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Background: According to WHO, Sleep is triggered by a complex group of hormones that are active in the body, and that respond to cues from the body itself and the environment. Sleep disturbance is a frequently overlooked complication of intensive care unit (ICU). The aim of present study is to assess the quality of sleep and to identify the factors influencing quality of sleep among patients in intensive care unit. Materials and methods: A descriptive analytical survey design was used in this study. Total of 54 patients in between the age group of 18-60 who were admitted in the Intensive Care Unit of a Tertiary care unit, Ernakulam were selected using a sample of convenience. Data were collected using a structured questionnaire. Statistical analysis was computed using SPSS software. Results and Conclusion: Out of 54 subjects, 64.8% have good quality of sleep and 35.2% have poor quality of sleep. The study findings revealed that the noise produced by conversation is significantly associated with the quality of sleep among ICU patients (p=0.016). None of the other variables were found to be associated with the quality of sleep among ICU patients (p>0.05).

Background: Mosquitoes are one of the deadliest animals in the world. Their ability to carry and spread disease to humans’ cause millions of deaths every year. Knowledge regarding the bionomics of mosquito is utmost important for developing control measures. Dengue is one of the most important and fastest re-emerging arboviral diseases, with 2.5 billion people living in areas of risk. The larval indices are easy to assess and gives the mosquito density. Objective: This study was done to calculate standardized larval indices over a period of 5 months, to determine the major breeding sources for mosquitoes, to study the seasonal trends in larval indices in a rural residential area under Kaiparambu Panchayat of Thrissur district, Kerala. Methods: A cross sectional study was conducted over a period of 5 months (June-October) in the houses under ARCH (Amala Rural Community health) programme of Amala Institute of Medical Sciences- Kaiparambu panchayat of Thrissur district. A house to house survey was done and every water holding container-indoor and outdoor were counted, searched for larval presence, collected and assessed. Each Larvae collected was examined and species identified. Descriptive statistics was done manually to quantify the percentage of positive containers obtained. Result: A total of 581 houses were surveyed, 223 had larval presence. The entomological indices were respectively accounted as Container Index=29.03; House Index=49.1; Breteau Index=80.3 in June and CI=19.8; HI=32.6; BI=34.7 in October. There was seasonal variation in the indices. The commonest species of mosquito identified was Aedes albopictus. Conclusion: The area has high risk for mosquito borne disease outbreaks, with seasonal variations and rainfall patterns. With adequate preventive measures, it can be avoided. How to cite this article:Anna SP, Vincent J, Saju CR, Rafi MM. A Study on Larval Indices of Aedes and Risk for Dengue Outbreak in a Rural Area of Thrissur District, Kerala. J Commun Dis 2020; 52(1): 1-6. DOI: https://doi.org/10.24321/0019.5138.202001

Objectives To measure the prevalence of depression among the rural elderly population of North Tamilnadu in India and to identify the associated social factors. Methods A community based cross sectional study was carried out among those aged 60 years and above. The data was collected from 162 consenting participants, who were selected through a multi staged cluster sampling, using a structured interviewer administered questionnaire and Geriatric depression scale (short form) and prevalence was calculated. A binary logistic regression was done to identify the independent association of risk factors with depression. Results The study found the prevalence of old age depression as 52.5% (95% CI: 44.7-60.3) with factors low socio economic status, increasing age and single status posing strong independent risk. Conclusion The authors advocate community based support systems in rural areas which will increase the social interaction and inclusiveness of the aged.

Background: Malnutrition plays an important role in the economic burden of society as well as the country. This study aimed to identify the various risk factors and determinants of severe acute malnutrition (SAM) as defined by WHO growth reference standards in children aged 6 months to 59 months living in Vellore. Methods: A community-based case-control study matched for age (±2months), gender and location was done among the children of the age group 6- 59 months residing in both rural and urban Vellore. Children of age group 6-59 months with SAM according to WHO definition, i.e., weight for height of less than -3SD with or without nutritional oedema were classified as cases. Children with weight-for-height z-score more than -1 SD and MUAC ≥13.5cms were classified as controls. With 2 controls per case, the required sample size was 54 cases and 108 controls. A questionnaire used to identify the risk factors including dietary intake. Uni-variate and multivariate analysis was done to generate an odds ratio and 95% confidence interval for the risk factors. Results: Majority of the cases 64.8% and 50% of the controls belonged to low SES. After adjusting all confounders, Severe Acute Malnutrition was significantly associated with birth weight

Older people suffering from dementia are prone to develop malnutrition. Ensuring adequate nutrition among such patients has always been a challenge for the carers due to the pathological and chronic nature of the disease. In this article, the author tries to analyze the use of five different strategies in providing adequate nutrition for such patients in their own homes by the carers using a narrative literature review method. The strategies include nutrition screening and assessment, training and education program for the caregiver, mealtime environment and routine modification, provision of nutritional supplements, and role of artificial nutrition and hydration (ANH). An attempt was made to critically engage the readers while exploring the feasibility and challenges involved in implementing such strategies in resource-poor settings like low-middle-income countries. The article concludes that the first four strategies should be used in tandem to prevent the risk of malnutrition. It does not recommend ANH and concludes that it does not bring in any added benefit and may worsen the quality of life.

