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To ensure the security and privacy of the Patient’s confidential and critical data transmitted in a wireless body area network (WBAN), all parties must mutually authenticate. Some existing mutual a...

This paper provides the list of all the features that should be required in designing the authentication protocol for wireless body area network and enhances the implementation of revocation functi...

Data-driven modeling, action, and strategies have become popular, and the education community has witnessed increased interest in data-driven decision-making (DDDM). DDDM values and prioritizes decisions supported by high-quality, verifiable data that has been effectively processed and analyzed. The objective of our study is to describe the design, development, and implementation of a data-driven, evidence-based model of academic development in the context of CUNY Graduate School of Public Health and Health Policy (CUNY SPH) utilizing SMAART (Sustainability Multisector Accessible Affordable Reimbursable Tailored) model. The alignment of academic and student affairs within CUNY SPH brought with it several challenges. Defining roles and responsibilities across different student and academic affair units with a goal of collaborative leadership model and lack of meaningfulness were key challenges. It was important to listen to the experiences and recommendations of various individuals performing various functions in different capacities. A unified framework of key data indicators was needed to create a transparent and equitable model. An innovative interactive SMAART SPH dashboard designed, developed, and implemented to guide data-driven, evidence-based decision-making. Institutions can use a large amount of data from various sources to improve students’ learning experience, enhance research initiatives, support effective community outreach, and develop campus infrastructure to bring in sustainability.

The real-world data on short-course of ICI use is sparse and merits exploration. A multi-centric observational study on the safety and efficacy of ICI in oncology patients between August 2014 to October 2020 involving 1011 patients across 13 centers in India. The median age was 59 (min 16- max 98) years with male preponderance (77.9%). The predominant cohort received short-course ICI therapy; the median number of cycles were 5 (95% CI 1 - 27) and median duration of therapy was 3 (95% CI 0.5 - 13) months. ICI were used commonly in second and third line setting in our study (66.4%, n=671). Objective response rate (ORR) (complete or partial response) was documented in 254 (25.1%) of the patients, 202 (20.0%) had stable disease and 374 (37.0%) had progressive disease. The clinical benefit rate was present in 456 (45.1%). Among the patients whom ICI was stopped (n=906), the most common reason for cessation of ICI was disease progression (616, 68.0%) followed by logistic reasons like financial constraints (234, 25.82%). With a median follow up of 14.1 (95%CI 12.9-15.3) months, there were 616 events of progression and 443 events of death and the median progression free survival and overall survival were 6.4 (95%CI 5.5-7.3) and 13.6 (95%CI 11.6-15.7) months respectively in the overall cohort. Among the immune related adverse events (irAEs), autoimmune pneumonitis (29, 3.8%) and thyroiditis (24, 2.4%) were common. Real-world multicentric Indian data predominantly with short-course ICI therapy, has comparable efficacy/safety to international literature with standard ICI therapy. This article is protected by copyright. All rights reserved.

WSNs have enthused resurgence in research on machine learning-based approaches with the intent of overcoming the physical restraints of sensors. Although resource constrained in nature, WSNs domain has tremendous potential for building powerful applications, each with its own individual characteristics and requirements. This fascinating field of WSNs although comprises of various research issues and challenges, viz. energy efficiency, localization, etc., which needs to rectified. One such prominent challenge is detection of outliers whose chore is to preclude any kind of malicious attacks in the network or lessen the noisy error prone data in millions of wireless sensor networks. To do so, the methodologies developed needs to take care of inherent limits of sensor networks so that the energy intake of motes is minimum and lifespan of the motes is maximized. Consequently, the quality of data must be thoroughly patterned as any kind of outlier in the sensed network may degrade the quality of the data and hence affect the final decision. Thus, it becomes imperious to retain the quality of the data. Numerous ML-based methodologies have been used by several researchers over the time to detect any form of outliers or anomaly present in the network. In this paper, some machine learning methodologies have been discussed which have proved their mettle in outlier detection for sensor networks. This paper presents a brief survey on outlier detection in WSNs data using various ML-based techniques.

In this study, Wireless Optical Communication LOS model for underground trains to station based on FSO is designed and simulated to achieve optimum performance and reduced bit error ratio. The FSO medium is highly dependent on Air Quality and Weather conditions bit error ratio vary depending on the conditions. The aim of this design is to achieve a lower Bit error ratio and to increase the range for the communication. The simulation is designed to improve the quality of communication through FSO channel by reducing the bit error ratio through filtering techniques. The results of this simulation will help future research and implementations of the FSO based wireless optical communication for underground trains. This simulation is based on V2I architecture where the communication is based on FSO technology.

With the rapid pace of technological advancements, public health professions require a core set of informatics skills. The objective of the study is to integrate informatics competencies and job analysis to guide development of an evidence-based curriculum framework and apply it towards creation of a population health informatics program. We conducted content analysis of the Population Health Informatics related job postings in the state of New York between June and July 2019 using the Indeed job board. The search terms included "health informatics" and "population health informatics." The initial search yielded 496 job postings. After removal of duplicates, inactive postings and that did not include details of the positions' responsibilities resulted in 306 jobs. Information recorded from the publicly available job postings included job categories, type of hiring organization, educational degree preferred and required, work experience preferred and required, salary information, job type, job location, associated knowledge, skills and expertise and software skills. Most common job title was that of an analyst (21%, n=65) while more than one-third of the hiring organizations were health systems (35%, n=106). 95% (n=291) of the jobs were fulltime and nearly half of these jobs were in New York City (47%, n=143). Data/statistical analysis (68%, n=207), working in multidisciplinary teams (35%, n=108), and biomedical/clinical experience (30%, n=93) were the common skills needed. Structured query language (SQL), Python, and R language were common programming language skills. A broad framework of integrating informatics competencies, combined with analysis of the skills the jobs needed, and knowledge acquisition based on global health informatics projects guided the development of an online population health informatics curriculum in a rapidly changing technological environment.

Nutrition informatics (NI) is the effective retrieval, organization, storage, and optimum use of information, data and knowledge for food-and-nutrition-related problem-solving and decision-making. There is a growing opportunity to facilitate technology-enabled behavioral change interventions to support NI research and practice. This paper highlights the changing landscape of food and nutrition practices in India to prepare a NI workforce that could provide some valuable tools to address the double burden of nutrition. Management and interpretation of data could help clarify the relationships and interrelationships of diet and disease in India on both national and regional levels. Individuals with expertise in food and nutrition may receive training in informatics to develop national informatics systems. NI professionals develop tools and techniques, manage various projects and conduct informatics research. These professionals should be well prepared to work in technological settings and communicate data and information effectively. Opportunities for training in NI are very limited in developing countries. Given the current progress in developing platforms and informatics infrastructure, India could serve as an example to other countries to promote NI to support achieving SDGs and other public health initiatives.

