Natl Med J India
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Comparative Study
A comparative study of the informed consent process with or without audiovisual recording.
The Central Standard Drugs Control Organization (CDSCO) issued an administrative order in November 201 3 mandating audiovisual (AV) recording of the informed consent process for all regulatory studies. At this point, a phase 2/3 trial ongoing at our centre had recruited 45 participants using the written, informed consent process. Another 40 participants were recruited after the order and underwent AV recording of the consent process. We assessed the difference in participants' understanding between the two consenting processes as the trial fortuitously had both forms of consent. ⋯ AV recording of the informed consent process in a clinical trial appears to improve the understanding of participants relative to the written informed consent alone.
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Inappropriate footwear may be a major cause of foot ulceration among patients with diabetic neuropathy in India. No study has specifically examined the types of footwear or its components in patients with diabetes mellitus and their role in causing foot ulcers. We analysed the role of commonly used footwear in India in inducing first foot ulcers (FFU) in people with diabetes. ⋯ The use of softer insole is least effective in preventing foot ulcers. Similarly, straps contribute to a higher percentage of foot ulcers. Foot ulcers can be prevented by a combination of soft insole, with midsole and hard outsole with proper back counter and adjustable front and back straps.
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Growing evidence suggests that non-communicable diseases (NCDs) result in considerable economic burden for individuals and households. With the poor facing a greater burden of NCDs than the rich in India, we undertook this study to analyse the horizontal equity in utilization and vertical equity in out-of-pocket expenditure for NCD care. ⋯ Public facilities are utilized more by poorer individuals. Strengthening the capacity of the public sector to deliver NCD care is required to meet equitable outcomes.
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Since 201 4, there is a shift in terror targets, with a 1 72% increase in the deaths of common citizens. India ranks fourth in the global terrorism index. ⋯ Health impacts of terrorism that affect vulnerable and non-combative citizens will need a well-developed healthcare delivery mechanism consisting of four components: medical preparedness, incident management, care of injuries and body functions, and intervention for psychological consequences. Terror medicine should not be considered a 'dangerous territory', as it can provide opportunities for healthcare to gain new strengths of knowledge and research, similar to the medical outcomes from the two world wars.
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Family studies are an integral part of teaching of community medicine to all undergraduate medical and nursing students. It enhances the understanding of students about social determinants and multifactorial causation of disease. However, there is no standard approach towards it and it is seen as a clinical presentation with some elements of family included. We describe a systematic and comprehensive approach to a family study. ⋯ Availability of a systematic and comprehensive approach would improve students' understanding of the social model of disease and multifactorial causation of disease. It will also provide a standardized method of teaching this important component of community medicine nationally.