Healthcare Professionals In India Research Articles

Evidence-based medicine during the COVID-19 pandemic: a survey among healthcare professionals in India

<h3>Abstract</h3> In vertebrates, motor control relies on cholinergic neurons in the spinal cord that have been extensively studied over the past hundred years, yet the full heterogeneity of these neurons and their different functional roles in the adult remain to be defined. Here, we developed a targeted single nuclear RNA sequencing approach and used it to identify an array of cholinergic interneurons, visceral and skeletal motor neurons. Our data expose markers for distinguishing these classes of cholinergic neurons and their extremely rich diversity. Specifically, visceral motor neurons, which provide autonomic control, could be divided into more than a dozen transcriptomic classes with anatomically restricted localization along the spinal cord. The complexity of the skeletal motor neurons was also reflected in our analysis with alpha, beta, and gamma subtypes clearly distinguished. In combination, our data provide a comprehensive transcriptomic description of this important population of neurons that control many aspects of physiology and movement and encompass the cellular substrates for debilitating degenerative disorders.

The Role of Image Quality in Telehealth: Adoption Challenges in the Subcontinent

Abstract Background: The purpose of this paper is to explore the underlying challenges in the telehealth environment in India and Pakistan that impede the delivery of high-quality images between a patient and health care professional. Method: An exploratory study was conducted among healthcare professionals in India and Pakistan to assess their perceptions regarding image quality, which is used for the diagnosis and treatment decision making. This cross-sectional qualitative study used semi-structured interviews with healthcare professionals in both India and Pakistan. Results: The interviews were analyzed using a thematic analysis, which revealed three major themes. These themes being: ICT infrastructure and connectivity, expertise of persons taking images, and multiple transmission degrading image quality. Conclusions: Findings indicate that in both countries, the main underlying challenge is the lack of consistency in the network infrastructure between urban, rural and remote areas. Additionally, training patients to use hand-held devices to take high-quality images could hold the key to improving the reliability and, consequently, the quality of images transmitted between patients and health care professionals.

Reasons of Generic Medicines avoidance by Patients in India: A Quantitative Investigation

The high cost of healthcare is a major concern for patients in India, and one of the ways to reduce this burden is by increasing the use of generic medicines. However, despite the availability and affordability of generic medicines, their usage remains low in the country. This study aims to investigate the reasons behind the avoidance of generic medicines by patients in India. This can highlight the need for improving the perception and trust in the quality of generic medicines among patients and healthcare professionals in India. Furthermore, policymakers could also introduce regulations that mandate the use of generic medicines in public health facilities and incentivize doctors and pharmacists to prescribe and dispense generic medicines. By addressing the factors contributing to this issue, policymakers, healthcare professionals, and pharmaceutical companies can work together to increase the use of generic medicines and improve access to affordable healthcare for all.

Consensus on the use of DPP4 Inhibitors and SGLT2 Inhibitors in T2DM with Chronic Kidney Disease-from Indian Context

Chronic Kidney Disease and Diabetes are diseases of concern globally including developing countries like India. The delayed intervention of non-communicable disease management, the unique socioeconomic condition, etc makes chronic kidney disease a potential threat in the future. Diabetes in India plays an important role in developing CKD &amp; its associated complications. To treat diabetes, many innovative antidiabetic agents were introduced in the last two decades. Some of these newer anti-diabetic medications have established cardio-renal safety in diabetic patients. Many endocrine and cardiovascular societies have already adopted these anti-diabetic agents into the respective algorithms. Overall for newer anti-diabetic medication, there is no available published guidance in India that has prioritized both renal safety and other parameters related to nephrology practice. A group of Indian nephrologists, after analyzing existing published evidence and guidance from different guidelines, prepared a simple common algorithm to manage diabetes patients with associated CKD. This new algorithm, having both DPP4i and SGLT2i, will surely help Indian health care professionals to manage diabetes in CKD patients, in a more efficient way.

Pharmacovigilance: Perspectives in India

ABSTRACT Background Adverse drug reactions are a significant burden on the health system across the world. Paradoxically, a considerable chunk of ADRs is missed or not reported on account of avoidable reasons, resulting in bottlenecks in carrying out the proper management. This problem is much more evident in India and other resource-limited communities than in the prosperous countries of the West. Aim and objective To provide a state-of-the-art update on pharmacovigilance with special reference to perspectives in India and make appropriate recommendations for improving ADR reporting. Design The contents are based on a review of English medical literature augmented with the author's first-hand experience in the field over the past more than a decade. Results Well-organized pharmacovigilance started in India with the launching of the Pharmacovigilance Programme of India in 2010. Despite it making a perceptible improvement in ADR reporting, high underreporting of ADRs still prevails. The yet greater thrust on inculcating awareness comprising knowledge attitudes and practices among the healthcare professionals is likely to lead to further improvement in ADR reporting, resulting in augmentation of the safe use of drugs. Conclusion Pharmacovigilance, a mandatory drug safety activity, needs to be propagated with yet greater vigor among healthcare professionals in India. How to cite this article Gupte N, Pradhan S. Pharmacovigilance: Perspectives in India. J Med Acad 2020;3(2):59–62.

