Department of Community Medicine

Permanent URI for this collectionhttp://10.0.2.71:4000/handle/123456789/391

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A Scoping Review to Evaluate Different Treatments Used in Advanced Nonsmall‑cell Lung Cancer in India
(Wolters Kluwer, 2026-04-18) Semwal, Jayanti; Juyal, Ruchi et al.
Nonsmall‑cell lung cancer (NSCLC) accounts for nearly 85% of all lung cancers and represents a major global health burden. In India, treatment strategies must be optimized through a customized approach that considers genetic and environmental differences. Objectives: To provide evidence from Indian RCTs with valuable insights into effective and cost effective treatment options. Materials and Methods: This review, conducted according to the Cochrane Handbook guidelines, identified 179,960 studies across databases—PubMed (26,383), Google Scholar (17,100), ScienceDirect/Embase (136,458), and the Clinical Trials Registry of India (19). Results: After screening, 11 primary studies involving 3,470 patients were included. Treatment regimens studied included platinum‑based chemotherapy (carboplatin and cisplatin), taxanes (paclitaxel and docetaxel), epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs), and combination therapies. Carboplatin and cisplatin were the most frequently used agents; gefitinib plus cisplatin showed better efficacy in EGFR‑mutated patients; pemetrexed plus carboplatin was more tolerable than paclitaxel plus carboplatin; and chemoimmunotherapy demonstrated superior survival outcomes compared to chemotherapy alone. Targeted therapies such as EGFR TKIs were equally effective with fewer toxicities. Conclusion: In conclusion, platinum‑based chemotherapy remains the mainstay of NSCLC treatment, but patient tolerance, mutational status, and toxicity profiles must be carefully considered. Chemoimmunotherapy and EGFR TKIs are promising alternatives with improved results, while personalized treatment approaches and novel drug combinations should be the focus of future research.
Effect of structured yoga practice on glycemic and hepatic outcomes in patients with Co-existing Type 2 Diabetes Mellites and Non -Alcoholic Fatty Liver Disease
(Indian Journal of Community Health, 2026-03-31) Paliwal, Charu; Srivastava, Ashok Kumar; Yadav, Nikku; Pandey, Anil Kumar
Background: Non-alcoholic fatty liver disease and type 2 diabetes mellitus often coexist and have similar metabolic risk factors. A key component of management is still changing one’s lifestyle. Hepatic and metabolic parameters may be improved by yoga, as an adjuvant therapy to the standard. Aims and objective:The current study aim was to evaluate the effect of yoga asanas on biochemical parameters of diabetes (FBS, PPBS, HbA1c) and NAFLD (ALT, AST). Methodology: This study was designed as a quasi-experiment and conducted at ESIC Medical College and Hospital, Faridabad. Total 160 participants with T2DM and NAFLD were recruited after obtaining the inform consent and ethics approval. The enrolled participant further divided in the two -group intervention and control group. Intervention group included the addition of the designed yogic program to the standard care of treatment and control group included the participant with standard care of treatment alone. The enrolled participants are followed up for 12 months. Biochemical parameter (Fasting Blood Sugar, Post-prandial Blood Sugar and HbA1c as glycemic and ALT and AST as Hepatic) is evaluated at month 3, month 6, month, month 9 and month 12. Result: The Intervention group showed significant reduction in FBS (153.18 ± 46.34 to 96.32 ± 21.21), PPBS (261.85 ± 56.23 to 162.10 ± 38.42 mg/dL) and HbA1c (8.19 ± 0.76% to 6.52 ± 0.66%) at 12 months (p < 0.0001), with significant inter-group differences for HbA1c at all follow-ups. ALT decreased from 62.58 ± 19.33 to 58.47 ± 15.37 U/L with significant inter-group differences at Months 9 and 12, while AST showed comparable changes between groups (p > 0.05). Overall, the intervention was associated with significant improvements in glycemic parameters and ALT levels over 12 months.Conclusion: Over 12 months, period of follow up, the intervention group showed good decrease in liver enzymes and significant long-lasting improvements in glycemic parameters (FBS, PPBG, and HbA1c). These results indicate that individuals with coexisting T2DM and NAFLD can benefit from an integrated approach that effectively improves both metabolic and hepatic outcomes.
