A Cross-Sectional Study on Sedentary Lifestyle Among Budding Doctors: Silent Killer?

Background Internship is the time period when young doctors learn to balance between professional and personal lives. If they have good awareness and practice of any kind of physical activity during this period, it will help them to continue it forward. This enables them to educate and inspire people and patients around them. The main objectives of this study were to assess patterns of physical activity among medical interns and to understand the factors preventing physical activity among them. Methodology This cross-sectional survey was carried out among interns of a tertiary care hospital in western Maharashtra from July 2022 to September 2022. Ethical clearance was obtained before starting data collection. The survey was administered to those who fulfilled the inclusion criteria. The questionnaire was adopted from the Global Physical Activity Questionnaire. The data collected were entered into Microsoft Excel (Microsoft Corporation, Redmond, WA) and analysis was done using MedCalc v.18.2.1 (MedCalc Software Ltd, Ostend, Belgium). Results A total of 220 interns were enrolled in the survey, of which 13 were removed due to incomplete data and 28 interns did not participate in the study. Finally, 179 interns were included for analysis in the study. The response rate was 87.27%. The mean age of participants was 23.12 years. The study population consisted of 72 (40.22%) males and 107 (59.78%) females. Among participants, 33 interns (18.44%) were involved in vigorous activity during work, and 108 interns (60.34%) were involved in moderate physical activity during work. The median time of a sedentary lifestyle was 300 minutes per day and was more common among males. Cumulatively busy working schedules and exam preparation were the important reasons for reduced physical activity. Conclusion There is a gap in the practice of physical activity among interns. A sedentary lifestyle was more prevalent among male interns than in female interns. The main constraints were demanding working hours and the pressure of competitive exams. Medical students will become doctors in the future who can advise their patients on healthy lifestyle habits. We recommend that it is necessary to promote physical activity in medical schools and to reinforce the importance of physical exercise in the medical curriculum.

Impact of COVID-19 pandemic on mental health of general population: A comparison study between rural and urban population

Background

The coronavirus disease 2019 (COVID-19) pandemic has impacted the mental health of the population globally with the increase in cases of depression, suicide, and self-harm. According to the World Health Organization, there has been an increase of 28% and 26% in major depressive disorders and anxiety, respectively, during 1 year of the COVID-19 pandemic. Only a few studies had been conducted in India assessing mental health, especially the post hoc effect of a pandemic. Therefore, the current study was conducted to estimate the prevalence of depression, anxiety, and stress in rural against urban populations as well as the contributing factors viz age, gender, socioeconomic class, change in occupation, and income.

Materials and Methods

A community-based cross-sectional study was conducted from July 2021 to February 2022 among participants residing in the area covered by the Urban Health Training Centre (Ajmera, Pimpri, Pune) and Rural Health Training Centre (Alandi, Pune) of a medical college in Pune. One hundred fifty-four participants (total of 308) above 18 years of age who were not diagnosed or under treatment for psychiatric illness were interviewed using the Depression Anxiety Stress Scale - 21 (DASS-21) to screen for anxiety, depression, and stress in each setting.

Results

Overall prevalence of mental distress was 35.71% (n = 110). In the rural area, it was 29.2% (n = 45) as compared to 42.2% (n = 65). in the urban category. The prevalence of depression was significantly higher in urban areas (33.1%) compared to rural areas (19.4%), with an overall prevalence of 26.3%. The net prevalence of anxiety and stress was 35.7% and 15.6%, respectively, which were also higher in urban areas (Anxiety OR = 1.769, P = 0.018*; Stress OR = 2.262, P = 0.013). The upper middle class had the least psychological problems. Overall, 11% of participants had lost their jobs; 48.75% in rural and 37% of urban participants had a decrease in their income.

Conclusion

The COVID-19 pandemic has resulted in an increased burden of mental illness. The prevalence of mental health problems is alarmingly high, especially in urban communities. To combat the global mental health pandemic, the interventions that mediate psychological distress must be quickly implemented. Due importance should be given to mental healthcare in the community.

