Indian Healthcare Research Articles

Management of traumatic brain injury in India: A protocol for systematic review and meta-analysis

Abstract* Introduction This systematic review and meta-analysis protocol aims to evaluate the management of traumatic brain injury (TBI) in India, addressing a critical gap in the understanding and treatment of TBI in low- and middle-income countries (LMICs). Despite advancements in healthcare focusing primarily on communicable diseases, TBI remains a leading cause of death and disability worldwide, significantly affecting the quality of life of patients and their families. Recent interest has surged in platelet-rich plasma (PRP) as a novel treatment for TBI, necessitating a comprehensive review of its therapeutic benefits. Methodology The study will source articles from PubMed, EMBASE, SCOPUS, and the Cochrane Central Register of Controlled Trials, targeting a range of studies including randomized controlled trials (RCTs), observational studies, and cohort studies. The review will exclude case series, review articles, and studies not reported in English. The primary aim is to collate evidence-based data on TBI management, with particular focus on the Indian healthcare context, evaluating the efficacy of current treatments and the potential role of PRP in enhancing neurological function and recovery post-TBI. Data management will involve a rigorous selection process, with independent reviewers conducting initial screenings and resolving discrepancies through discussion or arbitration. A PRISMA flow diagram will illustrate the study selection procedure, and a standardized form will be used for data extraction, ensuring thoroughness and consistency. Conclusion By highlighting current knowledge gaps, this systematic review and meta-analysis will guide future research directions and clinical practice, potentially revolutionizing TBI management strategies in LMICs. This protocol underscores the necessity for high-quality, evidence-based approaches to TBI treatment, aiming to improve patient outcomes through enhanced management practices.

Literature review on identifying the factors influencing shift from prescription to Over the Counter Medicines (OTC) and its impact on Indian healthcare industry

Literature review on identifying the factors influencing shift from prescription to Over the Counter Medicines (OTC) and its impact on Indian healthcare industry

Growth of Life and Non-life Insurance Market in India

In the midst of high cost of health care both at the macro and micro levels, health insurance becomes a viable alternative for financing health care in India. Health insurance is fast emerging as an important mechanism to finance health care needs of the people. The insurance industry in India has witnessed an impressive growth rate over the last two decades driven by the greater private sector participation and an improvement in distribution capabilities, along with substantial improvements in operational efficiencies. The paper presents the growth of life and non-life health insurance in India

Health Care in India before 2000 & After 2000

The advancement of health care gear some time recently and after 2000 implies a transformative jump in therapeutic hone. Pre-2000, restricted capabilities in conclusion, treatment, and persistent are won. Be that as it may, post-2000 progressions, counting high-resolution imaging, AI integration, and negligibly obtrusive surgical strategies, have revolutionized restorative hones, moving forward understanding results. Telemedicine advances expand health care get to, whereas progressed checking frameworks empower ceaseless farther checking and early intercession, promising a future of accuracy pharmaceutical and personalized healthcare conveyance.

Impacts on Imported Medical Device in India

The limited indigenous production capability of medical equipment necessitates that the Indian healthcare industry recognise the repercussions of importing them. There are advantages and disadvantages to the system from the rise of these devices. In order to manage these effects, comprehensive laws and regulations are essential. Costs associated with import tariffs, shipping, and currency exchange rates rise when medical equipment is purchased overseas. This is partly due to the need for high-quality services, the rise in healthcare spending, and technological improvements. The rapid advancement of technology may present difficulties in terms of infrastructure adaptation and educating healthcare workers.

