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   Table of Contents - Current issue
Coverpage
September-December 2020
Volume 1 | Issue 1
Page Nos. 1-44

Online since Thursday, December 31, 2020

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EDITORIAL  

Call for integration of public health and primary care p. 1
Raman Kumar
DOI:10.4103/jphpc.jphpc_26_20  
Primary Care (PC) and Primary Health Care (PHC) are often employed interchangeably; however, they differ in practical application, context, and public health setting. There interface between Public Health and Primary Care is also not clearly understood by academicians and professionals. Due to a lack of proper understanding, the concepts are applied sub-optimally. WHO has called to close the gap between Public Health (PH) and Primary Care (PC) through integration. Academic forums and professional need to actively engage to develop support for the agenda of integration of Public Health and Primary Care.
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COMMENTARIES Top

Employing information technology methods to strengthen our fight against COVID-19 pandemic p. 3
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/jphpc.jphpc_10_20  
The coronavirus disease-2019 (COVID-19) pandemic has affected almost every person across the world and it is high time that we reach to each and every one of them with reliable information at the earliest to minimize the risk of acquisition as well as transmission of the infection. In these testing times, there is an immense need to utilize the communication technology in the various activities of the disease mitigation, treatment and advocacy, communication and social mobilization. It is important to acknowledge that this is the first pandemic in which technology and social media are simultaneously being utilized to ensure people safety. In conclusion, in the battle against the COVID-19 pandemic, information technology and social media have emerged as one of the important tools for the health sector to create not only awareness about the disease, but also it has aided in the prevention and control of the novel viral infection.
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Bioethical principles, COVID-19 pandemic, and our response p. 5
Sudip Bhattacharya, Sheikh Mohd Saleem, Ozden Gokdemir
DOI:10.4103/jphpc.jphpc_11_20  
The pandemic caused by novel corona virus resulted in 81,839,654 cases and 1,784,850 deaths globally till 29th December, 2020. China responded a little bit delayed by sharing information to the World Health Organization (WHO). The WHO responded at its level best by multi-pronged approaches like, rapid diagnostics development; issuing various guidelines on patient monitoring, specimen collection, and treatment; and till date providing up-to-date information by media briefing about the outbreak. Several countries adopt containment measures like travel restriction, screening of the travellers, contact tracing and many more to break the chain of transmission. During this crisis, there are many ethical issues that have emerged across the globe, we have tried to seek few of the answers in this paper.
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Health system strengthening during COVID-19 pandemic through virtual out-patient clinics: An experience from India p. 10
Sudip Bhattacharya, Neha Sharma, Siddharth Angrish, Amarjeet Singh
DOI:10.4103/jphpc.jphpc_9_20  
Whenever any pandemic accelerates, e.g., the corona virus disease 2019 (COVID-19), it is commonly observed that health care systems face tremendous workload in terms of infectious patients seeking testing and care. During such public health emergencies, besides logistics, there is shortage of trained personnel. In this COVID-19 pandemic Government of India is doing its level best for minimizing the impact of COVID-19. Multiple stringent measures are already taken like nationwide lockdown, social distancing, in hospitals-closing of out-patient services, postponement of elective surgeries, creating dedicated COVID-19 treatment hospital, one third of health staff is working on rotation basis and many more, for prevention of COVID-19 and minimizing the impact. Despite of this, the looming communication gap between people living in remote areas and the specialist doctors has always been in the picture. Due to COVID-19, as most of the routine OPDs are closed it is it has become very tough for people specially who have chronic diseases to consult their doctor. In this scenario artificial intelligence enabled Virtual OPD (VOPD) can be boon to the Indian population. The existing problems related to lack of access to OPD care for a major proportion of population can be solved by some extent by virtual OPD care services, in which patients consult with doctors in a virtual platform via mobile phone, computer and other e-devices. It is supposed to offer a number of advantages over traditional medical consultations in terms of convenience and cost. First and foremost, leverage of video consultation is “Therapeutic presence” that it is reassuring for the patients when they see doctor on video. The second advantage is that it helps in diagnostic assessment of the patients. Not only virtual OPDs solve the issues of delays and self-medication. This not only give benefit of availing the service as per the convenience but also provides the utmost medical consultation directly from the expertise. Alongside, the waiting period of minimum 3-4 hours can be reduced by simply audio-video consultations. It becomes easy to generate electronic prescription and can be emailed. However, evidence of clinical outcomes of VOPD is limited in Indian context. Furthermore, if integrated smartly into existing health care systems, VOPD care have the potential to manage the problem caused by the COVID-19 pandemic.
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Role of public health literacy during COVID-19 pandemic, its implications and future recommendations- An analysis from India p. 13
Neha Sharma, Sudip Bhattacharya
DOI:10.4103/jphpc.jphpc_8_20  
The term “Health literacy” was coined by Ratzan et al. in 1970s stating for the littlest health education in schools. But still this term is almost new and is in its early phase of development. Though many attempts have been made in the past to define health literacy. WHO construed it as “the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health”. Health Literacy not only focuses on the individual behaviour-oriented communication but also on the various determinants of health like environmental, social, political etc., thus it is ahead of the cramped concept of health education. If health education methods go beyond the bounds of “information diffusion” and bring about interaction, participation and critical analysis, such kind of approach will lead to health literacy, personal aid and social benefit by enabling adequate community action and will contribute to the advancement of social capital. We believe that nowadays, health literacy is limited to the non-communicable diseases, Maternal and Child Health care and health education is provided to the citizens which is more of kind a bureaucratic formality rather than serving its real purpose. However, this COVID-19 pandemic has become an eye opener for us and revealed that health literacy as a part of health education, is equally important for communicable diseases as well and not only system preparedness, but individual preparedness is also the key to deal with the actual life problems during crises situations.
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REVIEW ARTICLE Top

