Global Journal of Medicine & Public Health

Evaluation of Hematological and Biochemical parameters in Malaria positive patients- A hospital based cross-sectional observational study

Preeti Jain — 2026-10-02

Introduction: Malaria remains a major public health problem in tropical countries, especially in India leading to anemia, thrombocytopenia, leucopenia, hyperbilirubinemia and if untreated; it may damage kidney and liver. It is associated with significant hematological and biochemical alterations that reflect disease severity and prognosis.
Aims and objectives: To evaluate hematological and biochemical parameters in patients diagnosed with malaria.
Methods: This was a hospital-based prospective observational study conducted in the Department of Pathology and Medicine over a period of 6 months from June 2025 to December 2025 in over 591 Malaria positive patients in the Departments of Pathology and Medicine, Bharatratna Dr. Babasaheb Ambedkar Municipal General Hospital, Mumbai. Hematological parameters were analysed using automated hematology analyzers and biochemical parameters were assessed using fully automated biochemistry analyzer.
Results: Anemia, thrombocytopenia and leucopenia were the most common hematological findings. Among the biochemical parameters; hyperbilirubinemia was the most common abnormal biochemical finding with blood urea, serum creatinine, Serum Glutamic- Oxaloacetic Transaminase (SGOT), Serum Glutamate Pyruvate Transaminase (SGPT), alkaline phosphatase and serum protein also showing alterations.
Conclusion: Evaluation of Hematological and biochemical parameters in malaria can serve as an important diagnostic and prognostic indicators to prevent and to monitor liver, kidney and multi-organ dysfunction.

Assessment of Awareness and Attitude Towards Mental Illness Among Outpatient Attendees in a Tertiary Care Hospital of North Gujarat

Bipin Patel — 2026-10-02

Background: Mental illness is a significant global health concern, and in India, it is compounded by a considerable treatment gap and widespread social stigma. This study aimed to assess the knowledge, attitudes, and practices towards mental illness among Outpatient Attendees in a Tertiary Care Hospital of North Gujarat, a region with limited existing data.
Methods: An observational, descriptive cross-sectional study was conducted on 400 adult participants attending Outpatient Department in a Tertiary Care Hospital of North Gujarat. Data were collected using a pre-designed, pre-tested questionnaire to evaluate the participants' knowledge, attitudes, and help-seeking behaviours regarding mental illness. The collected data were analyzed using descriptive statistics, with results presented in frequencies and percentages.
Results: The findings revealed a mixed level of mental health literacy. While 75.2% of participants correctly identified that individuals with mental illness could suffer from depression, a significant majority (96.0%) believed severe cases should be confined to a mental hospital. Over half (61.7%) perceived individuals with mental illness as prone to violence, and 76.0% attributed the illness to a lack of willpower. A profound attitudinal dichotomy was observed: while 88.0% of respondents agreed on the need for social acceptance, a substantial portion held stigmatizing views regarding marriage (56.5%) and employment (59.0%). In terms of help-seeking, 52.2% would consult a friend or family member, contrasting with only 24.5% who would see a general practitioner.
Conclusion: The study underscores the persistence of misconceptions and deeply rooted stigma towards mental illness in North Gujarat. The findings highlight a critical gap between acknowledging the existence of mental illness and a willingness to fully integrate affected individuals into society. Targeted public health interventions are urgently needed to address these prevailing myths and improve mental health literacy, thereby fostering a more inclusive and supportive community.

Assessment of Risk Factors, Causes, and Anatomical Patterns of Varicose Veins recurrence Following Surgical and Endovenous Interventions: A Prospective Single-Centre Cohort Study