IUPS Physiology Education Workshop series in India: organizational mechanics, outcomes, and lessons.

Active learning promotes the capacity of problem solving and decision making among learners. Teachers who apply instructional processes toward active participation of learners help their students develop higher order thinking skills. Due to the recent paradigm shift toward adopting competency-based curricula in the education of healthcare professionals in India, there is an emergent need for physiology instructors to be trained in active-learning methodologies and to acquire abilities to promote these curriculum changes. To address these issues, a series of International Union of Physiological Sciences (IUPS) workshops on physiology education techniques in four apex centers in India was organized in November 2018 and November 2019. The "hands-on" workshops presented the methodologies of case-based learning, problem-based learning, and flipped classroom; the participants were teachers of basic sciences and human and veterinary medicine. The workshop series facilitated capacity building and creation of a national network of physiology instructors interested in promoting active-learning techniques. The workshops were followed by a brainstorming meeting held to assess the outcomes. The aim of this report is to provide a model for implementing a coordinated series of workshops to support national curriculum change and to identify the organizational elements essential for conducting an effective Physiology Education workshop. The essential elements include a highly motivated core organizing team, constant dialogue between core organizing and local organizing committees, a sufficient time frame for planning and execution of the event, and opportunities to engage students at host institutions in workshop activities.

Psychological impact of COVID-19 pandemic on health-care professionals in India – A multicentric cross-sectional study

Objectives:The world is grappling with an ongoing COVID-19 pandemic that has shaken the mankind to the core and disrupted the lives of everyone. The aim of the study was to assess the presence of psychological distress, depression, anxiety, stress, and insomnia experienced by the Indian healthcare workers.Material and Methods:A cross-sectional study was conducted in India among 777 doctors to evaluate the mental health of doctors working in Corona wards from April 2020 to May 2020 using a pre-designed, pre-tested validated, semi-structured DASS-21 questionnaire, and the Insomnia Severity Index. Continuous variables between the groups were measured using the Mann–Whitney U-test and the Kruskal–Wallis H test.Results:Among the doctors working for the pandemic, around 55% of medical officers in the study reported having moderate levels of depression. With respect to anxiety, it was found that among men as many as 52% reported experiencing severe anxiety and 24% had moderate levels of anxiety whereas females reported as high as 68% and 48% of moderate and severe anxiety, respectively. In our study, around 30% and 44% of male doctors reported mild and moderate levels of stress, respectively, whereas 70% and 56% of female doctors reported mild and moderate levels of stress, respectively. It was also observed that among female doctors the rates of moderate insomnia were especially high (65%), whereas a high level of male participants reported sub-threshold insomnia (52%).Conclusion:Early screening targeting the medical workforce and the implementation of psychological interventions is essential for protecting and maintaining the functionality of the health-care system.

Challenges of Allied Healthcare Professionals in India–Establishing the Council is Need of the Hour

There is a supply-demand gap of about 65 lakh allied health professionals in India. With India facing aheavy burden of disease with many challenges as achieving millennium development goals, shortage ofskilled manpower will be a great hurdle for the health care delivery system. In such a situation, AlliedHealth workers can play a major role in providing holistic health services to the community. Though manyinstitutions or Universities in India are generating allied healthcare professionals, there is no uniformityin the outcome of such professionals. There is no standardization of this professional till date. Hence, toestablish a Centralized council is a need of an hour so that all such programs will come under a commonplatform and generated manpower will be able to provide the necessary services to the community. Inthis article, some suggestions are provided to improve the quality of AHPs, like estimation of workforceaccording to WHO requirement, uniformity in curricula, common nomenclature for all programs, creatingjob opportunities in private and public sectors etc.