Prevalence of Vitamin D Deficiency in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study

Background Type 2 diabetes mellitus (T2DM) is one of the most common non-communicable diseases, causing a high mortality rate globally. Vitamin D deficiency has been reported as a rising pandemic. Vitamin D levels have been found to be associated with obesity and insulin resistance. However, there is not much research done to study the various factors associated with the association between vitamin D levels and diabetes mellitus in the Indian population. Objective The objective of this study is to estimate the prevalence of vitamin D deficiency in T2DM patients and find the factors associated with vitamin D levels among type 2 diabetes mellitus patients. Materials and methods A cross-sectional analytical study was planned and done in the Urban Health Training Centre of Dr. D.Y. Patil Medical College. The sample size was calculated using published data on prevalence. Data from 116 T2DM patients were collected using a questionnaire about their socio-economic status, dietary patterns, outdoor activities, exercise, drug and supplement intake, occupation, and symptoms, which was filled out by the participants after written informed consent. Levels of serum vitamin D were estimated from the blood samples taken from the participants. Statistical analysis was done using MedCalc software. Results Vitamin D deficiency was found in 86 (74.14%) out of 116 diabetic patients. There were 63 males, and 71.43% of them had lower-than-normal vitamin D levels. The number of female participants was 53, and 77.36% were found to suffer from vitamin D deficiency. There were 88 obese participants, and only 22.73% were found to have sufficient levels of vitamin D. Conclusion The results depict a high prevalence of vitamin D deficiency in type 2 diabetes mellitus patients. Regular supplementation of vitamin D for diabetic patients can prevent them from developing any further complications. Increasing awareness about a healthy lifestyle, a proper diet, adequate sunlight, and exercise can help keep most non-communicable diseases at bay. Additional studies should be done to understand the pathophysiology better, which can aid in preventing diseases in the beginning stages of development.

Stress in Caregivers of Stroke Patients During Rehabilitation: An Observational Study

INTRODUCTION

Stroke causes a high burden of death and disability all over the world. The majority of stroke survivors continue to have difficulties, and their families must shoulder a considerable portion of the expenditures of ongoing rehabilitation and long-term care. In India, stroke rehabilitation is still underachieved due to various reasons leading to delay or incomplete recovery of the patients thus adding up more burden on the caregivers. Thus, studying the caregiver burden of stroke rehabilitation will help policymakers tackle this issue faced by our lower economically challenged citizens.

OBJECTIVES

The objective is to measure the perceived burden on caregivers during stroke rehabilitation.

METHODS AND MATERIALS

The observational study was conducted by interviewing the stroke survivors' caregivers and visiting the physiotherapy OPD using the caregiver burden scale/questionnaire.

RESULTS

The study had 76 caregivers, 51.32% were women and 48.68% were men. The average age for caregivers was 42 years and 55 years for patients. The average duration of giving care was six months. The perceived caregiver burden score was low (mean-19.61) suggesting that not all assistance is associated with stress. The correlation of each burden measure with Modified Rankin Scale for disability is significantly correlated (r=0.7, P<0.0001). Further investigation revealed that caregivers had considerably higher levels of stress when the patient needed to exercise, walk or use the restroom. A low yearly income, a higher secondary education, and a small number of family members were shown to be connected with individuals who scored the highest on stress.

CONCLUSION

Based on this study, we conclude that people with low income residing in nuclear families require more support for caregiving during rehabilitation. We recommend that health and welfare policy measures be developed to lessen caregiver burden in order to improve caregivers' post-stroke experiences.