Background: Acute upper gastrointestinal bleeding (UGIB) is a common medical emergency characterised by haematemesis and/or melaena. All patients presenting with UGIB require prompt assessment using a validated assessment tool. Early assessment identifies patients at high risk of death, of further bleeding and those requiring intervention, including surgery. Aim of the study: To study clinical and endoscopic profile in acute upper gastrointestinal bleeding in tertiary health care centre. Materials and methods: The present study reviewed medical records of 100 patients who presented to the outpatient department with upper GI bleeding and underwent GI endoscopy. The age of the participants selected was more than 18 years. Clinical and endoscopic data of these patients was compiled and analysed. Results: Number of male patients in study group was 79 and number of female patients was 21. The mean age was 50.16 years. It was seen that esophageal varices is the most common findings (33%) followed by peptic ulcer disease (31%). The least common finding was malignancy which was present in only 2 % patients. Conclusion: Within the limitations of the present study, it can be concluded that esophageal varices was the most common finding followed by peptic ulcer disease in our study population. Malignancy was least common finding.

Introduction: Anemia is a common, underestimated problem in cancer patients receiving myelosuppressive chemotherapy and has significant adverse effect on the quality of life and outcome. Darbepoetin has been shown to be effective in this setting, but controversy surrounds it actual use. Methods: We analyzed prospectively collected clinical practice data of patients receiving darbepoetin in a real-world setting for this retrospective audit. Patients with baseline hemoglobin (Hb) of

Background & Objective: Cryptographic protocols had been evident method for ensuring con dentiality, Integrity and authentication in various digital communication systems. However the validation and analysis of such cryptographic protocols was limited to usage of formal mathematical models until few years back. Methods: In this paper, various popular cryptographic protocols have been studied. Some of these protocols (PAP, CHAP, and EAP) achieve security goals in peer to peer communication while others (RADIUS, DIAMETER and Kerberos) can work in multiparty environment. These protocols were validated and analysed over two popular security validation and analysis tools AVISPA and Scyther. The protocols were written according to their documentation using the HLPSL and SPDL for analysis over AVISPA and Scyther respectively. The results of these tools were analysed to nd the possible attack an each protocol. Afterwards The execution time analysis of the protocols were done by repeating the experiment for multiple iterations over the command line versions of these tools.As the literature review suggested, this research also validates that using password based protocols (PAP) is faster in terms of execution time as compared to other methods, Usage of nonces tackles the replay attack and DIAMETER is secure than RADIUS. Results and Conclusion: The results also showed us that DIAMETER is faster than RADIUS. Though Kerberos protocol was found to safe, the results tell us that it is compromisable under particular circumstances.

Experiential learning is a core competency of curricula across accredited U.S. schools of public health, helping students to hone diverse skill sets that will enable them to readily join the workforce and contribute to solving complex public health problems. At the City University of New York (CUNY) Graduate School of Public Health and Health Policy (SPH), all master’s and doctoral students are required to complete a practicum during their degree programs; yet practicum development and selection processes are often overlooked. To enhance the experiential learning program and Human Research Protection Program processes surrounding student practica at the CUNY SPH, researchers mined an administrative database and analyzed characteristics of practicum projects undertaken by graduate students. Findings from this novel study will facilitate policy and procedural changes within the SPH Office of Experiential Learning, which oversees the practicum program, and across SPH offices, including the Human Research Protection Program, to promote an optimal, student-centered practicum experience. Additionally, these analyses will serve as a model for other schools of public health seeking to develop, refine, and strengthen their practicum programs.

OBJECTIVES: To estimate the prevalence of hypertension and its risk factors among adults in four slum communities in Port-au-Prince. METHODS: Cluster area random sampling was used to select adults for a health and demographic survey, including anthropometric measurements. Hypertension was defined as systolic blood pressure ≥140 and/or diastolic blood pressure ≥90 mmHg, or current hypertension treatment, and was age-standardized to WHO world population. Correlates of hypertension were tested using sex-stratified logistic regression. RESULTS: Overall, 20.3% of adults had hypertension (28.5% age-standardized), including 22.3% of men and 18.9% of women. Three percent of participants reported current hypertension treatment, and 49.5% of them had their hypertension controlled. Overweight/obesity (BMI≥25) was the most common risk factor (20.6% among men, 48.5% among women), while smoking was less common (11.8% and 3.9%, respectively). Increasing age and hypertension prevalence in immediate surroundings were associated with greater odds of hypertension. Among men, having in-migrated in the 3 years prior (versus ≥3 years) was also associated with hypertension (adjusted odds ratio [aOR]=3.32, 95% confidence interval [CI]:1.79-6.17); as was overweight and obesity (aOR=1.90, 95% CI:1.09-3.33, and aOR=5.73, 95% CI:2.49-13.19, respectively) and non-receipt of needed medical care in the preceding six months (aOR=2.82, 95% CI:1.35-5.88) among women. CONCLUSIONS: Hypertension prevalence was high across the age spectrum, in addition to substantial levels of overweight/obesity and unmet healthcare needs. It is important to better understand the possible effects of intraurban migration and environmental risk factors on hypertension, and ensure that benefits of increasingly cost-effective prevention and treatment programs extend to slum residents.

Past research has evidently proved that public key cryptosystems are usually slower than symmetric key cryptosystems due to the reason that they use one additional cryptographic key and different methods for encryption and decryption. RSA is one of the most common asymmetric key cryptography algorithms. Recent research has focused on speeding up RSA using various techniques. With the introduction of distributed computing, parallelization of algorithms enables them to run on multiple cores concurrently at a time. RSA consists of two resource intensive operations namely Modular Exponentiation of up to 1024-bit exponents and repeated calculation of Greatest common divisor. Thus, RSA lays the perfect base for application of Montgomery Reduction algorithm to optimize the Repeated Modular multiplication in exponentiation. In this paper we proposed a parallel scheme for RSA using a new parallel data structure known as Concurrent Indexed List of character blocks. The aim of our research was to improve the...

Body Area Network (BAN) is emerging as promising technology for wireless network and widely being deployed in the field of medical applications for data extraction, storage and transfer of details regarding custom-made health care services. Securing of inter sensor communication within BANs is critical in preserving the health data privacy and also for ensuring safe healthcare delivery. The cumulative usage of wireless communication networks and the constant shrinking of electrical devices have endowed the development of Wireless Body Area Networks (WBANs). This research paper discusses the various authentication schemes and protocols available for WBAN. This research provides a survey of multilevel authentication protocols for WBANs. This paper also lists out the design issues in WBAN Authentication protocols. The outcome of this research provides essential future directions for further research on advancement of WBANs. Finally, this paper provides a summary on exposed research issues and challen...

