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Tholeti P, Uppangala S, Jayaram RK, Udupa KS, Kalthur G, Spears N, Woodruff T, Adiga SK. Oncofertility awareness among primary care physicians in India. F1000Res 2023; 12:153. [PMID: 37767024 PMCID: PMC10521121 DOI: 10.12688/f1000research.126232.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Primary care physicians not only coordinate referrals to oncology services but can play a crucial role in successful fertility preservation referrals in cancer-diagnosed patients. Hence, it is important to assess their knowledge and attitudes towards fertility preservation. METHODS An eighteen-item oncofertility survey was administered to primary care physicians between May 2019 to September 2020. Results: A total of forty-six responses were received and analysed. About 60% of primary care physicians did not have adequate knowledge about available fertility preservation options and only 26-32% were aware of international guidelines recommending fertility preservation in cancer patients. Conclusions: Imparting awareness and knowledge of fertility preservation and its options to primary care physicians could enable an integrated cancer care model while also facilitating successful oncofertility referrals in countries like India.
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Affiliation(s)
- Prathima Tholeti
- Centre for Fertility Preservation, Division of Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576 104, India
| | - Shubhashree Uppangala
- Division of Reproductive Genetics, Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576 104, India
| | | | - Karthik S Udupa
- Department of Medical Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576 104, India
| | - Guruprasad Kalthur
- Division of Reproductive Biology, Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576 104, India
| | - Norah Spears
- Department of Biomedical Sciences, University of Edinburgh, Edinburgh, EH8 9XD, UK
| | - Teresa Woodruff
- Oncofertility Consortium, Room A626B, Michigan State University, East Lansing, Michigan, 48824-1316, USA
| | - Satish K Adiga
- Centre for Fertility Preservation, Division of Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576 104, India
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Mondal H, Panigrahi M, Mishra B, Behera JK, Mondal S. A pilot study on the capability of artificial intelligence in preparation of patients' educational materials for Indian public health issues. J Family Med Prim Care 2023; 12:1659-1662. [PMID: 37767452 PMCID: PMC10521817 DOI: 10.4103/jfmpc.jfmpc_262_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 09/29/2023] Open
Abstract
Background Patient education is an essential component of improving public health as it empowers individuals with the knowledge and skills necessary for making informed decisions about their health and well-being. Primary care physicians play a crucial role in patients' education as they are the first contact between the patients and the healthcare system. However, they may not get adequate time to prepare educational material for their patients. An artificial intelligence-based writer like ChatGPT can help write the material for physicians. Aim This study aimed to ascertain the capability of ChatGPT for generating patients' educational materials for common public health issues in India. Materials and Methods This observational study was conducted on the internet using the free research version of ChatGPT, a conversational artificial intelligence that can generate human-like text output. We conversed with the program with the question - "prepare a patients' education material for X in India." In the X, we used the following words or phrases - "air pollution," "malnutrition," "maternal and child health," "mental health," "noncommunicable diseases," "road traffic accidents," "tuberculosis," and "water-borne diseases." The textual response in the conversation was collected and stored for further analysis. The text was analyzed for readability, grammatical errors, and text similarity. Result We generated a total of eight educational documents with a median of 26 (Q1-Q3: 21.5-34) sentences with a median of 349 (Q1-Q3: 329-450.5) words. The median Flesch Reading Ease Score was 48.2 (Q1-Q3: 39-50.65). It indicates that the text can be understood by a college student. The text was grammatically correct with very few (seven errors in 3415 words) errors. The text was very clear in the majority (8 out of 9) of documents with a median score of 85 (Q1-Q3: 82.5-85) in 100. The overall text similarity index was 18% (Q1-Q3: 7.5-26). Conclusion The research version of the ChatGPT (January 30, 2023 version) is capable of generating patients' educational materials for common public health issues in India with a difficulty level ideal for college students with high grammatical accuracy. However, the text similarity should be checked before using it. Primary care physicians can take the help of ChatGPT for generating text for materials used for patients' education.
