Reshmirhiju Ramachandran | Kerala University Of Health Sciences (original) (raw)

Papers by Reshmirhiju Ramachandran

Research paper thumbnail of Sero-prevalence of Nipah antibodies among close contacts of the index case during 2019 Ernakulam outbreak

Journal of Family Medicine and Primary Care

Research paper thumbnail of Prevalence of thyroid disorders in antenatal women and its impact on maternal and foetal outcome

Indian Journal of Forensic and Community Medicine, 2020

Introduction: Thyroid disorders are the commonest endocrine disorders affecting women of reproduc... more Introduction: Thyroid disorders are the commonest endocrine disorders affecting women of reproductive age group. The most frequent thyroid disorder in pregnancy is maternal hypothyroidism. Antenatal period can be viewed as a state in which a combination of events concurs to modify the thyroidal economy. Thyroid dysfunction has varied impact on pregnancy outcome. In this study we have assessed the prevalence and the impact of thyroid disorders among antenatal woman registered in the Urban Health Training Centre of a Tert iary care teaching hospital in Kerala, Southern India. Materials and Methods: A prospective observational study was done among 451 antenatal women registered in the Urban Health Training centre of a Tertiary care hospital. Prevalence of thyroid disorders was assessed based on TSH, Free T4 and Anti TPO antibody status. Maternal and Foetal outcomes with respect to their Thyroid function status were also evaluated. Results: The prevalence of thyroid dysfunction in pregnancy was 22.39%, subclinical hypothyroidism (20.63%) was the most common thyroid disorder among these women. Statistically significant association was found between thyroid disorders and maternal complications (P value=<0.0000001), were as no such significant association was found with regards to foetal outcome (P value=0.5) and antenatal thyroid dysfunction. Conclusions: This study concludes that there is a high prevalence of thyroid disorder in pregnancy. Subclinical hypothyroidism was found to be the major thyroid disorder as per this study.

Research paper thumbnail of Vitamin D Supplementation - is It Essential for Lactating Mothers and Breast - Fed Infants??

Journal of Evolution of medical and Dental Sciences, 2015

Research paper thumbnail of Alkaline phosphatase (ALP), Body Mass Index (BMI), 25-Hydroxy Vitamin D (25-OH Vit D), Parathyroid Hormone (PTH), Phosphorus (P)

Research paper thumbnail of Clinical Profile of Chikungunya Patients during the Epidemic of 2007 in Kerala, India

Journal of Global Infectious Diseases, 2011

C hikungunya is described as an acute illness, with fever, skin rash and incapacitating arthralgi... more C hikungunya is described as an acute illness, with fever, skin rash and incapacitating arthralgia. [1] Arthralgia is the salient feature of Chikungunya that distinguishes it from Dengue, which otherwise shares the same vectors, symptoms and geographical distribution. [2] The disease itself is rarely fatal [3] and is sometimes confused with Dengue, O'nyong-nyong or Sindbis virus infection. [4] Typical features of the disease include abrupt, massive outbreaks with a high attack rate [5,6] followed by slow decline of cases as herd immunity develops. [7-9]

Research paper thumbnail of Internship Training, Community Medicine, Medical Education, Kerala, GMR 2019

Effectiveness of Educational Interventions on Internship Training in Community Medicine in a Tertiary Care Centre in Alappuzha District of Kerala, South India; A Quasi-Experimental Study, Oct 30, 2021

Research paper thumbnail of Deprived Among the Marginalized - Health Status of Women in a Tribal Settlement

Indicators related to health of women in Kerala depict a rosy picture. But there is a lot to be o... more Indicators related to health of women in Kerala depict a rosy picture. But there is a lot to be observed in between the social strata of the population, especially among those communities who are getting increasingly marginalized, like the tribal community. The aim of this study is to analysis the status of a tribal community compared to a non-tribal community sharing the same geographical location with respect to the gender. Present study is a cross sectional study conducted in a tribal belt inhabited by both the tribal and non-tribal people. Two cross sections were taken for better comparison. The data regarding all the 52 tribal families were analysed against 95 families who are not tribal. The tribal women enjoy a very low standard of living and poor living conditions. The health issues of these deprived should be considered for the all-inclusive development of the state and the country.