Background: The lack of surveillance system is a major barrier in prevention and control of rheumatic fever/rheumatic heart disease (RF/RHD). Efficacy of school-based surveillance was evaluated for detection of acute pharyngitis and RF/RHD in Shimla district, HP. Methods: The schools in district Shimla were randomly assigned to intervention and controlled arm (442 vs. 441 schools). The trained nodal teachers reported children with symptoms of acute pharyngitis and or RF/RHD in intervention arm and children taken to hospitals by parents for symptoms of acute pharyngitis and or RF/RHD under control arm through mobile phone to coordinating centre. Final outcome for presence of RF/RHD or other heart Diseases was recorded after examination at nearest primary health centers and/or at Indira Gandhi Medical College Hospital, Shimla. Difference in detection rate between intervention arm and control arm was compared using Z test. Results: The number of school children reported from intervention group was significantly higher than in control due to suspected symptoms of acute pharyngitis and or RF/RHD were 65 (2.84/1000) and 15 (0.60/1000), respectively (p

COVID-19 vaccine is regarded as the most promising means of limiting the spread of or eliminating the pandemic. The success of this strategy will rely on the rate of vaccine acceptance globally. The study aims to examine the factors that influence COVID-19 vaccine acceptance, intention, and hesitancy. PubMed was searched comprehensively for articles using the keyword “COVID-19 vaccine surveys.” Of the 192 records, 22 studies were eligible for the review. Eighty-two percent of these studies were conducted among the general population. Gender, age, education, and occupation were some of the socio-demographic variables associated with vaccine acceptance. Variables such as trust in authorities, risk perception of COVID-19 infection, vaccine efficacy, current or previous influenza vaccination, and vaccine safety affected vaccine acceptance. Globally, in March 2020, the average vaccine acceptance observed was 86% which dropped to 54% in July 2020 which later increased to 72% in September 2020. Globally, the average rate of vaccine hesitancy in April 2020 was 21%, which increased to 36% in July 2020 and later declined to 16% in October 2020. Large variability in vaccine acceptance and high vaccine hesitancy can influence the efforts to eliminate the COVID-19. Addressing the barriers and facilitators of vaccines will be crucial in implementing effective and tailored interventions to attain maximum vaccine coverage.

The purpose of this article is two pronged; first, to identify and report public health implications of the ongoing coronavirus (COVID-19) pandemic, and second, to report challenges uniquely faced by the citizens of India from a population health perspective. We have done both while closely examining epidemiological data that is accessible via SMAART's RAPID Tracker. This policy informatics platform is a live database aimed to track the geospatial spread of the COVID-19 outbreak and policy actions globally and is administered collaboratively by CUNY's Graduate School of Public Health and Health Policy and a global, non-profit public health incubator. Infectivity, incidence, and recovery rates were computed and graphical representations of epidemiological datasets were studied. We have discussed a plausible conceptual framework based on the principles of population health informatics for countries with similar characteristics to build a stronger public and community health foundation in order to safeguard populations during a health emergency in the future.

The number of wearable electronic devices in the modern world is growing steadily. The amalgamation of these devices worn by a single person to form a network is known as body area networks. Traditionally, for ensuring the security of this type of network authentication protocols are used. Many protocols has been proposed for authenticating the mobile station with various service providers. The problem arises in Intra-BAN authentication. Specifically, when these devices area changed frequently. This paper presents authentication protocol specifically designed for operation in conditions of unstable connection with a certification center (center certification) also keeping in mind frequent change in devices. Similar scenarios may occur in the case of increased load in the existing network and in places with low cellular coverage or when operating in hard-to-reach (remote) areas. We have reviewed the closest analogues of the protocol, its relative advantages are analysed functioning scenario under consideration. A detailed description of the protocol is given. Our Protocol proved to ensure integrity and confidentiality about the user of the device.

BACKGROUND: A large number of individuals with hypertension are turning to the Internet and m-health technologies for assistance. There is a need to study the content of smartphone applications on hypertension. The study aimed to review and investigate the functional and analytical characteristics of apps related to the self-management of hypertension available on Google Play Store. METHODS: Search was conducted in February 2021 in India using the Google Play Store database to identify currently available Android-based apps related to self-management of hypertension/high blood pressure (BP). Keywords used were: ‘Hypertension’, ‘High blood pressure’, ‘DASH diet’, ‘Hypertension diet’, and ‘Blood pressure diet’. A total of 822 apps were screened based on the duplicates, inclusion, and exclusion criteria. A total of 210 were included for further analysis. RESULTS: Eighteen percent (n=37) of the apps had an overall rating of 4.5 or above. About 41% of the apps belonged to the medical category and 41% of the apps were characterized in the health and fitness category. Feature of logging/recording the BP measurement was seen in 73% of the apps. In-app graphing to analyze BP trends was reported in 64 % of the included apps. A few apps focused on tracking medication (n=19), sodium intake (n=2), and calorie intake (n=4). CONCLUSIONS: The features were common across all the included apps and were focusing only on recording the BP, providing statistics and trends of BP, and providing educational information. App developers should now aim to provide other components of self-management techniques to help individuals tackle hypertension.

Background Disparities in access to specific technologies within gender groups have not been investigated. Slum settings provide an ideal population to investigate the contributing factors to these disparities. Objective This study aimed to examine gender differences in mobile phone ownership, internet access, and knowledge of SMS text messaging among males and females living in urban slum settings. Methods A convenience sampling approach was used in sample selection from 675 unnotified slums. A total of 38 slum sites were then selected across four geographic zones. Of these, 10% of the households in each slum site was selected from each zone. One household member was interviewed based on their availability and fulfillment of the eligibility criteria. Eligible individuals included those aged 18 years and above, residing in these slums, and who provided voluntary consent to participate in the study. Individuals with mental or physical challenges were excluded from the study. Results Our results showed that females were half as likely to own mobile phones compared with males (odds ratio [OR] 0.53, 95% CI 0.37-0.76), less likely to have internet access (OR 0.79, 95% CI 0.56-1.11), or know how to send text messages (OR 0.93, 95% CI 0.66-1.31). The predictors of mobile phone ownership, internet access, and text messaging between males and females included age, individual education, housing type, and the number of earning members in a household in the adjusted analysis. Among males, the number of earning members was a predictor of both mobile phone ownership and text messaging, whereas household education was a predictor of both internet access and text messaging. Age and individual education only predicted internet access, whereas housing type only predicted text messaging. Among females, household education was a predictor of all the technology outcomes. Age and type of toilet facility only predicted mobile phone ownership; housing type only predicted internet access whereas television ownership with satellite service and smoking behavior only predicted text messaging. Conclusions Our study findings showing disparate access to technology within gender groups lend support for further research to examine the causal mechanisms promoting these differences to proffer significant solutions. Specifically, our study findings suggest that improving household education is crucial to address the disparate access and usage of mobile phones, the internet, and text messaging among women in slum settings. This suggestion is due to the consistency in household educational level as a predictor across all these technology indicators. In addition, the mechanisms by which the number of household earning members influences the disparate access to technology among men call for further exploration.

