is no clarity regarding the functioning of the committee on this aspect.

Indian Journal of Community Health

During the COVID-19 pandemic times, non-COVID patients faced many difficulties to access health c... more During the COVID-19 pandemic times, non-COVID patients faced many difficulties to access health care because of diversion of health resources to manage the pandemic, partial or complete closure of routine OPD services and travel restrictions due to lockdown. Increased use of technology enhanced the effectiveness of the healthcare system to maintain treatment avenues in this challenging time. Also, the pandemic accelerated diffusion of technological innovations like teleconsultation among healthcare workers and patients. The present case study is about a young, breast cancer, female patient from rural India who was diagnosed with the disease just before the pandemic times. She was put on neo-adjuvent chemotherapy in a tertiary care hospital about 150 kms away from her native place but meanwhile lockdown was imposed in India to control COVID-19 spread. She was maintained on follow up through teleconsultation services. She was facilitated through travel restrictions for chemotherapy cy...

Indian Journal of Psychological Medicine

Background: Little is known about elder abuse in the domestic environment. In lower-middle income... more Background: Little is known about elder abuse in the domestic environment. In lower-middle income countries like India, the demographic transition is throwing novel challenges. The older adults are relatively more vulnerable because of coexisting medical and psychological problems. Any form of abuse affects mental health and increases the chances of anxiety and depression among the older adults. The study aimed to assess the burden of abuse amongst older adults visiting a primary health care center of north India. Methods: This is secondary data analysis conducted on the data collected in the primary study between September 2017 and June 2018 in northern India among 311 older adult patients attending the noncommunicable disease clinic. Diabetes mellitus and hypertension were diagnosed as per standard guidelines. Vulnerability to Abuse Screening Scale (VASS) was used to assess elder abuse. Depression, anxiety, and loneliness were assessed by using the Patient Health Questionnaire (PH...

Indian Journal of Psychological Medicine, 2021

Background: Little is known about elder abuse in the domestic environment. In lower-middle income... more Background: Little is known about elder abuse in the domestic environment. In lower-middle income countries like India, the demographic transition is throwing novel challenges. The older adults are relatively more vulnerable because of coexisting medical and psychological problems. Any form of abuse affects mental health and increases the chances of anxiety and depression among the older adults. The study aimed to assess the burden of abuse amongst older adults visiting a primary health care center of north India. Methods: This is secondary data analysis conducted on the data collected in the primary study between September 2017 and June 2018 in northern India among 311 older adult patients attending the noncommunicable disease clinic. Diabetes mellitus and hypertension were diagnosed as per standard guidelines. Vulnerability to Abuse Screening Scale (VASS) was used to assess elder abuse. Depression, anxiety, and loneliness were assessed by using the Patient Health Questionnaire (PH...

During the COVID-19 pandemic times, non-COVID patients faced many difficulties to access health c... more During the COVID-19 pandemic times, non-COVID patients faced many difficulties to access health care because of diversion of health resources to manage the pandemic, partial or complete closure of routine OPD services and travel restrictions due to lockdown. Increased use of technology enhanced the effectiveness of the healthcare system to maintain treatment avenues in this challenging time. Also, the pandemic accelerated diffusion of technological innovations like teleconsultation among healthcare workers and patients. The present case study is about a young, breast cancer, female patient from rural India who was diagnosed with the disease just before the pandemic times. She was put on neo-adjuvent chemotherapy in a tertiary care hospital about 150 kms away from her native place but meanwhile lockdown was imposed in India to control COVID-19 spread. She was maintained on follow up through teleconsultation services. She was facilitated through travel restrictions for chemotherapy cy...

Introduction: Physical inactivity in children is a precursor to childhood obesity, which is a maj... more Introduction: Physical inactivity in children is a precursor to childhood obesity, which is a major public health concern due to its increasing prevalence over the years. Aim of this study was to predict physical activity (PA) behavior among upper elementary school children from Northern India through Multi -Theory Model (MTM). Methods: The Multi-Theory Model (MTM) was used to predict PA behavior among 214 upper elementary school children in District Ambala, Haryana, India. A 38-item Physical Activity (PA) questionnaire was used to assess the constructs of MTM. Significant predictors of PA behaviour change (i.e., initiation and sustenance) were assessed by using stepwise multiple regression. Results: Our findings showed that the mean for the intention to initiate engaging in 60 minutes of physical activity every day in the upcoming week was 2.14 units (SD = 1.23, possible range 0-4 units). The initiation model explained 12.5% variance in the intention to start PA behavior change. Su...