A human rights analysis of clustered regularly interspaced short palindromic repeats germline-editing for disease prevention p. 17
Lance Garrett Shaver, Amit Sundly, Abdullah Omar Saif
DOI:10.4103/jphpc.jphpc_21_20  
Our purpose is to discuss ethical concerns with disease prevention applications of CRISPR germline editing using a human rights approach. If applied towards furthering health, these tools may aid to prevent diseases, thereby improving health and reduce suffering. On the other hand, commercialization of this technology, such that it becomes accessible only to the wealthy few, may have the opposite effect. We argue that caution needs to be taken against the use of germline-editing technology for disease prevention, as unequal access to the technology might negatively impact the health of the population by perpetuating socioeconomic inequality. What were once diseases and immunities of chance could soon become diseases of the poor and immunities of wealth. Hence, if germline editing is to be used for disease prevention, commercialization must be resisted, and efforts must be made to make it available and accessible within the human rights framework.
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ORIGINAL ARTICLES Top

Exploring college student's menstruation-related difficulties during early COVID-19 lockdown period in North India Highly accessed article p. 22
Surbhi G Garg, Ruqayya Alvi, Suman Gupta, Absar Ahmad
DOI:10.4103/jphpc.jphpc_13_20  
Objective: Sanitary napkins are an essential aspect of the menstrual hygiene management. Despite its critical importance to women and adolescent girls from menarche and menopause, access to menstrual hygiene products has been neglected during the COVID-19 pandemic. At the time of this writing, there was no information on the challenges associated with accessing menstrual hygiene products in Indian settings during this period. This paper investigates the prevalence of socio-demographic correlations of access to sanitary napkins among college students in Lucknow, the largest state located in North India. Methods: Students of undergraduate (UG) and post-graduate (PG) courses currently studying in colleges in Lucknow were eligible to participate in the study. An online cross-sectional survey was conducted in Lucknow in September 2020. In total, 1439 participants took part in the survey. After removing 55 participants who quit the survey by clicking on the disagree button and 13 who did not satisfy inclusion criteria, the final sample comprised 1371 participants. The data collection was anonymous. Responses were analysed using descriptive statistics and bivariate logistic regression. Results: Up to 1371 students completed the survey, resulting in a response rate of 96.2 percent. The analysis revealed that about 12.5 percent of students reported problems in access to sanitary pads during the lockdown. Logistic regression analysis showed that being Muslim, having less-educated fathers, having farmers as fathers, having low income, rural residence, and a history of using cloth, all independently predict challenges in getting access to sanitary pads during the COVID-19 lockdown (P < 0.05). Conclusion: During the COVID-19 lockdown, students were dependent on either locally available resources as absorbents during menstruation or paid more to buy sanitary pads in Lucknow. Low-income families are reluctant to spend on sanitary pads, which is why few college girls resumed their previous practice of managing their periods using cloth pieces or rags. This study's findings may be used to plan and implement interventions during a future pandemic or such crises to maintain the supply chain of sanitary pad.