Background. The novel coronavirus disease (COVID-19) has spread globally from its epicenter in Hubei, China, and was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. The most popular search engine worldwide is Google, and since March 2020, COVID-19 has been a global trending search term. Misinformation related to COVID-19 from these searches is a problem, and hence, it is of high importance to assess the quality of health information over the internet related to COVID-19. The objective of our study is to examine the quality of COVID-19 related health information over the internet using the DISCERN tool. Methods. The keywords included in assessment of COVID-19 related information using Google’s search engine were “Coronavirus,” “Coronavirus causes,” “Coronavirus diagnosis,” “Coronavirus prevention,” and “Coronavirus management”. The first 20 websites from each search term were gathered to generate a list of 100 URLs. Duplicate sites were excluded from this search, allowing analysis of unique sites only. Additional exclusion criteria included scientific journals, nonoperational links, nonfunctional websites (where the page was not loading, was not found, or was inactive), and websites in languages other than English. This resulted in a unique list of 48 websites. Four independent raters evaluated the websites using a 16-item DISCERN tool to assess the quality of novel coronavirus related information available on the internet. The interrater reliability agreement was calculated using the intracluster correlation coefficient. Results. Results showed variation in how the raters assigned scores to different website categories. The .com websites received the lowest scores. Results showed that .edu and .org website category sites were excellent in communicating coronavirus related health information; however, they received lower scores for treatment effect and treatment choices. Conclusion. This study highlights the gaps in the quality of information that is available on the websites related to COVID-19 and study emphasizes the need for verified websites that provide evidence-based health information related to the novel coronavirus pandemic.

It is evident from the past literature that in any authentication protocol there is a trade-off between efficiency and security. This paper aims to solve this problem in the domain of heterogeneous wireless networks, by proposing an efficient authentication protocol which operates in two modes namely full authentication and fast re-authentication. This paper proposes a protocol which mitigates the delay in authentication by reducing the number of message excahnges in full authentication procedure and reducing the number of authenticating parties in fast re-authentication procedure. This paper also used hash-chain technique to guarantee safety and freshness of the information. AVISPA (Autmated Validation of Internet Security Protocols and Applications) was used to formally analyse the security of the protocol. Some other existing authentication protocols were also analyzed and compared with our proposed protocol. Our analysis showed that the proposed authentication protocol is efficient while guaranteeing the security and improved performance of the heterogeneous wireless networks.

As we know that cryptography is a technique to transmit the data or message in a secure manner so that only authorized user is allowed to read the message. To do this, there are two ways, first one is symmetric encryption and second is asymmetric encryption or public key encryption. In cryptography, encryption and decryption always need some secret information, referred to key. Some algorithm uses the same key for encryption and decryption known as secret key or symmetric encryption while some uses a pair of key, one for encryption and other for decryption. So the key must be kept secret so that unauthorized user cannot decrypt the message. There are three important terms that are related to cryptography, the first one is key generation process, second is encryption process, and third is decryption process. Many algorithms have been proposed for the above three parameters. Some algorithms have good result in encryption and decryption process but very few algorithms are available for the secrecy of the key and we know that the strength of any cryptographic technique is fully dependent on the key. So the objective of this paper is to develop a new approach known as Kryptos key generation to provide security to the key at generation time. The term Kryptos is a Greek word whose meaning is hidden that means this key generation process is only known to sender. Modern cryptography concerns itself with the four objectives: confidentiality, integrity, non-repudiation, and authentication. The proposed algorithm fulfills above four objectives in an efficient manner. The proposed technique when well implemented and used will reduce the attacks on key generation. It will also ensure that key generation will be securely integrated as well as authenticated. This work will contain proposed technique as well as the implementation of test data.

Background Early childhood caries (ECC) has reached epidemic proportions affecting millions of children worldwide. Its prevention becomes imperative owing to the significant morbidity and financial implications involved with its treatment. The Integrated Child Development Scheme (ICDS), launched in India to provide mid-day meals, pre-school education and primary healthcare to children, can be utilised to counsel and deliver oral health education to mothers. The purpose of the study is to compare the effect of an oral health care package (OHCP) with usual care on the change in dental disease status among 1 to 3-year-old children at Anganwadi centres (AWC) in periurban areas of Chandigarh and rural areas of Cuttack, Orissa over a follow-up period of three years. Methods Two geographically distant ICDS blocks would be selected at each of the two study sites and would be randomly allocated to intervention and control group. Closely located AWCs under each of the selected blocks shall constitute the study setting. OHCP would be delivered to the mothers of the 1–6-year-old children enrolled in the AWCs of the experimental group whereas mothers under control group would receive usual care advice available at the AWCs. Discussion ECC prevention had conventionally focused upon testing effectiveness of programs targeting behaviour change among the caregivers and children, but surprisingly minimal efforts have been made to seek translation of these efforts into reduction of ECC at the community level. The present study has two components; testing effect of altering maternal and child behavioral aspects on ECC incidence through cohort follow up of 1–3-year-old children for three consecutive years and cross-sectional follow up of all available 1–6-year old children at the selected AWCs at regular intervals to look for change in prevalence of ECC at community level. In other regions of the world surveys of ECC prevalence before and after the intensive educational programs have shown a significant reduction in ECC prevalence. A similar decline can be anticipated through this program. Trial registration This trial has been prospectively registered at Clinical Trials Registry, India (CTRI/2019/02/017556, 08 February 2019).

This paper presents the design and implementation of a particle detector in a Bipolar-CMOS-DMOS (BCD) 180 nm technology. The design has a substrate potential of — 50 V and supply voltage of 1.8 V. Size of the unit pixel sensor is $250\times 50\ \mu\mathbf{m}^{2}$ . The chip consists of an array of $47\times 6$ pixels including the signal processing circuitry. The total chip area is $3.3 \times 4.4\ \mathbf{mm}^{2}$ . The complete signal processing circuitry is hosted inside the diode sensor to achieve 100% fill factor. The chip consists of 106 input-output pads, including the pads for supplies viz. — 50 V, 0 V and 1.8 V. The measurement results are presented to validate the noise and crosstalk models of the designed detector. The comparison shows an average mismatch of 2.65 $\mu\mathbf{V}$ for the crosstalk voltages in a range of 3000 to 7000 injected electrons. The circuit noise has an average mismatch of $1.23\times 10^{-10}\ \mathbf{V}^{2}/\mathbf{Hz}$ between the analytical and the measurement results for a frequency range of 100 kHz to 22 MHz. The analog processing circuitry provides a measured voltage gain of 33.3 dB at 100 kHz of input frequency.

Liver involvement in celiac disease (CD) is classified into autoimmune and cryptogenic. The association between CD and autoimmune liver diseases like autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis is well-established; however, the data on patients with cryptogenic cirrhosis, particularly from India, are scanty. So we did this study to find the prevalence of CD in patients with cryptogenic cirrhosis. This was a prospective observational study, involving children of less than 18 years old attending Pediatric and Gastroenterology clinic with a diagnosis of cryptogenic cirrhosis. The patients were evaluated for CD and divided into two groups: chronic liver disease (CLD) with CD, and CLD without CD. Both the groups were followed up for 6 months. CLD with CD group was treated with gluten-free-diet (GFD) and CLD without CD group was followed up without any specific intervention except standard care of CLD. Out of 84 patients, 11 (13.1%) were diagnosed as CLD with CD. There was an improvement in hemoglobin levels, liver function tests, and Child-Pugh score after initiation of GFD in CLD with CD group. The prevalence of CD in cryptogenic cirrhosis was 13.1%. Screening for CD is recommended for cryptogenic cirrhosis. Hepatic functions improve with a GFD in CD patients with cirrhosis.