Background: The geriatric population is on a rise in India, which is accompanied by an increase in their health care needs. As they are prone to have multiple diseases simultaneously the tendency for over the counter (OTC) or non-prescription drugs is much higher among the elderly population. A thorough knowledge about the medication practices among elderly is indispensable since the chances for adverse drugs events; drug interactions etc. are higher among them. The primary objective of the present study was to measure the prevalence of over the counter drug usage among those aged 60 years or above residing in a rural block of North Tamilnadu, India. Methods: A community based cross sectional study was conducted among those aged 60 years or above using an interviewer administered questionnaire and data was collected from 100 consenting participants who were selected using multi stage sampling. Results: The prevalence of the usage of over the counter drugs among the elderly population was found to be 51% (95% CI 41.1-60.9). It was shown that the usage of OTC drugs was associated with higher socio economic status (p value 0.015) and literacy (p value 0.003). Conclusions: Further studies need to done to identify whether such high prevalence of OTC drug usage among elderly is a reflection of drug practices among general population and if proven otherwise should explore the various reasons for the same so that necessary measures can be implemented to alleviate the situation.

India had always been known as the land that portrayed cultural and traditional vibrancy through its conventional arts and crafts. Every region in India has its own style and pattern of art, which is generally known as folk art. Perhaps the best-known genre of Indian folk paintings is the Warli painting from Maharashtra state. Traditionally Warli paintings were done by hand which is tedious, time consuming and laborious process. But due course of time with easy availability of different styles of printing, these paintings can be brought down on cloth by using various printing techniques. Hence, in the present study an attempt was made to develop blocks of Warli paintings of Maharashtra for printing of apparels and handicraft items. Total thirty designs were developed with the help of computer software "Adobe Photoshop" and "Corel Draw", ten each for apparels including kurties, suits and sarees. All the developed designs were subjected to visual evaluation for selection of two best designs from each category by the panel of thirty judges. The selected designs were applied on apparels using block printing technique. The cost of each article was calculated on the basis of expenditure on raw materials, labour charges, finishing charges and profit margin. Among the apparel items, brick red and black colour printed kurti (K9), green and purple colour painted suit (D7) and purple colour printed saree (S6) were highly appreciated and accepted. However, all the other products were also appreciated. Selling price of apparel items was ranged between Rs. 492/- to Rs. 1163/-. The adaptation of Warli motifs on apparels using block printing has paved the way for the plethora of product diversification that could lead to a flourishing market.

Replacement of missing tooth has evolved from removable dentures to fixed dentures and recently to dental implants. The need of sufficient bone around the endosseous implant is critical for the success of the implant. The present study was aimed to evaluate the efficacy of a novel implant (HYBRID IMPLANT-submitted for patency) for replacement of the missing teeth.1. Research design A prospective research design with a follow up after 1st week ,2nd week ,3rd week,1st month ,3rd month,6th month and 1st year postoperatively. 2. Sampling method Population: All patients who reported for replacement of missing teeth. Inclusion criteria 1. All patients above the age group of 16years 2. Patients who need replacement of single or multiple teeth in the anterior or posterior region of the maxilla and mandible. Exclusion criteria 1. Medically compromised patients. 2. Patients having craniofacial syndromes. 3. Sample size 5 patients were selected taking into consideration the inclusion and exclusion Criteria. Results PAIN All the patients were non symptomatic during the 1st month to 1st year postoperative periods.We experienced mobility during the 1st and 2nd postoperative periods where the implants were inserted in the mandibular molar region.Radiographic assessment showed no bone loss during the postoperative periods.The novel implant (hybrid implant) showed good stability and minimum patient discomfort during one year postoperative period evaluation. The implant system leads to new prospect in the field of prosthetic rehabilitation.

