Rakesh Kakkar | All India Institute of Medical Sciences (original) (raw)

Papers by Rakesh Kakkar

Indian Journal of Community Health

Background: The dermatological condition accounts for an important public health problem of the g... more Background: The dermatological condition accounts for an important public health problem of the global load of disease in low and middle-income countries and places significant pressure on primary healthcare centers. There is heterogeneity in the frequency of diverse skin conditions between different areas (1). Most of the knowledge presently available about various aspects of skin diseases is based on observations made and data collected from secondary and tertiary level hospitals (2). Information on community-based prevalence and pattern of skin diseases would be a better measure of burden due to skin diseases in general population in order to assist in the planning of possible intervention strategies (3). Aims & Objectives: To find out the prevalence, distribution, and determinants of various dermatological manifestations at the community level in Doiwala block of district Dehradun. Material & Methods: This cross-sectional study was conducted over a period of 12 months, the study...

International Journal of Preventive Medicine, 2021

Background: Globally Noncommunicable Diseases is lead causes of mortality. This calls for the nee... more Background: Globally Noncommunicable Diseases is lead causes of mortality. This calls for the need of sensitive and cost appropriate screening tools to identify asymptomatic healthy individuals with higher risk and/or subclinical NCD in the community. The study aims to generate pilot evidence based, validated, good quality, cost appropriate, and sustainable risk assessment score for NCD for developing countries like India. Methods: This descriptive retrospective study of diabetic camp data of 84 patients was conducted. A risk score having 10 questions and three measurements for NCDs appropriate for Indian communities was generated. It was compared to IDRS, FINDRISC, FRS, CBAC, and WHO/ISH prediction charts. Results: The study finally included 36 patients with NCD as case and 44 subjects without NCD as control. The means of weight, waist circumference, blood pressure, and blood sugar were significantly different among the two groups. AMNRAS of more than 14 was highly predictive for a...

International Journal of Medicine and Public Health

Background: The current Coronavirus pandemic has infected more than 15 million people worldwide a... more Background: The current Coronavirus pandemic has infected more than 15 million people worldwide and has been responsible for more than 630,000 deaths worldwide, a significant number of which has been healthcare professionals. Povidone-iodine (PVP-I) has been known as microbicidal agent since the past few decades and it has also demonstrated better anti-viral activity than other antiseptics in a few in vitro studies against other coronaviruses (SARS-CoV and MERSCoV). Povidone iodine has also been found to be a safe and effective solution to be used as a gargle or intranasally. Aim and Objectives: Through our study, we would like to propose the application of PVP-I in appropriate and safe concentration through nasal application and oropharyngeal wash to limit the spread of the virus from infected patients to healthcare workers and thus reduce the transmission of COVID-19. Methods: This application is to be done according to the proposed protocol, which has been devised keeping in mind the feasibility, safety and efficacy of PVP-I application. This should be used regularly by patients with a suspected or confirmed COVID-19 infection to not only prevent the spread, but also by healthcare workers prior to treating such patients, or performing perioral or nasal procedures during the pandemic, regardless of the status of the patient. Patients undergoing such procedures should also be treated with PVP-I. The total iodine exposure according to the proposed protocol has been found to be within previously recorded safe limits. Conclusion: We hypothesize that usage of PVP-I as a personal protective equipment at the portal of entry would help decrease the rates of transmission of the SARS-CoV-2 infection.

Background: The assessment of quality of life (QOL) is a particularly important public health too... more Background: The assessment of quality of life (QOL) is a particularly important public health tool for the elderly in an era when life expectancy is increasing. Objectives: To measure the Quality of Life among the elderly and identify its determinants. Methodology: This cross-sectional study was conducted on 220 elderly residing in rural areas of Dehradun district after taking written informed consent. Multistage random sampling was done to select the study subjects. Standardized WHO questionnaire on QOL for the elderly (WHOQOL-OLD) was used to assess the QOL. Statistical analyses were done by SPSS-22. Results: Out of 220 subjects, 55.5% were females and the rest were males. Maximum percentage of respondents were in the age group of 66-75 years (46.4%). The mean (±SD) of transformed total QOL score (TTS) was 57.76 (±10.97). The mean score of facet V (death and dying) was the highest (82.58) and the lowest mean score was observed in facet VI, intimacy (44.83). Overall QOL scores were...

Nepal Journal of Epidemiology, 2016

Secondary prevention by community physician can be provided at PHC & CHC level. Focus should alwa... more Secondary prevention by community physician can be provided at PHC & CHC level. Focus should always be on early detection of diseases through screening programmes and prevention of mortality. Prevention of chronic morbidity and functional impairment should be emphasized more. At policy level advocacy should be done for providing essential medication like insulin available and affordable to all who need them. At tertiary level rehabilitation, disability limitation and palliative care of person with NCDs is also needed.