Strictures of the small intestine have been attributed many causes of Crohn's disease, nonsteroidal anti-inflammatory drugs, neoplastic, post-surgical, and corrosive ingestion. Opium as a cause of small intestine strictures has not been described. Six cases of opium addicts diagnosed with small intestine strictures were selected after excluding the possible etiology of strictures. Investigations like upper gastrointestinal endoscopy, colonoscopy (in patients with small intestinal obstruction), barium meal follow-through, and histopathology of strictures were done in all patients. Among the six cases, two patients were diagnosed with small intestinal obstruction and four patients with gastric outlet obstruction. Histopathology of the strictures revealed marked thickening of submucosa with infiltration by lymphocytes, plasma cells, and plenty of eosinophils. There was dilatation of vessels and lymphatics. The granulomatous reaction was not seen. These histological features are suggestive of concentric fibrous thickening in submucosa with stricture formation possibly as a result of drug abuse like opioids and opioid-like products resulting in transient ischemia of the small intestine leading to fibrosis. Patients were managed by surgery and deaddiction treatment was given to prevent further complications. Opium and opioid-like drugs can cause small intestinal strictures causing ulceration and fibrosis in opioid-dependent patients.

Objectives The objective of this study was to evaluate the features of diet and nutrition apps available in the Google Play Store. Methods A search was conducted in August 2017 using the Google Play Store database to identify apps related to diet and nutrition. Terms entered into the app search engine included 'diet apps' and 'nutrition apps'. The first 50 apps resulting from each search term was assessed. Duplicates were removed, and a comparative analysis was performed on the remaining diet and nutrition apps. Results A total of 86 diet and nutrition apps were identified. One hundred percent (n = 86) of the apps retrieved were freely available. More than half of the apps were applicable to a target user group of all ages (94%, n = 81). Stratified analysis across unique diet and nutrition apps (total, n = 72) showed a higher average rating for the diet apps (4.4) in comparison to that for the nutrition apps (4.3). Diet apps were more likely to be recently updated than the nutrition apps (72% vs. 66%), and diet apps were more likely to feature app purchase than nutrition apps (36% vs. 19%). The average rating was slightly higher for diet apps not featuring in-app purchases, but ratings were similar for the nutrition apps. Conclusions A centralized resource is needed that can provide information on health-related apps to allow for systematic evaluation of their effectiveness. Further research needs to examine improved methods of designing app-store platforms and presenting the available apps to properly guide users in app selection.

AIMS The aim of the study was to evaluate the shear bond strength (SBS) of orthodontic brackets after mouth rinsing. MATERIALS AND METHODS Sixty orthodontically extracted maxillary premolar teeth were used in the present study. Buccal surfaces of all the teeth were bonded with orthodontic bracket. Later, each tooth was embedded into acrylic resin and stored in distilled water. All the teeth were randomly divided into four groups (group I: Artificial saliva, group II: Alcohol mouth rinse- Listerine, group III: Chlorhexidine (CHX) mouth rinse-Hexidine, and group IV: Herbal mouth rinse-Befresh) and stored in each solution for 12 hours. Later, each tooth was subjected to SBS testing using universal testing machine. Brackets and enamel surfaces were examined under a stereomicroscope at 10* magnification for modified adhesive remnant index (ARI). The data were statistically evaluated using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, version 20.0 (IBM Corp., Armonk, New York, USA) and using one-way analysis of variance (ANOVA) and Chi-square test with significance of p < 0.05. RESULTS Highest mean SBS was observed in artificial saliva control group (14.27 ± 0.52 MPa), followed by herbal Befresh group (11.14 ± 0.72 MPa) and CHX, and least was found in alcohol-Listerine group of 8.48 ± 0.52 MPa (p < 0.001). The ARI score showed highest bond failure for group I (ARI 14) compared to group II (ARI 11) (p < 0.001). CONCLUSION Alcohol-containing mouth rinses should be avoided in patients during fixed orthodontic treatment because it affects the bond strength. CLINICAL SIGNIFICANCE Shear bond strength is affected with the use of alcohol-based mouth rinse compared with herbal or CHX mouth rinses.

Background Empirical research acknowledges the capability of mHealth and eHealth interventions for ensuring high-quality and tailored healthcare to individuals. People living with various health conditions get access to a wide range of healthcare services through digital interventions. The aim of the study is to examine the usefulness of Swasthya Pahal, a community-based Health for all program, aimed to enhance screening and self-management of diabetes, hypertension, and obesity among police personnel. Methods A convenient sample of 64 individuals aged 18 years and above present at the Police Sanchar Training Centre, Dehradun, Uttarakhand were enrolled over 2 days in January 2020. The Swasthya Pahal pilot program was approved by the Uttarakhand State Police authorities. Individuals' health data was recorded using an interactive, bi-lingual, touch screen, computer-based program. Subjective data was collected and self-reported information was gathered about (I) socio-demographics, (II) health behaviors, (III) clinical status, and (IV) Knowledge, Attitudes, and Practices (KAP). Objective data assessments included measurements such as weight, blood pressure, and blood sugar levels using a series of physiological sensors. Additional information gathered at 1 month follow up included modifications that individuals made in their self-management of diabetes and hypertension, diet, physical activity, alcohol consumption, and smoking. Information was gathered related to individuals' interest in receiving SMS based health messages. Results The average age of study participants was 37 (SD =8) years, 88% were males, and 42% had graduate education. Hypertension (31%) was found to be the most common family history. Thirty-six percent of individuals were presently smokers or consumed alcohol. Sixty-two percent of them self-reported doing some form of exercise. Walking, jogging and yoga were the most common exercise types. Eighty-seven percent of them were not receiving any treatment to self-manage hypertension. Based on the JNC 8 criteria, 37% of the individuals were hypertensive. Fifty of the 64 individuals expressed interest to receive SMS message, 64% of them expressed keenness to receive weekly SMS messages. Messages related to diet, physical activity, sleep, and smoking and alcohol consumption were perceived as important. Conclusions The Swasthya Pahal program using the SMAART informatics framework is a useful tool to enhance screening and self-management of non-communicable diseases (NCDs) among police personnel.

