Yuvaraj Krishnamoorthy - Academia.edu (original) (raw)

Papers by Yuvaraj Krishnamoorthy

Irish Journal of Medical Science (1971 -)

Background Development of a prediction model using baseline characteristics of COVID-19 patients ... more Background Development of a prediction model using baseline characteristics of COVID-19 patients at the time of diagnosis will aid us in early identification of the high-risk groups and devise pertinent strategies accordingly. Hence, we did this study to develop a prognostic-scoring system for predicting the COVID-19 severity in South India. Methods We undertook this retrospective cohort study among COVID-19 patients reporting to Hindu Mission Hospital, India. Multivariable logistic regression using the LASSO procedure was used to select variables for the model building, and the nomogram scoring system was developed with the final selected model. Model discrimination, calibration, and decision curve analysis (DCA) was performed. Results In total, 35.1% of the patients in the training set developed severe COVID-19 during their follow-up period. In the basic model, nine variables (age group, sex, education, chronic kidney disease, tobacco, cough, dyspnea, olfactory-gustatory dysfunction [OGD], and gastrointestinal symptoms) were selected and a nomogram was built using these variables. In the advanced model, in addition to these variables (except OGD), C-reactive protein, lactate dehydrogenase, ferritin, d-dimer, and CT severity score were selected. The discriminatory power (c-index) for basic model was 0.78 (95%CI: 0.74-0.82) and advanced model was 0.83 (95%CI: 0.79-0.87). DCA showed that both the models are beneficial at a threshold probability around 10-95% than treat-none or treat-all strategies. Conclusion The present study has developed two separate prognostic-scoring systems to predict the COVID-19 severity. This scoring system could help the clinicians and policymakers to devise targeted interventions and in turn reduce the COVID-19 mortality in India.

Journal of Education and Health Promotion, 2018

BACKGROUND: Dengue is the most common life-threatening arboviral infection contributing to 92 mil... more BACKGROUND: Dengue is the most common life-threatening arboviral infection contributing to 92 million infections worldwide. India alone contributes for 34% of the global burden. Success of dengue control depends largely on adequate knowledge and good practices of preventive measures. However, there is a need to find the existing awareness among the general population, especially in rural areas. Thus, our present study was done to determine the awareness, attitude, and practice measures regarding dengue fever in rural Tamil Nadu. MATERIALS AND METHODS: A community-based cross-sectional survey was done among 303 individuals belonging to the selected village in rural Tamil Nadu during November 2016. Information regarding sociodemographic details and awareness, attitude, and practice toward dengue were collected using a semi-structured questionnaire. Adequacy of knowledge and attitude was summarized as proportion with 95% confidence interval. RESULTS: Among 303 participants, 204 (67.3%)...

Nigerian Postgraduate Medical Journal

Background Sex determination refers to knowing the sex of foetus during prenatal period for non-m... more Background Sex determination refers to knowing the sex of foetus during prenatal period for non-medical reasons. Attitude of married women to sex determination is important to improve the sex ratio at birth. Aim and Objectives This study aimed to assess preference on sex determination and associated factors among currently married reproductive age group women. Materials and Methods This cross-sectional community-based study was done during 2016-2017 among 2228 currently married women of 18-49 years' age group in urban and rural Puducherry, India. Information on the demographic characteristics, level of awareness and preference for sex determination was obtained. Multiple logistic regression was used to identify factors influencing preference for sex determination. Unadjusted and adjusted odds ratio (AOR) as a measure of effects was used. Results Of 1979 respondents, all were aware that sex determination is possible. Majority of them did not prefer sex determination (95.4%, 1888). About 80 (4.0%) preferred, while 11 (0.6%) were undecided about it. Majority of them were aware that sex determination without medical indication is a crime. Common source of information was healthcare workers (76.4%). After adjusting for confounders, age group (18-24, AOR = 5.334; 25-29, AOR = 3.249; 30-34, AOR = 3.857; 35-39, AOR = 2.279), middle level education (AOR = 2.3), those with unmet need for family planning (AOR = 2.970) and urban area (AOR = 67.679) subjects were preferred more; housewife (AOR = 0.481) and those without living son (AOR = 0.406) had preferred lesser for sex determination compared to their counterparts. Conclusion About one in 25 currently married women preferred sex determination. It is comparatively more in urban areas. High-risk groups should be educated to develop correct awareness and attitude on prenatal sex determination.

Indian journal of cancer, 2021

Background Breast and cervical cancers are the two leading causes of cancer-related morbidity and... more Background Breast and cervical cancers are the two leading causes of cancer-related morbidity and mortality in India. Early diagnosis of these cancers through screening offers the best chance to achieve successful treatment outcomes. Hence, the current study was done to determine the prevalence and predictors of breast and cervical cancer screening among women aged 30-49 years in India. Methods We have analyzed the most recent National Family Health Survey-4 data (NFHS-4) gathered from Demographic Health Survey program. Stratification and clustering in the sample design were accounted using svyset command. Adjusted prevalence ratio (aPR) with 95% confidence interval (CI) was reported. Results In total, 336,777 women aged 30-49 years were included. Proportion of women aged 30-49 years with history of breast cancer examination in their lifetime was 12.9% (95% CI: 12.6-13.2%), while it was 29.8% (95% CI: 29.3-30.3%) for cervical cancer. It was found that women aged 45-49 years (aPR=1.0...

Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine, 2019

Background: Low birth weight (LBW) is a major cause of neonatal morbidity and mortality. In addit... more Background: Low birth weight (LBW) is a major cause of neonatal morbidity and mortality. In addition to medical/clinical risk factors, various socio-demographic factors also have an impact on birth weight. Objective: The objective of the study is to determine the association of antenatal social support and spouse abuse during pregnancy with LBW in Urban areas of Puducherry. Materials and Methods: A community-based case–control study was conducted in Puducherry. Mothers of 100 LBW infants and normal birth weight infants in 2016 were studied. Functional Social Support Questionnaire and Index of Spouse Abuse scales were used. Conditional logistic regression for matched pair studies was done for multivariate analysis. Results: Mean (± standard deviation) age and education of the study participants was 25.6 (±3.5) and 8.28 (±3.6) years, respectively. The proportion of girl child was 59% and 43% among cases and controls, respectively. Mothers with higher perceived social support (odds rat...

Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 2020

Background: Breast cancer is the most common cancer accounting for about one-fourth of total canc... more Background: Breast cancer is the most common cancer accounting for about one-fourth of total cancer cases and 15% of all cancer deaths among women worldwide. It is important to determine its trend across the regions in the world to find the high-focus regions. Hence, the current study was done to assess the global trends and deviations in the incidence of breast cancer. Materials and Methods: A descriptive trend analysis was done using the data on breast cancer incidence from the WHO Cancer Incidence Data of Five Continents plus database. Joinpoint regression was performed to determine the average annual percent change (AAPC), and age-period-cohort analysis was done to obtain age-, period-, and cohort-specific deviations and rate ratio. Results: All the regions showed an increasing trend in breast cancer incidence, with an exception of America. Maximum increase was observed in Asia (AAPC = 2.6%; 95% confidence interval [CI]: 2.4%–2.9%) followed by Europe (AAPC = 0.7%; 95% CI: 0.5%–1...

Indian journal of cancer, 2021

Background Cervical cancer ranks fourth in global cancer incidence and mortality among women. A c... more Background Cervical cancer ranks fourth in global cancer incidence and mortality among women. A comparison of the global trends in cervical cancer would help us to identify high focus regions and serves an opportunity to evaluate the impact of the screening programs. Hence, the current study was done to assess the global trend in the incidence of cervical cancer from 1993 to 2012 among individuals aged between 30 and 79 years. Methods This secondary data analysis was conducted using the World Health Organization (WHO) Cancer Incidence data of five continents plus database (America, Asia, Europe, and Oceania) on the incidence of cervical cancer. Joinpoint regression was performed to determine the average annual percent change (AAPC) in cervical cancer incidence. We performed an age-period-cohort analysis to obtain age, period, and cohort-specific deviations and rate ratio (RR). Results Out of the four regions studied, all the regions showed a declining trend in cervical cancer incide...

International Journal Of Community Medicine And Public Health

Background: India contributes to one-third of rabies death globally. Despite the efforts taken by... more Background: India contributes to one-third of rabies death globally. Despite the efforts taken by government, Rabies incidence in India has been constant for over a decade. Hence, there is need to assess the awareness and treatment-seeking behaviour which will help to plan strategies to prevent rabies related deaths. The objective of the study was to assess the awareness about rabies among general population and to determine the treatment-seeking behaviour and adherence to anti-rabies vaccine among victims of dog-bite in rural PuducherryMethods: Community based cross-sectional study was conducted during November 2016 in rural Puducherry. 386 individuals were covered in four villages. Information on socio-demographic characteristics and awareness regarding rabies, treatment-seeking behaviour and adherence to anti-rabies vaccine among dog-bite victims was collected using pre-tested questionnaire.Results: Among 386 participants, 244 (63.2%) were in the age group 31-60 years, 259 (67.1%...

Indian Journal of Tuberculosis, 2021

Background Timika scoring system is a radiographic grading tool, widely employed for grading the ... more Background Timika scoring system is a radiographic grading tool, widely employed for grading the severity of tuberculosis (TB). We evaluated the predictive accuracy of this tool for adverse treatment outcomes among TB patients in Indian setting. Methods We undertook a longitudinal analysis of cohort data under the RePORT-India consortium. Cohort having participants with active pulmonary TB were included. CXRs were independently scored by chest physicians. Timika scoring system had a total score of 140. The predictive nature of the tool was assessed using the ROC analysis. Results Around 364 laboratory confirmed TB patients were enrolled. The mean (SD) of overall Timika score was 62.3 (24.9). Sputum conversion was achieved among 218/260 (83.8%) patients available at end of intensive phase. AUC for Timika score was 0.53 (95%CI: 0.43-0.63) and for percent lung affected, was 0.56 (95%CI: 0.46-0.65). Unfavorable treatment outcome was observed among 67/287 (23.3%) at the end of continuati...

Journal of Education and Health Promotion, 2018

BACKGROUND: India is currently having a deceased donation rate of 0.05–0.08 per million populatio... more BACKGROUND: India is currently having a deceased donation rate of 0.05–0.08 per million population. The National Organ and Tissue Transplant Programme have planned strategies to improve organ donation by creating awareness and capacity building. There is great need to assess the knowledge regarding organ donation among general population. OBJECTIVE (S): Among the adult population (≥18 years) residing in urban slum of Puducherry to determine the knowledge, attitude, and practice regarding organ donation. MATERIALS AND METHODS: Community-based cross-sectional study was conducted during April to May 2017 among 257 randomly selected participants in selected wards of urban Puducherry. Data regarding knowledge, attitude, and practice were collected through pretested semi-structured questionnaire. RESULTS: Mean (standard deviation) age of the study participants was 45 (15) years and majority (57%) were female, 41% of them were educated more than secondary. Almost 90% of the study participa...

