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Background: Screening of presumptive cases of TB for HIV is a challenge as it requires pre-test counselling and informed consent of the patients. This study aims to measure the proportion of presumptive TB cases who were screened for HIV status and their outcome.Methods: The present study was a record based cross sectional study comprising of all presumptive and confirmed cases of tuberculosis patients who visited PIMS during the study period, from June 2019 to June 2021. Percentage and proportions were used to express the outcome variable.Results: A total of 862(39.3%) out of 2,193 presumptive tuberculosis patients were screened for HIV in the last 2 years, out of which 9 patients (1%) turned positive. Out of 328 microbiologically confirmed tuberculosis patients we have screened 325(99%) patients and 6 (1.8%) patients were found to be positive.Conclusions: As per provide initiated HIV testing and counselling guidelines, screening of presumptive cases of TB yielded positive results in identifying additional cases of HIV positive patients.

Background: Strong surveillance systems which include both active and passive surveillance are the important steps to halt a disease outbreak by early case detection and management, which helps in breaking the chain of transmission. The main aim of this article is to share our experience regarding the active and passive surveillance done during COVID 19 spread in the year 2021.Methods: The early case detection of COVID 19 cases through active and passive surveillance was slightly different from the usual methods that are carried out for regular known communicable diseases. Active surveillance was done round the clock by screening of all vehicles entering the union-territory of Puducherry and by house-to-house survey. Passive surveillance was carried out by screening of various symptomatic patients attending to hospitals which needed motivation of health personnel as well as awareness among the general public.Results: Out of 12 Govt. PHCs (3,30,000population) where active and passive surveillance was conducted, the total number of individuals referred to designated COVID centre by active and passive surveillance is 30 and 110 respectively for COVID testing and further management.Conclusions: Active and Passive surveillance plays a major role in early case detection and prevention of disease spread in COVID-19 pandemic.

Background: Road traffic injuries (RTIs) are a leading public health problem. Approximately 1.3 million people die each year as a result of road traffic crashes as of June 2021. RTIs cause considerable economic losses to individuals, their families, and to nations as a whole. 93% of the world's fatalities on the roads occur in low-and middle-income countries. This study aimed to assess the pattern of RTIs among individuals attending a rural health training center in Tamil Nadu.Methods: The present study was a record based cross sectional study comprising of 113 patients who attended an outpatient department in rural health training center in Tamil Nadu from January 2021 to June 2021.We collected socio-demographic data (age and sex) and pattern of injuries from the database. We entered data in excel sheet and analyzed using SPSS version 21.0.Results: Mean (±SD) age of the patients was 34.2(±18.46) years. Most common pattern of injury was abrasion 98 (86.7%), followed by contusion 28 (24.8%) and laceration 14 (12.4%) respectively. Most RTIs required dressing 106 (93.8%) while 13 (11.5%) needed suturing.Conclusions: The present study showed that RTIs were more common in the younger male population. Abrasion was the most common type of injury reported.

Background: To find the characteristics of an effective medical teacher, as perceived by the under graduate medical students who are at different stages of the MBBS course.Methods: A cross sectional study was done among all the undergraduate medical students studying in a medical college and hospital in Puducherry. The undergraduate students were visited in batches and students were explained regarding objectives and those who consented for the study were administered with a validated and pretested questionnaire in line with the objective of the study. The results are expressed in the form of proportions and percentages and the chi-square-test was used to test the significance of difference observed between different batches of studentResults: The most important qualities perceived by the students for being an effective medical teacher are creating interest in the subject, having good communication skills, providing good resource material, inspiring and motivating students, being easily approachable, respecting students/ patients / other staff, being enthusiastic, energetic and good listener. There is a significant difference in the perceived importance among different batch of students in the domain of teaching skills of a medical teacherConclusions: This study identified qualities of medical teachers related to their teaching skills, usage of teaching learning methods, approach towards students and their personal qualities that are perceived to be more important by medical students.

Background: Usage of social networking sites like WhatsApp and Facebook in smartphones has become a basic necessity in today’s life, especially among college students. However, the excess usage of mobile phone affects sleep quality and attention span. Nursing students are prone to sleep disturbance due to their academics and work pattern. The aim of the study was to assess the pattern of WhatsApp and Facebook usage among nursing students and its impact on their sleep quality.Methods: A cross-sectional study was conducted among 168 nursing students of a nursing college in Puducherry. Participants were explained about the purpose of study and written informed consent was obtained. Data was collected using a self-administered questionnaire. Sleep quality was assessed using PSQI scale. Institutional ethics committee approval was obtained for the study. The data was entered in Microsoft Excel and analyzed using STATA 14.Results: Among the study participants, most of them prefer WhatsApp over Facebook. Almost 40% of the students had poor quality of sleep. There was statistically significant association between usage of WhatsApp while feeling sleepy, while having food and poor quality of sleep. However, the adjusted prevalence ratio of poor sleep quality did not show statistical significance. Conclusions: The current study showed statistical significance between certain pattern of WhatsApp usage leading to poor sleep quality among nursing students. Thus, corrective measures have to be implemented to moderate the mobile phone usage and improve the sleep quality of nursing students.