Research paper thumbnail of Effectiveness of Educational Interventions on Internship Training in Community Medicine in a Tertiary Care Centre in Alappuzha District of Kerala, South India; A Quasi-Experimental Study

Journal of Evidence Based Medicine and Healthcare

BACKGROUND India has been facing various challenges in the past decade, which include outbreaks o... more BACKGROUND India has been facing various challenges in the past decade, which include outbreaks of different communicable diseases and the rising of slow pandemics of non-communicable diseases. The current COVID 19 pandemic brings to light the need to revamp the training in public health during the internship. A standardized and outcome-based approach to internship training is the need of the hour for the Indian medical graduate (IMG). The internship program in community medicine should train the Indian medical graduate to develop patient management and administrative skills to promote health care through a health facility. The training provided is not standardized or evaluated across the medical colleges. Hence, it was aimed to study the effectiveness of educational interventions on internship training during the posting at the rural training health centre (RTHC). METHODS A quasi-experimental study was conducted among the interns posted in the rural training health centre using a v...

Research paper thumbnail of Trends in Acute Undifferentiated Febrile Illness in Patients Seeking Treatment from a Tertiary Care Hospital of Central Kerala

Journal of Evidence Based Medicine and Healthcare

BACKGROUND Acute undifferentiated febrile illness (AUFI / AFI) is one of the most common reasons ... more BACKGROUND Acute undifferentiated febrile illness (AUFI / AFI) is one of the most common reasons for people seeking medical care globally. Investigation into the aetiology and trends in AUFI cases are valuable public health data source. Absence of such evidence-based data may result in unintended public health consequences. Present study was undertaken to address the gap in period specific trends in AUFI cases reported from the region. METHODS A record based descriptive study was done in patients treated with AUFI from January 1st, 2015 to December 31st , 2019 in Government Medical College, Ernakulam. Universal sampling technique was adopted, and the data was entered in Microsoft Excel and analysed using Epi-Info software. Line diagram was constructed to obtain the trends in AUFI cases over the five-year period. Chisquare test was applied to find out the association between age group (paediatric and others) and causative agents of AUFI. RESULTS A total of 7998 AUFI cases were includ...

Research paper thumbnail of Quality of life and sociodemographic factors associated with poor quality of life in elderly women in Thiruvananthapuram, Kerala

Indian journal of public health

India is going through a phase of demographic transition leading to population aging and feminiza... more India is going through a phase of demographic transition leading to population aging and feminization of aging resulting in increased proportion of elderly women than men. Problems faced by the elderly women are more critical than men due to family and social conditions prevailing in India. The study made an attempt to assess the quality of life (QOL) using the World Health Organization QOL (WHOQOL-BREF) scale and sociodemographic factors affecting QOL of elderly women residing in a community setting in South Kerala. A community-based, cross-sectional study to assess the QOL of elderly women using WHOQOL-BREF questionnaire. Data were collected from 160 elderly women. 2.5% (95% confidence interval [CI]: 0.07-4.84) of the study participants were having "very good" QOL. 38.8% (95% CI: 31.2-46.4) had "good," 43.1% (95% CI: 35.4-50.8) had "poor," and 15.6% (95% CI: 9.98-21.22) had "very poor" QOL, respectively. QOL was least in the psychological do...

Research paper thumbnail of Deprived Among the Marginalised – Health Status of Women in a Tribal Settlement

International Research Journal of Social Sciences

Indicators related to health of women in Kerala depict a rosy picture. But there is a lot to be o... more Indicators related to health of women in Kerala depict a rosy picture. But there is a lot to be observed in between the social strata of the population, especially among those communities who are getting increasingly marginalized, like the tribal community. The aim of this study is to analysis the status of a tribal community compared to a non-tribal community sharing the same geographical location with respect to the gender. Present study is a cross sectional study conducted in a tribal belt inhabited by both the tribal and non-tribal people. Two cross sections were taken for better comparison. The data regarding all the 52 tribal families were analysed against 95 families who are not tribal. The tribal women enjoy a very low standard of living and poor living conditions. The health issues of these deprived should be considered for the all-inclusive development of the state and the country.