Journal of Education and Health Promotion, 2018

BACKGROUND: Patients with cancer often delay seeking medical advice in developing countries. In I... more BACKGROUND: Patients with cancer often delay seeking medical advice in developing countries. In India, only 20%–30% of cancers are being diagnosed in Stages I and II. Screening for red flag symptoms of cancer can be used to identify high-risk individuals in the community. METHODOLOGY: A community-based cross-sectional study was conducted in February 2017 among 302 participants in one of the service areas of Jawaharlal Institute of Postgraduate Medical Education and Research urban health center selected by universal sampling. Data on the presence of red flag symptoms of cancer (persistent cough, persistent change in bowel/bladder habits, nonhealing ulcer, persistent difficulty in swallowing, unexplained weight loss, unexplained lump, persistent unexplained pain, unexplained bleeding, and change in the appearance of mole) and presence of risk factors were collected through interviews. The collected data were entered using EpiData version 3.0. RESULTS: The mean (standard deviation) age...

Journal of Education and Health Promotion, 2019

BACKGROUND: Noncommunicable diseases (NCDs) are the leading causes of mortality worldwide. Enviro... more BACKGROUND: Noncommunicable diseases (NCDs) are the leading causes of mortality worldwide. Environmental factors play an important role in development of risk factors. Hence, the study was done to assess the neighborhood environmental factors related to NCDs in urban area. METHODOLOGY: This community-based cross-sectional study was carried out among three selected wards of urban Puducherry. All shops/establishments related to the risk of NCDs within the study area were study units. Information regarding tobacco, alcohol, diet, and physical activity-related establishments was assessed using pretested semi-structured pro forma. Shops/establishments were labeled either as “favorable” (prevents the risk of NCDs) or “unfavorable” (increases the risk of NCDs). RESULTS: Among 655 establishments, 372 (56.8%) belonged to favorable and 283 (43.2%) to unfavorable category, respectively. Tobacco-related establishments amount to 15.1% (95% confidence interval: 12.6–18.1) of the total establishme...

Human Vaccines & Immunotherapeutics

ABSTRACT The second wave of COVID-19 pandemic has spread rampantly throughout India between April... more ABSTRACT The second wave of COVID-19 pandemic has spread rampantly throughout India between April and May 2021, leading to high mortality rates. Identifying any change in the rate of vaccine hesitancy or refusal due to such mass casualty events will provide further insights on developing appropriate risk communication strategy. Hence, this study was undertaken to identify the vaccine hesitancy and refusal before and during the second wave of COVID-19 pandemic. We conducted a longitudinal study among 900 adults to know about their vaccine hesitancy and refusal pattern before (March 2021 – round-1) and during the second wave of COVID-19 pandemic (May 2021 – round-2). Telephonic interview was conducted using the pre-tested semi-structured questionnaire. There was an increase in the vaccine hesitancy (27.8% in round-1 to 32.7% in round-2) and refusal (25.6% in round-1 to 35.6% in round-2) during the second wave of pandemic in Puducherry. In adjusted analysis, vaccine hesitancy was found to increase by 1.19 times during the round-2 survey compared to round-1 survey (aIRR = 1.19; 95%CI: 1.03–1.37). We also found that the vaccine refusal increased by 1.40 times during the round-2 survey compared to round-1 survey (aIRR = 1.40; 95%CI: 1.22–1.62) after adjusting for age, place of residence, and occupation. We found that the confidence in COVID-19 vaccine efficacy and safety has declined over time leading to increase in the vaccine hesitancy and refusal in our study cohort, with more than one-third refusing to get themselves vaccinated during the second wave of pandemic.

Journal of Education and Health Promotion, 2020

CONTEXT: Harmful use of alcohol has led to 1.7 million deaths from noncommunicable diseases and 1... more CONTEXT: Harmful use of alcohol has led to 1.7 million deaths from noncommunicable diseases and 1 million injury deaths including road traffic accidents, self-harm, and interpersonal violence. The opportunistic screening can be used to screen for substance abuse in outpatient department (OPD) attendees of primary health-care (PHC) settings in India. AIMS: This study was conducted to determine the prevalence of willingness to quit alcohol use among alcohol users and factors associated with it. SUBJECTS AND METHODS: A facility-based cross-sectional study was conducted in urban PHCs and willingness to quit alcohol was assessed among the alcohol users. Alcohol Use Disorder Identification Test (AUDIT) scale was used to assess the alcohol use disorder score. Data were entered using Epidata version 3.1 and analyzed using STATA version 14. RESULTS: It is found that two-third of the male OPD patients are using alcohol and 59% of the alcohol users were willing to quit alcohol. Education (adju...

Background: Nutrition of the elderly affects immunity and functional ability and leads to increas... more Background: Nutrition of the elderly affects immunity and functional ability and leads to increased morbidity and mortality. Validation of a short-form (SF) scale will make the assessment easier for primary care physicians. Hence, the study was done to assess the validity and reliability of Mini-Nutritional Assessment–SF (MNA-SF) Questionnaire among elderly in Puducherry. Methods: A cross-sectional study among 279 elderly was conducted in four villages of rural Puducherry. We have used three forms of MNA questionnaire. Diagnostic accuracy of the MNA-SF was assessed and internal consistency was interpreted using Cronbach's alpha. Results: The prevalence of malnutrition by the MNA full-form scale was 17.9%. Similar prevalence was reported by the body mass index (BMI) MNA-SF (16.5%), but calf-circumference (CC) MNA-SF overestimated the prevalence (38%). Sensitivity was higher in CC-MNA-SF (92%) when compared to BMI-MNA-SF (72%), while specificity was higher in BMI-MNA-SF (95.6%) wh...

