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Background Government of India is committed to eliminate tuberculosis by 2025 under National Tuberculosis Elimination Program which provides free investigations and treatment as well as incentives for nutritional support during their treatment course.Many tuberculosis patients prefer to seek treatment fromthe private sector which sometimes leads tofinancial constraints for the patients. Our study aims to find the burden of tuberculosis patients in the private sector and the expenses borne by them for their treatment.Methodology :Sales data of Rifampicin-containing formulations drug consumption in the private sector of six districts of Jharkhand was collected from Clearing and Forwarding (C & F) agencies and drug controller office during the SNC activities in the state. Based on the drug sales data total incurring costs of the drugs, total private patient months, total number of patients and cost per patient seeking treatment from private sector were calculated for the year 2015–2021. Data collected was analysed using Jamovi and statistical test such as ANOVA and post hoc test- Tukey HSD method was applied to note the difference between districts.Results There was a marked difference amongst all the districts in relation to all the variables namely total costs, total private patient months, cost per patient and total private patients seeking treatment from the private sector which was statistically significant (p Conclusion From the study, it was concluded that purchase of medicines for tuberculosis treatment from private sector is one of theessential elements in out-of-pocket expenditure (OOPE) borne by tuberculosis patients. Hence, newer initiatives should be explored to foresee the future costs of out-of-pocket expenditure borne by the patients and decrease OOPE-induced poverty.

Introduction: Cardiovascular diseases (CVDs) are major problems in India and many other developing and developed countries. As India is committed to provide universal health care for the population, there is a need to find out the prevalence and determinants of CVD risk among high-risk individuals (Diabetes and Hypertensive patients) in the remote rural area of India to deliver appropriate services, as they are considered as neglected population. Methods: We screened high-risk individuals (Hypertension and Diabetes patients) for CVD risk using WHO/ISH chart, in a remote rural area of south India, covering ten villages surrounding the Rural Health Training Centre (RHTC), in August–September 2017. After line-listing the participants from the electronic database of RHTC, screening with questionnaire and biochemical tests was done at village level as the first step. Thereafter, the participants were invited to the hospital on a particular day where electrocardiography (ECG) and echocardiography (ECHO) were done with special consultation. Results: Among the total of 303 individuals screened at the village level, 64 [21%(CI 17–25)] had a higher risk for CVD. 235 people attended the special consultation; among them, 212 underwent ECG and 88 underwent ECHO. Among those screened with ECHO, 18 had some cardiac pathologies. The relationship between CVD risk and other factors is shown in. After final adjustment, illiteracy [adjusted prevalence ratio (aPR) 1.8 (0.1–3.1)], anemia [aPR 1.8 (1–3.6)], and chronic renal diseases [aPR 1.8 (1.0–3.4)] were found to be associated with high risk for CVD among hypertension and diabetes groups. Conclusion: Cardiovascular disease risk assessment using WHO/ISH chart showed an association with poor education, anemia, and chronic kidney disease.

Introduction: We assessed the contact screening of smear-positive pulmonary tuberculosis (PTB) and the coverage of isoniazid preventive therapy (IPT) in Puducherry district of Puducherry State. Methods: A retrospective record review of treatment cards, under the Revised National Tuberculosis Control Programme, was conducted between the reference period of October 2018 and December 2018. Results: A total of 145 index cases were linelisted. Among them, the number of household contacts of >6 years was 399, of which 359 (90%) were screened for PTB and one was diagnosed with PTB and initiated on treatment. Among the 35 children

Background: Six diverse Demographic Development and Environmental Surveillance System (DDESS) sites were established in urban slum, urban resettlement, peri-urban, rural, and tribal areas located in Northern, North-East, Eastern, and Southern regions of India from June 2020 to March 2022. Understanding the community dynamics and engaging people in the community is critically important in the process of establishing DDESS. We ascertained the barriers, challenges, and facilitators during the establishment of multiple DDESS sites across India. Methods: This was a cross-sectional descriptive mixed-methods study. Results: Multiple barriers and challenges encountered were reported in the process of community engagement (CE), such as geographical inaccessibility, language barriers, adverse weather, non-responsiveness due to perceived lack of individual benefit or financial gain, fear of contracting COVID-19, COVID-19 vaccine hesitancy, etc. Facilitators in the CE process were pre-existing links with the community, constitution of community advisory boards, community need assessment, concomitant delivery of outreach health services, and skill-building facilities. Conclusion: Most community barriers in the development of DDESS sites in resource-limited settings can be overcome through a multipronged approach, including effective community engagement by focusing on demonstrating trust at the local level, enlisting community mobilization and support, utilizing pre-existing community linkages, initiating community diagnosis, and meeting perceived community health needs.