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A cross-sectional study to assess the knowledge, attitude, and practices towards road traffic safety regulations among college going students of himalayan region, Uttarakhand, India p. 30
Swati Sharma, Neha Sharma, Shaili Vyas, Jayanti Semwal
DOI:10.4103/jphpc.jphpc_5_20  
Background: As per WHO, nearly 1.33 million people die every year due to road traffic accidents (RTAs) all over the world. 10% of the annual average of road traffic accidents cases occurs in India. Aims and Objective: To determine the knowledge, attitude and practices related to road safety rules among college students. Methodology: A descriptive cross-sectional study was conducted on 102 college students through a pre-tested questionnaire. Statistical Package for Social Sciences (SPSS version-23) software, Chicago, USA, was used for data analysis. Results: 91.3% of the college students knew the right age for getting a driving license but only 24.5% students responded correctly for the blood alcohol concentration while driving. Most of the study participants had good attitude towards road traffic rules and regulations, driving license, road signs & symbols. 63-65% of the study participants responded that they always wear belt or helmet while driving and keep a specific speed limit while driving, and never used mobile phone or play loud music while driving. Conclusion: RTAs can be minimized by strict enforcement of regulations by the road traffic police and through frequent road traffic awareness. But the self-responsibility by the drivers should also be there to bring about drastic change in minimizing RTAs.
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Impact of educational intervention and reinforcement on adverse drug reporting by nursing students: A prospective follow up study p. 36
Manisha Bisht, Puneet Dhamija, Bhomik Goel, Vasantha Kalyani, Shailendra S Handu
DOI:10.4103/jphpc.jphpc_19_20  
Objectives: This study aimed to evaluate the improvement in knowledge, attitude and practice (KAP) towards the reporting of adverse drug reactions (ADRs) with an educational intervention and the practice of ADR reporting with repeated reinforcement. Methodology: This prospective follow-up study included nursing students in B.Sc. final year attending clinical postings in a tertiary care teaching hospital which is a regional ADR monitoring center. The validated predesigned KAP questionnaire was used to assess the participants pre and post educational session. After the session, students were randomly distributed in to two equal groups (26 each) by computer generated random sequence – Group A (Reinforcement group) and Group B (Control group). Group A was followed up every week till completion of their clinical posting of two months and students were reminded to report adverse event whereas the other group (Group B) was not followed up. The number of adverse drug reports received from the nursing students were recorded during the study period. Results: A total of 52 nursing student participated in the study. There was significant improvement in the knowledge and attitude in the study participants after the educational intervention. There was a significant increase in ADR reporting in post educational session group. (Nil vs 15%, P value < 0.005) and strikingly all the adverse reports were submitted by the reinforcement group. Conclusion: Although educational intervention develops the knowledge about pharmacovigilance, but continuous follow up and reinforcement has more impact on the practice of ADR reporting.
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LETTER TO EDITOR Top

Epidemiology, epidemiologists, and coronavirus disease (COVID-19) - A perspective p. 43
Sudip Bhattacharya, Amarjeet Singh, Md Mahbub Hossain
DOI:10.4103/jphpc.jphpc_7_20  
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