Introduction: Thalassemia is a severe chronic anaemia. Caregivers face many stresses to provide the best possible medical care for their children. They develop a variety of coping mechanism. Objectives: To determine coping mechanism among caregivers of thalassemia patients and its associated factors; To explore challenges faced by caregivers of thalassemia patients. Methods: Institutional based observational study with convergent parallel mixed method study design was conducted in tertiary care hospital at OPD of Haematology Department in Kolkata, India. Total of 130 caregivers were selected through systematic random sampling for the quantitative strand who were interviewed using pre-tested questionnaire and the Coping Health Inventory for Parents-45 (CHIP). Additionally, seven in-depth interviews were conducted for the qualitative strand. Data were analysed using MS Excel 2019, SPSS v25, and QDA Miner Lite v3.0.2 with coding and thematic analysis after data saturation. Results: Among the caregivers 55 (42.3%) and 75 (57.7%) were mothers and fathers respectively with median age of 34 years. The median total score of the CHIP was 75, where 49% caregivers had adequate and 51% had inadequate coping skills. There was significant association between inadequate coping with poor social support (p=0.045) and frequent blood transfusion interval (p=0.020). The qualitative strand of this mixed-methods study identified five major themes-health problems, self-negligence, financial issues, familial issues and spiritual beliefs. Conclusion: Nearly half of the caregivers exhibited inadequate coping due to poor social support and shorter intervals between blood transfusions. Comprehensive support systems are crucial to improve their coping and overall quality of life.

Introduction: Adult vaccination is widely recognized as a highly cost-effective public health measure, despite its benefits many diabetics may not grasp their importance or have misconceptions, affecting their acceptance. The purpose of the study was to assess the awareness and to estimate the coverage and find out the level of acceptance of adult vaccination. Methods: An observational study with cross-sectional design was conducted in Diabetes OPD of tertiary care hospital in Kolkata among 423 diabetics patients using consecutive sampling methods attending Diabetic OPD for a duration 6 months (September 2023-February 2024). A pre-designed, pre-tested, structured schedule comprising of socio demographic clinical profile, awareness, coverage and acceptance of vaccine was used for face-to-face interview. Data were analysed by Microsoft Excel 2019 and SPSS v25.0. Results: Out of 423 participants more than half (57%) were male, and mean age of them were 50.7 years (±11.2). Ninety one percent (91%) of study participants had type II Diabetes Mellitus, and more than two thirds (67.4 %) suffered from co-morbidities. Thirteen percent (13%) had adequate awareness about adult vaccination and very few (7%) had administered Hepatitis B vaccine. Seventy one percent (71%) of the study participants were ready to get Influenza vaccine after being aware. Fear of adverse effects and out of pocket expenditure were the major reason from non-acceptance of vaccines. Conclusion: Eighty-seven percent (87%) of the participants had inadequate awareness about adult vaccines and only seven percent (7%) of them had taken Hepatitis B vaccination.

Introduction: Tele-counselling may emerge as a promising strategy for improving neonatal outcomes in low-birthweight (LBW) babies especially in resource-constrained settings. Objective: To explore barriers and enablers in implementing tele-counselling for caregivers of LBW infants in a rural Indian setting drawing insights from a community based interventional study. Methods: This qualitative study was nested within a larger community based interventional study, conducted in Agra, Uttar Pradesh, the qualitative component is presented. Tele-counselling was provided to caregivers of 40 LBW infants over eight weeks selected consecutively. Data related to challenges were collected through in-depth interviews and analysed by thematic analysis, supplemented with qualitative reflections and case narratives. Results: Key barriers included poor network coverage (35%), lack of willingness to talk (35%), time constraints (25%) and comprehension difficulties (7.5%). Enablers included ASHA worker involvement, flexible scheduling and personalized support. Six themes emerged: technological barriers, communication and comprehension gaps, trust and reluctance, time constraints and competing priorities, role of Community Health Workers, and personalization and case-based support. Conclusion: Despite technological and behavioural barriers, tele-counselling can serve as an effective postnatal intervention tool when combined with trust-building, flexible timing and collaboration with frontline workers. Tailored counselling, regular follow-up and community integration are critical for success.