CKD-EPI (chronic kidney disease-epidemiological) serum creatinine equation is widely accepted for calculating estimated glomerular filtration rate (eGFR). The effect of transitioning from the older 2009 to the newer race-independent 2021 CKD-EPI equation on the estimated kidney disease burden (eKDB) was studied in an Asian-Indian population.The study included 1156 adults, the two equations were compared for agreement (Bland-Altman and Cohen's kappa) and concordance (Lin's correlation and test for proportions).The 2021 CKD-EPI increased the eGFR (positive-bias), independent of age-group, gender or presence of type 2 diabetes mellitus (T2DM) and hypertension (HTN). Thus, the eKDB was significantly decreased by 2021 CKD-EPI equation. The agreement was highest for the age-group 31-40 years (95.8 % versus 87.5 % for 50 years). Besides, the eGFR category was shifted from G3 to G1 in 8.2 % (95 % CI: 6.8-9.9) individuals by 2021 CKD-EPI. The effect of transition on eKDB was greater in individuals 50 years (7.4 %) or with HTN (6.3 %).In comparison to the old equation, the 2021 CKD-EPI equation increased the eGFR, lowering the eKDB in this Asian-Indian cohort. The degree of lowering was affected by age-group, and presence of T2DM /HTN, but independent of gender.

Introduction: Xpert MTB/RIF was implemented in 2016 as the initial diagnostic test for extrapulmonary, pediatric, and human immunodeficiency virus–associated tuberculosis (TB) and as an add-on test for sputum microscopy–negative patients under Revised National TB Control Programme, Puducherry, India. We intended to study the change in TB case notification rates (CNRs) after 2015 and explore the enablers and barriers for implementation of Xpert. Materials and Methods: Sequential mixed-methods study, quantitative phase followed by a descriptive qualitative phase (key informant interviews with healthcare providers in the program). Results: The TB (all forms) CNR increased in 2016 followed by a drop to 2015 levels in 2017. There was a reduction in patients notified as sputum-negative pulmonary TB and pediatric TB during 2016–2017. Healthcare providers used a negative Xpert result in ruling out TB among patients who would previously get diagnosed clinically. Perceived benefits of Xpert were efficiency, rapid results, and detecting resistance. Barriers included poor awareness among medical colleges and the private sector, difficulty in motivating sputum microscopy–negative patients for Xpert, and incompletely filled referral forms. Conclusion: Xpert-negative results should be interpreted cautiously after clinical assessment. Identified barriers should be addressed to ensure that all eligible undergo testing.

Background: Dengue fever is the most prevalent mosquito-borne viral disease in the world, with 390 million dengue infections occurring every year. There is an unmet medical need to develop a safe, effective and affordable dengue vaccine against all four Dengue serotype viruses-DENV1, DENV-2, DENV-3 and DENV-4. Panacea Biotec Ltd (PBL) has developed a cell culture-derived, live-attenuated, lyophilized Tetravalent Dengue Vaccine (TDV). Here, in phase I/II study we assessed the safety and immunogenicity of single dose ‘Dengue Tetravalent Vaccine’ in healthy Indian adults. Methods: In the study, 100 healthy adult volunteers aged 18–60 years were enrolled. The participants were allocated to TDV and placebo groups in 3:1 ratio, i.e. 75 participants to TDV group and 25 participants to the placebo group. Enrolled participants were administered a single dose of 0.5 ml of the test vaccine / placebo by subcutaneous route. Primary outcome for safety included all solicited AEs up to 21 days, unsolicited AEs up to 28 days and all AEs/serious adverse events (SAEs) till day 90 post-vaccination. For immunogenicity assessment the primary outcome was seroconversion & seropositivity rate by PRNT50 to all four serotype till 90 days. Results: Overall, 100 subjects were vaccinated out of which 8 subjects (5 subjects in vaccine group and 3 subjects in placebo group) dropped out from the study. The most commonly reported solicited local AE was pain and most common solicited systemic AE was headache and fever. No SAE was reported during the study. There was no statistically significant difference between TDV and placebo groups in terms of AEs. Of the 92 subjects who completed all scheduled visits in the study, 59 (81.9%) achieved seroconversion for DENV-1, 56 (77.8%) for DENV-2; 59 (81.9%) for DENV-3 and 57 (79.2%) for DENV-4 in TDV group. The seroconversion rate in the TDV group was statistically significant (p