Outcome-Based Learning: Advancing the Framework of Competency-Based Medical Education
(IJCH, 2026-03-31) Sharma, Taruna; Shikha, Deep; Megha; Juyal, Ruchi
The implementation of Competency-Based Medical Education (CBME) in India by the National Medical Commission (NMC) in 2019 is a landmark change in the medical education scenario. This change in the medical curriculum from a time-bound model to an outcome-based model is an important move in ensuring that medical students are competent in facing the challenges of modern-day medicine. In this article, we attempt to critically examine the developments in the CBME model, which has been an evolving entity since 2019 and has seen recent developments in 2024. By emphasizing learner-centered and patient-centered learning strategies, CBME aspires to achieve the integration of theoretical knowledge with the practical skills and competencies required to provide effective medical practice. The curriculum development focuses on the holistic learning experience by incorporating the cognitive, psychomotor, and affective domains of learning to enable students to perform basic functions in the field of medicine and community health. It also promotes the culture of research and scholarly pursuit among the students. By examining the implementation strategies, feedback mechanisms, and performance outcomes of these curricula, the importance of these curricular changes can be clearly understood. The findings of this review emphasize the need to continuously improve and modify the curriculum to fulfill the needs of health care, leading to the achievement of the “Health for All” concept.
Prevalence and patterns of workplace violence against doctors of North India: a cross-sectional study
(Frontiers, 2026-05-04) Vyas, Shaili; Singh, Abhinav et al.
Background: Workplace violence (WPV) against physicians represents an esca lating global concern, with significant implications for India. This phenomenon substantially undermines the mental health, professional morale, and clinical performance of healthcare providers. A comprehensive understanding of the prevalence, patterns, and contextual factors associated with WPV is essential to develop evidence-based prevention and mitigation strategies. Methods: A cross-sectional study was conducted with 200 physicians (100 employed at a tertiary care teaching hospital and 100 in private healthcare settings) in Dehradun, Uttarakhand, North India. Data were collected using a pretested, self-administered questionnaire assessing experiences of workplace violence, contributing factors, physicians’ perceptions, and recommended pre ventive measures. Both descriptive and inferential statistical analyses were per formed using SPSS version 23. Results: Workplace violence was reported by 75% of the respondents (95% confidence interval [CI]: 68.9–81.0%), with verbal abuse representing the most prevalent form (59.33%; 95% CI: 51.4–67.1%). Violence occurred more frequently among male physicians, particularly in private healthcare settings and surgical specialties. A majority of incidents occurred during junior residency and were perpetrated by patients’ relatives (68%) or organized groups (mobs). Notably, only 18% of cases were formally reported by police authorities. Conclusion: Workplace violence was highly prevalent among physicians in Uttarakhand, with verbal abuse and mob-related incidents constituting the pre dominant manifestations. Urgent interventions, including enhanced security measures, structured physician-patient communication programs, and stringent legal enforcement, are necessary to establish a safer and more supportive work ing environment for healthcare professionals.
Risk Factor Assessment and Comorbidity Profile in Gallstone Disease: A Cross-Sectional Study in Uttarakhand, India
(2026-03-31) Sinha, Richa; Maheshwari, Sonam; Joshi, Parmarth; Shikha, Deep et al.
Background: Gallstone disease (GSD) remains a major global health concern, typically benign but can lead to life-threatening complications. Risk factors such as advanced age, female gender, and overweight are well-established, yet gaps remain in understanding the regional epidemiology and associated comorbidities. Aim & Objective: To explore the demographic and epidemiological patterns, assess risk factors, and evaluate comorbid conditions related to GSD. Settings and Design: Cross sectional study was conducted at a tertiary care hospital at Dehradun. Methods and Material: The study was conducted among 233 patients who underwent laparoscopic cholecystectomy. Data was collected via patient interviews, medical records, and pathology reports. Statistical analysis used: Mann-Whitney U tests for continuous variables and z-tests for proportions, with multilevel logistic regression used to identify predictors of symptomatic GSD. Results: Out of the 233 participants, 143 were symptomatic and 88 were non-symptomatic. Symptomatic patients had significantly higher median BMI (p=0.021), waist circumference (p=0.014), systolic blood pressure (p=0.021), diastolic blood pressure (p=0.032), and insulin levels (p=0.004) compared to non-symptomatic patients. In multivariate analysis (Model 5), six significant covariates were identified: age (OR: 1.43, p<0.05), BMI (OR: 1.29, p<0.05), waist circumference (OR: 1.33, p<0.05), systolic blood pressure (OR: 1.27, p<0.05), insulin resistance (OR: 2.17, p<0.05), and the presence of comorbidities (OR: 2.41, p<0.05). Conclusions: The study highlights that symptomatic GBD in Uttarakhand is strongly associated with higher BMI, waist circumference, insulin resistance, and multiple comorbidities. These findings underscore the importance of early intervention strategies targeting modifiable risk factors to reduce the burden of symptomatic GSD.