Vakamudi Prakash — 2026-10-02

Recurrence rates appear to be rising with time in patients who underwent surgery for varicose veins. Following a follow-up period of three to eleven years, clinical recurrence rates ranging from 26% to 62% have been reported. Recurrences are due to variations in the initial therapy, recurrence measurement technique, and follow-up period.
Aims and objectives:
To identify the risk factors, possible causes and patterns of recurrence following all modalities of varicose veins surgery.
Methods:
This observational study was conducted in Department of General Surgery in Narayana Medical College Hospital to identify the risk factors, possible causes and patterns of recurrence following varicose veins surgery. A total of 40 Patients with recurrent varicose veins after surgery were recruited in to the study between October 2023 to August 2025.
Results:
Recurrent varicose vein after surgery was noted among 17.5% of the cases who underwent Endo venous laser ablation (EVLA) and 82.5% who underwent Trendelenburg procedure (TP). Probable causes for recurrence were found to be in surgeries of Double long saphenous vein (27.5%), Double short saphenous vein (15%), involvement of Neovascularization (37.5%), Inadequate pre-operative- evaluation (17.5%) and incomplete surgery (2.5%) the patients. Areas of body where Recurrence occurred included inguinal (2.5%), thigh (12.5%), popliteal fossa (15%), legs (20%) and both thigh and leg (50%) of the patients.
Conclusions:This study concluded that patients who underwent TP had more recurrences when compared to EVLA procedure. Among cause for recurrence, neovascularisation being the most common and body areas of recurrence being both thighs and legs.

HIV Self-testing in Africa: adoption, barriers, and health outcomes: a systematic review and Meta-Analysis

Chidera.C. Igbomezie — 2026-10-02

Background: HIV testing is an essential pathway to HIV prevention and management services. However, HIV testing has remained low in resource-constrained settings in Africa owing to certain barriers such as stigma and confidentiality issues. HIV self-testing (HIVST) is an alternative preventive measure for HIV that can address these constraints. This study examined HIVST adoption/ uptake, health outcomes and barriers among adults in Africa.
Methods: This was a systematic review and meta-analysis that surveyed published literature from January 2018 to August 2024 using five electronic databases (PsycINFO, MEDLINE in PubMed, Web of Science, CINAHL, and EMBASE) and bibliographic search. Studies were included if they were peer-reviewed, published in the English language, and examined HIVST uptake, barriers and health outcomes following HIVST uptake within Africa. The Joanna Briggs Institute Critical Appraisal Checklist was used for critical appraisal of the quantitative articles while the qualitative articles were appraised using the Critical Appraisal Skills Program. Narrative synthesis and effect size computations were used to analyze findings. The review was registered with PROSPERO under registration number 600021.
Results: Twenty-two articles related to HIVST were included in the final synthesis. Of the included articles, 13 measured HIVST adoption/ uptake/ acceptability, 6 reported the outcomes of HIVST, and 18 reported barriers to HIVST. The meta-analysis revealed a pooled HIVST uptake estimate of 67% among adults in Africa. Early diagnosis and linkage to care were the most commonly reported health outcomes following HIVST by adults within Africa. The barriers to HIVST uptake were participants’ lack of expertise in interpreting results, cost of the kits, social stigma and discrimination, lack of professional help, not having enough time to test or get a self-test kit, and differing spousal opinions regarding self-testing were significant barriers to the use of HIVST.
Conclusion: Continued health education, promotion, and healthcare provider-assisted services should be encouraged to foster uptake rates within Africa. Also, HIVST should be made available, free of charge particularly in resource-limited settings to ensure cost is not a barrier to access. Nevertheless, caution should still be taken when generalizing these results since high heterogeneity was observed within this analysis

A Comparative Psychometric Study for Development of Questionnaires to Assess Knowledge and Practices among Frontline workers and Mothers regarding Home-Based Newborn Care (HBNC) and Home-Based Care for Young Child (HBYC) Programs in Delhi

Vishal Mishra — 2026-10-02

Objectives: Developing a validated and reliable questionnaire for ASHA workers and mothers regarding Home-Based Newborn Care (HBNC) and Home-Based Care for Young Child (HBYC) programs.
Methods: For designing the questionnaire(s), initially 80 items on 3 constructs of HBNC and HBYC program were identified. For the content validity (study 1), a panel of three content matter experts reviewed the initial draft and based on logical analysis initial questionnaire was designed. In studies 2, 3, and 4, ASHA workers (n = 17) and Mothers (n=10) completed the HBNC and HBYC questionnaire to review the clarity of the items for determining the face validity. ASHA workers (n=10) were provided with the modified questionnaire to determine internal consistency in study 5. In study 6, test -retest reliability was undertaken involving ASHA workers (n=10) by filling the questionnaire twice over a period of two weeks. In study 7, construct validity was undertaken involving Accredited Social Health Activists (n=16) and Graduates (n=16).
Results: As part of content validity, experts agreed (CVI > 0.9; Agreement, Kendall's W > 0.3, p<0.001) that 2 out of 3 constructs were relevant to evaluate knowledge.. The final modified HBNC and HBYC questionnaire had acceptable internal consistency ( Cronbach's ? > 0.7), test-retest reliability (r > 0.85), and highly differentiated (U =3.5 and U=0, p < 0.001) knowledge scores for HBNC and HBYC items between ASHAs and Graduates.
Conclusions: This study provides a validated and reliable questionnaire to assess the HBNC and HBYC programs in Delhi.