Innovation in Healthcare Through Information Technologies: A Review

The application of innovative information technologies in healthcare can definitely subside the present limitations of the healthcare industry through better affability and accessibility. It encompasses the use of artificial intelligence, big data, biomedical research including drug invention, medical education, innovative/robotic surgical technology, cutting-edge equipment, telemedicine, virtual consultation, online supportive platforms, etc. The present review is an attempt to identify and analyse the impact of these innovative information technologies and explore the potential scope of improvement in the Indian healthcare system. The database search was performed in Scopus, Web of Science, PubMed, ProQuest, Google Scholar and Wiley Online Library. Initially, 319 articles related to innovative digital healthcare technologies have been sourced. However, 105 articles were taken into consideration for the review due to various exclusion criteria. Through an extensive review of previously published articles, the present study concludes that undoubtedly information technologies and their applications aid providers reduce inefficiencies, increasing quality, increasing access, removing human errors, reducing costs and making diagnosis, treatment and medicine more personalised for patients. It has really improved the quality, quick and convenient healthcare system.

Greener healthcare operations during COVID-19 pandemic: A data envelopment analysis approach

This study examines internal greener operations in Indian healthcare during COVID-19 pandemic. Specifically, the research explores the interrelationships among three parallel healthcare lines: general care, emergency care, and biomedical waste (BMW) management to fulfill greener healthcare’s targeted sustainable development goals. We use the three parallel stage data envelopment analysis (DEA) approach model to assess efficiencies of the overall system and the individual parallel stages. We collected panel data for cities in the state of Maharashtra, India during the second wave of pandemic in 2021. We find that the effectiveness of general and emergency medical services depends on the requirements of healthcare resources such as beds and equipment in times of pandemics. By contrast, the capacity of individual BMW treatment processes such as incineration, autoclave, shredder, and deep burial would have a bearing on the efficiency of both BMW management and the total system for greener operations. In the second phase, we evaluated the impact of context-specific exogenous factors using a regression model. We found that literacy level was the most important factor at all three parallel stages separately. Additionally, the total population and number of female vaccinated persons were significant across the system while population density and number of male vaccinated persons were inconsequential factors. Interestingly, the Wilcoxon rank-sum hypothesis test offered no evidence to suggest that performance of general care and BMW management, and emergency care and BMW management were equivalent. Implications of these findings for academic theory, practitioners, and policy makers are offered.

A Narrative Review-Participation of Fathers in Child Health Care in India

Abstract Review studies of the father’s role in child care and father involvement, attitudes, and values associated with it, and strategies for promoting their participation. This review aims to analyze fathers’ involvement in child care and father behavior, as well as associated values and strategies for development. To study the father-child connection and factors such as the child’s social behavior, academic performance, and health-related psychological factors. They are more sensitive, loving, and encouraging toward their young children. When it comes to their young children, they are more receptive, affectionate, and assured. They are also better at maintaining their composure when dealing with rebellious toddlers. A child’s emotional and social development is significantly influenced by how fathers cooperate with their children through play. Compared to mothers, fathers spend a far larger volume of their one-on-one time with infants and preschoolers engaging in stimulating play activities. PubMed and Google Scholar Searches were conducted using Medical Subject Headings terms and related keywords. This study examined the various reviews on the relationship between the roles of fathers in childcare and the factors that may influence the same. Traditional gender norms in child care influence the group of people’s images of fathers’ obligation and serve as a barrier to their involvement in the community. In most populations, fathers can support their families financially. They act as positive role models for their children, defend their families from harm, and exercise control over their wives, children, and other family members. Fathers may provide for and nurture their children. Fathers play and teach their children alone or hold them when their mothers are busy. Interventions focused on improving fathers’ and mothers ideas and attitudes about child care, and the relevance of shared childcare duties may improve fathers’ engagement. Fathers’ participation has various impacts on the child’s healthy development of character, social skills, understanding, intellect, academic achievement, gender roles, morality, and emotion. Fathers’ participation in childcare is affected by family and society, and fathers’ personalities affect children’s personalities to some extent. Father involvement, results also revealed that father involvement was low in childcare responsibilities only; however, other subareas of involvement were high. It was found that especially mothers were responsible as primary caregivers for child care.

IJCM_269A: Knowledge, attitude, and practice of artificial intelligence in medical field among Undergraduate and Postgraduate medical students in Tamil Nadu: A cross-sectional online survey.