Background: As committed by India in Global Action Plan, Sustainable Development Goals and National Health Policy 2017, India has the responsibility to provide accessible, affordable noncommunicable disease care to the people. Our study aimed to find out the burden of cardiovascular risk factors among hypertension and diabetic patients, through a community-based screening, in a remote rural area of South India. Methods: A special program named “Chunampet Rural–Cardiovascular Health Assessment and Management Program” (CR-CHAMP) was launched in August and September 2017 in a Rural Health Training Center (RHTC), functioning under a private medical college in South India. In this program, participants with hypertension (HT) and diabetes (DM) were line listed from 10 remote villages, and then history, initial biochemical, hormonal, and hematological screenings were done to assess the cardiovascular diseases (CVDs) risk factors among these patients, following which special consultation was offered in RHTC. Results: Out of 415 eligible patients with HT and DM, 389 were approached; among them, 328 were willing to participate and were screened initially; among them, 235 were attended special consultation. Higher CVD risk was found in 21%. Prevalence of chronic kidney disease was 14%, deranged lipid profile was more than 50%, metabolic syndrome was 49%, anemia was 68%, abnormal waist-hip ratio was 56%, abdominal obesity was 59%, and overweight and obesity using body mass index (BMI) was 59%. Females' participation was more in our community-based screening procedure (66%) than male participation (34%). Conclusion: CR-CHAMP demonstrated feasibility and value of implementing a screening program for high-risk individuals with HT and DM for CVD risk through existing primary care in a remote rural area of South India. This will help the National Program and policymakers to plan for interventions in the remote rural area in future.

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.

To assess the effect of migration (rural-to-urban and vice versa) on prevalence of diabetes and metabolic disorders in Asian Indians participating in the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study.The ICMR-INDIAB study is a national study on diabetes and associated cardiometabolic disorders in individuals aged ≥20 years from 28 states and 2 union territories of India. Individuals who moved to a different place from their place of birth and had resided in the new location for at least one year were considered as migrants. Anthropometric measurements, blood pressure estimation and a capillary oral glucose tolerance test were performed.Of the 113,043 participants, 66.4% were non-migrant rural dwellers, 19.4% non-migrant urban dwellers, 8.4% rural-urban migrants, 3.8% multiple migrants and 2.0% urban-rural migrants. Weighted prevalence of diabetes was highest in rural-urban migrants followed by urban dwellers, urban-rural migrants and rural dwellers [14.7%, 13.2%, 12.7% and 7.7% respectively (p 0.001)]. Rural-urban migrants had highest prevalence of abdominal obesity (50.5%) compared to the other three groups. The risk for diabetes was 1.9 times higher in rural-urban migrants than among rural dwellers. Five risk factors [hypertension, abdominal and generalized obesity, physical inactivity and low fruit and vegetable intake] together explained 69.8% (partial population attributable risk) of diabetes among rural-urban migrants and 66.4% among non-migrant urban dwellers.Rural-to-urban migration is associated with increased risk of developing diabetes and other cardiometabolic abnormalities. Adoption of healthier lifestyle patterns among migrants could help prevent/delay onset of these abnormalities in this population.

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.

Introduction: Nutrition is defined as the process by which the organism utilizes food. Malnutrition is a major public health problem as both under nutrition and obesity has serious negative health implications. Childhood malnutrition adversely impacts the overall lifelong health of individuals by affecting growth and development. Materials and Methods: A cross sectional study was conducted among the mothers of under five children in Anaichikuppam, a rural area of Villupuram district during the month of November 2013. A total of 157 mothers of pre school children were interviewed in the study. The mothers were asked to fill six food groups in the appropriate boxes based on the requirements per day in the “The food guide pyramid”. The food items present in the food pyramid were given in the questionnaire and asked to mark in the appropriate boxes based on their priority. Results: A total of 157 mothers were interviewed in the study. Maximum number of mothers marked fats and oils (66%) against the appropriate box in the food pyramid. Majority of the mothers (92%) had wrong perception about cereals and marked it wrongly in the food pyramid. Conclusion: The knowledge of the mothers regarding nutrition is fairly acceptable in our study population. More emphasis needs to be given to fruits, vegetables and cereals since least priority has been given to these food groups.

