Amarjeet Singh

The contemporary global landscape is defined by a rigid, often invisible hierarchy of intellectual labor that traces its lineage back to the era of physical colonialism. Historically, the dominance of developed nations over Low- and Middle-Income Countries (LMICs) was established through the extraction of raw materials and the exploitation of physical labor.(1) In the modern era, this has evolved into a sophisticated form of "intellectual hegemonism." (2)Developed nations have strategically positioned themselves as the "think tanks" of the world, monopolizing the high-value, creative phases of innovation while relegating LMICs to the status of executors and assemblers. This systemic division of labor is not merely an economic byproduct but a deliberate structural design that maintains the Global North's technological and scientific superiority.(3) By controlling the intellectual "source code" of industries, developed nations ensure that LMICs remain in a state of perpetual dependency, performing the repetitive, middle-class tasks that sustain the global economy without ever owning the means of innovation.(4)

Objectives: The objectives of this study were as follows: (1) To ascertain the prevalence of hypertension (HTN) among village women. (2) To determine the impact of an intervention strategy of Behavior Change Communication utilizing a camp approach supplemented with nukkad natak on the self-care capacity of village women for lifestyle modification for prevention of HTN. Materials and Methods: The study was conducted during June–July 2023 in the field practice area of Community Medicine of a medical college. Sample size was arbitrary (n = 200) out of all willing women attending outpatient departments during the study period. First, a baseline assessment of the study population was done. Street plays were held for the study population on HTN-related healthy lifestyle. Changes in their knowledge were documented. Appropriate statistical analysis was done using Excel sheets. Results: Most (79%) of the women in the village had normal blood pressure, with 19% of them having mild and 2% had moderate HTN. Most hypertensive women (72%) were not taking medications. Out of 12 hypertensive women who were taking antihypertensive medications, half of them were regular. There was a significant improvement in the score of self-care capacity, treatment HTN diet-related knowledge of the women after the intervention. Respondents liked the idea of organizing drama to propagate health-related messages. Conclusion: One in every five persons in the study population of rural health training centre (RHTC) had HTN. Most hypertensive women (72%) were not taking medications. Those who were taking antihypertensive medications, only half were regular in it. After Nukkad Natak based intervention, there was a significant improvement in the scores of HTN diet and treatment-related knowledge and self-care capacity of the respondents for prevention of HTN. Our respondents liked the idea of organizing drama to propagate health-related messages.

Objectives: The objective of this study was to investigate the prevalence of hypertension (HTN) in adult females at the Urban Health Training Center (UHTC) of a private medical college using a color-coded stratification based on levels of prevention. Materials and Methods: This cross-sectional study was conducted during June–July 2023 at UHTC, a private medical college. The sample size was calculated as 256. First, a basic health assessment of the study population was done. This focused on basic socio-demographic data of the adult women, their health status and blood pressure reading, risk profile, treatment-seeking behavior, etc. A proforma was developed to record the data. The principal investigator did a level of prevention-based color-coded stratification for HTN patient segmentation. Results: The majority of respondents were married (75.4%). Their literacy rate was 72%. The majority of the respondents were homemakers (58.2%). The mean age of the respondents was 38.23 years (range 18–75 years). Monthly household income ranged from Rs. 1,000 to 60,000, with a mean of Rs. 10,611.72. The average family size was 4.61 members. Some (22%) of the respondents fell into the “Health promotion” category (Green), indicating that they were free of HTN. About 39% of respondents were categorized under “Specific protection” (Blue), signifying that they were at risk of developing HTN; 14% were diagnosed with HTN cases without apparent complications, classified as “Early Diagnosis/Treatment” (Yellow). About 21% of respondents were placed in the “Disability Limitation” (Orange) category, indicating some complications, while 4.3% were identified as HTN patients needing “Rehabilitation” (Red) due to serious complications. Conclusion: This approach of the color-coded stratification based on levels of prevention among adult females of UHTC revealed the spectrum of HTN in the general community. Overall, 39% of the respondents had HTN. About two-fifths of respondents were at risk of developing HTN. This method has the potential to enhance the individualized management of HTN.