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Affiliation(s)
- Himel Mondal
- Department of Physiology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - Muralidhar Panigrahi
- Department of Pharmacology, Bhima Bhoi Medical College and Hospital, Balangir, Odisha, India
| | - Baidyanath Mishra
- Department of Physiology, Sri Jagannath Medical College and Hospital, Puri, Odisha, India
| | - Joshil K. Behera
- Department of Physiology, Nagaland Institute of Medical Science and Research, Nagaland, India
| | - Shaikat Mondal
- Department of Physiology, Raiganj Government Medical College and Hospital, West Bengal, India
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Dasappa H, Agrawal T, Joy M, Ravindran GD. Knowledge, attitude, and practice of patients, visiting a private primary level health care facility towards family physicians. J Family Med Prim Care 2023; 12:1185-1189. [PMID: 37636188 PMCID: PMC10451603 DOI: 10.4103/jfmpc.jfmpc_2507_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/25/2023] [Accepted: 03/02/2023] [Indexed: 08/29/2023] Open
Abstract
Aim and Objective To study the knowledge, perception, attitude, and practice of patients visiting a private primary health centre towards family physicians. Methodology A cross-sectional questionnaire-based study was planned. Results A total of 272 patients visiting the health centre were included in the study. Knowledge Above 90% of the patients felt confident in the capabilities of family physicians in managing all kinds of health problems and the time/cost-effectiveness of this speciality. Timely referral and holistic care were other areas that boosted their confidence on family physicians. 96.7% knew that family physicians are trained specialists. Attitude Although only 50% of the study participants were already seeking the services of a family physician, 88% of them felt that a family physician would be their primary point of contact in their health care needs. Practice The positive attitude, knowledge, and perception towards family medicine were not reflected on their treatment seeking practice in areas of care, such as childcare (66.2%) and pregnancy (81.6%), where they preferred the services of a specialist. Also, for diabetes (52%) and chest pain (66%) related issues, the patients favoured a specialist's care over that of a family physician. Conclusion Patients visiting our primary health centre had good knowledge and positive perception about the family physicians. Preference for specialists over family physicians was seen for conditions such as chest pain, diabetes care, child care, and obstetrics issues.
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Affiliation(s)
- Hemavathi Dasappa
- Department of Family Medicine, St John’s Medical College, Bengaluru, Karnataka, India
| | - Twinkle Agrawal
- Department of Community Health, St John’s Medical College, Bengaluru, Karnataka, India
| | - Manuel Joy
- Department of Family Medicine, St John’s Medical College, Bengaluru, Karnataka, India
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Evaluation of anticancer activity of N H/N-Me Aziridine derivatives as a potential poly (ADP-ribose) polymerase 1 inhibitor. J Mol Struct 2022. [DOI: 10.1016/j.molstruc.2022.132689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Sabharwal M, Misra A, Ghosh A, Chopra G. Efficacy of Digitally Supported and Real-Time Self-Monitoring of Blood Glucose-Driven Counseling in Patients with Type 2 Diabetes Mellitus: A Real-World, Retrospective Study in North India. Diabetes Metab Syndr Obes 2022; 15:23-33. [PMID: 35023937 PMCID: PMC8743499 DOI: 10.2147/dmso.s345785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/16/2021] [Indexed: 04/20/2023] Open
Abstract
PURPOSE Poor glycemic control is prevalent in patients with type 2 diabetes mellitus (T2DM) in India. This study aims to understand the effectiveness of a smartphone-connected glucometer, real-time feedback, and contextualized counseling on glycemic control and hypoglycemic episodes in T2DM patients. METHODS This retrospective, multicenter study reviewed the medical records of T2DM patients belonging to several cities of north India, who were digitally engaged with a smartphone-connected glucometer and who had received at least one counseling session between September 2019 and July 2020. Intervention included self-monitoring of blood glucose (SMBG) using a smartphone-connected glucometer enabled with real-time transmission of information to certified diabetes educators (CDE) and their corresponding counseling based on SMBG findings. RESULTS Of 7111 adult T2DM patients included in this study, majority (75%) of the patients received a single session of counseling, and the remaining patients received 2 (16.7%), 3 (5%), 4 (2%), or ≥5 (1.3%) sessions. The mean age of the patients was 51.6 years, and the majority (77.9%) were males. Digital monitoring of BG and counseling with CDE significantly reduced the mean fasting (by 9.6%), pre-prandial (by 9.9%), and post-prandial (by 9.2%) BG values in 53%, 52%, and 54% of patients, respectively. The majority (81.4%) of patients showed no hypoglycemic episode (≤70 mg/dL) post-counseling. The hypoglycemia episodes observed with FBG, pre-prandial, and post-prandial BG values were reduced significantly by 58.5%, 48.1%, and 61.8%, respectively, post-counseling. CONCLUSION Digitally supported and real-time SMBG-driven counselling was effective in glycemic control and reduction of hypoglycemic episodes in T2DM patients in India. Moreover, reduction in hypoglycemia may be due to back end real-time support of CDE intervention.