Healthline journal is a peer reviewed official publication of Indian Association of Preventive and Social Medicine (IAPSM). The Healthline aims to promote quality research in the field of Community Medicine and Public health.

Introduction: Tuberculosis is a public health concern for developing and low-income countries including India. The emergence of drug-resistant tuberculosis has added to the already existing economic and social burden. Objective: To assess the determinants of drug resistance among tuberculosis patients attending the tertiary care hospital Method: A hospital-based case-control study was carried out with sample size of 220 in a tertiary care institution, Dehradun, Uttarakhand, over the span of one year. Convenient sampling method was used to identify the cases and matched controls were selected with 1:1 ratio from patients visiting the outpatient department of the hospital. Data collection involved face-to-face interviews using a pretested structured questionnaire. The data were analyzed using SPSS for Windows. Results: The majority of study subjects belonged to the age group of 15-34 years. Higher numbers of DR-TB cases were found to have Diabetes mellitus (14.5%) as compared to controls (9.1%). The risk involved in development of drug resistance was approximately 4 times higher in TB contacts and it was statistically significant (p-value 0.027). Higher number of DR-TB cases reported having TB in the past (66.3%) as compared to controls (20%). The majority of cases (48.2%) were found to be underweight as compared to controls (10.1%). Conclusion: Risk of development of DR-TB among diabetic cases was 1.7 times more in comparison to controls. The risk of development of drug resistance was 7.8 times more in subjects who had TB in the past. Underweight cases were more susceptible to developing DR-TB (OR 4.9; p<0.0001)

Introduction: Glaucoma, causes irreversible vision loss, involves optic nerve damage due to increased aqueous outflow resistance in primary open-angle glaucoma (POAG) or iris blockage in primary-angle closure glaucoma (PACG). Objective: This study evaluates different treatment patterns and their effectiveness in primary glaucoma using the NEI VFQ-25. Method: A 2-month prospective observational study included patients with primary glaucoma, excluding those with secondary glaucoma or other ocular conditions. The sample size was determined based on study duration. Treatment groups received medical, laser, or surgical interventions, alone or combined. NEI VFQ-25 was administered at baseline and one month. Results: Among 100 patients, mean age 56.7 years, equally divided between POAG and PACG, QoL improved significantly across all treatment groups, greatest in medical treatment alone, multimodal treatment, least. One-way ANOVA showed difference in treatment approach on outcomes. Conclusion: Using NEI-VFQ-25, study assessed QoL in glaucoma patients across six treatment groups, finding highest QoL with medical therapy alone and lowest with combined treatments.

Introduction: With the advent of mechanization and technological advancement, there is an increase in sedentary and light intensity nature of work in the food manufacturing industry. Objective: To describe the morbidity profile of sedentary workers and factors associated with it in a food packaging industry in Goa. Method: A retrospective record-based study was conducted for a period of 3 months on 523 workers from food packaging industry in North Goa who are registered with an Occupational Health Service. Morbid conditions such as common chronic diseases like Diabetes, Hypertension, Visual and auditory problems were studied. Continuous data with normal distribution were expressed as mean and standard deviation. Morbidity profile was depicted as frequency and percentage and association with appropriate statistical test. Results: Majority, i.e. 495 workers (94.6%) did not have any co-morbidity, 17 (3.3%) had hypertension, 7 (1.3%) had diabetes and 4 (0.8%) had both diabetes and hypertension. Age ≥30 years (p=0.000), presence of comorbidities (p=0.011), near vision (p=0.000), total vision (p=0.031) and blood pressure (p=0.002) were significantly associated with being overweight or obese. A low positive correlation was observed between Body Mass Index and systolic blood pressure (r=0.232, p=0.000), diastolic blood pressure (r=0.166, p=0.000) and Random Blood Sugar Level (r=0.089, p=0.042). Conclusion: Workers from the food packaging industry suffer from diabetes, hypertension and overweight, which are known to progress with prolonged periods of reduced physical activity as seen at their workplace.