Healthcare Informatics Research

Objectives: Health systems are shifting from traditional methods of healthcare delivery to delive... more Objectives: Health systems are shifting from traditional methods of healthcare delivery to delivery using digital applications. This change was introduced at a primary care centre in Chandigarh, India that served a marginalised population. After establishing the digital health system, we explored stakeholders’ perceptions regarding its implementation.Methods: Ethnographic methods were used to explore stakeholders’ perceptions regarding the implementation of the Integrated Health Information System for Primary Health Care (IHIS4PHC), which was developed as a patient-centric digital health application. Data were collected using focus group discussions and in-depth interviews. Participatory observations were made of day-to-day activities including outpatient visits, outreach field visits, and methods of health practice. The collected information was analysed using thematic coding.Results: Healthcare workers highlighted that working with the digital health system was initially arduous, ...

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

Introduction: Health Care Workers (HCWs) can acquire or transmit Corona Virus Disease 2019 (COVID... more Introduction: Health Care Workers (HCWs) can acquire or transmit Corona Virus Disease 2019 (COVID-19) from and to patients respectively. There is limited data on risk factors for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection among HCWs. Aim: To evaluate the risk factors for SARS-CoV-2 infection amongst HCWs of tertiary care hospitals in Mumbai, Maharashtra, India. Materials and Methods: A questionnaire based cross-sectional study was conducted among 801 HCWs from three tertiary care hospitals. Data regarding demography, co-morbidities (hypertension, diabetes, heart disease, cancer, immunosuppressive therapy, asthma), symptoms, contact with confirmed cases of COVID-19 and protective precautions at the work place was collected. Infection diagnosed by Respiratory Tract samples- Reverse Trancriptase Polymerase Chain Reaction (RT-PCR) test was correlated with the above factors. Results: Of the participants, 50.1% were working in designated COVID-19 area; 85.1% ha...

International Journal Of Community Medicine And Public Health

Background: Coronavirus disease 2019 (COVID-19) pandemic has affected more than 200 countries cau... more Background: Coronavirus disease 2019 (COVID-19) pandemic has affected more than 200 countries causing loss of life and livelihood. The accelerated development of the COVID-19 vaccine is a vital development, and early data suggests that it is both, safe and efficacious. However, the acceptance of COVID-19 vaccine depends on various socio-demographic characteristics. The aim of this study was to understand the knowledge and attitude towards COVID-19 vaccine in India. Methods: This is a cross-sectional study done in an urban slum in Mumbai, India. The main outcome variable was the responses related to COVID-19 vaccine acceptance among the study participants.Results: A total of 1342 participants were included in the study. Almost two thirds (64.5%) of the young adults aged between 18 and 40 years were unaware about the COVID-19 vaccine availability, followed by 56.4% person aged between 40 and 60 years and 46.2% of the persons aged more than 60 years were unaware about the vaccine avai...

Asia Pacific Journal of Public Health

Journal of Neurosciences in Rural Practice

Objectives This study aimed to estimate the prevalence of depression and anxiety, and assess the ... more Objectives This study aimed to estimate the prevalence of depression and anxiety, and assess the knowledge, practice, and concerns regarding coronavirus disease 2019 (COVID-19) among the residents of an urban slum in Chandigarh, India. Materials and Methods Participants were screened using Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales. Results The mean (standard deviation) age of 200 enrolled participants was 33 (13) years with 83% (n = 166) being females. The prevalence of depression and anxiety was 3.5% (95% confidence interval [CI]: 0.95–6.05) and 2.5% (95% CI: 0.34–4.66), respectively. Of total, 46% (n = 92) knew that COVID-19 can transmit through droplets and 30.5% (n = 61) were concerned that they might get infected with disease. Half of the participants (n = 100) believed that there was unnecessary worry regarding COVID-19 and 78% (n = 156) covered mouth while coughing or sneezing. Conclusion To cope with this critical situation, it is necessary to ...