Exploring the Scope of Probiotics to Combat Infectious and Nutritional Challenges across Africa

Laverdure Tchamani Piame — 2026-10-02

Context and objectives:
Probiotics are garnering significant interest for the prevention and management of infectious and nutritional diseases in Africa, a continent where malnutrition, HIV, and respiratory or diarrheal infections remain formidable challenges. However, clinical data regarding the use of specific probiotic strains in African populations are rarely synthesized. This review aims to provide a thorough overview of the current state of knowledge on probiotic applications for human health in Africa.
Search strategy
A targeted literature search was conducted in PubMed, Scopus, and Web of Science using MeSH terms and free-text keywords on November 2025, with priority given to randomized controlled trials and pilot studies conducted in African populations
Clinical evidence and health impacts
The evidence demonstrates that specific probiotic strains significantly reduce the duration and severity of acute infantile diarrhea and promote the restoration of beneficial gut microbiota in malnourished children. Furthermore, probiotics show promise in modulating systemic immunity and managing urogenital infections. However, their impact on anthropometric growth and respiratory infections remain modest and inconsistent across studies. Notably, a critical finding suggests that certain strains might increase HIV vulnerability by elevating activated endocervical CD4+ receptors.
Future Outlook: Probiotics represent a potent, low-cost therapeutic avenue for Africa, yet current data are insufficient to support generalized clinical guidelines.

Utility of the Neutrophil-to-Lymphocyte Ratio, in Differentiating Childhood Pulmonary Tuberculosis from Bacterial Pneumonia: A Cross-Sectional Study from a Peripheral Hospital in Suburban Mumbai

Prajakta Joshi — 2026-10-02

Background: Childhood pulmonary tuberculosis (TB) can clinically mimic bacterial community-acquired pneumonia (CAP), making diagnosis difficult, particularly where microbiological confirmation is delayed or unavailable. Complete Blood Count (CBC)-derived parameters, especially the neutrophil-to-lymphocyte ratio (NLR), may provide a simple and low-cost adjunct for differentiation.
Objective: To evaluate whether routine CBC parameters and the NLR can help differentiate childhood pulmonary TB from bacterial CAP.
Methods: This cross-sectional comparative study included 30 hospitalized children aged 2–14 years from a peripheral hospital in suburban Mumbai (January–July 2026), comprising 15 bacterial CAP and 15 pulmonary TB patients. Clinical features and CBC parameters, including NLR, were compared between groups based on established diagnostic criteria.
Results: The mean age was 5.85±3.00 years in the pneumonia group and 7.47±3.25 years in the TB group (p=0.168). Males constituted 60.0% of the pneumonia group and 53.3% of TB group (p=1.000). Mean WBC count was higher in children with pneumonia than in those with TB (14,009.33±3,898.98 vs. 12,038.67±3,952.76/?L; p=0.180). The mean neutrophil percentage was also higher in pneumonia (74.52±12.70% vs. 66.46±12.32%; p=0.089), whereas lymphocyte percentage was higher in TB (25.23±10.96% vs. 18.71±11.82%; p=0.128). Mean platelet count was 282,867±71,773/?L in pneumonia and 328,200±77015/?L in TB (p=0.107). CRP was higher in pneumonia than TB (17.42±18.29 vs. 8.04±9.21; p=0.091). The NLR was significantly higher in bacterial pneumonia than pulmonary TB (7.26±6.67 vs. 3.21±2.08; p=0.038), with a mean between-group difference of 4.05.
Conclusion: Among the evaluated CBC-derived parameters, NLR showed the clearest discriminatory signal between bacterial pneumonia and pulmonary TB, with higher values observed in bacterial pneumonia and may serve as an inexpensive, readily available supportive marker for differentiation. Larger multicentre studies are needed to validate its diagnostic utility.