Exploration of factors affecting the use of Web 2.0 for knowledge sharing among healthcare professionals: an Indian perspective

PurposeThis study aims to explore knowledge sharing (KS) attitudes and intention of healthcare professionals in India through the use of information and communication technology platforms such as Web 2.0. The research specifically focuses on individual motivators such as the face, reputation and reciprocity, which, to an extent, are influenced by indigenous culture.Design/methodology/approachThe study uses a cross-sectional survey design to collect data. A sample of 207 was obtained from professionals working in healthcare in India. The data were analyzed using the partial least square-structural equation modeling.FindingsThe results confirmed that attitude toward KS leads to the intention to share knowledge. Attitude toward KS using Web 2.0 was found to be positively related to self-efficacy and reciprocity. Furthermore, face and reputation were found to moderate the relationship between attitude and intention to share knowledge while the moderating effect of rewards was found to be insignificant.Research limitations/implicationsThis study was limited to healthcare professionals in India. Knowledge workers in other industries can be considered for further studies.Practical implicationsThis study provides useful insights into KS practices using Web 2.0 among knowledge workers. Particularly it emphasizes the individual motivators, which can be manipulated by Web 2.0 designers to nurture a positive attitude toward KS and to encourage user’s participation.Originality/valueThe study investigates, using an integrated theoretical framework, how certain factors act as a motivator or a barrier for sharing knowledge using Web 2.0. in the specific cultural context of healthcare professionals in India.

COVID Related Original Research: Stress, coping and attitudinal change towards medical profession during COVID-19 Pandemic among health care professionals in India: a cross sectional study

COVID Related Original Research: Stress, coping and attitudinal change towards medical profession during COVID-19 Pandemic among health care professionals in India: a cross sectional study

Comments on "Knowledge and Beliefs About Autism Spectrum Disorders in Indian Healthcare Professionals".

Comments on "Knowledge and Beliefs About Autism Spectrum Disorders in Indian Healthcare Professionals".

Evaluation of depression, anxiety and stress among nurses working in a South Indian Covid Hospital – A cross sectional study

Background: The corona virus disease2019 (COVID-19) pandemic has caused great financial and psychological havoc. Health care professionals (HCPs) are among the many groups of people who are in the frontline and facing a risk of direct exposure to the virus. This study aimed to assess the prevalence and predictors of stress, depressive, and anxiety symptoms in nurses worked in Covid care center.Methods: It was a cross-sectional study. Anxiety, depression and stress among nurses working in Covid care centres was estimated by DASS21 scale.Results: The study revealed that anxiety, depression and stress were the major psychological symptoms observed in nurses while working in Covid care center. There was no significant difference in all three psychic problems. Conclusion: The prevalence of stress, depressive, and anxiety symptoms among HCPs in India during the pandemic is comparable with other countries.

Prevalence and Predictors of Stress, anxiety, and Depression among Healthcare Workers Managing COVID-19 Pandemic in India: A Nationwide Observational Study

Background:The coronavirus disease 2019 (COVID-19) pandemic has caused great financial and psychological havoc. Healthcare professionals (HCPs) are among the many groups of people who are in the frontline and facing a risk of direct exposure to the virus. This study aimed to assess the prevalence and predictors of stress, depressive, and anxiety symptoms among HCPs of India.Methods:It was a cross-sectional, online survey conducted in April 2020 among HCPs who are directly involved in the triage, screening, diagnosing, and treatment of COVID-19 patients and suspects. Stress was estimated using Cohen’s perceived stress scale. Depression and anxiety were assessed using the tools Public Health Questionnaire—9 and Generalized Anxiety Disorder—7. Predictors were analyzed using univariate and multivariate binary logistic regression.Results:A total of 433 online responses were obtained, and N = 350 were finally included. The prevalence (95% CI) of HCPs with high-level stress was 3.7% (2.2, 6.2), while the prevalence rates of HCPs with depressive symptoms requiring treatment and anxiety symptoms requiring further evaluation were 11.4% (8.3, 15.2) and 17.7% (13.9, 22.1), respectively. Women had approximately two times the increased odds of developing moderate- or high-level stress, depressive symptoms requiring treatment, and anxiety symptoms requiring further evaluation. Similarly, women staying in a hostel/temporary accommodation had two times the increased odds of developing depression or anxiety symptoms.Conclusion:The prevalence of stress, depressive, and anxiety symptoms among HCPs in India during the pandemic is comparable with other countries.

Hip Displacement in Cerebral Palsy: The Role of Surveillance.