Background: Artificial Intelligence (AI) in the health care has gained attention worldwide due to its potential to revolutionize health care delivery, improve diagnostics, and enhance patient outcomes. AI has the potential to address challenges in Indian health care sector like shortage of workforce by providing decision support, automating repetitive tasks, and improving diagnostic accuracy. Objective: To assess the Knowledge, Attitude and Practice (KAP) of Artificial Intelligence in health care among Undergraduate and Postgraduate medical students in Tamil Nadu. Methodology: A cross-sectional online survey was conducted among 200 undergraduate and postgraduate medical students over a period of 2 months (Sept to Oct 2023). Data collection was done using Google form which comprises of a pretested, semi-structured questionnaire and statistical analysis was done using IBM SPSS version 21. Results: Out of 200 participants, 94 (47%) were Undergraduates and 106 (53%) were Postgraduates. In total 123 (61.5%) had good knowledge, 190 (95%) had positive attitude and 61 (30.5%) had good practice towards Artificial Intelligence in healthcare. Postgraduates had better knowledge and practice than undergraduates Conclusion: A majority of the participants displayed good knowledge and positive attitude towards Artificial Intelligence in healthcare. Notably, postgraduates outperformed undergraduates, suggesting the need for tailored educational interventions. While AI training in the curriculum remains limited, the high willingness to engage with AI in the future underscores its potential for transformative impact in healthcare.

Prevalence and Assessment of Factors Associated With Malnutrition in Children Residing in Slums of Mumbai: A Cross-Sectional Study.

Background Malnutrition in children continues to be a serious public health problem in India. Therefore, this study aims to evaluate the prevalence of malnutrition and assess factors contributing to it in children of the marginalized slum population of India, masked in the metropolitan cities. Methods A retrospective data analysis with a cross-sectional model was conducted by medical volunteers affiliated with the Rotaract Club of Medicrew who had organized a free pediatric health check-up camp in the Dharavi village of Mumbai, India for children under five. Children under five years of age group of either sex residing in the slums of Dharavi and whose parents consented are included in the study. Neonates, children older than five years of age, and children whose parents did not consent for them to be included in the study were excluded. A pretested, pre-validated questionnaire was administered, and statistical analysis was done with p-values <0.05 considered to be statistically significant. Results A total of 126 children were included. Out of these children, 109 of them (86.50%) had a mid-arm circumference of more than 12.5 cm (normal), 11 (8.73%) were between 11.5 cm and 12.5 cm (moderate acute malnutrition), and five (4.77%) were less than 11.5 cm (severe acute malnutrition). Among the 126 kids, 86 kids were above the age of two and their BMI was assessed, 36 (44.19%) were found to be underweight (<5th percentile) while 14 (16.3%) were obese (>95th percentile), and four (4.65%) were overweight (85th-95th percentile). For 106 (84.13%) of these children, the caregivers were mothers while others were fathers (n=4; 3.18%), grandmothers (n=5; 3.97%), sisters (n=5; 3.97%), and aunts (n=6; 4.76%). Out of those who had commenced receiving formal education, only 39 (55.71%) were in an appropriate grade for their age. The mean expenditure on food as a proportion of the total household income was 36.40% (standard deviation (SD) 15.0%). On the single-item sleep quality scale, the sleep of only 36 kids (28.58%) was reported by their caregivers as excellent. A high proportion of other medical problems were reported in the children. Conclusion Our study reports a substantial burden of malnutrition among children residing in the slums of Dharavi. Rigorous strengthening and conceptualization of on-ground nutritional programs targeted towardslum children should be done by Indian healthcare policymakers.