Aim: To empower and bring the underprivileged senior citizens in the rural areas to the mainstream of life through setting up of model “senior citizens' recreation centers” that can be replicated in the other parts of the country. Materials and Methods: Six senior citizens' recreation centers are run in six villages under a community health program of a leading Medical College in South India, which were started by looking into their perceived needs and in a location where organized self-help women groups (SHGs) showed willingness to take the role of caretakers. Together there are 140 members in 6 centers and the most deserving members were identified using a participatory rural appraisal (PRA) method. These centers are open for 5 days a week and the main attraction of the center has been provision of one good, wholesome, noon-meal a day, apart from several recreational activities. The members were also assessed for chronic energy deficiency (CED) and quality of life at the beginning of enrolment using body mass index (BMI) and WHO-BREF scale. Results: The attendance to these centers was nearly 90% of the enrolled beneficiaries. A statistically significant improvement was noticed in quality of life in the physical, psychological, social, and environmental domain (P < 0.05). There was also a significant increase in the average BMI after 1 year of the intervention (P < 0.05). Conclusion: Care of underprivileged senior citizens is a growing need in the rural areas and the “Recreation centers” proved to be a beneficial model that can be easily replicated.

Malaria is endemic across lowland Papua New Guinea (PNG) and case management has been based on symptomatic diagnosis and presumptive treatment of fever cases with an antimalarial. This study aimed to investigate the prevalence of malaria infection among fever cases presenting to 5 purposely selected sentinel health facilities in order to estimate the proportion of patients requiring antimalarial drugs. A total of 1807 fever patients were screened. Overall, 45% of fever patients had a positive malaria blood slide; 35% were infected with Plasmodium falciparum, 9% with P. vivax and 2% with P. malariae. Slide positivity was highest in Dreikikir (75%) and lowest in Wipim (2%). Among patients aged 1-4 years, 22% had moderate to severe anaemia (Hb8 g/dI) and 21% of children 2-9 years of age showed signs of splenomegaly (Hackett score 1-5). Comorbidity differed significantly between study sites and was not closely correlated with malaria infection. Clinical diagnosis by health facility staff was malaria for 67% of all fever cases, including 89% of slide-positive and 48% of slide-negative patients. 70% of rapid diagnostic test-negative cases were treated with an antimalarial. It is estimated that due to the lack of parasitological diagnosis the selected health facilities reported an excess of 18% (Dreikikir) to 98% (Wipim) malaria patients on average each month. In consideration of the significant differences in malaria-attributable fevers between study sites, the implementation of parasitological diagnosis in health facilities and administration of antimalarials only to test-positive patients has the potential to significantly improve the management of fever cases and reporting of malaria. A better tailoring to different settings may increase the effectiveness of malaria control interventions.

The name of Garfield Todd, Prime Minister of Southern Rhodesia, became known outside the country in 1958 when his cabinet successfully rebelled against him. Inside the country, the wonder was that he became prime minister in the first place. Historians have concentrated on Garfield Todd's sudden emergence as an MP in 1946, and his meteoric rise and fall, rather than on his background as a missionary and teacher. If failure in the political arena was his destiny, then his legacy is massive success as a missionary and the shaper of the lives and careers of so many young men and women who went on to dominate the leadership of several aspects of African life after 1980. The authors believe that the tenth anniversary of Garfield's death in 2002 is a good time to consider the Dadaya years and their impact on the man, and this article makes that assessment.

Introduction: With the rise in aged population there is a greater need to look into their nutritional and physical disability aspects which is otherwise neglected. The study aimed to assess the prevalence of malnutrition, anemia and physical disability among the community-dwelling aged population. Materials and Methods: A cross-sectional study was carried out in a rural block of north Tamil Nadu. Seventeen villages were selected using cluster sampling based on probability proportional to size. A total of 340 participants of age 60 years and above were selected from these clusters using simple random sampling. Nutritional status and physical disability were assessed using mini nutritional assessment scale and Barthel index. Blood samples were collected for anemia. Appropriate data entry and statistical analysis were done in EPIDATA and SPSS 16. Statistical Analysis Used: Besides calculating prevalence chi square and logistic regression tests were done to identify associated risk factors. Results and Conclusions: The overall prevalence of "at risk of malnutrition," anemia and physical disability were 10.9%, 38.2% and 20.6%, respectively. None of the community-dwelling aged population was found to be malnourished. Anemia and physical disability were significantly higher among the older age group [(OR 2.29 (1.17-4.89), (OR 2.81 (95% CI 1.31-6.04), respectively]. Similarly women were more affected with physical disability than men (OR 2.27 (1.28-4.02)). Further studies need to be done to explore the reasons for high prevalence of anemia.

A new telephone health advice service implemented in September 2000 is integral to the Capital Health (Edmonton) Region's strategy to build a comprehensive approach to primary healthcare. Capital Health Link operates 24 hours a day, seven days a week and was the first comprehensive nurse-based health advice phone line in Alberta.