Journal of Education and Health Promotion, 2019

BACKGROUND: Almost 15% of all pregnant women can develop potentially life-threatening complicatio... more BACKGROUND: Almost 15% of all pregnant women can develop potentially life-threatening complications. As a result, identification of high-risk pregnancy at earliest stage will be useful in directing appropriate intervention. Hence, the current study was done to determine the prevalence and outcome of high-risk pregnancy among antenatal women in rural Puducherry. MATERIALS AND METHODS: A record-based longitudinal study was done during March 2018 among 569 antenatal women who have attended rural health center of tertiary care institute. High-risk pregnancy was classified based on the guidelines from Pradhan Mantri Surakshit Matritva Abhiyan and outcome assessment based on the obstetric and neonatal outcomes. RESULTS: Among 569 antenatal case record reviewed, 315 (55.3%) were in the age group of 20–25 years and majority (463, 81.4%) belonged to below poverty line families; 410 (74.3%) registered their current pregnancy within the first trimester. The prevalence of high-risk pregnancy am...

Journal of Mid-Life Health, 2021

Background: Menopause characterized by a gradual decline in ovarian hormones takes its toll on th... more Background: Menopause characterized by a gradual decline in ovarian hormones takes its toll on the women both physically and mentally. These health problems can negatively impact the mental status. Hence, the current study was done to determine the level of stress and its associated factors among postmenopausal women in urban Puducherry, India. Materials and Methods: A facility-based cross-sectional study was done among 219 postmenopausal women attending the outpatient department in urban primary health center during May 2017–June 2017. Information regarding sociodemographic profile was collected using pretested semi-structured questionnaire and Cohen's Perceived Stress Scale was used to assess the stress level. We calculated adjusted prevalence ratios (aPRs) to identify the determinants of stress. Results: Among 219 participants, 46.6% were in the age group of 60–74 years; 32.9% had primary to secondary level of education; 56.2% were unemployed; 42.5% belonged to lower socioeco...

Anxiety, Uncertainty, and Resilience During the Pandemic Period - Anthropological and Psychological Perspectives

WHO has declared COVID-19 as a pandemic on March 11, 2020. Like the virus affects the entire body... more WHO has declared COVID-19 as a pandemic on March 11, 2020. Like the virus affects the entire body, the pandemic affected the entire global trade and economy, leading to the loss of jobs and businesses. Thus, it would be appropriate to quote COVID-19 as a social disease rather than treating only as a medical condition. The COVID-19 pandemic, being a social disease, affects all the individuals of the society in terms of their physical, mental, social health and challenges the economic status of the entire population, irrespective of whether they were physically sick. However, the mental health impact of the COVID-19 pandemic has been overlooked, given its benign nature. We can anticipate a higher prevalence of psychological distress during any pandemic than typical situations. The COVID-19 instils fear and anxiety among people. Isolation and quarantine to reduce disease transmission have a negative impact on one’s mental health. The lockdowns lead to the closure of educational institu...

PLOS ONE

This review was done to determine the prevalence of metabolic syndrome (MS) among adult general p... more This review was done to determine the prevalence of metabolic syndrome (MS) among adult general population in India. We also wanted to find the gender, setting, and regionwide distribution of MS in India. Methods We conducted systematic searches in various databases including Medline, ScienceDirect, Cochrane library and Google Scholar from inception until August 2019. We included studies conducted in India reporting the prevalence of MS among adults aged 18 years or more. We used the Newcastle Ottawa scale to assess the quality of included studies. We carried out a meta-analysis with random-effects model and reported pooled prevalence with 95% confidence intervals (CIs). We used the Funnel plot to assess publication biases. Results In total, we analysed 113 data from 111 studies with 133,926 participants. Majority of the included studies (76 out of 111) had low risk of bias. We found significant heterogeneity among the included studies (p<0.001). We also found a symmetrical funnel plot indicating an absence of publication bias. The prevalence of MS among adult population in India was 30% (95%CI: 28%-33%). There was a steady increase in the burden across the age groups from 13% (18-29 years group) to 50% (50-59 years). We also found that people living in urban areas (32%; 95%CI: 29%-36%) had higher prevalence when compared to tribal (28%; 95%CI: 21%-36%) or rural adults (22%; 95%CI: 20%-25%). Gender distribution of MS showed that the females had higher prevalence (35%; 95%CI: 31%-38%) when compared to males 26% (95%CI: 22%-29%). Conclusion Almost one in three adults in India suffer from MS. Females, people living in urban areas and in northeast region had higher prevalence of MS. Development and implementation of

BMJ Open

ObjectiveTo determine the prevalence and determinants of diabetes mellitus (DM) among tuberculosi... more ObjectiveTo determine the prevalence and determinants of diabetes mellitus (DM) among tuberculosis (TB) patients and to assess the additional yield and number needed to screen (NNS) to obtain a newly diagnosed DM among TB patients.DesignWe undertook a cross-sectional analysis of the cohort data under Regional Prospective Observational Research for Tuberculosis-India consortium. Newly diagnosed TB patients recruited into the cohort between 2014 and 2018 were included. Pretested standardised questionnaires and tools were used for data collection. Prevalence of DM among TB patients was summarised as proportion with 95% CI. Type II DM was diagnosed if random blood sugar level was >200 mg/dL or if the participant had a documented history of DM. NNS by blood glucose testing to diagnose one new DM case among TB patients was also calculated.SettingThree districts of South India: Puducherry, Cuddalore and VillupuramSubjectsNewly diagnosed sputum smear positive pulmonary TB patients aged ≥...