Background: Food handlers play an important role in ensuring food safety throughout the chain of production, processing, storage and preparation. Mishandling and disregard of hygienic measures by food handlers may lead to food contamination and cause illness among the consumers. This study was undertaken to determine the knowledge, attitude and practice towards food-borne diseases and personal hygiene among food handlers in a tertiary care hospital and to assess their morbidity status.Methods: A cross-sectional study was conducted among the food handlers working in the food establishments within the campus of Pondicherry Institute of Medical Sciences (PIMS), Puducherry. Total 51 food handlers consented and participated. Participants were explained about the purpose of study and written informed consent was obtained. Data was collected using a pre-tested pre-validated questionnaire. Data was analyzed using SPSS version 17.0. Institutional ethics committee approval was obtained for the study.Results: Overall the average score for knowledge, attitude and practices was good among the food handlers. There was statistically significant association between the lesser attitude & practice scores and the history of gastrointestinal morbidity among the participants. There was positive correlation between the years of work experience and the mean knowledge, attitude and practice scores.Conclusions: Although knowledge, attitude and practices of the food handlers working in the tertiary care hospital was good but periodic health education and awareness will contribute in maintaining and reinforcing the existing knowledge and practices so as to prevent any food contamination and potential outbreak of food borne illness.

Background: Ebola Virus Disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans. The current outbreak in West African countries like Guinea, Liberia and Sierra Leone is one of the largest in the history. Hence, to forecast the trend in a number of cases of EVD reported in these Countries a univariate time series model was used. Methods: We adopted an Auto Regressive Integrated Moving Average (ARIMA) models on the data collected between March 2014 to December 2014 and verified it using the data available between Jan 2015 to June 2015. The same has been used to predict the number of cases till December 2016 without any additional intervention. Results: The results also showed an increasing trend in the actual and forecasted numbers of EVD cases. The appropriate ARIMA (1, 1, 0) model was selected based on Bayesian Information Criteria (BIC) values. Conclusions: Hence, to prevent the disease from getting established as an endemic in these countries, additional interventions with an increase in the intensity of existing interventions and support of the international community along with WHO is essential to stop the epidemic.

Background: There is growing concern among medical educators that conventional modes of teaching medical students neither encourage the right qualities in students nor impart a life-long respect for learning. The aim is to study the perception of undergraduate medical students about tutorials as a teaching learning method. Methods: A cross-sectional study was conducted among 7 th semester M.B.B.S students of Pondicherry Institute of Medical Sciences. A tutorial session was conducted among 71 medical undergraduate students who were divided into 6 groups. The handouts were distributed to all the groups. Tutorial was conducted by trained faculty of the department of community medicine. At the end of the tutorial, a predesigned pretested questionnaire with responses prepared using Likert’s scale was given to all students to record their responses and feedback. Proportions of students’ response for various items were calculated and analysed using SPSS software. Results: Among the students who participated in the tutorial session 45 (63.4%) said that they could understand the topic better in tutorial. 49 (69%) students felt time management was better in a tutorial as compared to lecture. 55 (77.5%) expressed that tutorials are more interactive than a lecture. Conclusions: To conclude, the medical undergraduates felt that tutorial is an effective method of teaching learning process.

Background: In the year 2018, Kerala experienced natural disastrous due to heavy rainfall and floods due to breakdown of dams. More than five lakhs people were affected and disruption in transportation, communication and damaged health care facilities. Objective of this study was to access the morbidity pattern of flood victims in the post flood recovery phase.Methods: The study was carried out by the investigators along with medical team conducted free camps in seven different locations in the districts of Wayand and Kozhikode in the month of October 2018. Data were obtained in the format designed by the National Centers for Disease Control and Prevention, India.Results: A total of 3123 patients were attended the flood relief camp. The most of the camp people were come up with complaints of myalgia 24.8%, acute respiratory infections 14.6%, skin infections 8.3% and 7.7% had fever.Conclusions: To create awareness to the community about the natural disaster and appropriate action to prevent it through information, education and communication by regular period of intervals. And to provide basic amendments to improve the health care infra structure.