IJCM_235A: Extent and pattern of telemedicine usage and perceptions about telemedicine among health care practitioners across the state of Karnataka, A cross sectional study

Background: Telemedicine is a developing technology in the Indian healthcare sector. The success of any new technology depends on factors such as knowledge, perception, and willingness of users and professionals to engage it. Hence this study will be conducted to assess the perceptions and usage of telemedicine by healthcare professionals in Karnataka state of India. Objectives: a. To ascertain the extent of telemedicine usage by healthcare professionals in different parts of the state of Karnataka. b. To determine the different models of telemedicine used by healthcare professionals. c. To compare the utilization pattern of telemedicine across various demographic, academic, career and healthcare setting-related parameters of healthcare providers. Methodology: Methods: This study will be conducted using a cross-sectional survey design. The survey will be conducted among healthcare professionals in Karnataka, including doctors, nurses, and other healthcare professionals. Results: In the present study overall usage f telemedicine was 30%. The utilization pattern of telemedicine various widely across various demographic, academic, career and healthcare setting-related parameters of healthcare providers. Different models of telemedicine were used by healthcare professionals in different parts of Karnataka. The utilization pattern of telemedicine is more in urban areas of state. Covid 19 pandemic has a great effect on usage of telemedicine by healthcare professionals. Conclusion: In the present study overall usage f telemedicine was 30%. The utilization pattern of telemedicine various widely across various demographic, academic, career and healthcare setting-related parameters of healthcare providers. Different models of telemedicine were used by healthcare professionals in different parts of Karnataka.

PAs in India: A survey report on qualifications, deployment, specialties, and job satisfaction.

This report is based on a 2023 nationwide survey and literature review of physician associates/assistants (PAs) in India. The National Commission for Allied and Healthcare Professions Act, 2021, which is being implemented in India, included guidelines for PA licensing, creating a unified national curriculum, and preventing malpractice. Using a purposive sampling strategy, we surveyed 536 PAs in India between February 10 and April 30, 2023. The survey collected data on demographics, academic qualifications, specialties, salaries, job satisfaction, and future outlooks through an online questionnaire. The survey showed that most PAs are below age 30 years, and most graduated PAs were involved in clinical practice in 2023. PAs work in almost all clinical specialties; most practice in private hospitals. States in southern India continued to dominate educating and employing PAs, with a nationwide representation of more than 14 states. More than 80% of practicing PAs are satisfied with their profession; however, the majority are unsatisfied with their wages. This first formal survey on India's PAs illustrates the challenges of PA professional practice and standardization of education and licensure in the Indian healthcare system.

Role of Artificial Intelligence in Health care System

The Indian healthcare scenario presents a spectrum of contrasting landscapes. In all, 400 million individuals had no access to any form of basic healthcare while two billion people do not have access to required medications. Therefore, more than one-fourth of the world population has unmet health needs. This leaves the global community with the challenge of how to support a significant number of the world’s populace still lacking in access to basic healthcare facilities. AI has been a disruptive healthcare innovation. With its sophisticated algorithms and several applications, AI has assisted doctors and medical professionals in the domains of health information systems, geocoding health data, epidemic and syndromic surveillance, predictive modelling and decision support, and medical imaging. Artificial intelligence (AI) rapidly dominates the health service system. It removes the manual health system into automatic, in which humans conduct the routine works/tasks in medical practice to the management of patients and medical resources. Drug development is a famously costly procedure. Machine Learning can improve the efficiency of many of the analytical techniques used in drug development. In terms of practical implications, this paper aims to create a fruitful discussion with healthcare professionals and administrative staff and the role of artificial intelligence in healthcare system. Furthermore, this investigation offers a broad comprehension of bibliometric variables of AI techniques in healthcare.

Numbing Effect of Emotional Exhaustion on COVID-19 Fear and Contrasting Effect on Job Satisfaction and Quality of Work Life Among Indian Healthcare Workers