Tuberculosis (TB) remains a major global public health problem and it has been the leading cause of death due to an infectious agent in the past five years. During the last decade, the global and national efforts have been focused on achieving the targets set by the Millennium Development Goals (MDGs) and the Stop TB Strategy to reduce the burden of tuberculosis disease. In 2016, the Sustainable Development Goals (SDG) framework of goals, targets and indicators were adopted and in line with it End TB Strategy was unanimously endorsed by all WHO member states for the period of 2016 – 2035 (1). Based on these global efforts, India which accounts for about one quarter of world TB cases has formulated the National Strategic Plan (NSP) for TB elimination 2017-2025 to guide the activities of all stakeholders whose work is relevant to TB elimination in India.

Introduction and Objective: To achieve elimination of tuberculosis by 2025, identifying the remaining 25% of missed cases would play a major role. But there is paucity of evidence on this statement. This study aimed to assess feasibility of active case finding for tuberculosis in selected region of Puducherry. Methods: Community based survey was conducted by groups of trained undergraduate medical students. During January 2018, all residents of study area were assessed for presence of presumptive symptoms related to tuberculosis. Presumptive cases of tuberculosis were identified as per the programme definition and the same were facilitated to undergo follow up necessary investigations to rule out tuberculosis through frequent domiciliary visits. The data collection was done using mobile based Epicollect open access app. Feasibility was assessed using indicators namely household coverage, proportions of presumptive cases identified and undergone follow up investigations, number needed to screen for presumptive and confirmed cases of tuberculosis and average time spent per person. Results: Of the 2252 houses, 1746 were covered resulting in a response rate of 77.5% and included 6606 residents. Of the 55 presumptive cases identified (55/6606) 51 underwent investigations (51/55). Two new cases of tuberculosis were diagnosed in this survey. To identify one presumptive and confirmed case 120, 3303 people need to be screened respectively. Conclusion: Active case finding for tuberculosis is feasible provided the health system is able to invest adequate human resources and referral linkages to support peripheral centres.

Aim Type 2 diabetes (T2DM) and hypertension (HTN) are the main modifiable risk factors of chronic kidney disease (CKD), among the known traditional and non-traditional risk factors. Methods We determined the prevalence and care-cascade of these modifiable CKD-risk factors and their association with socioeconomic status in adjoining Lucknow and Puducherry cities of India. Results 439 participants reported no CKD were recruited. Serum analysis revealed an Estimated Glomerular Filtration Rate (eGFR) ≥ 90 ml/min/1.73 m2 in 60.36% of the population. Of them, 55.85% had HTN and/or T2DM as CKD-risk factors; however, less than half of this population was unaware of their CKD-risk status. Awareness and treatment were significantly higher in Puducherry and were associated with literacy, occupation, and residence place. Although the CKD-risk population was about two times higher in Puducherry than Lucknow, the populations with mild-low eGFR were comparable in the two regions. Moreover, in Lucknow, mild-low eGFR and low awareness were more prevalent among the younger participants ( Conclusions Despite a higher prevalence of CKD-risk factors in Puducherry, populations with mild-low eGFR were comparable to Lucknow. More heightened awareness and better care cascade for CKD-risk factors in Puducherry may prevent or delay eGFR reduction.

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.

Introduction Fever is a common symptom during the monsoon in the coastal regions in India. Fever can lead to dangerous life threatening conditions in some cases if left untreated. Thus it is important to know the occurrence of acute febrile illness (AFI) and the treatment seeking behavior for the same among population of coastal areas. Materials and methods A community based observational study was conducted in coastal area of Villupuram district, Tamilnadu. Using a pre-designed and pre-tested questionnaire, house-to-house survey was done by trained medical students, under the supervision of post graduate students and faculty. Occurrence of fever and treatment seeking behavior was studied in the resident population. Results Among 811 subjects, 15.9% ( n = 129) reported to have one or more episodes of fever in the past 3 months. More males (17%) reported to have fever than females (14.6%). The reported incidence was highest among children of age group of less than 10 years (36.5%) followed by age group 10–19 years (17.80%). Average duration of fever was 5.4 ± 2.7 days. Nearly 20% of the participants with fever ( n = 27) neither visited any health care facility nor reported to have any form of treatment. Most of the study participants (47.7%) preferred to access government health facility for their febrile illness that occurred last time. Conclusion The reported incidence of the AFI was high among children as compared to adults and government primary health care facilities were the most preferred health care facility visited for febrile illness.