Cross-Sectional Study of Serum Vitamin B12 and Vitamin D3 Levels Amongst Corporate Employees

Background In today's busy world, health is often neglected especially among full-time workers. Consequently, lifestyle disorders such as vitamin deficiencies are increasing, perhaps because of inadequate nutrition and lack of sunlight due to long hours working indoors. These deficiencies can lead to various short-term and long-term complications. Objective To estimate serum levels of vitamin B12 and vitamin D3 among vegetarian employees. Methods and materials A questionnaire about dietary and exercise habits was administered to participants who fulfilled the inclusion criteria and provided informed written consent. Participants also were asked about drug and supplement intake, history of smoking and alcohol, specific symptoms of vitamin B12 and D3 deficiency, and sociodemographic status. Blood samples were collected to estimate serum B12 and D3 levels. Results The results indicated that 14.00% of participants were vitamin B12 deficient and 82.00% were D3 deficient. Differences by gender were not statistically significant; vitamin B12 deficiency was identified in 10.00% of women and 14.44% of men, and vitamin D3 deficiency occurred in 100.00% of the women and 80.00% of men. Among 71 participants aged 35-45 years, 15.49% and 91.55% were deficient in B12 and D3, respectively; among 25 participants aged 46-55, 12.00% and 64.00% were deficient in B12 and D3, respectively; among four participants older than 55, no vitamin B12 deficiency was observed, but 25.00% were deficient in vitamin D3 (p=0.00002). Nearly all (96.15%) participants who reported never exercising were found to be vitamin D3 deficient, compared to 77.02% of those who exercised (OR=0.13, p=0.043). No significant association was found between alcohol consumption and vitamin B12 (p=1) or D3 (p=0.713) deficiency. Conclusions The results revealed a prevalence of both vitamin B12 and D3 deficiencies among corporate employees who identified as vegetarians. Increased awareness, dietary modifications, conscious physical activity, and most importantly, attention to one's health may help improve vitamin sufficiency. Women over age 45 should pay particular attention due to their increased risk of vitamin D3 deficiency. Further research is needed to assess nutrition profiles among other populations to better understand vitamin deficiencies and design adequate preventive measures.

People's Perspective on Out-of-Pocket Expenditure for Healthcare: A Qualitative Study From Pune, India

Background Out-Of-Pocket Expenditure (OOPE) directly reflects the burden of health expenses that households bear. Despite the availability of social security schemes providing healthcare benefits, a high proportion of Indian households are still incurring OOPE. In order to recognize the reasons behind OOPE, a comprehensive understanding of people's attitudes and behavior is needed. Methodology By purposive sampling, 16 in-depth interviews were conducted using an interview guide in the catchment area of urban and rural health centers of a tertiary healthcare hospital. Interviews were conducted in Marathi and Hindi and were audio tape-recorded after taking informed consent. The interviews were transcribed and translated into English, followed by a thematic analysis. Results Although most participants knew that government hospitals provide facilities and experienced doctors, inconvenience and unsatisfactory quality deter them from utilizing government facilities. A few had experiences with government schemes; almost all concur that the formality and procedure of claiming insurance are cumbersome and all have had bad experiences. Cost of medications and consultation accounted for the majority of the healthcare expenditures. While some participants had benefitted from insurance, few regretted not enrolling in one. Conclusion The awareness regarding government schemes was derisory. Government-financed health insurance schemes and their utilization are crucial to reducing OOPE. Efforts should be made to increase accessibility to public healthcare services. Nevertheless, there is potential to redress the barriers to improve scheme utilization.

An Association between CT Score and the Severity of COVID-19

Introduction: COVID-19 has changed the world fabric. While many still haven’t recovered from the grief of losing their loved ones; the virus continues to mutate leaving the world to deal with a social and economic pandemic. In this study we aim at determining an association between CT SCORE and the severity of COVID-19 thereby understanding the prognosis/severity of disease in patients. Method: A prevalidated google questionnaire was used to obtain data. The study population consisted of people who tested real time RT-PCR COVID-19 positive. Results: A statistically significant correlation was seen between CT score and outcome of disease. Conclusion: Routine CT scan of suspected COVID-19 cases gives early diagnosis; it could also guide in hastening the treatment received by the patient and improve overall prognosis be used as a guide for the management of the patients and hence improve overall prognosis.