Introduction: Maternal morbidity and mortality in India continues to remain high despite concerte... more Introduction: Maternal morbidity and mortality in India continues to remain high despite concerted efforts during the past decades. Aim &Objective:To determine the prevalence of demographic determinants of maternal 'near miss' cases in rural Uttarakhand. Material and Methods: A cross-sectional study, over a period of 12 months was conducted as per the WHO criteria for 'near-miss' by using Probability sampling for random selectionof health facilities. All the women attending health-care facilities, who were pregnant, in labour, or who had delivered or aborted up to 42 days ago arriving at the selected health facility were included. Result: A significant association between maternal outcome and age of study population was found. Out of total 937 pregnant women, there was a significant association between state of residence and development of PLTC. Majority 27 (52.94%) cases of the 'near miss' cases had gestational age ranging between 24-36 weeks. In the cases of maternal death 50% of the death occurred in women with more than 36 weeks of gestation. Conclusion: The WHO 'near miss' approach has been found to be an effective measure to assess quality of care in maternal health across countries including India.

Objective: The study was conducted to estimate the morbidity and mortality status of general popu... more Objective: The study was conducted to estimate the morbidity and mortality status of general population in the Hoshangabad District. Methodology: This is a community-based cross-sectional (descriptive) study carried out in the Hosangabad district of Madhya Pradesh covering of 509 families comprises of 2985 population. Sample was selected by multistage sampling technique. Result-A total of 2985 respondents, 725 (24%) were from Rural areas and 2260 (76%) from Urban areas. Major cause 640 (21%) of morbidity were due to acute illnesses. In acute illnesses most common was Acute Respiratory Infection241 (8.07%) followed by worm infection 84 (2.81%) and gastroenteritis 58(1.94%). Prevalence of ARI was higher in rural areas but gastroenteritis was higher in urban areas. Most common cause of chronic morbidity among studied population was cataract 42 (1.37%) followed by arthritis 24 (0.80%) and chronic amoebiasis 21 (0.70%). Acute morbidity in urban areas was higher in females (20%) than males (15%). Age specific mortality rate for age group 0-1 and 46-60 & above were significantly higher in rural areas than urban areas. Mortality rate were higher in females (9.7/1000) than males (7.2/1000). Most common cause of mortality in rural areas were diarrhoea, vomiting and dehydration (DVD) 7(38%) followed by cardiac diseases 3(17%) and in contrast urban areas were cardiac diseases 3(43%) followed by 1 (14%) DVD.

Ageing is inevitable; it is a natural phenomenon and has its own dynamics, which is beyond human ... more Ageing is inevitable; it is a natural phenomenon and has its own dynamics, which is beyond human control. Sir James Sterling Ross commented that “you don’t heal old age, you protect it and you promote it” these are the principles of Preventive Medicine1.The Indian elderly population is currently the second largest in the world2. The proportion of elderly population in India rose from 5.6% in 1961 to 7.5% in 20013 & it will rise to 9% by 20164.

... Search result page. Title: Geographical Distribution, Effect of Season &amp;. Author:... more ... Search result page. Title: Geographical Distribution, Effect of Season &amp;. Author: Parag Sharma, Rakesh Kakkar, Shilpa.N.Kaore,Vijay. K. Yadav, Raj Sharma. Abstract: Not Available. Journal: JK Science : Journal of Medical Education &amp; Research. Issn: 09721177. EIssn: Year: 2010 ...

International Journal Of Community Medicine And Public Health, 2018

Background: The first six years of a child’s life are most crucial as the foundations for cogniti... more Background: The first six years of a child’s life are most crucial as the foundations for cognitive, social, emotional, physical, motor and psychological development are laid at this stage. The present study was conducted to assess the nutritional status of children availing the services under Integrated Child Development Service Scheme.Methods: The study was done with house to house survey with the help of a prepared scheduled proforma by personal interview and taking necessary anthropometric measurements and clinical examination. In the present study the following age independent criteria's are taken into account for the assessment of the nutritional status of the (3-5 years) age group of children in both the I.C.D.S and non I.C.D.S area separately: Mid upper arm circumference; Kanwati’s index; Rao’s index; Bangle screening method.Results: The association of nutritional status and MUAC measurement is statistically significant…

International Journal of Epilepsy

Introduction Incidence is the number of new epilepsy cases occurring during a given time interval... more Introduction Incidence is the number of new epilepsy cases occurring during a given time interval, usually in 1 year, in a specified population. Most incidence studies of epilepsy are from developed countries with a rate of 40 to 70 per 100,000 population. Aims We conducted this survey to study incidence of all new onset unprovoked in rural and semiurban areas of the Uttarakhand State. This study is conducted on more than 100,000 of population with longitudinal follow-up of 3 years. Methods This was a community-based, longitudinal, observational study in two blocks of Dehradun district of Uttarakhand state. Total population of approximately 100,000 from two blocks will be surveyed (50,000 in each block). This door-to-door survey was conducted annually for 3 years duration from May 2014 to April 2017. The initial data were collected on National Institute of Mental Health and Neurosciences (NIMHANS) questionnaire by door-to-door survey. Results After longitudinal follow-up for 3 years...