Setting: Four Tuberculosis (TB) Units in the Union Territory of Puducherry in India. Objectives: To identify factors associated with unfavourable outcomes among retreatment TB cases in Puducherry. Design: The study had a mixed-methods design in which routinely reported TB data from retreatment TB cases registered during 2014 and 2015 were used for the quantitative part; the qualitative phase comprised interviews and focus group discussions with health care providers. Results: Among the 392 retreatment cases, 297 (75.8%) had favourable outcomes. Outcome for previous treatment such as loss to follow-up (LTFU) (adjusted relative risk [aRR] 1.6, 95%CI 1.1-2.4, P = 0.001), treatment failure (aRR 1.7, 95%CI 1.04-2.8, P = 0.03) and pre-treatment weight

South-east Asia has one fifth of the world diabetic cases, with India alone contributing 61.3 million cases. Oral hypoglycemic agents substantially delay complications. Non adherence to medications decreases effectiveness of treatment leading to complications and increased cost of health care. Therefore, the objectives of this study are to measure the prevalence of patient’s adherence to anti-diabetic medications and to assess the factors associated with patient’s adherence. Cross-sectional study was conducted among 350 diabetic patients residing in the urban field practice area under Community Medicine Department of a medical college. Data were collected from May to August 2011 by house to house survey, using a pretested structured questionnaire. Patient’s adherence to diabetic medication was assessed using Morisky 4-Item Self-Report measure. Adherence to medication among the diabetics was 50.6 %. Adherence was 55.6 % among patients who were healthy subjectively (P = 0.000). Adherence was higher in non-alcoholics (53.8 %) and non smokers (52.1 %) as compared to alcoholics (23.7 %) and smokers (25.0 %). Adherence was higher among those who did not do physical exercises (56.7 %). Patients taking only one type of medication (67.7 %) were adhering better than those taking two or more type of medication (P = 0.000). Almost 50 % of diabetic patients were not adhering to the medications. Lifestyle factors were significantly associated with patient’s adherence. Hence, patients with poor lifestyle habits should be the primary target of effective intervention for enhancing patient’s adherence to anti-diabetic medications through Behaviour Change Communications.