Introduction: Reproductive tract infections continue to be a major public health issue, especially for urban low-income women of reproductive age. RTI burden is increased by delayed diagnosis and treatment due to poor health-seeking behaviour and other socioeconomic constraints. This study looks at the health-seeking habits and difficulties of married, reproductive-age women living in Agra's urban slums. Objective: 1. To assess the health seeking behaviour for reproductive tract infections among married women of urban slum of Agra. 2. To explore the challenges they faced for the treatment of reproductive tract infections Method: A cross-sectional study among 500 married women in Agra's urban slums used the WHO syndromic approach for RTI/STI diagnosis. Multistage random sampling selected one ward and two slums. Interviews followed a random starting direction and the left hand rule until the sample size was met. Results: The study found that 57.92% of females with RTI/STI symptoms sought treatment, while 42.07% did not, with barriers including perceived lack of importance, financial constraints, embarrassment, lack of family support, and time limitations. Conclusion: In Agra's urban slums, just over half of women sought treatment for RTI/STI symptoms, primarily at government facilities, while significant barriers prevented others. Perceived lack of seriousness, financial constraints, and embarrassment were key deterrents. A major reason for stopping the treatment was absence of symptoms. Interventions are needed to increase awareness, improve access, address financial issues and reduce stigma.

Introduction: The increasing global consumption of medications has led to a significant rise in the improper disposal of unused and expired drugs, posing risks to both human health and the environment. Objective: This study aims to evaluate the understanding, beliefs, and behaviours related to the disposal of such medications within the rural community of Sarojini Nagar, Lucknow. Method: A cross-sectional study was conducted in June 2024 with 317 participants from rural Sarojini Nagar, including patients and attendants visiting the General and NCD OPD of PHC Sarojininagar, chosen purposively. Participants aged 18 years and above who provided consent were included, while those with cognitive or communication issues were excluded. Participants were interviewed by Junior Residents and Data was gathered using a structured questionnaire to evaluate demographic characteristics, knowledge, perceptions, attitudes, and practices related to the disposal of unused and expired medications. Results: The study revealed a lack of awareness about proper disposal methods, with 77.3% of participants reporting no prior information on the subject. Only 14.8% were aware of drug take-back policies. A majority (87.9%) recognized the harmful effects of improper disposal, and 93.7% agreed that such practices negatively impact the environment. Despite this, 69.4% of participants reported keeping unused medications at home, and 78.0% disposed of expired medications by throwing them in household trash. Conclusion: The findings highlight a significant gap in knowledge and practices regarding safe drug disposal among rural community of Sarojini Nagar. There is an urgent need for targeted educational programs and the implementation of effective drug take-back systems to mitigate the risks associated with improper disposal. Raising awareness and providing clear guidance on safe disposal methods are crucial steps towards protecting public health and the environment in these communities.

Introduction: Functional disability among the elderly reduces autonomy, leading to dependency, decreased quality of life, increased hospitalization, and higher mortality rates, ultimately lowering general life expectancy and increasing disabled life expectancy. Objectives: 1. To estimate the prevalence of functional disability among the elderly residing in the field practice area of Rural Health and Training Centre, Mandur, Goa. 2. To determine the factors associated with functional disability among study participants Methods: A community-based cross-sectional study was conducted among elderly individuals (aged 60 years and above) in the field practice area of Rural Health and Training Centre, Mandur, Goa. Systematic random sampling recruited 372 participants from 1,588 households. Functional disability was assessed using the Barthel Index, with data analysed using SPSS 22.0. Prevalence was expressed as a percentage, and associations were evaluated using significance tests and Odds ratios with 95% confidence intervals. Results: Out of 372 participants (mean age: 71.24 ± 8.03 years), 95 (25.5%) had functional disabilities in ADL, visual, or hearing impairments. Significant associations were found with age, literacy, financial dependence, and current alcohol consumption (p < 0.05). Conclusion: The high prevalence of functional disability among the elderly in rural Goa highlights the need for targeted interventions to improve quality of life and independence. Health education, literacy, and financial support are critical for preserving functional abilities. Community based initiatives and supportive healthcare policies are essential for reducing disability and healthcare costs among the elderly