Knowledge, Attitude and Practice of Cervical Cancer among women residing in an Urban area of Y.S.R. Kadapa: A Community-based Cross-sectional study

Divya Sree Akuthota — 2026-10-02

Cervical cancer is a leading cause of morbidity and mortality among women in India. Despite the availability of effective screening methods and HPV vaccination, their utilisation remains low due to inadequate awareness and socio-cultural barriers. This study aimed to assess the Knowledge, Attitude and Practices (KAP) regarding cervical cancer among women in an urban area of Y.S.R. Kadapa, Andhra Pradesh
Material and Methods:
A community-based cross-sectional study was conducted from November to December 2023 among 424 women aged 25–60 years using multi-stage random sampling. Data was collected using a pre-tested semi-structured questionnaire by the face-to-face interview technique. Statistical analysis was performed using Epi Info, and associations were tested using the Chi-square test/Fisher’s exact test (p<0.05).
Results: The majority (89.6%) of participants had poor knowledge, while only 1.9% had good knowledge regarding cervical cancer. However, 63.4% showed a positive attitude towards prevention. Screening practices were extremely low, with only 0.7% ever screened and none vaccinated against HPV. The major barriers identified were lack of awareness (43.2%) and perceived lack of need (30.6%). Only 27.6% expressed willingness for future screening. Significant associations were observed between knowledge and selected socio-demographic factors.
Conclusion: There exists a substantial gap between knowledge and preventive practices. Improving awareness through targeted health education, addressing misconceptions, and enhancing accessibility to screening and vaccination services are crucial for effective cervical cancer prevention.

Clinical Reasoning Skills of Registered Nurses in Individualized Nursing Care Planning and Quality of Patient Care in Tertiary Hospitals

Louisa Lodi — 2026-10-02

Background:
Nursing care plans are essential for providing personalized and well-coordinated patient care. This study assesses nurses' proficiency in developing nursing care plans within an academic hospital.
Methods:
A cross-sectional study was conducted in selected wards involving 273 registered professional nurses, chosen through a random sampling approach. Analyses were conducted using STATA version 16.1 (StataCorp, Texas, USA), with a p-value of 0.05 considered statistically significant.
Results:
The findings show that out of 218 participating nurses (79.9% response rate), most nurses, 207 (94.8%), were knowledgeable in writing nursing care plans. Additionally, 136 (62.4%) had a positive attitude, but notably, 128 (58.7%) demonstrated poor practice. Nurses in psychiatry, obstetrics and gynaecology, and paediatrics wards were more knowledgeable (p<0.05). Moreover, those aged 60+ had less favourable attitudes (p<0.05), and those with over five years of experience were more likely to have poor practices (p<0.05).
Conclusion:
This study highlights the need for systems that connect academic knowledge with clinical practice through ongoing and specialized training. Improving practical skills in care plan development is crucial for enhancing patient care quality, increasing workflow efficiency, and boosting nurses’ satisfaction. This research adds to the discussion on nursing education and practice transformation in resource-constrained healthcare environments.

The association between iron profile studies and febrile seizures in age group 6 months - 5 years

Prajakta Joshi — 2026-10-02

Abstract: Children with febrile seizures often demonstrate lower hemoglobin levels, reduced serum ferritin, and altered iron indices compared with febrile children without seizures. These findings suggest that iron deficiency may act as a modifiable risk factor by lowering seizure threshold during febrile illnesses. Hence, this study was undertaken to assess the association between iron profile and febrile seizures in children aged 6 months to 5 years. This was a cross-sectional observational study carried at department of Paediatrics. Total 200 study participants were enrolled in this study with mean age was 27.57 ± 16.25 months. Most of the study participants who developed febrile seizures belonged to the 25–60 months. About 120 (60%) were males and 80 (40%) were females. Family history of febrile seizure was present in 38 (19%) and about 28 (14%) had recurrence of seizure during same illness. About 152 (76%) were found to be iron deficient, while only 48 (24%) had normal iron status. Moderate anemia was the most common hematological finding seen in 74 (37%) study participants followed by mild anemia in 52 (26%). There was statistically highly significant association between serum Iron level and Serum ferritin level with the occurrence of febrile seizure (p <0.01). There was no association found between MCV, TIBC, Transferrin saturation and duration of seizure during febrile seizure episode. Based on the findings of this study, it can be concluded that iron deficiency anemia is significantly associated with febrile seizures in children aged 6 months to 5 years.