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 The household is a potentially important but understudied unit of analysis and intervention in chronic disease research. We sought to estimate the association between living with someone with a chronic condition and one’s own chronic condition status. Methods and findings We conducted a cross-sectional analysis of population-based household- and individual-level data collected in 4 socioculturally and geographically diverse settings across rural and urban India in 2013 and 2014. Of 10,703 adults ages 18 years and older with coresiding household members surveyed, data from 7,522 adults (mean age 39 years) in 2,574 households with complete covariate information were analyzed. The main outcome measures were diabetes (fasting plasma glucose ≥ 126 mg/dL or taking medication), common mental disorder (General Health Questionnaire score ≥ 12), hypertension (blood pressure ≥ 140/90 mmHg or taking medication), obesity (body mass index ≥ 30 kg/m2), and high cholesterol (total blood cholesterol ≥ 240 mg/dL or taking medication). Logistic regression with generalized estimating equations was used to model associations with adjustment for a participant’s age, sex, education, marital status, religion, and study site. Inverse probability weighting was applied to account for missing data. We found that 44% of adults had 1 or more of the chronic conditions examined. Irrespective of familial relationship, adults who resided with another adult with any chronic condition had 29% higher adjusted relative odds of having 1 or more chronic conditions themselves (adjusted odds ratio [aOR] = 1.29; 95% confidence interval [95% CI] 1.10–1.50). We also observed positive statistically significant associations of diabetes, common mental disorder, and hypertension with any chronic condition (aORs ranging from 1.19 to 1.61) in the analysis of all coresiding household members. Associations, however, were stronger for concordance of certain chronic conditions among coresiding household members. Specifically, we observed positive statistically significant associations between living with another adult with diabetes (aOR = 1.60; 95% CI 1.23–2.07), common mental disorder (aOR = 2.69; 95% CI 2.12–3.42), or obesity (aOR = 1.82; 95% CI 1.33–2.50) and having the same condition. Among separate analyses of dyads of parents and their adult children and dyads of spouses, the concordance between the chronic disease status was striking. The associations between common mental disorder, hypertension, obesity, and high cholesterol in parents and those same conditions in their adult children were aOR = 2.20 (95% CI 1.28–3.77), 1.58 (95% CI 1.15–2.16), 4.99 (95% CI 2.71–9.20), and 2.57 (95% CI 1.15–5.73), respectively. The associations between diabetes and common mental disorder in husbands and those same conditions in their wives were aORs = 2.28 (95% CI 1.52–3.42) and 3.01 (95% CI 2.01–4.52), respectively. Relative odds were raised even across different chronic condition phenotypes; specifically, we observed positive statistically significant associations between hypertension and obesity in the total sample of all coresiding adults (aOR = 1.24; 95% CI 1.02–1.52), high cholesterol and diabetes in the adult-parent sample (aOR = 2.02; 95% CI 1.08–3.78), and hypertension and diabetes in the spousal sample (aOR = 1.51; 95% CI 1.05–2.17). Of all associations examined, only the relationship between hypertension and diabetes in the adult-parent dyads was statistically significantly negative (aOR = 0.62; 95% CI 0.40–0.94). Relatively small samples in the dyadic analysis and site-specific analysis call for caution in interpreting qualitative differences between associations among different dyad types and geographical locations. Because of the cross-sectional nature of the analysis, the findings do not provide information on the etiology of incident chronic conditions among household members. Conclusions We observed strong concordance of chronic conditions within coresiding adults across diverse settings in India. These data provide early evidence that a household-based approach to chronic disease research may advance public health strategies to prevent and control chronic conditions. Trial registration Clinical Trials Registry India CTRI/2013/10/004049; http://ctri.nic.in/Clinicaltrials/login.php, In a cross-sectional analysis, Shivani Patel and colleagues estimate the extent of chronic disease concordance within Indian households., Author summary Why was this study done? Prior research, largely set in high-income country settings, demonstrates the concordance of physical health and mental health outcomes among spouses and between parents and their adult children. These prior studies have examined neither disease concordance among coresiding adults who are not parent-child pairs or spouses nor the correspondence of different chronic conditions (e.g., husband’s diabetes status and wife’s common mental disorder status). Few have examined physical and mental health outcomes simultaneously. Understanding associations of shared and differing chronic conditions among all coresiding adults in households may shed light on new approaches to identify and treat chronic illness in low- and middle-income countries such as India. What did the researchers do and find? We examined 5 chronic disease conditions—hypertension, diabetes, obesity, common mental disorder, and high total blood cholesterol—in 7,522 adults living in 2,574 households in 4 diverse settings in India. We demonstrate that there is substantial concordance in diabetes, common mental disorder, and obesity among Indian adults residing in the same household regardless of relationship type. Correspondence across different chronic conditions was weaker. What do these findings mean? Adults who live with someone with diabetes, common mental disorder, or obesity are more likely to have that same condition. Addressing the burgeoning chronic disease burden in India will benefit from understanding and intervening upon mechanisms responsible for disease concordance within households in this setting.

Background: The traditional teaching learning methods involve a one way process of transmission of knowledge leaving the students lacking behind in creative abilities. Medical schools need to change their teaching strategies to keep the interest of students and empower them for future self- learning and critical thinking. Objective: To assess the impact of mind mapping technique in information retrieval among medical college students in Puducherry. Methods: A pilot study was conducted using experimental study design among sixth semester MBBS students (n = 64) at a medical college in Puducherry, India. One group (n = 32) followed the text reading method and another group (n = 32) followed the mind mapping technique to learn the same passage given to them. The knowledge about the topic was assessed using a pre designed questionnaire at baseline, day 0 and day 7. The knowledge gain is the primary outcome variable and is compared between two groups. The feedback regarding the teaching methods was obtained from the participants. Results: Mean knowledge score in the text group was lesser than the mind map group at baseline (2.6 Vs 3.5; p = 0.08). On Day 0, the mean score in text group was slightly lesser than the mind map group (8.7 Vs 9.0; p = 0.26). On Day 7, the mean score in mind map group is significantly more than the text group (8.9 Vs 8.5; p = 0.03). Conclusion: The mind mapping technique is an innovative and effective method in remembering things better than the routine way of reading texts.