Irish Journal of Medical Science (1971 -)

Background Development of a prediction model using baseline characteristics of COVID-19 patients ... more Background Development of a prediction model using baseline characteristics of COVID-19 patients at the time of diagnosis will aid us in early identification of the high-risk groups and devise pertinent strategies accordingly. Hence, we did this study to develop a prognostic-scoring system for predicting the COVID-19 severity in South India. Methods We undertook this retrospective cohort study among COVID-19 patients reporting to Hindu Mission Hospital, India. Multivariable logistic regression using the LASSO procedure was used to select variables for the model building, and the nomogram scoring system was developed with the final selected model. Model discrimination, calibration, and decision curve analysis (DCA) was performed. Results In total, 35.1% of the patients in the training set developed severe COVID-19 during their follow-up period. In the basic model, nine variables (age group, sex, education, chronic kidney disease, tobacco, cough, dyspnea, olfactory-gustatory dysfunction [OGD], and gastrointestinal symptoms) were selected and a nomogram was built using these variables. In the advanced model, in addition to these variables (except OGD), C-reactive protein, lactate dehydrogenase, ferritin, d-dimer, and CT severity score were selected. The discriminatory power (c-index) for basic model was 0.78 (95%CI: 0.74-0.82) and advanced model was 0.83 (95%CI: 0.79-0.87). DCA showed that both the models are beneficial at a threshold probability around 10-95% than treat-none or treat-all strategies. Conclusion The present study has developed two separate prognostic-scoring systems to predict the COVID-19 severity. This scoring system could help the clinicians and policymakers to devise targeted interventions and in turn reduce the COVID-19 mortality in India.

Journal of Education and Health Promotion, 2018

BACKGROUND: Dengue is the most common life-threatening arboviral infection contributing to 92 mil... more BACKGROUND: Dengue is the most common life-threatening arboviral infection contributing to 92 million infections worldwide. India alone contributes for 34% of the global burden. Success of dengue control depends largely on adequate knowledge and good practices of preventive measures. However, there is a need to find the existing awareness among the general population, especially in rural areas. Thus, our present study was done to determine the awareness, attitude, and practice measures regarding dengue fever in rural Tamil Nadu. MATERIALS AND METHODS: A community-based cross-sectional survey was done among 303 individuals belonging to the selected village in rural Tamil Nadu during November 2016. Information regarding sociodemographic details and awareness, attitude, and practice toward dengue were collected using a semi-structured questionnaire. Adequacy of knowledge and attitude was summarized as proportion with 95% confidence interval. RESULTS: Among 303 participants, 204 (67.3%)...

Nigerian Postgraduate Medical Journal

Background Sex determination refers to knowing the sex of foetus during prenatal period for non-m... more Background Sex determination refers to knowing the sex of foetus during prenatal period for non-medical reasons. Attitude of married women to sex determination is important to improve the sex ratio at birth. Aim and Objectives This study aimed to assess preference on sex determination and associated factors among currently married reproductive age group women. Materials and Methods This cross-sectional community-based study was done during 2016-2017 among 2228 currently married women of 18-49 years' age group in urban and rural Puducherry, India. Information on the demographic characteristics, level of awareness and preference for sex determination was obtained. Multiple logistic regression was used to identify factors influencing preference for sex determination. Unadjusted and adjusted odds ratio (AOR) as a measure of effects was used. Results Of 1979 respondents, all were aware that sex determination is possible. Majority of them did not prefer sex determination (95.4%, 1888). About 80 (4.0%) preferred, while 11 (0.6%) were undecided about it. Majority of them were aware that sex determination without medical indication is a crime. Common source of information was healthcare workers (76.4%). After adjusting for confounders, age group (18-24, AOR = 5.334; 25-29, AOR = 3.249; 30-34, AOR = 3.857; 35-39, AOR = 2.279), middle level education (AOR = 2.3), those with unmet need for family planning (AOR = 2.970) and urban area (AOR = 67.679) subjects were preferred more; housewife (AOR = 0.481) and those without living son (AOR = 0.406) had preferred lesser for sex determination compared to their counterparts. Conclusion About one in 25 currently married women preferred sex determination. It is comparatively more in urban areas. High-risk groups should be educated to develop correct awareness and attitude on prenatal sex determination.

Indian journal of cancer, 2021

Background Breast and cervical cancers are the two leading causes of cancer-related morbidity and... more Background Breast and cervical cancers are the two leading causes of cancer-related morbidity and mortality in India. Early diagnosis of these cancers through screening offers the best chance to achieve successful treatment outcomes. Hence, the current study was done to determine the prevalence and predictors of breast and cervical cancer screening among women aged 30-49 years in India. Methods We have analyzed the most recent National Family Health Survey-4 data (NFHS-4) gathered from Demographic Health Survey program. Stratification and clustering in the sample design were accounted using svyset command. Adjusted prevalence ratio (aPR) with 95% confidence interval (CI) was reported. Results In total, 336,777 women aged 30-49 years were included. Proportion of women aged 30-49 years with history of breast cancer examination in their lifetime was 12.9% (95% CI: 12.6-13.2%), while it was 29.8% (95% CI: 29.3-30.3%) for cervical cancer. It was found that women aged 45-49 years (aPR=1.0...

Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine, 2019

Background: Low birth weight (LBW) is a major cause of neonatal morbidity and mortality. In addit... more Background: Low birth weight (LBW) is a major cause of neonatal morbidity and mortality. In addition to medical/clinical risk factors, various socio-demographic factors also have an impact on birth weight. Objective: The objective of the study is to determine the association of antenatal social support and spouse abuse during pregnancy with LBW in Urban areas of Puducherry. Materials and Methods: A community-based case–control study was conducted in Puducherry. Mothers of 100 LBW infants and normal birth weight infants in 2016 were studied. Functional Social Support Questionnaire and Index of Spouse Abuse scales were used. Conditional logistic regression for matched pair studies was done for multivariate analysis. Results: Mean (± standard deviation) age and education of the study participants was 25.6 (±3.5) and 8.28 (±3.6) years, respectively. The proportion of girl child was 59% and 43% among cases and controls, respectively. Mothers with higher perceived social support (odds rat...

Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 2020

Background: Breast cancer is the most common cancer accounting for about one-fourth of total canc... more Background: Breast cancer is the most common cancer accounting for about one-fourth of total cancer cases and 15% of all cancer deaths among women worldwide. It is important to determine its trend across the regions in the world to find the high-focus regions. Hence, the current study was done to assess the global trends and deviations in the incidence of breast cancer. Materials and Methods: A descriptive trend analysis was done using the data on breast cancer incidence from the WHO Cancer Incidence Data of Five Continents plus database. Joinpoint regression was performed to determine the average annual percent change (AAPC), and age-period-cohort analysis was done to obtain age-, period-, and cohort-specific deviations and rate ratio. Results: All the regions showed an increasing trend in breast cancer incidence, with an exception of America. Maximum increase was observed in Asia (AAPC = 2.6%; 95% confidence interval [CI]: 2.4%–2.9%) followed by Europe (AAPC = 0.7%; 95% CI: 0.5%–1...

Indian journal of cancer, 2021

Background Cervical cancer ranks fourth in global cancer incidence and mortality among women. A c... more Background Cervical cancer ranks fourth in global cancer incidence and mortality among women. A comparison of the global trends in cervical cancer would help us to identify high focus regions and serves an opportunity to evaluate the impact of the screening programs. Hence, the current study was done to assess the global trend in the incidence of cervical cancer from 1993 to 2012 among individuals aged between 30 and 79 years. Methods This secondary data analysis was conducted using the World Health Organization (WHO) Cancer Incidence data of five continents plus database (America, Asia, Europe, and Oceania) on the incidence of cervical cancer. Joinpoint regression was performed to determine the average annual percent change (AAPC) in cervical cancer incidence. We performed an age-period-cohort analysis to obtain age, period, and cohort-specific deviations and rate ratio (RR). Results Out of the four regions studied, all the regions showed a declining trend in cervical cancer incide...

International Journal Of Community Medicine And Public Health

Background: India contributes to one-third of rabies death globally. Despite the efforts taken by... more Background: India contributes to one-third of rabies death globally. Despite the efforts taken by government, Rabies incidence in India has been constant for over a decade. Hence, there is need to assess the awareness and treatment-seeking behaviour which will help to plan strategies to prevent rabies related deaths. The objective of the study was to assess the awareness about rabies among general population and to determine the treatment-seeking behaviour and adherence to anti-rabies vaccine among victims of dog-bite in rural PuducherryMethods: Community based cross-sectional study was conducted during November 2016 in rural Puducherry. 386 individuals were covered in four villages. Information on socio-demographic characteristics and awareness regarding rabies, treatment-seeking behaviour and adherence to anti-rabies vaccine among dog-bite victims was collected using pre-tested questionnaire.Results: Among 386 participants, 244 (63.2%) were in the age group 31-60 years, 259 (67.1%...

Indian Journal of Tuberculosis, 2021

Background Timika scoring system is a radiographic grading tool, widely employed for grading the ... more Background Timika scoring system is a radiographic grading tool, widely employed for grading the severity of tuberculosis (TB). We evaluated the predictive accuracy of this tool for adverse treatment outcomes among TB patients in Indian setting. Methods We undertook a longitudinal analysis of cohort data under the RePORT-India consortium. Cohort having participants with active pulmonary TB were included. CXRs were independently scored by chest physicians. Timika scoring system had a total score of 140. The predictive nature of the tool was assessed using the ROC analysis. Results Around 364 laboratory confirmed TB patients were enrolled. The mean (SD) of overall Timika score was 62.3 (24.9). Sputum conversion was achieved among 218/260 (83.8%) patients available at end of intensive phase. AUC for Timika score was 0.53 (95%CI: 0.43-0.63) and for percent lung affected, was 0.56 (95%CI: 0.46-0.65). Unfavorable treatment outcome was observed among 67/287 (23.3%) at the end of continuati...

Journal of Education and Health Promotion, 2018

BACKGROUND: India is currently having a deceased donation rate of 0.05–0.08 per million populatio... more BACKGROUND: India is currently having a deceased donation rate of 0.05–0.08 per million population. The National Organ and Tissue Transplant Programme have planned strategies to improve organ donation by creating awareness and capacity building. There is great need to assess the knowledge regarding organ donation among general population. OBJECTIVE (S): Among the adult population (≥18 years) residing in urban slum of Puducherry to determine the knowledge, attitude, and practice regarding organ donation. MATERIALS AND METHODS: Community-based cross-sectional study was conducted during April to May 2017 among 257 randomly selected participants in selected wards of urban Puducherry. Data regarding knowledge, attitude, and practice were collected through pretested semi-structured questionnaire. RESULTS: Mean (standard deviation) age of the study participants was 45 (15) years and majority (57%) were female, 41% of them were educated more than secondary. Almost 90% of the study participa...