Research paper thumbnail of A prospective study on the relationship between blood pressure and blood group among adult male blood donors in a Tertiary care center

International Journal of Clinical and Experimental Physiology, 2015

Research paper thumbnail of Determinants of childhood tuberculosis--a case control study among children registered under revised National Tuberculosis Control Programme in a district of South India

The Indian journal of tuberculosis, 2011

To study the determinants of Tuberculosis (TB) in children between the age group of 0-14 years re... more To study the determinants of Tuberculosis (TB) in children between the age group of 0-14 years receiving treatment under Revised National TB Control Programme (RNTCP). A case (registered under RNTCP) control study was undertaken with 41 cases and 82 controls. Factors found to have significance according to binary logistic regression were low-birth weight (LBW) [Odd's ratio = 3.56],Malnutrition [Odd's ratio = 3.96], Passive smoking [Odd's ratio=6.28] and exposure to fire-wood smoke [Odd's ratio = 6.91]. LBW, malnutrition, passive smoking and fire-wood smoke are the risk factors to be addressed to prevent pediatric TB.

Research paper thumbnail of Environmental factors of households in five districts of Kerala affected by the epidemic of chikungunya fever in 2007

The National medical journal of India

Two epidemics of chikungunya fever were reported from Kerala in 2006 and 2007. We aimed to invest... more Two epidemics of chikungunya fever were reported from Kerala in 2006 and 2007. We aimed to investigate the environmental factors of households affected by chikungunya fever and to estimate the proportion of population that suffered from the disease during the epidemic in 2007. A cross-sectional survey was conducted in the 5 heavily affected districts of Kerala during October-November 2007. The 2-stage sampling technique was used to collect data from 10 clusters, each having 18 houses from every district, by interviewing the subjects using a structured questionnaire. The sample size was 900. The proportion of the population affected by chikungunya fever was 57.1% (95% CI: 52.8%-61.4%). There was a significant association between location of houses and disease status. Houses located near a public conveyance facility (within 250 m) were relatively protected from the disease (OR 0.19 [0.06-0.60]). About 69% of the households perceived mosquito infestation as a problem and 46.6% used fum...

Research paper thumbnail of Study of acute febrile illness: A 10-year descriptive study and a proposed algorithm from a tertiary care referral hospital in rural Kerala in southern India

Tropical doctor, Jan 23, 2014

Acute febrile illness (AFI), the initial diagnosis of whose cause is often presumptive, can somet... more Acute febrile illness (AFI), the initial diagnosis of whose cause is often presumptive, can sometimes be a challenge for the treating physician. To address this issue we carried out a hospital- based descriptive study. More than half (51.5%) of the patients were presumed to have viral fever. Most of the patients (60%) were in the productive phase of life (age range, 18-45 years). The outcome was worst among those aged over 65 years. A definite seasonal trend was observed with a peak in incidence with the arrival of the monsoon in Kerala. Public awareness regarding fevers in the pre-monsoon season should be heightened. Special care should be given to the elderly as they are often the most vulnerable. The use of the proposed locally based algorithm may avoid unnecessary investigations and treatment.

Research paper thumbnail of Prevalence of Hypertension and Pre-Hypertension among Adolescents

The Journal of Pediatrics, 2007

Research paper thumbnail of Elementary school enrolment and its determinants among children with cerebral palsy in Thiruvananthapuram district, Kerala, India

Journal of Neurosciences in Rural Practice, 2013

Context: There is enough documented evidence to prove the benefits of early and appropriate initi... more Context: There is enough documented evidence to prove the benefits of early and appropriate initiation of education among children with cerebral palsy (CP). Aim: To find out the proportion of children with CP who are enrolled for some kind of formal education and to study the determinants of the same. Setting and Design: This cross sectional study was done among children, attending the special clinics at government medical college, Thiruvananthapuram. Materials and Methods: Children between 3 and 12 years of age diagnosed with CP were subjects for the study. Statistical Analysis Used: Enrollment for any form of formal education was the major outcome variable. The factors associated with initiation of formal education were tested using Chi-square test or Fischer′s exact test. Independent association of each factor was evaluated through binary logistic Regression analysis. Results and Conclusions: The mean (SD) age of the children (n = 86) was 5.7 (2.3) years with forty-six (53.5%) of...