Journal of Family Medicine and Primary Care

Introduction: Malnutrition and tuberculosis are the major concerns of underdeveloped regions of t... more Introduction: Malnutrition and tuberculosis are the major concerns of underdeveloped regions of the world. Undernutrition increases the risk of tuberculosis (TB) and in turn TB can lead to Malnutrition. Undernutrition is therefore highly prevalent among people with TB. It has been demonstrated that undernutrition is a risk factor for progression from TB infection to active TB disease and severe form viz. MDR-TB. Undernutrition is a predictor of increased risk of death and TB relapse. Objectives: To study the effect of nutrition in MDR-TB patients at DR-TB centre, Dehradun. Methodology: The Observational cross sectional study was conducted at Drug Resistant Tuberculosis (DR-TB) Centre of HIMS, Dehradun over a period of 12 months to include all the cases reported from 1st October, 2011 (start of DR-TB Centre at HIMS, Dehradun) to 30th April, 2014. 376 Subjects were recruited from 1598 suspected MDR TB subjects who were screened by Drug Susceptibility Testing (DST) results. Results: Out of 376 MDR-TB patients, 258 (68.6%) subjects were found to be undernourished. The mean body mass index (BMI) was 17.33+1.99 kg/m 2 . Though undernutrition was more common among Males (61.2%) but female’s BMI was more affected by MDR in comparison to males. Treatment success was better amongst males between 21- 60 year age group with normal BMI having mono drug resistance with no adverse reaction. The majority 47 (18.2%) of adverse effect was found in undernourished patients. Treatment outcome was also poor among undernourished (76.9%) MDR-TB patients. Conclusion: Prevalence of undernutrition was high (68.6%) among subjects and the mean BMI was lower in female. Adverse drug reaction, poor treatment outcome are attributes of Undernutrition.

Nepal Journal of Epidemiology

Background: The present retrospective study on urinary stone disease in the Uttarakhand state was... more Background: The present retrospective study on urinary stone disease in the Uttarakhand state was necessitated as no study has been done yet. Methods: A retrospective study covering a period of about 13 years (2005-18) was conducted on the urinary stones removed from the patients, admitted at Himalayan Institute of Medical Sciences, Dehradun. The incidence of the disease, site of stones in urinary tract upon diagnosis, composition of removed stones and occurrence of a possible co-relationship between the incidence of the urinary stone disease at different times, age, sex, religion of the patients was investigated. Results: The frequency of occurrence of urinary stones in males was found to be almost three times more as compared to their female counterparts. The above trend was consistent over the entire period of the study. Interestingly, in the Muslim and Sikh population of the area, females were found to be less prone to the problem as compared to their Hindu counterparts. Howeve...

In the present study, based upon their total serum bilirubin values ranging from 0.3-30.8 mg/dl, ... more In the present study, based upon their total serum bilirubin values ranging from 0.3-30.8 mg/dl, 47 patients visiting OPD and IPD of HIMS were divided into five groups. Their serum creatinine levels were estimated by the Jaffe’s and the Enzymatic methods. Total serum bilirubin concentration was estimated by the timed endpoint Diazo method. Results obtained during the studies revealed that in all the five groups, estimation of serum creatinine by the Jaffe’s method always gave significantly higher values (p< 0.01) as compared to their estimated values by the Enzymatic method at the identical serum bilirubin concentrations. The differences in the mean values of serum creatinine obtained between the two methods were found to significantly increase with the increase in the serum total bilirubin concentrations. At serum total bilirubin concentration of < 2.0 and >20.0 mg/dl, the mean differences between the Jaffe’s and Enzymatic methods were found to be 0.2206  0.0508 and 0.678...

Vital registration of births and deaths (including, marriage, divorce, and adoption) is the impor... more Vital registration of births and deaths (including, marriage, divorce, and adoption) is the important act of recording and documenting of vital events in a personâ€™s life and is therefore a fundamental function of governments. Registration of vital events contributes in administration and governance by giving every person with legitimate individuality and civilian identity and this population database can be used as the source of civil registries

Indian Journal of Community Health, 2013

Introduction: Tuberculosis is a disease of poverty affecting mostly young adults in their most pr... more Introduction: Tuberculosis is a disease of poverty affecting mostly young adults in their most productive years. WHO has suggested that the expected effect of improved diagnostic and treatment services may be negated by an increase in the prevalence of risk factors for the progression of latent TB to active disease in segments of the population. The risk factors broadly described may be biomedical, environmental or socioeconomic. The impact of these other determinants on TB epidemiology in India has yet to be fully understood . Methodology: Study was undertaken on all patients in the age group of 18 years and above with history of cough for more than 2 weeks attending DOTS Microscopy centre of HIMS with or without other symptoms suggestive of tuberculosis attending DOTS Microscopy centre for a period of six months i.e. from 1st July to 31st December 2010 were included in study group. Total patients attended the centre were 538. Results: Majority of participants were farmers 159(43.9...

Indian Journal of Community Health, 2020