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: Lifestyle changes have increased the epidemic of obesity, diabetes, hypertension (HTN), dyslipidemia, and cardiovascular diseases in the 20th century. In India, the estimated adult prevalence of coronary artery disease (CAD) is increasing which leads to a huge economic loss. Objectives: The objective of the study is to measure the prevalence of risk factors for CAD among population aged 30 years and above in a rural area of Tamil Nadu. Materials and Methods: A community-based cross-sectional study was done in 16 villages under the field practice area of the Department of Community Medicine, Pondicherry Institute of Medical Sciences. 631 participants were selected by multistaged random sampling and interviewed using modified WHO-STEPS questionnaire. The variables studied were age, sex, socioeconomic status, smoking, alcohol, diet, physical activity, obesity, diabetes, and HTN. Data analysis was done using SPSS version 20. Results: Out of 631 participants interviewed in this study, the prevalence of smoking was 13.8%. 29.6% respondents had consumed alcohol once in their lifetime. Almost all the respondents (99.5%) did not consume fruits and vegetables adequately. Majority of the participants consumed salt dense foods and used unsaturated oil for cooking. Only 17.8% were sedentary workers. 32.5% were pre-hypertensives and 25.8% were hypertensives. 28.2% were overweight and 6.6% were obese. Conclusion: The prevalence of various risk factors for CAD such as unhealthy diet, obesity, alcohol consumption, and comorbidities was found to be high among our study population. Hence, concerted efforts should be taken by various stakeholders to reduce the risk of developing CAD.

The objectives of this study are to determine the prevalence of domestic accidents, describe the factors associated with domestic accidents and assess the medical and economical consequences of domestic accidents. Community-based cross-sectional study was conducted in a semi-urban area of Tamil Nadu during February 2013. A total of 3947 study participants were interviewed using a structured questionnaire. Study variables included were socio-demography, housing conditions, epidemiological factors, medical and economical consequences of domestic accidents. Means and proportions were calculated. The prevalence of domestic accidents was 12.7%. Out of 500 domestic accidents, falls (54.4%) was the most common type of domestic accident. Females and the respondents in age group of 21-40 years were more commonly affected. About 60% of victims received treatment. Mean duration of hospital stay, mean amount of money spent for treatment and mean number of days away from routine work for falls category were 16 days, US$25 and 8 days, respectively, which are higher than other types of accidents. The burden and impact of domestic accidents was high. Therefore, in order to prevent and control domestic accidents, promotion of house safety measures and creation of awareness among the community using IEC programmes have to be undertaken.

Background: Tuberculosis is a chronic communicable bacterial disease of ancient origin. It is caused by Mycobacterium tuberculosis, primarily infects the lungs causing pulmonary tuberculosis. TB continues to be a major public health problem worldwide. World Bank has estimated the global burden of TB in terms of DALYs loss and stated that tuberculosis stands 7 th in the ten leading causes of global DALYs loss and expected to maintain its position even in 2010 AD. Because of its severity and consequences, in 1993, WHO has declared TB as a "global emergency". Premature death is the main cause of the burden of TB, as measured in terms of DALYs lost. Besides the disease burden, TB also causes an enormous socio-economic burden to India. TB primarily affects people in their most productive years of life with important socio-economic consequences for the household and the disease is even more common among the poorest and marginalized sections of the community. Almost 70% of TB patients are aged between the ages 15 and 54 years of age. So this study was planned to know about prevalence of chest symptomatics in study population. Material and Methods:A cross sectional study was carried out in Kancheepuram, a district belonging to the field practice area of Rural Health training Centre-Chunampet, Department of Community Medicine, Pondicherry Institute of Medical Sciences. House to house survey was done for selection of the study respondent. The study was carried out in from the month of Feb-April, 2012. About 2005 adults were interviewed by using a pretested validated questionnaire. Data entry and analysis was done using SPSS 16.0. Result: Total of 2005 respondents were interviewed out of which 1196(59.7%) were females and remaining 809 (40.35) were males. Maximum (35.3%) respondents belonged to the age group of 15-30 years followed by 31-35 years age group (28.7%). Out of the 2005 study population majority, 1474(73.5%) had no ailments whereas, 277(13.8%) suffered from associated symptoms like hemoptysis, chest pain, Breathlessness, loss of appetite and decreased energy levels despite adequate rest. However, 254(12.7%) were found with one or more symptoms suggestive of TB. When the symptoms suggestive of TB was considered, 181(9.0%) of the study respondents had cough for more than 2 weeks, 91(4.5%) had loss of weight, 57(2.8%) and 49(2.4%) had fever for more than 2 weeks and night sweats respectively. Conclusion: prevalence of suspected tuberculosis patient was high in the community. Key words:- Tuberculosis, prevalence, rural area