Research paper thumbnail of Epidemiology of measles outbreaks in Kerala, India, during 2007-2008

Annals of Tropical Medicine and Public Health, 2012

Context: Measles imparts high morbidity and mortality in low-income countries with weak health in... more Context: Measles imparts high morbidity and mortality in low-income countries with weak health infrastructure. The coverage of measles vaccination in Kerala which is best performing state of India in indicators of health has also not reached the elimination level and outbreaks of measles continue to occur. Aim: The aim of the paper was to study the profile of measles outbreaks in Kerala during the years 2007-2008. Settings and Designs: The study design was cross-sectional and data of the measles surveillance project of Kerala were analyzed. Results: The total number of clinically suspected measles outbreaks in Kerala during the 2-year period of 2007 and 2008 was 29. But only 15(53.6%) were found to be 'measles only' outbreak. The total number of epidemiologically linked measles cases was 718 (314 in 2007 and 404 in 2008). The cases that were immunized but developed the disease were 187 (28.6%), the number of cases that were not immunized was 355 (54.3%) and those whose immunization status was unknown were 112 (17.1%). The mean age of occurrence of disease was higher in the vaccinated group as compared to not vaccinated group. Two deaths were recorded in the study. Conclusions: Significant morbidity and mortality due to measles do occur in the most developed state of India. The epidemics were clustered in some districts. The study indicated an age shift in occurrence of measles cases among who received the vaccination.

Research paper thumbnail of Clinical Profile of Chikungunya Patients during the Epidemic of 2007 in Kerala, India

Journal of Global Infectious Diseases, 2011

C hikungunya is described as an acute illness, with fever, skin rash and incapacitating arthralgi... more C hikungunya is described as an acute illness, with fever, skin rash and incapacitating arthralgia. [1] Arthralgia is the salient feature of Chikungunya that distinguishes it from Dengue, which otherwise shares the same vectors, symptoms and geographical distribution. [2] The disease itself is rarely fatal [3] and is sometimes confused with Dengue, O'nyong-nyong or Sindbis virus infection. [4] Typical features of the disease include abrupt, massive outbreaks with a high attack rate [5,6] followed by slow decline of cases as herd immunity develops. [7-9]

Research paper thumbnail of Pattern and determinants of respiratory mortality in Kerala, South India

International Journal of Medicine and Public Health, 2014

Context: Respiratory diseases are one of the leading causes of deaths worldwide. There are no pub... more Context: Respiratory diseases are one of the leading causes of deaths worldwide. There are no published studies on the pattern and determinants of respiratory mortality from South India. Aims: The aim was to fi nd out the pattern and determinants of respiratory mortality during July 1, 2002 to June 31, 2008 in Varkala, Thiruvananthapuram district, Kerala. Settings and Design: A nested case control study from a prospective cohort was done to fi nd out the determinants for respiratory mortality. The main outcome measure was mortality due to respiratory causes. Materials and Methods: The data collected here are from the Population Registry of Lifestyle Diseases study, a prospective cohort study involving the long-term followup of the residents of Varkala rural development block Thiruvananthapuram district of South Kerala. Statistical analysis used: The age specifi c respiratory mortality rate was calculated. Chi-square test and odds ratio (OR) were measured to fi nd out the association between exposure and outcome variables. Logistic regression was performed. Results: A total of 3467 deaths were reported among 77881subjects above the age group of 20 years during the follow-up period. Of which 531 (15.9%) were due to respiratory causes. On logistic regression smoking (AdjOR [95% confi dence interval]; 1.65 [1.25, 2.17]), lower socioeconomic status (AdjOR; 1.52 [1.24, 1.87]), lower educational status (AdJOR; 2.22 [1.15, 4.29]) and old age (>60 years) (AdjOR; 2.6 [2.03, 3.33]) were found to be the signifi cant risk factors for respiratory mortality. Conclusion: Mortality due to respiratory causes was found to be high in Kerala, a state which has the best health indicators compared to other states in India.

