Background: Timely pre-hospital care is critical in rural Nepal where formal Emergency Medical Services are scarce. In 2018, a three-day Community First Responder (CFR) program was delivered to more than 200 community volunteers in Geruwa Rural Municipality, Bardiya, Nepal; however, long-term effectiveness and degree of skill decay remained unknown. Purpose: To quantify first-aid knowledge retention and on-scene application among CFRs five years after their initial training. Method: A mixed-methods follow-up study was conducted in 2024. Quantitatively, 25-item validated MCQ administered to all reachable CFRs (n = 112). Qualitatively, in-depth interviews with two active CFRs and one elected ward chairperson. Knowledge scores were categorized into quartiles (low, moderate, significant, higher retention). Self-reported emergency responses since training were enumerated and thematic analysis of barriers performed. Results: The response rate was 100 %. Median post-course score was23/25; at five years 59 % of participants retained moderate knowledge, 36 % significant, 4 % higher and 2 % low. CFRs documented 510 real cases (trauma 35 %, burns 15 %, obstetrics 7 %, wildlife attacks 8 %). Complex skills showed the steepest decay: adult CPR ratio 4 % correct, snake-bite immobilization 5 %. Qualitative themes included language and literacy mismatches (Tharu vs. Nepali), transport delays, time-conflict with farming, demand for local refresher trainers. No serious adverse events were reported. Conclusion: Community-based CFR training yields measurable but partially decayed knowledge at five years, sustained by periodic field practice. Embedding language-appropriate refreshers, local trainers and transport solutions is essential to preserving life-saving competence in low-resource settings.

Background: Digital addiction is an emerging public health concern among adolescents, and India, with the world’s largest adolescent population, is particularly affected. This study estimated the prevalence and pattern of digital addiction among school-going adolescents and identified its socio-demographic and behavioural correlates. Methods: This cross-sectional analysis used baseline data from a cluster randomized controlled trial conducted in eight secondary schools (four government, four private) in India. A total of 400 adolescents aged 13–16 years (grades 8–10) were assessed using Young’s Internet Addiction Test (IAT-20), the Smartphone Addiction Scale–Short Version (SAS-SV), a socio-demographic and digital-use questionnaire, and the Depression Anxiety Stress Scales-21 (DASS-21). Factors associated with internet addiction were examined using multivariate logistic regression. Results: The mean age of participants was 14.25 ± 1.05 years; 57.5% were male, and 94.0% owned smartphones. On the IAT-20, 44.5% of adolescents had mild, 19.0% moderate, and 3.0% severe internet addiction; 66.0% were classified as smartphone-addicted on the SAS-SV. Mean daily screen time was 4.85 ± 2.15 hours, with 29.0% exceeding six hours per day. On multivariate analysis, urban residence (AOR 2.40, 95% CI 1.80–3.30), father’s education graduate and above (AOR 3.30, 95% CI 1.70–4.30), higher family income (AOR 1.90, 95% CI 1.50–3.51), smartphone use for more than three years (AOR 2.08, 95% CI 1.70–3.60), authoritarian (AOR 2.86, 95% CI 1.68–4.86) and permissive (AOR 2.34, 95% CI 1.42–3.86) parenting styles, daily screen time above six hours (AOR 4.56, 95% CI 2.68–7.76), and severe psychological distress (AOR 10.82, 95% CI 5.11–22.88) were significantly associated with internet addiction. Conclusion: Two-thirds of school-going adolescents showed some degree of internet addiction, with psychological distress, prolonged screen time, and non-authoritative parenting emerging as the strongest correlates. School-based screening and multi-level preventive interventions involving families are urgently needed.

Background: India accounts for approximately a quarter of global cervical cancer deaths, yet screening coverage remains among the lowest worldwide. Understanding the knowledge deficits and health beliefs that underlie non-participation is essential for designing effective demand-generation strategies. This study assessed knowledge of cervical cancer and Visual Inspection with Acetic Acid (VIA) screening, Health Belief Model (HBM) profiles, and determinants of screening uptake among women aged 30–49 years. Methods: A community-based cross-sectional study was conducted among 300 women aged 30–49 years residing in the rural and urban health training centre catchment areas of a medical college hospital in Indore, Madhya Pradesh. Women who had not been screened in the preceding three years and who had no history of cervical cancer or hysterectomy were enrolled. Data were collected through face-to-face interviews using a structured socio-demographic and reproductive history schedule, a 25-item knowledge questionnaire, and a Hindi-validated adaptation of Champion’s Health Belief Model Scale (30 items across six constructs, 5-point Likert). Determinants of subsequent VIA screening uptake, verified through screening registers, were examined using logistic regression. Results: The mean age of participants was 39.7 ± 5.4 years; 60.3% were homemakers, 31.3% had no formal or only primary education, and 35.0% reported a monthly family income below ₹10,000. Knowledge of cervical cancer and VIA screening was low, with a mean score of 8.7 ± 3.2 out of 25. The HBM profile was characterized by high perceived barriers (3.45 ± 0.65), moderate perceived severity (3.35 ± 0.75), and low self-efficacy (2.85 ± 0.65) and cues to action (2.65 ± 0.75). On multivariate analysis, higher baseline knowledge (adjusted OR 1.11 per point, 95% CI 1.02–1.21, p = 0.02) and higher self-efficacy (adjusted OR 1.48 per unit, 95% CI 1.02–2.15, p = 0.04) independently predicted screening uptake, while age, income, and parity did not; education at secondary level or above showed a borderline association (adjusted OR 1.74, 95% CI 0.97–3.12, p = 0.06). Conclusion: Women in this population begin from a position of substantial knowledge deficit, high perceived barriers, and low self-efficacy. Because knowledge and self-efficacy independently predicted screening uptake, interventions that combine education with explicit barrier reduction and confidence building are likely to be more effective than awareness campaigns alone.