Journal of Education and Health Promotion, 2018

BACKGROUND: Patients with cancer often delay seeking medical advice in developing countries. In I... more BACKGROUND: Patients with cancer often delay seeking medical advice in developing countries. In India, only 20%–30% of cancers are being diagnosed in Stages I and II. Screening for red flag symptoms of cancer can be used to identify high-risk individuals in the community. METHODOLOGY: A community-based cross-sectional study was conducted in February 2017 among 302 participants in one of the service areas of Jawaharlal Institute of Postgraduate Medical Education and Research urban health center selected by universal sampling. Data on the presence of red flag symptoms of cancer (persistent cough, persistent change in bowel/bladder habits, nonhealing ulcer, persistent difficulty in swallowing, unexplained weight loss, unexplained lump, persistent unexplained pain, unexplained bleeding, and change in the appearance of mole) and presence of risk factors were collected through interviews. The collected data were entered using EpiData version 3.0. RESULTS: The mean (standard deviation) age...

Journal of Education and Health Promotion, 2019

BACKGROUND: Noncommunicable diseases (NCDs) are the leading causes of mortality worldwide. Enviro... more BACKGROUND: Noncommunicable diseases (NCDs) are the leading causes of mortality worldwide. Environmental factors play an important role in development of risk factors. Hence, the study was done to assess the neighborhood environmental factors related to NCDs in urban area. METHODOLOGY: This community-based cross-sectional study was carried out among three selected wards of urban Puducherry. All shops/establishments related to the risk of NCDs within the study area were study units. Information regarding tobacco, alcohol, diet, and physical activity-related establishments was assessed using pretested semi-structured pro forma. Shops/establishments were labeled either as “favorable” (prevents the risk of NCDs) or “unfavorable” (increases the risk of NCDs). RESULTS: Among 655 establishments, 372 (56.8%) belonged to favorable and 283 (43.2%) to unfavorable category, respectively. Tobacco-related establishments amount to 15.1% (95% confidence interval: 12.6–18.1) of the total establishme...

Human Vaccines & Immunotherapeutics

ABSTRACT The second wave of COVID-19 pandemic has spread rampantly throughout India between April... more ABSTRACT The second wave of COVID-19 pandemic has spread rampantly throughout India between April and May 2021, leading to high mortality rates. Identifying any change in the rate of vaccine hesitancy or refusal due to such mass casualty events will provide further insights on developing appropriate risk communication strategy. Hence, this study was undertaken to identify the vaccine hesitancy and refusal before and during the second wave of COVID-19 pandemic. We conducted a longitudinal study among 900 adults to know about their vaccine hesitancy and refusal pattern before (March 2021 – round-1) and during the second wave of COVID-19 pandemic (May 2021 – round-2). Telephonic interview was conducted using the pre-tested semi-structured questionnaire. There was an increase in the vaccine hesitancy (27.8% in round-1 to 32.7% in round-2) and refusal (25.6% in round-1 to 35.6% in round-2) during the second wave of pandemic in Puducherry. In adjusted analysis, vaccine hesitancy was found to increase by 1.19 times during the round-2 survey compared to round-1 survey (aIRR = 1.19; 95%CI: 1.03–1.37). We also found that the vaccine refusal increased by 1.40 times during the round-2 survey compared to round-1 survey (aIRR = 1.40; 95%CI: 1.22–1.62) after adjusting for age, place of residence, and occupation. We found that the confidence in COVID-19 vaccine efficacy and safety has declined over time leading to increase in the vaccine hesitancy and refusal in our study cohort, with more than one-third refusing to get themselves vaccinated during the second wave of pandemic.

Journal of Education and Health Promotion, 2020

CONTEXT: Harmful use of alcohol has led to 1.7 million deaths from noncommunicable diseases and 1... more CONTEXT: Harmful use of alcohol has led to 1.7 million deaths from noncommunicable diseases and 1 million injury deaths including road traffic accidents, self-harm, and interpersonal violence. The opportunistic screening can be used to screen for substance abuse in outpatient department (OPD) attendees of primary health-care (PHC) settings in India. AIMS: This study was conducted to determine the prevalence of willingness to quit alcohol use among alcohol users and factors associated with it. SUBJECTS AND METHODS: A facility-based cross-sectional study was conducted in urban PHCs and willingness to quit alcohol was assessed among the alcohol users. Alcohol Use Disorder Identification Test (AUDIT) scale was used to assess the alcohol use disorder score. Data were entered using Epidata version 3.1 and analyzed using STATA version 14. RESULTS: It is found that two-third of the male OPD patients are using alcohol and 59% of the alcohol users were willing to quit alcohol. Education (adju...

Background: Nutrition of the elderly affects immunity and functional ability and leads to increas... more Background: Nutrition of the elderly affects immunity and functional ability and leads to increased morbidity and mortality. Validation of a short-form (SF) scale will make the assessment easier for primary care physicians. Hence, the study was done to assess the validity and reliability of Mini-Nutritional Assessment–SF (MNA-SF) Questionnaire among elderly in Puducherry. Methods: A cross-sectional study among 279 elderly was conducted in four villages of rural Puducherry. We have used three forms of MNA questionnaire. Diagnostic accuracy of the MNA-SF was assessed and internal consistency was interpreted using Cronbach's alpha. Results: The prevalence of malnutrition by the MNA full-form scale was 17.9%. Similar prevalence was reported by the body mass index (BMI) MNA-SF (16.5%), but calf-circumference (CC) MNA-SF overestimated the prevalence (38%). Sensitivity was higher in CC-MNA-SF (92%) when compared to BMI-MNA-SF (72%), while specificity was higher in BMI-MNA-SF (95.6%) wh...