The study conceptualises COVID-19 fear among healthcare workers as a job resource (meaningfulness of work) and job demand (physical and emotional demands), while exploring its effect on healthcare workers’ job satisfaction and quality of work life. The potential numbing effect of emotional exhaustion on COVID-19 fear is studied in the proposed framework. Data were collected from 202 Indian healthcare workers using standardised scales and analysed using Smart PLS 2.0. The results indicate that COVID-19 fear has a significant positive relationship with job satisfaction and a significant negative association with quality of work. The study results validate the hypotheses that COVID-19 fear simultaneously acts as a job resource and job demand. COVID-19 fear had an indirect, negative effect on job satisfaction via reduced quality of work. Emotional exhaustion in healthcare workers reduced healthcare workers’ COVID-19 fears, suggesting a numbing effect of emotional exhaustion on the arousal of emotions. The study is among the first, to the best of our knowledge, that identify the same factor (COVID-19 fear) as both a job resource as well as a job demand for an occupational group (healthcare workers). The ability of COVID-19 fear to simultaneously increase the meaningfulness of the job for healthcare workers and reduce their quality of work life suggests that healthcare administrators need to espouse policies that simultaneously enable healthcare workers to perceive strong emotions that make the meaning of their job salient and buffer them from the emotional, cognitive and physical demands consequences.

Biometric Monitoring, Service Delivery and Misreporting: Evidence from Healthcare in India

Abstract We examine the impact of biometric monitoring devices placed in tuberculosis treatment centers in Indian slums. The devices record health worker attendance and patient visits. Combining survey data, random center visits, and hospital registers, we find that patients at biometric-equipped centers are 25 percent less likely to interrupt treatment, reflecting increased efforts by health workers and greater daily adherence by patients. The technology also improves the quality of public data by reducing overreported patient numbers and underreported treatment interruptions. Overall, our results suggest that real-time monitoring of service delivery can strengthen the state's capacity to serve poor and marginalized populations.

Advancing pediatric perioperative care in India: Acontemporary overview.

In the last 30 years, significant advances have been made in pediatric medical care globally. However, there is a persistent urban-rural gap which is more pronounced in low middle-income countries than high-income countries, similar urban-rural gap exists in India. While on one hand, health care is on par or better than healthier nations thriving international medical tourism industry, some rural parts have reduced access to high-quality care. With this background, we aim to provide an overview of the present and future of healthcare in India. With the cumulative health experience of the authors or more than 100 years, we have provided our experience and expertise about healthcare in India in this narrative educational review. This is supplemented by the government plans and non government plans as appropriate. References are used to justify as applicable. With the high percentage of pediatric population like other low to middle-income countries, India faces challenges in pediatric surgery and anesthesia due to limited resources and paucity of specialized training, especially in rural areas. Data on the access and quality of care is scarce, and the vast rural population and uneven resource distribution add to the challenges along with the shortage of pediatric surgeons in these areas of specialized care . Addressing these challenges requires a multi faceted strategy that targets both immediate and long-term healthcare needs, focusing on improving the facilities and training healthcare professionals. Solutions could include compulsory rural service, district residency programs, increasing postgraduate or residency positions, and safety courses offered by national and international organizations like Safer Anesthesia from Education Pediatrics, Vital Anesthesia Simulation Training, and World Federation of Society of Anesthesiologists pediatric fellowships. India has achieved great strides in perioperative health care and safety. It has become the major international medical industry due to high-quality care, access and costs. Crucially, India needs to establish local hubs for pediatric perioperative care training to enhance healthcare delivery for children.

Exploring the Concepts of Collection Practices of Bark - From Ancient to Modern

Indian indigenous health care tradition plays a vital role in the health sector as it forms the major resource base of the medicinal plants. Precisely, 90% of the plant constituents are yet to be explored while only 10% have been studied. The global popularity of ancient Ayurvedic medicine is creating the persistent increase in demand and supply of Ayurveda medicinal plants. Advantages of these medicinal herbs either in single or many combinations, one part or the whole plant are known in every Indian house hold from the time of our ancestors. Ayurvedic science, the Indian system of medicine is known for the uniqueness of utilising different parts of the medicinal plant such as roots, leaves, flowers, barks etc and even minerals to treat various disorders. Even Ayurveda Acharyas has stressed upon the medicinal values that each part of the plant possess and has described multiple benefits of these drugs. Dravyaguna is one among the branches of Ayurvedic science that deals with the studies related to Ayurvedic drugs that includes Analytical and physio-chemical studies. In association with the clinical studies, physicochemical and analytical studies are need of the hour to comprehend the beneficial properties of the different parts of the medicinal plants. In this regard, we find many studies but not on the collection of barks. This study is an attempt to explore in depth, the collection practices of barks mentioned in ancient period and modern period.