We tested whether proteome reference maps established for one species can be used for cross-species protein identification by comparing two-dimensional protein gel patterns and protein identification data of two closely related bacterial strains and four plant species. First, proteome profiles of two strains of the fully sequenced bacterium Sinorhizobium meliloti were compared as an example of close relatedness, high reproducibility and sequence availability. Secondly, the proteome profiles of three legumes (Medicago truncatula, Melilotus alba and Trifolium subterraneum), and the nonlegume rice (Oryza sativa) were analysed to test cross-species similarities. In general, we found stronger similarities in gel patterns of the arrayed proteins between the two bacterial strains and between the plant species than could be expected from the sequence similarities. However, protein identity could not be concluded from their gel position, not even when comparing strains of the same species. Surprisingly, in the bacterial strains peptide mass fingerprinting was more reliable for species-specific protein identification than N-terminal sequencing. While peptide masses were found to be unreliable for cross-species protein identification, we present useful criteria to determine confident matching against species-specific expressed sequence tag databases. In conclusion, we present evidence that cautions the use of proteome reference maps and peptide mass fingerprinting for cross-species protein identification.

Background: The objectives of the study were to conduct a field survey to measure the prevalence of chronic diseases by taking history, to assess the feasibility of using remote data collection tools in field surveys and to create the map of the survey area using global positioning system (GPS). Methods: A community survey was carried out in two urban municipal wards by trainees with medical sociology back ground among those aged 35 years and above. There were a total of 563 participants from whom history of chronic diseases were collected and from those aged 60 years and above the presence of frailty was assessed using Canadian Study of Health and Ageing (CSHA) Clinical Frailty Scale. The data was collected using a remote data collection application named KoBo Toolbox, downloaded in their smart phones, which was sent directly to the main computer in the Clinical Epidemiological Unit, using mobile data or Wi-Fi hotspots. The co-ordinates of the households were marked using GPS which was also sent through the KoBo Toolbox to the main computer. At the centre the data was converted into excel sheets and various percentages were calculated. Results: In the survey the proportion affected with diabetes, hypertension, coronary artery disease and cerebrovascular accidents were 24%, 20.6%, 10.5% and 3.5% respectively. Among the older population 2.2% were found to be severely frail or worse requiring special care. The field map of the area surveyed was also generated using the co-ordinates marked using the GPS enabled phones. Conclusions: The remote data collection tool enabled us to conduct a survey on chronic diseases, effectively, within a limited period of time, creating a map of the area surveyed.

Background: Population is ageing in India. Health care and other needs associated with ageing have risen. The study objectives were to explore the concept of ‘healthy ageing’; health problems of elderly; and felt needs in the care of elderly perceived by the community.Methods: Total of five focus group discussions was conducted. Three Focus group discussions were conducted with family members of homebound elderly and one discussion each were conducted with primary health workers and residents of old age home to supplement the qualitative information gathered from the family members.Results: The participant could make a long list of geriatric health problems. But, their knowledge and attitude towards them was grossly incorrect. All the problems were regarded as part and parcel of ageing for which help was not sought proactively. Mental health problems were regarded as ‘behavioural’ and ‘psychological’ problems. The health problems had its bad effect on family relationships. The perceived healthcare needs were mostly of palliative nature. Day care centres were proposed to improve social interaction of elderly. The community could not afford the level of services which they need. Home care visits by a health team were regarded highly useful.Conclusions: Wide spectrum of barriers to healthcare access of elderly exists in the community. In this regard, a comprehensive community based geriatric health care program including health promotive, preventive, curative and palliative services needs to be formulated with a strong component of health education.

Purpose: The aim of this study was to evaluate the microstrain exhibited by bone around immediately loaded, platform-switched, and non-platform-switched implants under vertical and angled loading using a finite element analysis (FEA) and also to evaluate whether platform-switched implants evoke a better response than non-platform-switched implants on a mechanical basis. Materials and Methods: Three-dimensional finite element study was undertaken to model and analyze an immediate loaded situation. FEA was chosen for this study since it is useful in determining the stress and strain around the dental implant. Bone responses to vertical and angulated loads on straight and angulated abutments (platform-switched and non-platform-switched abutments) were evaluated. Results: Non-platform-switched abutments tend to exhibit a lower tensile stress and compressive stress but higher microstrain value (conducive to higher chance of bone resorption) than platform-switched abutments. Ideal bone remodeling values of microstrain (50-3000 μϵ) were exhibited by platform-switched straight abutments under vertical load and angled load (with an abutment-implant diameter difference of 1 mm). Conclusion: In spite of the obvious advantages, the practice of immediate loading is limited due to apprehension associated with compromised bone response and a higher rate of bone loss around an immediately loaded implant. The mechanical basis for the concept of "platform switching" in immediately loaded situation is analyzed in this context. The results of this limited investigation indicated that the ideal values of microstrain (50-3000 microstrain) can be exhibited by platform switching of dental implants (with an abutment-implant diameter difference of 1 mm) and can be considered as a better alternative for prevention of crestal bone loss when compared to non-platform-switched implants.