Asia Pacific Journal of Public Health

The widely agreed upon routes of transmission of severe acute respiratory syndrome coronavirus 2 ... more The widely agreed upon routes of transmission of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) are droplet infection, aerosols, and close contact. However, the rate of spread, disease load, and the symptom pattern of the corona virus disease 2019 (COVID-19) have raised the probability of other routes of transmission, such as feco-oral. A significant proportion of persons infected with SARS CoV-2 had diarrhea. Similar to earlier coronaviruses, SARS CoV-2 has also been reported to be found in fecal samples. 1 Plausible explanation for its presence in stool is that the ACE-2 receptors to which SARS CoV-2 binds are present in gastrointestinal mucosa as well. 2 Hence, in order to ascertain whether transmission through feco-oral route of SARS CoV-2 does occur or not, we conducted a review of literature in PubMed and the World Health Organization's collection of COVID-19 literature. The search terms used were "COVID-19," "SARS CoV-2," "Fecal-Oral route," "FecoOral transmission," "Sewage," and "Wastewater." Literature search revealed the presence of infectious SARS CoV-2 in feces of COVID-19 patient. 3,4 Stool samples tested positive for SARS CoV-2 RNA even up to 5 weeks after the respiratory samples tested negative for COVID-19. 3 These findings establish the presence of SARS CoV-2 in stools. Feco-oral transmission, if it is happening, can be very significant in developing and underdeveloped countries, where open defecation is common, and poor water sanitation and hygiene (WASH) practices are followed. In addition, reports have attributed SARS transmission from aerosol plumes of SARS CoV-1 patient with diarrhea, in 2003. Hence, as a precaution, it should be ensured that COVID-19 patients are provided with separate toilets, cleaned at least twice daily. The lid should be down while flushing, to avoid bio-aerosolization or water splashes. If the feco-oral route contributes to transmission of COVID-19 cases, then it is an issue of serious consideration with regard to modifying or adding the public health recommendation for COVID-19 prevention. However, further research is warranted to confirm the feco-oral transmission. 4 Isolation of SARS CoV-2 in sewage water has also been demonstrated. 5 This raises the possibility of SARS CoV-2 transmission through sewage-contaminated water sources. The detection of the virus in sewage, even when the reported COVID-19 prevalence is low or none in the community, indicates that a considerable proportion of COVID-19 cases are asymptomatic, and a sewage surveillance could be used to monitor the circulation of the virus in the population. 5 They

International Journal Of Community Medicine And Public Health

Background: A seroprevalence study for COVID-19 antibodies was conducted amongst health workers i... more Background: A seroprevalence study for COVID-19 antibodies was conducted amongst health workers in Mumbai, India, in June 2020.Methods: Healthcare workers (n=801) underwent a cross sectional survey through electrochemiluminescence immunoassay (Roche diagnostics’ Elecsys anti-SARS-CoV-2 assay, Roche diagnostics, Rotkreuz, Switzerland).Results: Of the 801 healthcare workers, 62 who had been previously diagnosed with a real time-polymerase chain reaction (RT-PCR) proven SARS-CoV-2 infection, 45 (73.6%) were found to be seronegative during the study. The duration between the positive RT-PCR test and the serological testing ranged from 15 to 49 days for 34 (54.8%), and was >50 days in 28 subjects. Up to 28 days after a positive PCR test, 90% of the subjects were found to be seropositive, but this reduced to less than half over the next two weeks (38.5% between 29 and 42 days).Conclusions: Our findings are in agreement with previous reports that demonstrate a peak antibody formation af...

Asian Journal of Social Science Studies

Background: With the increase in the elderly population in India, state and central government ha... more Background: With the increase in the elderly population in India, state and central government have initiated many schemes for the welfare of the elderly. The current study ascertained the pattern and extent of utilization of social welfare services by the elderly in the rural area of Punjab, a north Indian state.Results: Out of 400 participants, most (72%) of the respondents were females. About 99.5% had an awareness about and 91% were utilizing at least one social welfare scheme. A statistically significant difference was found between the utilization of schemes for availing healthcare services and medicines (p=0.001) and fulfilling basic needs (p=0.01) among rural and urban participants. A significant difference was seen in the number of schemes utilized with economic dependence, source of income, and social class (p<0.05). Lack of knowledge for a scheme was the most common reason for the non-utilization of schemes.Conclusion: The study concluded that the utilization of social...