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Affiliation(s)
- Mudit Sabharwal
- BeatO, Health Arx Technologies Pvt. Ltd., New Delhi, India
- Correspondence: Mudit Sabharwal Email
| | - Anoop Misra
- Fortis C-DOC Hospital, Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi, India
| | - Amerta Ghosh
- Fortis C-DOC Hospital, Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi, India
| | - Gautam Chopra
- BeatO, Health Arx Technologies Pvt. Ltd., New Delhi, India
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The architecture of the primary mental healthcare system for older people in India: what public policies tell us. Int J Ment Health Syst 2021; 15:72. [PMID: 34461949 PMCID: PMC8404305 DOI: 10.1186/s13033-021-00494-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 08/17/2021] [Indexed: 11/15/2022] Open
Abstract
Background Old age mental healthcare is an issue that cuts across old age, general health, and mental healthcare policies. While strengthening the primary mental healthcare system in India is a common strategy across policy fields to improve the mental health of older persons, very little is known about the system’s planned architecture. This study explores public policy strategies for and approaches to the mental health of older persons, focusing on the primary healthcare (PHC) level and the role of the family. Methods A document analysis of 39 key public national policy documents (2007 – 2019) from three thematically grouped policy fields (mental health, old age, and general health) was conducted. Results Comprehensive community-based primary mental healthcare – focusing on vulnerable population groups including older persons – has been strengthened significantly since 2007. The promulgated approaches and strategies build on traditional community-based approaches to mental healthcare in India. They focus on (a) integrating community health workers into primary mental healthcare, (b) empowering the community to participate in healthcare planning, implementation, and monitoring, (c) supporting the family through a family-led approach to mental healthcare, and (d) integrating traditional Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy (AYUSH) services into primary mental healthcare. Conclusions While all policy fields address mental PHC, they do so in different ways, and approaches and strategies that promote an integrated perspective across policy fields are lacking. To realize the policies vision, strengthening PHC will be essential. Further research should evaluate strategies and approaches in light of social developments, such as eroding family norms and the poor state of the public health system in India, in order to assess their opportunities, challenges, and overall feasibility, with the benefits older people would experience taking centre stage in these inquiries.
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Patil P, Taneja S. Medicine or martyrdom? A peek into the rising violence against doctors during times of COVID 19. J Family Med Prim Care 2021; 10:2732-2734. [PMID: 34660396 PMCID: PMC8483096 DOI: 10.4103/jfmpc.jfmpc_1790_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/20/2020] [Accepted: 10/05/2020] [Indexed: 11/04/2022] Open
Abstract
One would think, at a time where healthcare workers are the frontline warriors against the COVID 19 pandemic, the violence against them would subside; however, this is far from the truth. This commentary article addresses the underlying causes and implications of such acts of violence against health professionals, particularly those involved in primary healthcare, in India, and barriers to implementation of laws protecting these professionals from violence. Recommendations for administrative and on ground interventions, with a proposed collaboration with government and private medical establishments, have been discussed, as a probable solution to the problem of violence at hand.