Research paper thumbnail of Sero-prevalence of Nipah antibodies among close contacts of the index case during 2019 Ernakulam outbreak

Journal of Family Medicine and Primary Care

Research paper thumbnail of Prevalence of thyroid disorders in antenatal women and its impact on maternal and foetal outcome

Indian Journal of Forensic and Community Medicine, 2020

Introduction: Thyroid disorders are the commonest endocrine disorders affecting women of reproduc... more Introduction: Thyroid disorders are the commonest endocrine disorders affecting women of reproductive age group. The most frequent thyroid disorder in pregnancy is maternal hypothyroidism. Antenatal period can be viewed as a state in which a combination of events concurs to modify the thyroidal economy. Thyroid dysfunction has varied impact on pregnancy outcome. In this study we have assessed the prevalence and the impact of thyroid disorders among antenatal woman registered in the Urban Health Training Centre of a Tert iary care teaching hospital in Kerala, Southern India. Materials and Methods: A prospective observational study was done among 451 antenatal women registered in the Urban Health Training centre of a Tertiary care hospital. Prevalence of thyroid disorders was assessed based on TSH, Free T4 and Anti TPO antibody status. Maternal and Foetal outcomes with respect to their Thyroid function status were also evaluated. Results: The prevalence of thyroid dysfunction in pregnancy was 22.39%, subclinical hypothyroidism (20.63%) was the most common thyroid disorder among these women. Statistically significant association was found between thyroid disorders and maternal complications (P value=<0.0000001), were as no such significant association was found with regards to foetal outcome (P value=0.5) and antenatal thyroid dysfunction. Conclusions: This study concludes that there is a high prevalence of thyroid disorder in pregnancy. Subclinical hypothyroidism was found to be the major thyroid disorder as per this study.

Research paper thumbnail of Vitamin D Supplementation - is It Essential for Lactating Mothers and Breast - Fed Infants??

Journal of Evolution of medical and Dental Sciences, 2015

Research paper thumbnail of Alkaline phosphatase (ALP), Body Mass Index (BMI), 25-Hydroxy Vitamin D (25-OH Vit D), Parathyroid Hormone (PTH), Phosphorus (P)

Research paper thumbnail of Clinical Profile of Chikungunya Patients during the Epidemic of 2007 in Kerala, India

Journal of Global Infectious Diseases, 2011

C hikungunya is described as an acute illness, with fever, skin rash and incapacitating arthralgi... more C hikungunya is described as an acute illness, with fever, skin rash and incapacitating arthralgia. [1] Arthralgia is the salient feature of Chikungunya that distinguishes it from Dengue, which otherwise shares the same vectors, symptoms and geographical distribution. [2] The disease itself is rarely fatal [3] and is sometimes confused with Dengue, O'nyong-nyong or Sindbis virus infection. [4] Typical features of the disease include abrupt, massive outbreaks with a high attack rate [5,6] followed by slow decline of cases as herd immunity develops. [7-9]

Research paper thumbnail of Internship Training, Community Medicine, Medical Education, Kerala, GMR 2019

Effectiveness of Educational Interventions on Internship Training in Community Medicine in a Tertiary Care Centre in Alappuzha District of Kerala, South India; A Quasi-Experimental Study, Oct 30, 2021

Research paper thumbnail of Deprived Among the Marginalized - Health Status of Women in a Tribal Settlement

Indicators related to health of women in Kerala depict a rosy picture. But there is a lot to be o... more Indicators related to health of women in Kerala depict a rosy picture. But there is a lot to be observed in between the social strata of the population, especially among those communities who are getting increasingly marginalized, like the tribal community. The aim of this study is to analysis the status of a tribal community compared to a non-tribal community sharing the same geographical location with respect to the gender. Present study is a cross sectional study conducted in a tribal belt inhabited by both the tribal and non-tribal people. Two cross sections were taken for better comparison. The data regarding all the 52 tribal families were analysed against 95 families who are not tribal. The tribal women enjoy a very low standard of living and poor living conditions. The health issues of these deprived should be considered for the all-inclusive development of the state and the country.