Background: Benign Prostatic Hyperplasia (BPH) is a prevalent urological condition among men, characterized by urinary difficulties, discomfort and diminished quality of life. Despite advances in medical intervention, inadequate self-care practices remain a significant challenge. Hence, the study assessed the self-care practices of patients with Benign Prostatic Hyperplasia (BPH) in three selected hospitals, Akwa Ibom State, Nigeria. Materials and Methods: A prospective cross-sectional study among 251 patients was conducted in selected hospitals using the Self-care questionnaire. Data on self-care practices were obtained and analyzed using statistical tools. Results: Patients with BPH self-care practices involves lifestyle/dietary modifications (Mean=2.90, SD=0.80), physical activity and exercise (Mean=2.70, SD=0.87) and bladder training and fluid management (Mean=2.67, SD=0.86) and medication adherence/follow-up (Mean=3.08, SD=0.76), which were rated moderate. In the domain of Physical activity and exercise, Item 12 indicated mean score of 2.38 and standard deviation of 0.95 indicating a low-level level of self-care practice of exercises patients with BPH in the selected hospital. Conclusion: Most patients actively engage in self-management behavior such as adhering to medication schedules, modifying diet, maintaining personal hygiene, and attending follow-up appointments. Such a positive trend may be attributed to increased health awareness and education from healthcare professionals.

Surgical Site Infection (SSIs) remain a major cause of postoperative morbidity worldwide. This descriptive cross-sectional study was conducted among 167 surgical patients at Chattogram General Hospital, Bangladesh, from September to December 2016 to assess the prevalence and determinants of Surgical Site Infections (SSIs). Data were collected using a pre-tested semi-structured questionnaire and analyzed using appropriate statistical methods. The prevalence of SSIs was 17.0%. Significant host-related factors included age, education, Body Mass Index, glycemic status, nutritional status, Erythrocyte Sedimentation Rate (ESR), and fever, while gender showed no significant association. Procedure-related factors such as prolonged hospital stay, duration of surgery, type of incision, cadre of surgeon, antibiotic use, presence of septic focus, and wound contamination were significantly associated with SSIs. However, type of operation and sutures materials were not associated. The findings highlight the multifactorial nature of SSIs and emphasized the need for strengthened infection prevention and control strategies in resource-limited settings.

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Background: Trust between doctors and patients is foundational to effective healthcare delivery. Communication behaviours of physicians have been identified as key antecedents of trust formation; however, empirical evidence from Indian healthcare contexts remains sparse. Objective: This study examines the impact of six physician communication strategies — active listening, empathetic communication, information disclosure, non-verbal cues, patient-centred communication, and shared decision-making — on doctor-patient trust and, consequently, on patient satisfaction in Indian outpatient settings. Methods: A sequential explanatory mixed-methods design was employed. Quantitative data were collected from 320 adult outpatients across government and private hospitals in three Indian cities using validated scales (WFPTS, PSQ-18, physician communication scales). Structural equation modelling (SEM) was used to test the proposed conceptual model. Qualitative data were gathered through 26 semi-structured interviews analysed using reflexive thematic analysis. Results: All six communication strategies significantly predicted doctor-patient trust (total R² = 0.61). Patient-centred communication (beta = 0.37) and empathetic communication (beta = 0.34) were the strongest predictors. Trust, in turn, strongly predicted patient satisfaction (beta = 0.69, p < .001). SEM confirmed model fit (CFI = 0.96, RMSEA = 0.049). Qualitative findings identified five trust-shaping themes: listening as trust currency, emotional validation, transparency, cultural congruence, and systemic barriers. Conclusion: Communication strategies are robust predictors of trust and satisfaction in Indian clinical encounters. Healthcare institutions should invest in structured communication training, ensure cultural and linguistic responsiveness, and address systemic barriers — particularly consultation time constraints — to strengthen the therapeutic relationship.