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Affiliation(s)
- Poorvaprabha Patil
- Intern, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Address for correspondence: Dr. Poorvaprabha Patil, Kasturba Medical College, Manipal Academy of Higher Education, Tiger Cir Road, Madhav Nagar, Manipal - 576 104, Karnataka, India. E-mail:
| | - Sanjana Taneja
- Intern, Lady Hardinge Medical College, University of Delhi, New Delhi, India
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Satish P, Khetan A, Barbhaya D, Agarwal M, Madan Mohan SK, Josephson R, Webel AR. A qualitative study of facilitators and barriers to cardiovascular risk factor control in a semiurban population in India. J Family Med Prim Care 2019; 8:3773-3778. [PMID: 31879612 PMCID: PMC6924214 DOI: 10.4103/jfmpc.jfmpc_492_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 08/22/2019] [Accepted: 09/05/2019] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular (CV) risk factors like diabetes and hypertension are poorly controlled in both rural and urban India. This study was designed to identify the reasons for suboptimal control in a semiurban population in India. A total of 70 participants from the Study to Expand Heart Associated Treatments (SEHAT) trial, conducted in West Bengal, India. We qualitatively examined perspectives regarding CV risk factor control using focus group discussions based on the theory of reasoned action. Qualitative content analysis was used to analyze prevailing themes. Participants demonstrated a generalized knowledge of healthy lifestyle practices but lacked insight into disease-specific prevention methods. We further noticed significant gaps in the translation of existing knowledge into behavior. While personal and systemic barriers exist, factors like high patient motivation and a deep sense of trust in providers can potentially be harnessed to improve risk factor control in the community. We identified key facilitators and barriers to CV risk factor control in the community using a knowledge attitude behavior approach. Our findings provide direction for the development of community-based CV risk reduction models.
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Affiliation(s)
- Priyanka Satish
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Aditya Khetan
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
- Department of Cardiovascular Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44122, USA
| | - Dweep Barbhaya
- Department of Pharmacology, Seth G S Medical College, Mumbai, Maharashtra, India
| | - Manyoo Agarwal
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sri Krishna Madan Mohan
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
- Department of Cardiovascular Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44122, USA
| | - Richard Josephson
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
- Department of Cardiovascular Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44122, USA
| | - Allison R. Webel
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44122, USA
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Ghose S, Radhakrishnan V, Bhattacharya S. Ethics of cancer care: beyond biology and medicine. Ecancermedicalscience 2019; 13:911. [PMID: 31123494 PMCID: PMC6467456 DOI: 10.3332/ecancer.2019.911] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Indexed: 11/23/2022] Open
Abstract
Treatable cancers are on the rise due to improved early diagnosis and more innovative treatments, and preventative strategies against cancer are becoming a global concern. With the rapidly increasing complexity of cancer treatment, a clear definition of what constitutes ethical cancer care has become a matter of great debate. This situation is more complex in a developing country where healthcare resources are limited. Doctors, nurses and public health professionals engaged in the prevention, screening, diagnosis, treatment and research of cancers are often posed with ethical dilemmas while making complex choices. With a special focus on low- and middle-income countries, this paper is intended to highlight these real-world ethical concerns facing those involved in the management of cancer patients. While taking a neutral view, this paper has adopted a theme-wise approach to discuss barriers in cancer care.
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Affiliation(s)
- Soumita Ghose
- Administration and Policy, Tata Medical Centre, Kolkata 700156, India
| | - Vivek Radhakrishnan
- Department of Clinical Haematology and Hematopoietic Cell Therapy, Tata Medical Centre, Kolkata 700156, India
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Faizi N, Kazmi S. Universal health coverage - There is more to it than meets the eye. J Family Med Prim Care 2017; 6:169-170. [PMID: 29026777 PMCID: PMC5629889 DOI: 10.4103/jfmpc.jfmpc_13_17] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Nafis Faizi
- Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Shahwar Kazmi
- Project Coordinator, Médecins Sans Frontiéres, Operational Centre Barcelona-Athens, New Delhi, India
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