Journal of Education and Health Promotion, 2019

BACKGROUND: Almost 15% of all pregnant women can develop potentially life-threatening complicatio... more BACKGROUND: Almost 15% of all pregnant women can develop potentially life-threatening complications. As a result, identification of high-risk pregnancy at earliest stage will be useful in directing appropriate intervention. Hence, the current study was done to determine the prevalence and outcome of high-risk pregnancy among antenatal women in rural Puducherry. MATERIALS AND METHODS: A record-based longitudinal study was done during March 2018 among 569 antenatal women who have attended rural health center of tertiary care institute. High-risk pregnancy was classified based on the guidelines from Pradhan Mantri Surakshit Matritva Abhiyan and outcome assessment based on the obstetric and neonatal outcomes. RESULTS: Among 569 antenatal case record reviewed, 315 (55.3%) were in the age group of 20–25 years and majority (463, 81.4%) belonged to below poverty line families; 410 (74.3%) registered their current pregnancy within the first trimester. The prevalence of high-risk pregnancy am...

Journal of Mid-Life Health, 2021

Background: Menopause characterized by a gradual decline in ovarian hormones takes its toll on th... more Background: Menopause characterized by a gradual decline in ovarian hormones takes its toll on the women both physically and mentally. These health problems can negatively impact the mental status. Hence, the current study was done to determine the level of stress and its associated factors among postmenopausal women in urban Puducherry, India. Materials and Methods: A facility-based cross-sectional study was done among 219 postmenopausal women attending the outpatient department in urban primary health center during May 2017–June 2017. Information regarding sociodemographic profile was collected using pretested semi-structured questionnaire and Cohen's Perceived Stress Scale was used to assess the stress level. We calculated adjusted prevalence ratios (aPRs) to identify the determinants of stress. Results: Among 219 participants, 46.6% were in the age group of 60–74 years; 32.9% had primary to secondary level of education; 56.2% were unemployed; 42.5% belonged to lower socioeco...

Anxiety, Uncertainty, and Resilience During the Pandemic Period - Anthropological and Psychological Perspectives

WHO has declared COVID-19 as a pandemic on March 11, 2020. Like the virus affects the entire body... more WHO has declared COVID-19 as a pandemic on March 11, 2020. Like the virus affects the entire body, the pandemic affected the entire global trade and economy, leading to the loss of jobs and businesses. Thus, it would be appropriate to quote COVID-19 as a social disease rather than treating only as a medical condition. The COVID-19 pandemic, being a social disease, affects all the individuals of the society in terms of their physical, mental, social health and challenges the economic status of the entire population, irrespective of whether they were physically sick. However, the mental health impact of the COVID-19 pandemic has been overlooked, given its benign nature. We can anticipate a higher prevalence of psychological distress during any pandemic than typical situations. The COVID-19 instils fear and anxiety among people. Isolation and quarantine to reduce disease transmission have a negative impact on one’s mental health. The lockdowns lead to the closure of educational institu...

PLOS ONE

This review was done to determine the prevalence of metabolic syndrome (MS) among adult general p... more This review was done to determine the prevalence of metabolic syndrome (MS) among adult general population in India. We also wanted to find the gender, setting, and regionwide distribution of MS in India. Methods We conducted systematic searches in various databases including Medline, ScienceDirect, Cochrane library and Google Scholar from inception until August 2019. We included studies conducted in India reporting the prevalence of MS among adults aged 18 years or more. We used the Newcastle Ottawa scale to assess the quality of included studies. We carried out a meta-analysis with random-effects model and reported pooled prevalence with 95% confidence intervals (CIs). We used the Funnel plot to assess publication biases. Results In total, we analysed 113 data from 111 studies with 133,926 participants. Majority of the included studies (76 out of 111) had low risk of bias. We found significant heterogeneity among the included studies (p<0.001). We also found a symmetrical funnel plot indicating an absence of publication bias. The prevalence of MS among adult population in India was 30% (95%CI: 28%-33%). There was a steady increase in the burden across the age groups from 13% (18-29 years group) to 50% (50-59 years). We also found that people living in urban areas (32%; 95%CI: 29%-36%) had higher prevalence when compared to tribal (28%; 95%CI: 21%-36%) or rural adults (22%; 95%CI: 20%-25%). Gender distribution of MS showed that the females had higher prevalence (35%; 95%CI: 31%-38%) when compared to males 26% (95%CI: 22%-29%). Conclusion Almost one in three adults in India suffer from MS. Females, people living in urban areas and in northeast region had higher prevalence of MS. Development and implementation of

BMJ Open

ObjectiveTo determine the prevalence and determinants of diabetes mellitus (DM) among tuberculosi... more ObjectiveTo determine the prevalence and determinants of diabetes mellitus (DM) among tuberculosis (TB) patients and to assess the additional yield and number needed to screen (NNS) to obtain a newly diagnosed DM among TB patients.DesignWe undertook a cross-sectional analysis of the cohort data under Regional Prospective Observational Research for Tuberculosis-India consortium. Newly diagnosed TB patients recruited into the cohort between 2014 and 2018 were included. Pretested standardised questionnaires and tools were used for data collection. Prevalence of DM among TB patients was summarised as proportion with 95% CI. Type II DM was diagnosed if random blood sugar level was >200 mg/dL or if the participant had a documented history of DM. NNS by blood glucose testing to diagnose one new DM case among TB patients was also calculated.SettingThree districts of South India: Puducherry, Cuddalore and VillupuramSubjectsNewly diagnosed sputum smear positive pulmonary TB patients aged ≥...