OBJECTIVES The objective of this study was to describe the features of health informatics blogs on the Internet. METHODS A search was conducted in August, 2016 using the search engine, Google, and key words: 'mobile health blog,' 'telehealth/telemedicine blog,' 'Electronic Health Record blog,' 'personalized health record blog,' 'population health decision support system blog,' and 'public/population health dashboard blog.' The first 24 blogs resulting from each key word search were recorded, generating 144 blogs. A total of 109 unique blogs resulted after removing duplicates and non-functional sites. RESULTS Blogs with '.com' extensions were most prevalent (72%, n = 79). More than half of the blogs (79%, n = 86) were created by industries. Mobile health (88%, n = 96), telehealth (82%, n = 89), and health IT (78%, n = 85) were the predominant topics covered. Health providers (44%, n = 48), industries (33%, n = 36), patients/consumers (25%, n = 27) and payers/insurance providers (19%, n = 21) constituted the most common target audience. Blogs catering to payers commonly used '.org' extension (n = 10 out of 21), compared to '.com' (n = 7) or '.gov' (n = 2) (p < 0.0001). Significant differences were also observed by topics covered health IT (p = 0.007), subscription (p = 0.048) and LinkedIn social media (p = 0.019) across the website extensions. CONCLUSIONS Further research is needed to examine the use of blogs as channels of communication of best evidence in health informatics research among diverse stakeholders. The role of blogs as policy informatics tools need to be evaluated in order for stakeholders to collaborate, coordinate and share opportunities and challenges of various public health programs and policies.

Energy resources like fuel, water, and electricity form the fundamental requirements for the entire society to operate. It is observed that electricity is the driving force behind any society operations. As the energy requirements exponentially increase, there is a growing need for reliable and transparent power flow to the customers from the distributive end. One such transparent information flow is through the electricity bills that are generated after a month’s power consumption. This bill does not provide a split up device wise about power usage. In other words, it can be said that the billing system is not as transparent as should be provided to the user. This paper thus focuses upon the various stages through which power reaches the consumer, the need for a transparent billing system followed by the proposed system. This would, in turn, enable the customer to monitor, analyze, and optimize its resources in order to optimize usage and reduce billing amount, in other terms save power. This paper further evaluates the system in terms of its power consumption, various notifications, and bills generated.

Background Human-centered dietary decision support systems are fundamental to diabetes management, and they address the limitations of existing diet management systems. Objective The objective of the proposed study is to evaluate the use of an interactive, telephone-linked, personalized, human-centered decision support system for facilitating the delivery of personalized nutrition care for patients with diabetes. Methods A quasi-experimental trial was conducted between the period of June and December 2018. Study participants were recruited from Community Health Center, Dharamshala, Kangra (urban population), and Model Rural Health Unit, Haroli Block, Una (rural population). Eligible participants included adults aged ≥30 years with controlled or uncontrolled diabetes, those who agreed to participate in the study, those who were available for follow-up interviews, and those with a telephone or computer at home. Diabetic status was determined via a physician’s diagnosis. Individuals with mental or physical challenges that affected their ability to use an electronic diet record, those who were not available for a telephone follow-up, and those who were involved in other protocols related to dietary assessments were excluded. The study participants were randomized into the following two groups: the intervention group (telephone-linked dietary decision support system) and the control group (paper-based diet record). Study participants in the intervention group recorded their daily dietary intake by using a telephone-linked, personalized, human-centered dietary decision support system and received personalized feedback and diet education via SMS text messaging. Study participants in the control group were provided with only a paper-based diet record for documenting their daily dietary intake. Follow-up visits were conducted at 3 and 6 months from the baseline in both groups. Differences in diabetes knowledge, attitudes, and practices will be measured across groups. Results The collection of baseline data from 800 study participants in both the intervention (n=400) and control groups (n=400), which were stratified by urban (control group: n=200; intervention group: n=200) and rural settings (control group: n=200; intervention group: n=200), has been completed. Follow-up data collection for months 3 and 6 is ongoing and is expected to be completed by October 2019. Conclusions We anticipate that the intervention group will show significant changes in nutrition knowledge, attitudes, and practices; satisfaction with care; and overall diabetes management. We also expect to see urban-rural differences across the groups. The uniqueness of our nutrient data capture process is demonstrated by its cultural and contextually relevant features—diet capture in both English and Hindi, diet conversion into caloric components, sustained diet data collection and participant adherence through telephone-linked care, and auto-generated reminders. International Registered Report Identifier (IRRID) DERR1-10.2196/13635

This paper presents the design of a charge sensitive amplifier (CSA) for an analog processing circuit of 47×6 silicon pixel detector array. The design has been implemented in BCD 180 nm technology. A diode with an area of 250 × 50 µm^2 is used to realize a unit sensor pixel. A 100 % fill factor is achieved by confining the analog circuit in the diode. Low power and area efficient single ended folded cascode amplifier is employed as a basic building block of the CSA. Further, an on-chip corner control circuit is proposed to make the design insensitive to process variations and to reduce power dissipation in the CSA.

Introduction: Acknowledging the promising role of information and technology, a study was planned to determine the effect of personalized human-centered dietary decision support system (PHCDDSS) on dietary knowledge, attitude, practice (KAP), and mean fasting blood sugar (FBS) among participants with type 2 diabetes mellitus (T2DM). Materials and Methods: A community-based randomized control trial was conducted among 400 individuals with T2DM randomized into the 12-month intervention group (PHCDDSS) and 400 to the control (usual care) group. Results: In the control and intervention groups, 84.7% and 87.0% participants completed the follow-up at the end of 12 months. Mean knowledge score showed a significant (P = 0.00) declining trend (from 28.3 to 22.2) in the control group, but increasing (from 28.9 to 35.4) in the intervention group. Unlike knowledge, mean attitude score observed a significant declining trend in both the groups but less in the intervention group. The mean FBS (in mg/dL) trend was found to be insignificantly declining in control (199.2–195.4) and intervention (194.8–183.1) groups but the decline was relatively less in control when compared with the intervention group. Conclusion: In study participants, PHCDDSS proved to be effective in improving knowledge and attitude toward role of diet in managing T2DM. The intervention showed promising effect in reduction of mean FBS and proportion of individuals with sugar control.

Aims: The objective of our study was to search existing public health job websites over the internet and describe the challenges related to finding these job websites. Method: An internet search was conducted using different search engines, including Google, Yahoo and Bing, with several keywords including: Public Health Jobs, Epidemiology Jobs, Biostatistics Jobs, Health Policy and Management Jobs, Community Health Jobs, Health Administration Jobs, Nutrition Jobs, Environmental and Occupational Health Science Jobs, GIS Jobs, and Public Health Informatics Jobs. We recorded the first 20 websites that appeared in the results of each keyword search, thus generating 600 URLs. Duplicate sites and non-functional sites were excluded from this search, allowing analysis of unique sites only. Results: The initial search resulted in 600 websites of which there were 470 duplicates. More than half of the website categories were “.com” (54%; n = 323) followed by “.gov” (19%; n = 111) and “.edu” 15% (n = 90). Results of our findings showed 194 unique websites resulting from a search of 600 website links. More than half of them had actual public health or its related jobs (56%; n = 108). Conclusion: There is a need to establish standard occupational classification categories for the public health workforce.