The effect of maternal anemia on the anthropometric measurements in full term neonates

Preeti Jain — 2026-10-02

Background: Maternal anemia during pregnancy, prevalent in developing countries like India, is associated with adverse neonatal outcomes, including impaired anthropometric measurements. This study aimed to evaluate the effect of maternal anemia on the anthropometric measurements of full-term neonates.
Method: The study included 200 pregnant women (singleton pregnancies, aged 18-40 years, 37-41 weeks of gestation) presenting for antenatal care or labor. Data on hemoglobin levels, BMI, IFA supplementation, dietary intake, and pregnancy spacing were collected. Neonatal anthropometric measurements were analyzed based on the severity of maternal anemia.
Results: During the study period, a total of 3640 pregnant women were attended to our hospital, out of them 200 pregnant women had anemia. Thus, the prevalence of anemia in the present study was 5.49%. Among the anemic mothers, 171 (85.5%) women had mild, 24 (12%) had moderate, and 5 (2.5%) had severe anemia. Severe anemia was associated with lower mean neonatal weight (3.27±0.61 kg), length (48.69±1.31 cm), head circumference (34.04±1.45 cm), and chest circumference (32.43±1.63 cm) compared to mild and moderate anemia. Significant associations were observed between maternal hemoglobin levels and neonatal length, head circumference, and chest circumference (p<0.05). The percentile distribution of weight-for-age, length-for-age, and weight-for-length were significantly affected (p<0.0001), but head circumference-for-age was not. Maternal BMI, IFA supplementation, calorie intake, and pregnancy spacing positively influenced neonatal anthropometry. Conclusion: Maternal anemia adversely affects neonatal anthropometric measurements, particularly in severe cases. Improving maternal hemoglobin levels through prenatal interventions and addressing nutritional deficiencies is essential to optimize fetal growth and neonatal well-being.

1 www.gjmedph.com Vol. 15, No.4, 2026 ISSN# 2277-9604 Role of serum inflammatory biomarkers in diagnosis and therapeutic follow-up of neonatal sepsis: a longitudinal study from eastern India

Bushra Aslam — 2026-10-02

Objectives: The study aimed to compare levels of serum inflammatory biomarkers (CRP, PCT and IL-6) on Day 0,1 and 7 of intravenous antibiotic administration. It also measured their sensitivity, specificity, and predictive values in relation to blood culture in clinically suspected patients of neonatal sepsis.
Methods: An institution based, descriptive study with longitudinal study design was conducted over a period of 12 months at a tertiary care institute in eastern India. Neonates presenting with clinically suspected neonatal sepsis, fulfilling the inclusion criteria were included after informed written consent from parents. The study population was divided into 4 categories according to sepsis score and median levels of serum biomarkers were compared across the groups on day 0,1 and 7. Diagnostic accuracy: The data was tabulated in Microsoft excel and analysed with SPSS V.24 software. Sensitivity, specificity, positive predictive value, negative predictive value, and Receiver operating characteristic (ROC) curve analysis were done. A p-value of <0.05 was considered statistically significant for all tests performed. Therapeutic follow-up: The data was tabulated in Microsoft excel spreadsheets and analysed with Jamovi 2.7.3. The normality of data was tested by Shapiro-Wilk test. As the data was not normally distributed, Friedman Rank by Analysis of variance (ANOVA) was applied for statistical analysis of biomarkers (on Day 0, Day 1 and Day 7). Chi-square/ Fischer exact test was done for statistical analysis of categorical variables. A p value of <0.05 was considered statistically significant.
Results: IL-6 was found to have higher sensitivity and specificity than PCT and CRP. ROC curve analysis showed statistically significant association (p value < 0.001). The median score of each biomarker was decreased with administration of antibiotics. Friedman Rank by ANOVA test showed significant statistical association (p value
<0.05) of biomarkers (IL-6, PCT, CRP) at Day 0, Day 1 and Day 7 with antibiotic administration. Significantly higher median values of biomarkers (p value < 0.001) on day 7 were recorded in patients requiring any intervention- antibiotic upgradation, inotropes, mechanical ventilation, NICU transfer.
Conclusion: Procalcitonin and Interleukin-6 help in early diagnosis of neonatal sepsis and facilitate timely initiation of antibiotics. C-reactive protein should be used in conjunction with PCT/IL-6 in cases with clinical symptoms of sepsis but negative CRP to prove sepsis. IL-6 and PCT levels help in monitoring response to therapy, thus they can be used to avoid prolonged use of unnecessary antibiotics and reduce hospital stay.