Background: The salt pan workers are exposed to severe health hazards like extreme heat, intense manual labour, direct contact with salt, sunlight glare from salt crystals. This paper describes their knowledge, attitude and practices (KAP) regarding their work related hazards as well as availability and use of personal protective equipments (PPEs).Methods: A community based cross sectional study was conducted in 4 randomly selected villages among the 10 salt worker villages in Marakkanam, Tamil Nadu. A house to house survey of the selected villages enrolled 331 salt workers. The data was collected using a pre designed and pre tested questionnaire.Results: Majority of salt worker (78.5%) reported of being aware of one or more hazards like physical stress (70.7%), direct sunlight (38.7%) and glare from salt crystals (16%) in salt work that resulted in musculoskeletal problems, ophthalmic problems, headache and giddiness. 87% of the salt workers were aware of one or the other personal protective equipments. However, only less than 10% were using the conventional PPEs. The reasons for not using PPE were mainly inconvenience in using and PPE not provided by the employer.Conclusions: Most of the study population is aware of the hazards as well as one or the other methods of protective equipment but actual use of PPE is very low because of non-availability and perception of inconvenience in using them. There is a large gap between awareness and practice regarding PPE usage among these salt workers.

Background: The occupational hazards faced by salt pan workers during their occupation are myriad, a fact compounded by the lack of basic amenities at their workplace and lack of awareness regarding usage of personal protection equipment.Methods: This cross-sectional study was carried out among fifty-six salt pan workers in Marakkanam, Tamil Nadu to assess their common health problems and a qualitative component was added to assess their felt needs in work place and daily living. Data was collected using pre-designed data collection sheet for assessing the common morbidities. For the qualitative aspect of the study, in-depth interviews were conducted among twenty workers based on convenient sampling, using open ended questions. Data was collected after obtaining informed consent and steps were taken to ensure confidentiality at all stages.Results: The most common health problem of the workers in present study area included dental caries (41.7%), skin conditions (38.1%) musculoskeletal problems (36.7%) and anemia (35.1%) being other significant health problems. The qualitative aspect of the study revealed that the felt needs were improvement of their working conditions and more social support from the Government and the employers. There was very little awareness among the workers regarding use of PPE and none of them used any form of PPE.Conclusions: Salt pan workers had dental problems, dermatological problems and musculoskeletal problems as most common morbidities among them. Harsh working conditions, financial insecurity etc. are some of their work-related problems. Provision of housing facility and financial assistance during off- season by the government, basic amenities at the work place, paid leave in case of injuries, and insurance schemes for them by employer are their main felt needs. They also had no awareness regarding usage of personal protective equipment at the work place.

Background: The increasing prevalence and incidence of diabetes and hypertension with increasing age and adult age group are at high risk of developing diabetic and hypertensive retinopathies.Methods: The study was conducted in a rural area of Puducherry, data collection was carried over a period of six months. Self-reported patients of diabetes and hypertension were included in the study and predesigned questionnaire was used to collect the information about socio-demographic details, risk factors, physical activity, history related to DM/HTN and history of fundus examination.Results: Majority of patients screened for diabetes 56% and hypertension 47% was by government hospital. The proportion of diabetics and hypertensives who had undergone fundus examination to rule out diabetic and hypertensive retinopathy was found to be 29.3% (12) and 14.5% (10). Complications such as neuropathy and retinopathy were given by 36.5% (15) and 2.4% (1) of diabetic patients Two third of the patients 64.1% had sedentary life style.Conclusions: Health care providers need to plan for larger coverage of fundus examination among diabetic and hypertensive patients.

Background: Dengue virus infection is an important global public health issue. Dengue disease burden in India is one of the highest in the world. Dengue is transmitted by Aedes mosquitoes which breeds mostly in water stagnated in artificial containers in and around the home surroundings. Puducherry reported an increased incidence of dengue cases in the recent years. Hence this study was done to assess the environmental risk factors associated with dengue transmission.Methods: A community based cross sectional study was done in 200 households of Solai Nagar, an urban area in Puducherry. Assessment of home environment and examination of the house holds for the presence of breeding sites of dengue mosquitoes and its larvae was done and socio demographic details, details of protective measures against dengue practiced by the respondents were obtained.Results: More than 80% of people live in pukka houses. There was no open defecation practice in this area and 90% of households disposed their solid waste through municipality. On assessing the breeding sites of Aedes mosquitoes, potted plants with saucer were found in high number (355) in 30% of the houses, air coolers in 17% of the houses. Discarded junks and discarded food container, disposal cups and coconut shells were present in many of the houses. Less than 40% of households only used at least one type of protective measures against dengue.Conclusions: The study area had abundant potential breeding sites of Aedes mosquitoes and the protective measures followed by the residents against mosquito bites were not adequate.