This paper reports on an analysis of recent journal articles and proceedings papers which discuss international operations networks. These networks are comprised of supplier, manufacturing, warehouse and transportation facilities and the connections between these facilities. They are a key feature of international organizations and the subject of considerable research. The first aspect of the analysis presented here focuses on three descriptive dimensions of the current research on international operations networks: world region, topic and research method. The results are directed at determining if there are regional differences in approach to research on international operations networks either in the topic covered or the research method employed. A second aspect of the study is to evaluate three frameworks identified by other researchers, each of which was used to classify the research reviewed for this paper. The usefulness of each framework is also assessed. Two conclusions result from the research reported here. First, there are no overall differences found in the topics covered or research methods used in different world regions. Secondly, of the three frameworks assessed, the Giffi, Roth and Seal (1990) framework, based on manufacturing strategy components, appears to be the most useful for classifying international operations network research. When the research is classified by this framework, statistically significant differences among world regions, topics and research methods are found.

In an anticipation of the rising geriatric population in India, the Central government constituted the National Policy for Older Persons in 1999 to promote the health and welfare of senior citizens in India. A major strategy of this policy is to encourage families to take care of their older family members. The policy also encourages voluntary organizations to supplement the care provided by the family and provide care and protection to vulnerable elderly people. The implementation of this policy, particularly in the rural areas, has been negligible and calls for a scaling-up of programs to address the physical, psychological, and social needs of the poor. Due to breakdown of the joint family system and the migration of the younger generation to the towns and cities, the elderly parents in the villages are left to fend for themselves. Too old to work and with little or no source of income, the elders are struggling even to satisfy their basic needs. This article primarily focuses on the various facets of elderly care in India. As a fledgling nation in elderly care, we should take cues from other nations who have pioneered in this field and should constantly evolve to identify and face the various challenges that come up, especially from rural India. The Rural Unit for Health and Social Affairs Department of a well-known Medical College in South India has developed a “senior recreation day care” model which proves to be a useful replicable model to improve the quality of life and nutritional status of the elderly in the lower rungs of society. More than a decade since its inception, it is now the right time to assess the implementation of our geriatric health policy and scale-up programs so that the elderly in our country, irrespective of urban and rural, will have a dignified and good quality life.

We tested whether proteome reference maps established for one species can be used for cross-species protein identification by comparing two-dimensional protein gel patterns and protein identification data of two closely related bacterial strains and four plant species. First, proteome profiles of two strains of the fully sequenced bacterium Sinorhizobium meliloti were compared as an example of close relatedness, high reproducibility and sequence availability. Secondly, the proteome profiles of three legumes (Medicago truncatula, Melilotus alba and Trifolium subterraneum), and the nonlegume rice (Oryza sativa) were analysed to test cross-species similarities. In general, we found stronger similarities in gel patterns of the arrayed proteins between the two bacterial strains and between the plant species than could be expected from the sequence similarities. However, protein identity could not be concluded from their gel position, not even when comparing strains of the same species. Surprisingly, in the bacterial strains peptide mass fingerprinting was more reliable for species-specific protein identification than N-terminal sequencing. While peptide masses were found to be unreliable for cross-species protein identification, we present useful criteria to determine confident matching against species-specific expressed sequence tag databases. In conclusion, we present evidence that cautions the use of proteome reference maps and peptide mass fingerprinting for cross-species protein identification.

What are the strategic operations choices that shape the hospital’s capabilities and at the same time define its constraints? In this article, we identify competitive capabilities hospital executives believe are required for competing successfully and discuss the strategic role of technology in hospital operations. First, a meta-process model for understanding the hospital delivery system as an organized linkage of generic processes is presented. The importance of technology as a hospital-wide process enabler in the model is illuminated. Then we explore how 65 hospital executives perceive strategic technology choices now and in the future. From the data, we identify a core set of critical success factors with respect to strategic technology use in hospitals. Wide gaps between the competitive priorities needed to achieve success and current capabilities are found. These gaps are highlighted by investigating the differences in capabilities and investments in both clinical and management technologies.