Prevalence and gender difference in depression in primary health care in India: A systematic review and meta-analysis.

Depression contributes to the major burden of mental illness in India. Assessment of burden is essential to develop interventions to address the problem at the primary care level. We carried out a systematic review and meta-analysis of studies documenting the prevalence of depression in primary care in India. A wide literature search strategy was developed using keywords and Medical Subject Headings. The literature search was done in MEDLINE (via PubMed), IndMed, and major Indian psychiatric journal websites. The protocol was registered at PROSPERO. Bias assessment was carried out using a Cochrane risk of bias tool. A total of 186 studies were identified after an initial search, of which 17 were included in the final analysis using pre-specified inclusion and exclusion criteria. The aggregate point prevalence of depression at the primary care level of the 17 studies using the random-effect model was 23.0% (95% CI: 16.0-30.0%). Significant heterogeneity was reported among the studies attributed majorly to a variety of study tools for assessing depression. Sub-group analysis revealed the higher aggregated prevalence of depression among females as compared to males at the primary care level. The study provided updated evidence of higher and gender differential burden of depression at the primary care level in India.

A Study on Assessment of Rural Health Care System in India: Schemes and Implications

India’s rural healthcare system plays a pivotal role in ensuring access to quality healthcare for a significant portion of the population. This study aims to shed light on the state of rural healthcare infrastructure, the effectiveness of government healthcare initiatives, and the far-reaching implications for rural communities. Rural India presents unique healthcare challenges characterized by disparities in healthcare infrastructure, limited access to medical services, and varying health outcomes. The government of India has launched several healthcare schemes and initiatives over the years, such as the National Rural Health Mission (NRHM) and Ayushman Bharat, to address these challenges. Understanding the impact of these schemes and their consequences is essential to inform future healthcare strategies and policies. This study provides a holistic view of the primary healthcare infrastructure in rural India, offering insights into the effectiveness of government schemes and their implications for the health and well-being of rural populations. Its findings serve as a valuable resource for policymakers, stakeholders, and healthcare professionals working toward the improvement of rural healthcare in India.

Longitudinal Costs of Image-Guided Intensity-Modulated Radiation Therapy Versus Three-Dimensional Conformal Radiation: Lessons From Phase III PARCER Trial for Shaping Resource-Stratified Guidelines in Low- and Middle-Income Countries.

The PARCER trial provided level I evidence for image-guided intensity-modulated radiation therapy (IG-IMRT) in patients with cervical cancer. Further information regarding long-term financial impact is imperative for adoption into the National Cancer Grid of India cervical cancer resource-stratified guidelines. Patient data from the PARCER trial were analyzed to evaluate the cost implications of transitioning to IG-IMRT. Lacking differences in outcomes between the three-dimensional conformal radiation (3D-CRT) and IG-IMRT, differences in treatment costs, adverse event incidence, and toxicity management costs were examined. The overall financial impact was estimated by adding the treatment costs, toxicity management, and wage loss. This was extrapolated nationally to determine if a transition to IG-IMRT would be feasible for the Indian health care system. Of the 300 patients in the PARCER trial, 93 faced grades ≥2 adverse events (3D-CRT = 59, IG-IMRT = 34). Patients in the 3D-CRT and IG-IMRT arms spent an average of 2.39 years and 1.96 years in toxicity, respectively. The average toxicity management and the yearly financial impact per patient were, respectively, 1.50 and 1.44 times higher for 3D-CRT patients compared with IG-IMRT patients. Extrapolation to the national level showed that treatment with 3D-CRT led to a 2.88 times higher cost ratio when compared with treatment with IG-IMRT. Although the initial costs of IG-IMRT are high, on the basis of longitudinal data, it is financially inefficient to treat with 3D-CRT. Resource-stratified guidelines should include longitudinal health intervention costs rather than solely initial costs for policy decisions to implement advanced radiation technology.