Hip displacement is common in cerebral palsy (CP) and is related to the severity of neurological and functional impairment. It is a silent, but progressive disease, and can result in significant morbidity and decreased quality of life, if left untreated. The pathophysiology of hip displacement in CP is a combination of hip flexor-adductor muscle spasticity, abductor muscle weakness, and delayed weight-bearing, resulting in proximal femoral deformities and progressive acetabular dysplasia. Due to a lack of symptoms in the early stages of hip displacement, the diagnosis is easily missed. Awareness of this condition and regular surveillance by clinical examination and serial radiographs of the hips are the key to early diagnosis and treatment. Several population-based studies from around the world have demonstrated that universal hip surveillance in children with CP allows early detection of hip displacement and appropriate early intervention, with a resultant decrease in painful dislocations. Global hip surveillance models are based upon the patients' age, functional level determined by the Gross Motor Function Classification system (GMFCS), gait classification, standardized clinical exam, and radiographic indices such as the migration percentage (MP), as critical indicators of progressive hip displacement. Despite 25years of evidence showing the efficacy of established hip surveillance programmes, there is poor awareness among healthcare professionals in India about the importance of regular hip surveillance in children with CP. There is a need for professional organizations to develop evidence-based guidelines for hip surveillance which are relevant to the Indian context.

The infodemics of COVID-19 amongst healthcare professionals in India

BackgroundThere is a deluge of information and misinformation about COVID-19. The present survey was conducted to explore the sources of information /misinformation for healthcare professionals from India. MethodsA cross-sectional online survey using snowballing technique was conducted from 24 Mar to 10 Apr 2020. The questionnaire was pretested and developed using standard techniques. It was circulated among medical students and physicians. Data were analysed using the STATA software. ResultsData of 758 participants were analysed. A total of 255 (33.6%) medical students, 335 (44.2%) nonspecialists and 168 (22.1%) specialists participated. The most common source of formal and informal information was official government websites and online news, respectively. A total of 517 (68.2%) participants accepted receiving misinformation. Social media and family and friends were the most common sources of misinformation. Seventy-two percent of participants agreed that spread of information helped to contain COVID-19, but more than that 75% agreed to having received inaccurate information. Seventy-four percent of respondents felt the need for regulation of information during such times; 26% and 33% felt that information about COVID-19 made them feel uncomfortable and distracts routine decision-making, respectively, and 50% felt it was difficult to differentiate correct from incorrect information about COVID-19. ConclusionThe study explored the sources of information and misinformation and found a high prevalence of misinformation, especially from social media. We suggest the need to better manage the flow of information so that it can be an effective weapon against SARS-CoV2. There is a need for doctors to adapt to the changing times of infodemics accompanying pandemics.

Cross-Disciplinary Appraisal of Knowledge and Beliefs Regarding the Diagnosis of Autism Spectrum Disorders in India: A Cross-Sectional Survey.

Background:Many healthcare professionals, including pediatricians, psychiatrists, Clinical Psychologists (CPs), Occupational Therapists (OTs), and Speech-Language Pathologists (SLPs), are involved in the identification and intervention of Autism Spectrum Disorders (ASD) in children. Distinctive training backgrounds and professional exposure can result in contrasting ideas regarding the assessment, diagnosis, and treatment of ASD. Only a few studies have addressed the cross-disciplinary perspective of knowledge, belief, and awareness about diagnostic criteria required for diagnosing ASD.Materials and Methods:A total of 154 allied healthcare professionals (98 SLPs, 33 CPs, and 23 OTs) participated in the study. The survey tool used for this study was adapted from a previously available survey on the assessment of knowledge and belief about ASD and self-efficacy.Results:The overall knowledge and belief of allied healthcare professionals regarding ASD differed significantly across the groups. However, the knowledge of Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic criteria for ASD did not differ significantly between the groups.Conclusion:Our findings have salient clinical implications and advocates for the continued education of healthcare professionals in India regarding recent diagnostic criteria for ASD.

Study of Adverse Drug Reactions (ADRs) Occurring with the Drug Use in a Tertiary Hospital