Specific impact of sprint training (ST) on bone health has yet to be fully explored, in particular how it affects bone mineral density (BMD) and bone structure.Aim. To investigate the ST and bone health relationship between athletes of different training intensities and nonathletes of different ages.Materials and methods. A search of databases PubMed, Embase, and Pedro was conducted from January 2009 to August 2023. The full texts of all potentially relevant studies were obtained and evaluated by three independent reviewers for inclusion.Results. The comprehensive review of eight studies indicates a positive influence of ST on bone health. Sprinters show higher cortical and trabecular BMD in the tibia than controls, with a noted age-related decline in BMD. Short distance runners demonstrate significantly better BMD, counter-movement jump performance, and grip strength compared to long-distance runners. These benefits are consistent across various age groups, including older athletes, with minimal age-related changes in mid-tibial BMD. ST is also associated with a 21% increase in tibial stress-strain index, indicating sustained bone strength, and a reduction in fracture risk in the elderly through downregulation of fracture-related microRNAs.Conclusion. ST significantly enhances bone health, particularly in improving BMD and bone microarchitecture. Incorporating ST into exercise routines may benefit athletes and older individuals. Further research is essential to understand the mechanisms and develop optimal training protocols for bone health.

Background: Polycystic ovarian syndrome (PCOS) is a multifaceted endocrine disorder of women of reproductive age with a multifactorial aetiology. Despite much research, there is still inconclusive data on the impact of dietary, lifestyle and socio‐economic factors on PCOS aetiology. Thus, the present study explored the association of PCOS with diet, eating behaviour, other lifestyle and socio‐economic factors.Methods: A matched‐pair case–control study was conducted on 150 women with PCOS and 150 healthy controls. Information on diet, eating behaviour and physical activity, and also anthropometric and socio‐economic data were collected through standard questionnaires. The adjusted odds ratios (AmOR) were calculated and reported using conditional multivariable logistic regression.Results: The results showed low education level (AmOR = 8.44; 95% confidence interval [CI] = 1.63–43.68), high sugar consumption (AmOR = 11.61; 95% CI = 2.05–65.72) along with higher body mass index (BMI) and inactivity to be significantly associated with PCOS. Also, a significant protective effect was found for cognitive dietary restraint (AmOR = 0.79; 95% CI = 0.66–0.93), crude fibre (AmOR = 0.61; 95% CI = 0.45–0.82) and protein intake.Conclusions: Low education status may contribute to higher receptiveness to choosing unhealthy diets and lifestyles, resulting in adiposity and an increased risk of PCOS.

ObjectivesTo estimate the prevalence of sexual and reproductive health (SRH) problems among women with disabilities (WWD) in Chandigarh, India, and to ascertain the difficulties experienced by WWD in accessing hospital services. MethodsThis cross-sectional study was conducted during 2014 to 2017 in Chandigarh, India. The study participants were women 15 years and older with at least 40% disability. A pretested questionnaire and in-depth interview were used to determine sociodemographic profile, medical history, sexual and reproductive morbidity, treatment-seeking behavior, and the type, extent, and course of the disability. Verbatim responses of the participants were noted. Data were manually coded and collated into possible themes. ResultsPostpolio residual paralysis (80; 30.7%) was the main reported disability, followed by severe sight impairment (52; 19.9%). A majority (170; 65%) of participants were unmarried. Of them, 66 (39%) were not willing to get married. The prevalence of SRH problems was high (151; 57.9%) among WWD, and only 82 (54%) took treatment. Dysmenorrhea (47; 31.1%), irregular periods (36; 23.8%), and vaginal discharge (17; 11.3%) were the main problems reported. The WWD in this study were likely to hide their SRH problems from others out of shame or fear. ConclusionAmong WWD, the prevalence of SRH problems is high and obtaining relief is difficult.