Research paper thumbnail of Effectiveness of Educational Interventions on Internship Training in Community Medicine in a Tertiary Care Centre in Alappuzha District of Kerala, South India; A Quasi-Experimental Study

Journal of Evidence Based Medicine and Healthcare

BACKGROUND India has been facing various challenges in the past decade, which include outbreaks o... more BACKGROUND India has been facing various challenges in the past decade, which include outbreaks of different communicable diseases and the rising of slow pandemics of non-communicable diseases. The current COVID 19 pandemic brings to light the need to revamp the training in public health during the internship. A standardized and outcome-based approach to internship training is the need of the hour for the Indian medical graduate (IMG). The internship program in community medicine should train the Indian medical graduate to develop patient management and administrative skills to promote health care through a health facility. The training provided is not standardized or evaluated across the medical colleges. Hence, it was aimed to study the effectiveness of educational interventions on internship training during the posting at the rural training health centre (RTHC). METHODS A quasi-experimental study was conducted among the interns posted in the rural training health centre using a v...

Research paper thumbnail of Trends in Acute Undifferentiated Febrile Illness in Patients Seeking Treatment from a Tertiary Care Hospital of Central Kerala

Journal of Evidence Based Medicine and Healthcare

BACKGROUND Acute undifferentiated febrile illness (AUFI / AFI) is one of the most common reasons ... more BACKGROUND Acute undifferentiated febrile illness (AUFI / AFI) is one of the most common reasons for people seeking medical care globally. Investigation into the aetiology and trends in AUFI cases are valuable public health data source. Absence of such evidence-based data may result in unintended public health consequences. Present study was undertaken to address the gap in period specific trends in AUFI cases reported from the region. METHODS A record based descriptive study was done in patients treated with AUFI from January 1st, 2015 to December 31st , 2019 in Government Medical College, Ernakulam. Universal sampling technique was adopted, and the data was entered in Microsoft Excel and analysed using Epi-Info software. Line diagram was constructed to obtain the trends in AUFI cases over the five-year period. Chisquare test was applied to find out the association between age group (paediatric and others) and causative agents of AUFI. RESULTS A total of 7998 AUFI cases were includ...

Research paper thumbnail of Quality of life and sociodemographic factors associated with poor quality of life in elderly women in Thiruvananthapuram, Kerala

Indian journal of public health

India is going through a phase of demographic transition leading to population aging and feminiza... more India is going through a phase of demographic transition leading to population aging and feminization of aging resulting in increased proportion of elderly women than men. Problems faced by the elderly women are more critical than men due to family and social conditions prevailing in India. The study made an attempt to assess the quality of life (QOL) using the World Health Organization QOL (WHOQOL-BREF) scale and sociodemographic factors affecting QOL of elderly women residing in a community setting in South Kerala. A community-based, cross-sectional study to assess the QOL of elderly women using WHOQOL-BREF questionnaire. Data were collected from 160 elderly women. 2.5% (95% confidence interval [CI]: 0.07-4.84) of the study participants were having "very good" QOL. 38.8% (95% CI: 31.2-46.4) had "good," 43.1% (95% CI: 35.4-50.8) had "poor," and 15.6% (95% CI: 9.98-21.22) had "very poor" QOL, respectively. QOL was least in the psychological do...

Research paper thumbnail of Deprived Among the Marginalised – Health Status of Women in a Tribal Settlement

International Research Journal of Social Sciences

Indicators related to health of women in Kerala depict a rosy picture. But there is a lot to be o... more Indicators related to health of women in Kerala depict a rosy picture. But there is a lot to be observed in between the social strata of the population, especially among those communities who are getting increasingly marginalized, like the tribal community. The aim of this study is to analysis the status of a tribal community compared to a non-tribal community sharing the same geographical location with respect to the gender. Present study is a cross sectional study conducted in a tribal belt inhabited by both the tribal and non-tribal people. Two cross sections were taken for better comparison. The data regarding all the 52 tribal families were analysed against 95 families who are not tribal. The tribal women enjoy a very low standard of living and poor living conditions. The health issues of these deprived should be considered for the all-inclusive development of the state and the country.