Aim: To study the adverse drug reactions (ADRs) occurring with the drug use in a tertiary care hospital. Materials and Method: This observational study conducted over a period of four months (01-Nov-2015 to 29—Feb-2016). The Central Drug Standard Control Organization (CDSCO) suspect ADR forms (15) were distributed to all clinical departments personally in Kerala medical college hospital and research center, Mangode, Cherpullaserry. Regular visits were carried out twice a week for collecting data reports. They were then analyzed, compared with state data, national data, and international data. Results A total of 25 suspected Adverse Drug Reactions forms were reported during the period of four months of the study of the out patients and in patients departments of the hospital. Among all drugs NSAIDS, followed by Antimicrobials, Antipsychotics, Bronchodilators, Antihypertensive and oral hypoglycemic agent etc.. were reported to have adverse drug reactions. Most common route of adverse drug reactions was oral, followed by IV, IM, S/C, Topical and Inhalational routes. Reactions mostly seen affecting Skin, Gastrointestinal systems, Central nervous system, and Hematological system Most patients recovered from adverse events taking suitable measures like complete stopping the offending agent, or were prescribed antihistamines, steroids in addition Conclusion: Awareness about ADR reporting is still poor amongst healthcare professionals in India. The incidence and severity of Adverse Drug Reactions documented in our study are lower than those reported in other studies. NSAIDS comprise the major drug family associated with adverse drug reactions so should be rationally prescribed. Improved communication between the physicians and nurses with the pharmacovigillance centre in the hospital is suggested.

Prevalence and Factors Associated with Burnout among Healthcare Professionals in India: A Systematic Review and Meta-Analysis.

Background:With increasing workload and dismal working conditions, healthcare professionals (HCPs) in India often suffer from burnout. Understanding the extent of these problems and the contributing factors is necessary to build a healthy workforce capable of serving the society. The purpose of this study was to systematically review and analyze: 1) the prevalence of burnout among HCPs in India and 2) the factors associated with burnout in this population.Methods:A systematic search of MEDLINE and EMBASE, from the inception of these databases to October 2019, was conducted using keywords. The search results were screened to identify studies evaluating burnout among HCPs in India using a standard burnout tool. Using a random effect model, the pooled prevalence of burnout was estimated using Maslach Burnout Inventory (MBI) in three domains: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Risk factors for burnout were assessed qualitatively.Results:A total of 15 studies assessing burnout in 3845 Indian HCPs were identified. The pooled prevalence of burnout was 24% in the EE domain, 27% in the DP domain, and 23% in the PA domain. Younger age, female gender, unmarried status, and difficult working conditions were associated with increased risk of burnout.Conclusion:Burnout is highly prevalent among Indian HCPs, with close to one-fourth of them suffering from burnout. A number of personal and professional factors are associated with burnout, and these should be considered while developing solutions to tackle burnout.

All India Ophthalmological Society - Indian Journal of Ophthalmology consensus statement on preferred practices during the COVID-19 pandemic.

The COVID-19 pandemic has taken tragic proportions and has disrupted lives globally. In the wake of governmental lockdowns, ophthalmologists need practical and actionable guidelines based on advisories from national health departments on how to conduct their duties during nationwide lockdowns and after these are lifted. In this paper, we present a preferred practice pattern (PPP) based on consensus discussions between leading ophthalmologists and health care professionals in India including representatives from major governmental and private institutions as well as the All India Ophthalmological Society leadership. In this document, the expert panel clearly defines the range of activities for Indian ophthalmologists during the ongoing lockdown phase and precautions to be taken once the lockdown is lifted. Guidelines for triage, governmental guidelines for use of personal protective equipment from ophthalmologists' point of view, precautions to be taken in the OPD and operating room as well as care of various ophthalmic equipment have been described in detail. These guidelines will be applicable to all practice settings including tertiary institutions, corporate and group practices and individual eye clinics and should help Indian ophthalmologists in performing their professional responsibilities without being foci of disease transmission.

Psychological resilience of COVID-19 frontline warriors: Need of the hour

Background: Amid the rapid rise of COVID-19 cases, risk of infection from patients, isolation, and other factors are taking its toll on the mental health status of the healthcare professionals. The frontline health workers in the COVID-19 pandemic are undergoing psychological turbulence handling the corona situation. Objectives: The present study assessed the self-reported mental health status of healthcare professionals and studied their perspectives of COVID-19 control. Materials and Methods: A descriptive study was conducted among healthcare professionals in India using a web-based online questionnaire. A total of 152 participants took part in the survey in April 2020. Self-reported mental health status was assessed using the DASS-21 scale. Mann–Whitney and Chi-square tests were applied. Results: The overall prevalence of depression, anxiety, and stress was 13.82%, 8.55%, and 23.68%, respectively. A higher prevalence of depression, anxiety, and stress was found in the frontline workers subgroup. The median (interquartile range) scores of frontline workers for depression, anxiety, and stress were 6 (10.5), 6 (8), and 10 (10), respectively. Fifty percent of the participants responded that quarantine and isolation was the best method for control of COVID-19 in Indian setting. Conclusion: The psychological disturbance was found among frontline health workers involved in the diagnosis and management of COVID-19. Psychological debriefing and regular mental status evaluation in addition to psychological counseling may be indispensable.