Background: Duchenne muscular dystrophy (DMD) is a rare progressive muscular disease that primarily affects boys. A lack of comprehensive care for patients living with DMD is directly associated with a compromised quality of life (QoL) for those affected and their caregivers. This disease also has a huge economic impact on families as its treatment requires substantial direct, indirect, and informal care costs. Objective: This study presents a protocol developed to evaluate the feasibility and efficacy of a patient-centered care (PCC) model for children with DMD. The care model was designed with the aim to empower families, improve QoL, and reduce economic burden on their families. Methods: This study is planned as a quasi-experimental study that will enroll 70 consecutive families with boys (aged 5-15 years) with DMD visiting a tertiary care center. The study is being conducted in 2 phases (preintervention and postintervention phases, referred to as phase 1 and phase 2, respectively). During phase 1, the patients received routine care. The study is now in phase 2, with the intervention currently being administered. The intervention is based on the PCC model individualized by the intervention team. The model has a comprehensive DMD telecare component that includes teleconsultation as one of its key components to reduce in-person physician visits at the health facility. Teleconsultation is especially beneficial for late-ambulatory and nonambulatory patients. Data on economic burden are being collected for out-of-pocket expenses for both phases during in-person visits via telephone or messaging apps on a monthly basis. QoL data for patients and their primary caregivers are being collected at 3 time points (ie, time of enrollment, end of phase 1, and end of phase 2). Outcome measures are being assessed as changes in economic burden on families and changes in QoL scores. Results: Participant recruitment began in July 2021. The study is ongoing and expected to be completed by March 2023. The findings based on baseline data are expected to be submitted for publication in 2023. Conclusions: This paper outlines a research proposal developed to study the impact of a PCC model for patients with DMD in low- and middle-income countries (LMICs). This study is expected to provide evidence of whether a multicomponent, patient-centric intervention could reduce economic burdens on families and improve their QoL. The results of this study could guide policy makers and health professionals in India and other LMICs to facilitate a comprehensive care program for patients living with DMD. The economic impact of a rare disease is an important consideration to formulate or evaluate any health policy or intervention related to new treatments and financial support schemes. Trial Registration: Clinical Trials Registry India (ICMR-NIMS) CTRI/2021/06/034274; https://www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=56650 International Registered Report Identifier (IRRID): PRR1-10.2196/42491

Objectives: To assess and compare the effectiveness of mHealth‐based educational interventions on improving pregnancy self‐care knowledge, attitude, and practice (KAP) and the satisfaction in using the interventions.Methods: We conducted a three‐group, pragmatic, randomized controlled trial (July 2019–June 2020) among pregnant women (aged 20–45 years, gestation P < 0.001) improvement in KAP on pregnancy self‐care compared with the control group post‐intervention. However, the same was insignificant (P > 0.05) between Groups 1 and 2. Participant satisfaction with the intervention was significantly high among Group 2 compared with the control group (P < 0.001).Conclusion: mHealth‐based delivery of self‐care education effectively improved KAP among pregnant women. The effectiveness of mHealth‐based intervention must be assessed in primary healthcare settings before scaling up.Details of Trial Registration: Registered with Clinical Trial Registry India—CTRI/2019/10/021794 registered on October 29, 2019 (http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=37444&EncHid=&userName=CTRI/2019/10/021794).

Introduction: Access to optimum health care services is vital for every woman. Women with disabilities (WWD), in particular, face multiple discrimination and social exclusion on this issue. The objective of the study was to evaluate the user-friendliness of sexual and reproductive health (SRH) services in terms of the physical access to health facilities in various hospitals in a city in north India. Methods: This cross-sectional evaluation study was conducted during 2013-2017 in five purposively selected major government hospitals in a city in north India. A disabled friendliness evaluation tool was used to analyze the barriers to physical access in terms of approach to SRH care facilities. Data analysis was done through Microsoft Excel (Microsoft, Redmond, WA, USA) and content analysis. Results: Overall, 270 respondents aged 15 years and above with at least 40% disability were interviewed for the study. Lack of access to SRH care in hospitals (infrastructure/equipment/communication/transport) was the main barrier (46.36%) reported by WWD. Most of the hospitals lacked any special provisions for people with disability (PWD). Proper ramps, stairs, toilets, etc. were not present in hospitals as denoted by their verbatim responses. Conclusions: All the hospitals scored low on access to sexual and reproductive health services for WWD.