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Primary Healthcare Services01:30

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Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
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Disease surveillance is the systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice. This process integrates data dissemination to entities responsible for preventing and controlling disease, injury, and disability. Surveillance systems provide crucial information for action, helping public health authorities make informed decisions to manage and prevent outbreaks, ensure public safety, optimize...
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Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
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Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
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Redefining HCC Surveillance in India: A Call for Innovative and Inclusive Strategies.

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Hepatocellular carcinoma (HCC) diagnosis in India needs improved strategies beyond current ultrasound and AFP testing. New methods like blood markers and digital technology could enhance early detection and patient outcomes in resource-limited settings.

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Area of Science:

  • Hepatology
  • Oncology
  • Public Health

Background:

  • Hepatocellular carcinoma (HCC) is a leading cause of cancer death in India, with rising incidence.
  • Chronic HBV infection is a primary cause, but metabolic dysfunction-associated steatotic liver disease (MASLD) is emerging.
  • Most HCC cases are diagnosed late, leading to poor prognosis and limited treatment options.

Purpose of the Study:

  • To re-evaluate current surveillance and diagnostic strategies for early-stage HCC in India.
  • To explore alternative and improved screening approaches considering the changing epidemiology.
  • To address limitations of existing methods, particularly for MASLD patients.

Main Methods:

  • Review of current Indian National Association for the Study of Liver (INASL) guidelines for HCC surveillance.
  • Analysis of limitations of six-monthly ultrasound (USG) and Alpha Fetoprotein (AFP) testing.
  • Exploration of international models (e.g., Japanese guidelines) and emerging technologies (e.g., PIVKA II, GALAD/GAAD scores, digital health).

Main Results:

  • Current HCC surveillance in India is not well-organized and has significant limitations, especially for MASLD.
  • A shift towards community-based screening using blood markers and digital technology is proposed.
  • International data suggests newer markers and algorithms can refine surveillance.

Conclusions:

  • A radical change in HCC screening strategy is necessary for India.
  • Integrating advanced markers, digital health, and potentially community-based approaches can improve early detection.
  • Establishing a nationwide chronic liver disease registry and centers of excellence is crucial for effective implementation and improved patient outcomes.