Research paper thumbnail of A prospective study on the relationship between blood pressure and blood group among adult male blood donors in a Tertiary care center

International Journal of Clinical and Experimental Physiology, 2015

Research paper thumbnail of Determinants of childhood tuberculosis--a case control study among children registered under revised National Tuberculosis Control Programme in a district of South India

The Indian journal of tuberculosis, 2011

To study the determinants of Tuberculosis (TB) in children between the age group of 0-14 years re... more To study the determinants of Tuberculosis (TB) in children between the age group of 0-14 years receiving treatment under Revised National TB Control Programme (RNTCP). A case (registered under RNTCP) control study was undertaken with 41 cases and 82 controls. Factors found to have significance according to binary logistic regression were low-birth weight (LBW) [Odd's ratio = 3.56],Malnutrition [Odd's ratio = 3.96], Passive smoking [Odd's ratio=6.28] and exposure to fire-wood smoke [Odd's ratio = 6.91]. LBW, malnutrition, passive smoking and fire-wood smoke are the risk factors to be addressed to prevent pediatric TB.

Research paper thumbnail of Environmental factors of households in five districts of Kerala affected by the epidemic of chikungunya fever in 2007

The National medical journal of India

Two epidemics of chikungunya fever were reported from Kerala in 2006 and 2007. We aimed to invest... more Two epidemics of chikungunya fever were reported from Kerala in 2006 and 2007. We aimed to investigate the environmental factors of households affected by chikungunya fever and to estimate the proportion of population that suffered from the disease during the epidemic in 2007. A cross-sectional survey was conducted in the 5 heavily affected districts of Kerala during October-November 2007. The 2-stage sampling technique was used to collect data from 10 clusters, each having 18 houses from every district, by interviewing the subjects using a structured questionnaire. The sample size was 900. The proportion of the population affected by chikungunya fever was 57.1% (95% CI: 52.8%-61.4%). There was a significant association between location of houses and disease status. Houses located near a public conveyance facility (within 250 m) were relatively protected from the disease (OR 0.19 [0.06-0.60]). About 69% of the households perceived mosquito infestation as a problem and 46.6% used fum...

Research paper thumbnail of Study of acute febrile illness: A 10-year descriptive study and a proposed algorithm from a tertiary care referral hospital in rural Kerala in southern India

Tropical doctor, Jan 23, 2014

Acute febrile illness (AFI), the initial diagnosis of whose cause is often presumptive, can somet... more Acute febrile illness (AFI), the initial diagnosis of whose cause is often presumptive, can sometimes be a challenge for the treating physician. To address this issue we carried out a hospital- based descriptive study. More than half (51.5%) of the patients were presumed to have viral fever. Most of the patients (60%) were in the productive phase of life (age range, 18-45 years). The outcome was worst among those aged over 65 years. A definite seasonal trend was observed with a peak in incidence with the arrival of the monsoon in Kerala. Public awareness regarding fevers in the pre-monsoon season should be heightened. Special care should be given to the elderly as they are often the most vulnerable. The use of the proposed locally based algorithm may avoid unnecessary investigations and treatment.

Research paper thumbnail of Prevalence of Hypertension and Pre-Hypertension among Adolescents

The Journal of Pediatrics, 2007

Research paper thumbnail of Elementary school enrolment and its determinants among children with cerebral palsy in Thiruvananthapuram district, Kerala, India

Journal of Neurosciences in Rural Practice, 2013

Context: There is enough documented evidence to prove the benefits of early and appropriate initi... more Context: There is enough documented evidence to prove the benefits of early and appropriate initiation of education among children with cerebral palsy (CP). Aim: To find out the proportion of children with CP who are enrolled for some kind of formal education and to study the determinants of the same. Setting and Design: This cross sectional study was done among children, attending the special clinics at government medical college, Thiruvananthapuram. Materials and Methods: Children between 3 and 12 years of age diagnosed with CP were subjects for the study. Statistical Analysis Used: Enrollment for any form of formal education was the major outcome variable. The factors associated with initiation of formal education were tested using Chi-square test or Fischer′s exact test. Independent association of each factor was evaluated through binary logistic Regression analysis. Results and Conclusions: The mean (SD) age of the children (n = 86) was 5.7 (2.3) years with forty-six (53.5%) of...