To evaluate the impact of an interactive, computer based, bi-lingual breastfeeding educational program on breastfeeding knowledge, self-efficacy and intent to breastfeed among rural Hispanic women living in Scottsbluff, Nebraska.A two-group, repeated measures quasi-experimental study was conducted to evaluate the impact of a breastfeeding intervention. Forty six rural Hispanic women between ages 18 and 38 years were enrolled at the Regional West Medical Center in Scottsbluff, Nebraska. Study participants were randomized into intervention and control groups, with the intervention group (n=23) receiving bi-lingual (English and Spanish) breastfeeding education on a touch screen computer program, while the control group received printed educational material. Study participants were enrolled during their last six weeks of pregnancy, with follow up assessments conducted post-partum at days 3 and 7, weeks 2 and 6, and months 3 and 6. The study protocol was approved by the University of Nebraska Medical Center Institutional Review Board (IRB protocol #430-12-EP) and City University of New York Institutional Review Board (IRB protocol # 642980-1).A significant improvement in the breastfeeding knowledge and intent to breastfeed scores was seen over a 6 month period among all the study participants (p0.05). There was a gradual increase in the breastfeeding self-efficacy scores till week 6 followed by a decrease in self-efficacy scores at month 3 (p=0.46), and month 6 (P=0.54). Breastfeeding knowledge scores differed significantly between the study participants in the control and intervention groups at week 6 (p=0.03). There were no significant differences in the breastfeeding knowledge between the control and intervention groups at other time points. The control group showed gradual decline in their self-efficacy scores at month 3 and month 6 compared to the intervention group that showed a gradual increase in their self-efficacy scores at different time points during their follow up period. However, there were no significant differences in the self-efficacy scores between the intervention and control groups at different points. The control group showed significantly higher negative breastfeeding sentiment scores compared to the intervention group at days 3 (p=0.02) and 7 (p=0.03) indicating a lower intent to breastfeed.Hispanic women living in rural settings showed improvement in breastfeeding knowledge, self-efficacy and intent to breastfeed using the computer based bi-lingual educational program. Results show week 6 and month 3 to be the critical time points of intervention so that women continue to breastfeed.

BACKGROUND: Hypertension rates are increasing in India, and prior research has not explored the perception of using mobile based SMS among urban hypertensive individuals living in slum settings in India. OBJECTIVE: To explore the perception of receiving SMS based health messages among hypertensive individuals in urban slums. METHODS: A cross sectional study was conducted during the period of December 2013 in an urban slum setting of South Delhi, New Delhi, India. Eligible study participants included: 45 individuals aged 30 years and above, with confirmed diagnosis of high blood pressure, owned a mobile phone/landline and were willing to participate. RESULTS: Results of our study showed participants (n = 45) had an average age of 48 years (SD = 12), mostly female (64%, n = 29), and currently married (80%, n = 36). Their most common perceived hypertension risk factors included: worry/anxiety/stress (84%, n = 38), and high fat diet (68%, n = 30). Mobile calls were the most preferred mode of receiving lifestyle counseling among study participants (71%, n = 32). Majority preferred to receive counseling in Hindi language (67%, n = 30), and more than half were willing to pay for these services (60%, n = 27). CONCLUSION: Our findings suggest the need for innovations that utilize basic phone platforms, mobile calling feature, and language tailored interventions.

Background: The symptoms of menopause have a negative impact on quality of life, especially in women transitioning to menopause and earlier transitions. This study was conducted with the objective of assessing the effect of obesity on the severity of menopausal symptoms and the clustering of symptoms in postmenopausal women in India. Methodology: The Menopausal Rating Scale (MRS) was used to assess the severity of menopausal symptoms of postmenopausal women of Chennai, visiting Saveetha Medical College, Chennai, India. This cross-sectional study was conducted from August to November 2013 in Chennai, India. Sociodemographic characteristics, anthropometric measurements, blood pressure level, menopausal history, personal health history, and hormonal disorder issues were investigated. Results: The results have shown that 24% of the participants had complaint of mild to severe hot flushes, half of them had reported heart ailments (49%; n = 74), and disturbed sleep (48%; n = 72). The proportion of overweight/obese participants was higher in married (64%) than widows (41%), and this difference was found statistically significant (P = 0.005). There were no significant differences in MRS scores of obese and nonobese postmenopausal participants. Conclusion: There is a need of developing interactive, user friendly, technology based education module for addressing the chronic ailments of postmenopausal women.

The management of breast cancer with advanced disease or metastasis is a common problem in India and other countries. A panel of 13 oncology experts deliberated on the sidelines of the 35th Indian Cooperative Oncology Network Conference held in Mumbai to formulate an expert opinion recommendation on the novel drug delivery system (NDDS) formulations in the treatment of metastatic breast cancer (MBC). The survey comprised of 39 questions related to limitations of conventional formulations and therapeutic positioning of NDDS formulations of docetaxel, paclitaxel and doxorubicin in the management of MBC. The experts used data from published literature and their practical experience to provide expert opinion and recommendations for use by the community oncologists. The experts opined that the newer NDDS formulations should provide a significant efficacy advantage in terms of overall survival and progression-free survival, or demonstrate better tolerability when compared with conventional formulations. The newer NDDS formulations of taxanes should be considered in special circumstances such as diabetes, in patients who have had hypersensitivity reactions and in cases where steroids need to be avoided. The novel formulations of doxorubicin should be used in the elderly and in patients with borderline cardiac function.

This paper presents a chopper stabilized amplifier with a discrete time parametric amplifier (DTPA) based signal demodulator. The DTPA demodulator enables signal amplification while down converting the chopped signal to baseband frequency. The low frequency noise and chopping ripples are cancelled during the track-and-hold process involved in the parametric amplification. The design is implemented in a standard 180 nm CMOS technology and the layout occupies 0.12 mm2 of area. The post layout simulation results confirm the gain augmentation of 9 dB from the DTPA demodulator. The proposed amplifier consumes 1.02 μA DC current from a 1.5 V supply. The achieved input noise spectral density of 147 nV/√Hz gives a noise efficiency factor of 5.4 over 400 Hz bandwidth. Furthermore, the design shows satisfactory performance for −20° C to 80° C temperature range and ±10 % of supply voltage variation at various process corner combinations of transistors. The worst case result is found at slow corner for −20° C with 1.35 V supply and the corner shows 47 dB of gain and 425 nV/√Hz of input noise spectral density.

Breast and/or ovarian cancers are among the most common cancers in women across the world. In the Indian population, the healthcare burden of breast and/or ovarian cancers has been steadily rising, thus stressing the need for early detection, surveillance, and disease management measures. However, the burden attributable to inherited mutations is not well characterized. We sequenced 1010 unrelated patients and families from across India with an indication of breast and/or ovarian cancers, using the TruSight Cancer panel which includes 14 genes, strongly associated with risk of hereditary breast and/or ovarian cancers. Genetic variations were identified using the StrandNGS software and interpreted using the StrandOmics platform. We were able to detect mutations in 304 (30.1%) cases, of which, 56 mutations were novel. A majority (84.9%) of the mutations were detected in the BRCA1/2 genes as compared to non-BRCA genes (15.1%). When the cases were stratified on the basis of age at diagnosis and family history of cancer, the high rate of 75% of detection of hereditary variants was observed in patients whose age at diagnosis was below 40 years and had first-degree family member(s) affected by breast and/or ovarian cancers. Our findings indicate that in the Indian population, there is a high prevalence of mutations in the high-risk breast cancer genes: BRCA1, BRCA2, TP53, and PALB2. In India, socioeconomic inequality limiting access to treatment is a major factor towards increased cancer burden; therefore, incorporation of a cost-effective and comprehensive multi-gene test will be helpful in ensuring widespread implementation of genetic screening in the clinical practice for hereditary breast and/or ovarian cancers.