Asia Pacific Journal of Public Health

Health care systems across the world are facing the challenge of coronavirus disease-2019 (COVID-... more Health care systems across the world are facing the challenge of coronavirus disease-2019 (COVID-19) caused by a novel β-coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Even though patients with COVID-19 majorly report pulmonary symptoms, gastrointestinal (GI) involvement in COVID-19 constitutes a significant component of the extrapulmonary disease spectrum. A systematic review of 29 studies (n = 6064) reported a 15% pooled prevalence of GI symptoms, with nausea/vomiting, diarrhea, and loss of appetite being the 3 most common symptoms.1 Presence of GI symptoms has been associated with an increased risk of acute respiratory distress syndrome (ARDS), but not with mortality.2 The management of GI manifestations remains supportive and no beneficial targeted therapies have been reported to date. The precise influence of COVID-19 on preexisting GI disorders (inflammatory bowel disease [IBD] and celiac disease) is undetermined. Although IBD, via its immunesuppressive properties, theoretically affects the risk of acquiring and suffering from COVID-19, currently available evidence does not suggest so. As of July 7, 2020, only 1696 out of approximately 7 million IBD patients across the globe were reported to be diagnosed with COVID-19 in the collaborative voluntary online registry, Surveillance Epidemiology of Coronavirus (COVID-19) Under Research Exclusion—IBD (SECURE-IBD). Majority (70%) of these patients had minimal symptoms and did not require hospitalization. The mortality rates were comparable with non-IBD patients (4%).3 Similarly, only 48 patients with celiac disease have been reported to develop COVID-19 till July 10, 2020. Surprisingly, 56% of these patients did not have GI symptoms at COVID-19 diagnosis. Akin to IBD, majority of the patients did not require hospitalization.4 A greater challenge, however, for patients with celiac disease is availability and access to gluten-free diet, especially in the backdrop of lockdown orders by the authorities. The impact of COVID-19 on new diagnosis of GI diseases, disease-related symptoms, and quality of life remains an uncharted territory and needs further analysis. The viral genome has been detected in the anal swabs as well as feces. The presence of virus in the GI tract might be responsible for nosocomial spread of COVID-19, particularly in endoscopy suites, though this hypothesis needs corroboration. Fecal shedding of virus begins before the onset of symptoms and can persist for up to 5 weeks after the respiratory samples test negative for COVID-19.5 The fecal viral excretion raises a concern for feco-oral transmission of infection, especially in developing and underdeveloped countries where open defecation is practiced. Mixing of SARS-CoV-2 infected untreated sewage with water bodies may be another probable source of infection, just as it is for cholera, typhoid, hepatitis A, and poliomyelitis. Therefore, testing for the virus in sewage could be helpful in disease monitoring and surveillance. Although the evidence for direct feco-oral transmission of SARS-CoV-2 is lacking at the moment and further evaluation is warranted, extra precaution is indicated if a COVID-19 patient reports diarrhea to mitigate the risk of health care–associated infection. Whether feco-oral transmission emerges as a significant player or not, it is, nevertheless, a good reason to maintain and propagate personal hygiene.

Health Services Insights

Satisfaction with health care services is a desired outcome of health care delivery. Nonetheless,... more Satisfaction with health care services is a desired outcome of health care delivery. Nonetheless, there is scant information on client satisfaction with services provided in public health facilities in India. A cross-sectional study of persons attending public health facilities in Punjab, North India, was carried out in 2016. All district hospitals, subdistrict hospitals, 2 community health centres (CHCs), and 6 primary health centres (PHCs) were randomly selected from each of the 22 districts. A 60-item pre-tested and validated questionnaire was used to collect data. Participants (3278 outpatient department [OPD] and 1614 inpatient department [IPD]) visiting health care facilities were interviewed. Majority of OPD participants were satisfied with registration process, care providers, and personal issues like safety and security at the health facilities. Major domains of dissatisfaction were long waiting time and concern shown for patients during lab tests and x-rays. Most IPD parti...

Applied Biological Research

Asian Journal of Psychiatry

BACKGROUND Amongst all the ailments among the elderly persons, cognitive impairment has significa... more BACKGROUND Amongst all the ailments among the elderly persons, cognitive impairment has significant impact on the quality of life. Non-communicable diseases (NCDs) like diabetes and hypertension increase the risk of cognitive impairment and dementia. Little is known about the prevalence and correlates of cognitive impairment in elderly with NCDs. AIM The present study aimed to evaluate the prevalence and correlates of cognitive impairment among elderly patients living with NCDs. METHODOLOGY 297 patients attending the chronic disease clinic of two Community Health Centres were evaluated using Hindi mini-mental scale (HMSE), University of California Los Angeles Loneliness Scale (UCLA LS), Geriatric Depression Scale, Generalized Anxiety Disorder (GAD-7 scale) and Vulnerability to Abuse Screening Scale. RESULTS More than one-fourth (27.3 %) of participants had cognitive impairment as per the HMSE scores. The mean HMSE score was lowest (23.90+6.61) among patients with hypertension followed by patients with diabetes alone (26.90+4.46). People with hypertension had lower mean scores on all the domains of HMSE. Multivariable binary logistic regression depicted younger age, high education status, per capita income, long duration of diseases, loneliness, and hypertension emerged as the significant risk factors associated with cognitive impairment. CONCLUSION Older adults with non-communicable diseases have high prevalence of cognitive impairment. Physicians should make the patients and their family members aware about the association of non-communicable diseases with cognitive impairments and should encourage these persons to use remedial measures to reduce the risk of future development of dementia.