Research paper thumbnail of Epidemiology of measles outbreaks in Kerala, India, during 2007-2008

Annals of Tropical Medicine and Public Health, 2012

Context: Measles imparts high morbidity and mortality in low-income countries with weak health in... more Context: Measles imparts high morbidity and mortality in low-income countries with weak health infrastructure. The coverage of measles vaccination in Kerala which is best performing state of India in indicators of health has also not reached the elimination level and outbreaks of measles continue to occur. Aim: The aim of the paper was to study the profile of measles outbreaks in Kerala during the years 2007-2008. Settings and Designs: The study design was cross-sectional and data of the measles surveillance project of Kerala were analyzed. Results: The total number of clinically suspected measles outbreaks in Kerala during the 2-year period of 2007 and 2008 was 29. But only 15(53.6%) were found to be 'measles only' outbreak. The total number of epidemiologically linked measles cases was 718 (314 in 2007 and 404 in 2008). The cases that were immunized but developed the disease were 187 (28.6%), the number of cases that were not immunized was 355 (54.3%) and those whose immunization status was unknown were 112 (17.1%). The mean age of occurrence of disease was higher in the vaccinated group as compared to not vaccinated group. Two deaths were recorded in the study. Conclusions: Significant morbidity and mortality due to measles do occur in the most developed state of India. The epidemics were clustered in some districts. The study indicated an age shift in occurrence of measles cases among who received the vaccination.

Research paper thumbnail of Clinical Profile of Chikungunya Patients during the Epidemic of 2007 in Kerala, India

Journal of Global Infectious Diseases, 2011

C hikungunya is described as an acute illness, with fever, skin rash and incapacitating arthralgi... more C hikungunya is described as an acute illness, with fever, skin rash and incapacitating arthralgia. [1] Arthralgia is the salient feature of Chikungunya that distinguishes it from Dengue, which otherwise shares the same vectors, symptoms and geographical distribution. [2] The disease itself is rarely fatal [3] and is sometimes confused with Dengue, O'nyong-nyong or Sindbis virus infection. [4] Typical features of the disease include abrupt, massive outbreaks with a high attack rate [5,6] followed by slow decline of cases as herd immunity develops. [7-9]

Research paper thumbnail of Pattern and determinants of respiratory mortality in Kerala, South India

International Journal of Medicine and Public Health, 2014

Context: Respiratory diseases are one of the leading causes of deaths worldwide. There are no pub... more Context: Respiratory diseases are one of the leading causes of deaths worldwide. There are no published studies on the pattern and determinants of respiratory mortality from South India. Aims: The aim was to fi nd out the pattern and determinants of respiratory mortality during July 1, 2002 to June 31, 2008 in Varkala, Thiruvananthapuram district, Kerala. Settings and Design: A nested case control study from a prospective cohort was done to fi nd out the determinants for respiratory mortality. The main outcome measure was mortality due to respiratory causes. Materials and Methods: The data collected here are from the Population Registry of Lifestyle Diseases study, a prospective cohort study involving the long-term followup of the residents of Varkala rural development block Thiruvananthapuram district of South Kerala. Statistical analysis used: The age specifi c respiratory mortality rate was calculated. Chi-square test and odds ratio (OR) were measured to fi nd out the association between exposure and outcome variables. Logistic regression was performed. Results: A total of 3467 deaths were reported among 77881subjects above the age group of 20 years during the follow-up period. Of which 531 (15.9%) were due to respiratory causes. On logistic regression smoking (AdjOR [95% confi dence interval]; 1.65 [1.25, 2.17]), lower socioeconomic status (AdjOR; 1.52 [1.24, 1.87]), lower educational status (AdJOR; 2.22 [1.15, 4.29]) and old age (>60 years) (AdjOR; 2.6 [2.03, 3.33]) were found to be the signifi cant risk factors for respiratory mortality. Conclusion: Mortality due to respiratory causes was found to be high in Kerala, a state which has the best health indicators compared to other states in India.