BACKGROUND: Myocardial infarction (MI) is one of the most critical medical emergency and contributor to morbidity and mortality worldwide. Myocardial infarction is the most common form of coronary heart disease and leading cause of premature death. Past century has seen substantial advancement in the field of medical sciences but still mortality trends due to myocardial infarction is increasing in developing countries including India. We have conducted this study to compare the Sociodemographic characteristics of alcoholic and non alcoholic MI patients admitted in coronary care unit of Saveetha Medical College, Chennai, India. METHODS: An exploratory cross sectional study was performed by enrolling a convenient sample of 100 Myocardial Infarction patients. Information about Sociodemographic characteristics, past medical history, alcohol and tobacco intake, physical activity, psychological stress and biochemical measurements was gathered. RESULTS: The mean age of the respondents was 46 (SD=6) years and majority of them were male i.e. 82%. 100% married and 89% literate, there were 24% past and 22% present alcoholics. Consumption of alcohol on a monthly, weekly and daily basis was 8%, 11% and 5% respectively. Preference to brandy was 67%, rum was 21% and that the beer was 12%. Current smoker were 20% and former were 11%. 93% and 52% respondents were under medication of beta blocker and angiotensin-converting-enzyme (ACE) inhibitors respectively. CONCLUSION: Worldwide, MI is the most common cause of mortality and morbidity and hence early diagnosis and management is most essential. Results from our study revealed that, participants had sedentary lifestyles where risk factors of MI such as alcohol consumption, and smoking does existed.

BACKGROUND : Hypothyroidism causes considerable morbidity. Low knowledge coupled with inadequate health literacy may lead to poor prevention and management. This study aimed to assess health information-seeking behavior and hypothyroid knowledge among South Indian hypothyroid patients. METHODS : This cross-sectional study was conducted in October 2013 in Saveetha Medical College, Chennai, India. Hundred clinically diagnosed hypothyroid patients >18 years were interviewed in a hospital using a 57-item questionnaire to gather information on their socio-demographics, self-reported disease history, hypothyroid-related knowledge, health information sources, health literacy and health information-seeking behavior. Hypothyroidism was assessed by free T3 and T4 levels. RESULTS : Mean age of participants was 38 years (SD=12) with median age of 39.5 years, majority of the participants being females (77%) and living in urban setting (52%). Mean free T3 level was 0.0137ng/dl (SD= 0.003) and mean free T4 was 0.7ng/dl (SD= 0.06). Ninety three percent of the participants received initial hypothyroidism education from their physicians at the time of diagnosis. Half of the participants had incorrect hypothyroidism-related knowledge; similar between both genders. Participants with inadequate health literacy had poor knowledge about the hypothyroidism. Hypothyroidism-related health information was sought almost exclusively from health professionals, predominantly regarding treatment, linked to their faith in qualified medical assistance. Economic status primarily determined healthcare-seeking behavior. Marital status, education level, annual household income and health literacy were significantly associated with knowledge. CONCLUSION : Participants having higher educational qualification, higher annual household income and adequate health literacy had considerable knowledge about hypothyroidism. Developing multi-factorial and tailored health education for patients with marginal or inadequate health literacy is needed. Exploring healthcare institutions as a medium for delivery of such education should be explored. KEYWORDS : Hypothyroidism, Health Information-seeking Behavior, Knowledge, Health Literacy

Background: Rural population in developing countries face water, sanitation, and hygiene-related health issues. To objectively highlight these issues, we studied the knowledge, attitude, and practices-related to drinking water and sanitation facilities among the rural population of Chennai, India. Materials and Methods: A cross-sectional study was designed involving individuals over 18 years of age living in Thandalam village, Chennai, India. Basic information about sociodemographic profile and existing drinking water and sanitation related knowledge, attitude, and practices was collected using a modified version of previously validated questionnaire and analyzed. Results: Forty-five percent of the participants were not following any methods of water treatment and among them half of the participants felt that water available to them was clean and did not require any additional treatment. Twenty-five percent of the participants surveyed did not have access to toilets inside their household. Conclusion: There is a need for intervention to educate individuals about drinking water treatment methods, sanitation, and hand washing practices.

Background: Cardiovascular complications are now the leading causes of diabetes-related morbidity and mortality. The public health impact of cardiovascular disease (CVD) in patients with diabetes is already enormous and is increasing. Aims: To develop a mobile based intervention model for reduction of CHD risk factors among diabetic patients. 2. To prospectively evaluate the developed intervention model in the proposed group. Settings and Design: Endocrinology outpatient department of a tertiary care hospital and study design was Randomized controlled trial Material and Methods: Starting at random, the patients were allocated to control group and test group. Controls were given printed educational materials. Test group were counselled with intense lifestyle education using both printed materials and computers, they were contacted by telephones contacted by phone calls by the investigator in every 3 weeks for 3 months and SMS were sent in every week containing some educational tips. Results: In the follow up at 3 months, treatment was not changed in majority (80%) of diabetics that being taken at baseline. The change of treatment was proportionately high in control group (33.3%) than in the intervention group (11.8%). The mean measurements of blood sugar (fasting and post Prandial) were higher in the baseline control and intervention groups compared to the follow up in both arms. Statistical analysis used: Percentage, standard deviation, significance tests Conclusion: Intervention in the form of intensive life style education and phone calls and SMS became helpful in management of increased blood sugar, blood pressure, body weight (BMI, WHR) in our study. Health information through mobile phones has great potential to improve patient care and increase patient-provider communication, and to promote life style measures. Key words: CHD risk factors, Mobile based intervention, SMS.

This pilot cross-sectional study was conducted to assess water and sanitation hygiene-related knowledge, attitude and practices (KAP) among rural school students in Chennai, South India in September 2013. A convenient sample of 80 participants (70 children and 10 staff members) was enrolled in the study. The inclusion criteria included participants residing in rural areas and studying in a government school. A semi-structured questionnaire was used to assess sociodemographic and school characteristics and water and sanitation hygiene (WASH)-related KAP. The mean age of the students was 14 years (SD = 2) and half of them were females. The school had a government drinking water supply and did not use any water treatment/purification method. The majority of the participants had correct WASH-related knowledge. However, one-third of the students reported diarrheal episodes in the school due to unsafe drinking water. There was disparity in the response of the students compared to the staff about toilet facilities in the school. This study concluded that there is a need for multifaceted intervention that will facilitate adequate water and sanitation hygiene practices among school children through the availability of proper sanitation infrastructure and family-centered education.