Background: Increasing longevity of the world’s population has resulted in a shift in the disease patterns prevalent hitherto. The worst affected are the middle and low- income countries including India. The genetic make-up of Indians render them highly susceptible to cardiovascular diseases and diabetes at a much earlier age with resultant higher mortality rates. Thus, low- cost early detection, and innovative, customized preventive strategies are the need of the hour. Methods: In this cross- sectional study, we have used the WHO/ISH risk prediction charts tailor – made for the SEAR D region, to assess the cardiovascular risk of a rural population aged above 40 years. Data regarding multiple cardiovascular risk factors were collected using a pre- defined and pre-tested questionnaire, from 400 participants, including other variables like BP and anthropometric measurements. The data were entered in Microsoft excel and analysed using SPSS- ver16. Results: We found that 14.5% of the population had more than 10% risk of cardiovascular diseases and 41.5% were in stage I or II hypertension. People who belonged to the class II SES, use of oral tobacco, saturated cooking oils and sedentary lifestyle was found to be associated with high CV risk. However the association of CV risk with other risk factors like smoking and BMI was inconsistent. Conclusions: There is an increasing trend of cardiovascular risk in rural areas of Tamil Nadu and risk factors like higher socio economic class, use of oral tobacco, saturated cooking oils and sedentary occupation were found to be associated with high CV risk.

Background: Obesity is associated with cardiovascular diseases and has become the main public health issue in India. However, the prevalence of obesity in India varies widely. The aim of this study was to assess the prevalence of overweight and obesity among rural adults in a coastal area of South India.Methods: The prevalence of overweight and obesity was assessed among individuals of 15 years and above living in a rural coastal area of Tamil Nadu in India.Results: Among 207 adult participants, 69.1% were female. About one-fourth (23.7%) of the participants were in age group of 15-24 years and 67.2% participants were literate. About one-third (30%) of the adults were overweight. Obesity was present in 14% of the study participants (26% by using the Asian cut-offs). Using waist circumference and waist-hip ratio cut-offs, abdominal obesity was observed among 55% and 57% of the participants. Among females the central obesity was more common than males. Conclusions: The prevalence of obesity in rural areas was high. There is need to implement community based programs to tackle the increasing obesity.

Background: Understanding of health seeking behaviour (HSB) is essential to provide need based health care services to the population. Many factors like sex, age, type of illness, access to services and perceived quality of the services, influences the health seeking behavior. This study assessed the HSB among rural population of a coastal area in Tamil Nadu.Methods: A community based descriptive study was done in a rural coastal area of Villupuram district in Tamil Nadu state of India. Using simple random sampling method, 559 participants were selected. A pre-tested structured questionnaire was used to collect the data. Information about socio-demographic characteristics, presence of acute or chronic illness, health care seeking behavior and reasons for non-utilization of particular health facilities etc. was obtained. Chi square test was applied to find the association of health care seeking behavior with various participant characteristics. Results: Among 559 study participants, majority (56.4%) visited public health care facilities for various illnesses. Almost one-third of the study participants visited the private health facilities and another 11.6 percent visited other health facilities including pharmacies. Among various causes, febrile illnesses (39.5%) and pain (20.8%) were the most common reasons for visiting a health care facility. Individual’s income was significantly associated with the HSB (p value Conclusions: Public health care facilities were preferred by due to low cost of services and HSB varies with the type of illness and income of the individuals.

Background: Malnutrition and poor health among school children is the common cause of low school enrolment, high absenteeism, early dropout and poor classroom performance. This study was conducted to assess the various morbidities and nutritional status among school children. Methods: This descriptive study was conducted during year 2013 in a higher secondary school located in a coastal area of Puducherry. A total of 714 students were interviewed and examined. A pre-designed and pre-tested questionnaire was used to interview and examine all the participated students. Body weight and height were measured using standardized procedures. WHO criteria for classification of nutritional status was used. Visual acuity and colour vision was assessed using Snellen’s chart and Ishihara’s pseudo isochromatic chart respectively. Mean scores and proportions were calculated and chi-square test was applied. P value of

Background: Early diagnosis of the disease and prompt initiation of treatment are essential for an effective tuberculosis (TB) control program. The delay in the diagnosis and treatment may worsen the disease, increases the risk of death and enhances tuberculosis transmission in the community. This study was done to assess the extent of various delays and their determinants among TB patients. Methods: A cross-sectional study including retrospective medical record review and patient interviews was conducted during the year 2010 in and around union territory of Puducherry in India. A structured questionnaire used in the WHO multi-country study to estimate the diagnostic and treatment delay in TB was used to interview the patients. Average estimates and proportions were calculated for continuous and categorical variables respectively. Unadjusted odds ratios (OR) were calculated. Level of significance was determined at 95% confidence level (P value