Background: India was home to 62.4 million diabetics in the year 2011 and the incidence is on a continuous rise. Of the various risk factors for diabetes smoking is still under debate. Objectives: To assess the association between smoking and diabetes mellitus in a study population and to assess the association between socio demographic factors and diabetes in a study population. Methodology: A community based case control study to associate smoking and diabetes was conducted in the rural area of Chunampet, Cheyyurtaluk of Kanchipuram district in Tamilnadu, which is under field practicing area, Rural Health Training Centre , Department of Community Medicine, Pondicherry Institute of Medical Sciences, Chunampet. Study participants: Adult population aged above 30 years of age. Sample size: Calculated using Epi info. 150 cases and 150 controls. Definition of cases: Known diabetics or persons with FBS> 126 mg/dl or RBS>140mg/dl. Definition of controls: Persons who are not a known a case of Diabetes and with FBS

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: Despite various reforms brought in health care service delivery there is always a gap between community and health care providers. Hence there is a need to explore the successful strategies to reorient the medical students towards public health relevant community needs. Objective: This study aimed to assess the feasibility and impact of community based field training imparted among medical undergraduates to identify problems related to infant and young child feeding practices and design appropriate interventions. Material and Methods: This study is a mixed method study where improvement of knowledge were assessed quantitatively through quasi experimental pre-post study design. Difference in cumulative score obtained after training was compared using student's t test. Perception of students and mentor's views on this approach in terms of benefits and challenges were explored during in-depth interviews. Transcripts of qualitative interviews were analysed using manual content analysis. Results: Total of 781 infant and young children from 30 villages were surveyed by 36 medical undergraduates. There was significant improvement in knowledge on feeding practices from the baseline [baseline mean (SD) score: 3.3 (1.5); post training mean (SD) score: 6.5 (1.1), p

Introduction and objectives: Early diagnosis of the disease and prompt initiation of treatment are essential for an effective TB control program. The delay in the diagnosis and treatment may worsen the disease, increases the risk of death and enhance TB transmission in the community. This study was done to assess the extent of various delays and their determinants. Material and methods: An observational study including retrospective medical record review and patient interviews was conducted during 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. Average estimates and unadjusted odds ratios (OR) were calculated. Level of significance was determined at 95% (P value Results: Among 216 patients, majority (68.1%) were male and married (70.4%) and one-fourth (25.0%) were in the age group of 15 to 24 years. Majority (89.6%) of the patients were literate. Among TB patients 11.1% and 10.6% were smokers and alcohol user respectively. The median patient delay, health system delay and total delay was 37 days, 28 days and 93 days. Only18.0% were correctly aware of the cause of TB. Most of the patients (85.9%) were aware that TB is a communicable disease but were not aware of free diagnosis services (67.1%). The patient and health system delays were significantly more (P value Conclusions: Patient and health care system delay for TB patients is long. There is need to improve the referral mechanism to ensure an early initiation of treatment for TB patients diagnosed a tertiary care hospitals.

Background Salt workers are exposed to occupational hazards like contact with salt crystals and brine, physical stress, sunlight and glare due to sunlight reflected by salt crystals. Very few studies have documented the morbidity among the salt workers. Aim To assess the morbidity pattern among salt workers in Marakkanam, Tamil Nadu, India. Materials and methods A community based cross-sectional study was undertaken in 4 randomly selected salt worker villages. Three hundred thirty one salt workers were reached by a house-to-house survey during April 2010 to March 2011. Demographic data was collected; clinical examination was conducted using a predesigned and pretested questionnaire. A pilot study was conducted to estimate the prevalence of morbidity before initiating the study. The data was analyzed using SPSS Version 11.5. Chi-square test and odds ratios (OR) with 95% confidence intervals (CI) were calculated to determine the association of morbidity levels with various factors. Results Of the 331 salt workers in the study, 58% were females, mean age was 41.9 ± 10.8 y. Eighty seven percent salt workers had some or other morbidity. The observed morbidities include clinical pallor (44.4%), ocular morbidities including cataract, pterygium, conjunctivitis, pingecula and corneal ulcer (42%), caries teeth (41.7%), hypertension (23.3%), underweight (19.3%), goiter (19%), obesity (14.8%) and dermal conditions including dermatitis, thickening of palm and sole, tinea unguum, follicultitis (9.1%). The presence of morbidity did not show any significant association with increase in age, gender, duration of employment or the type of salt work involved with. However, the lower the education level, the higher is the morbidity level among salt workers (OR = 5.23, 95% CI= 2.07 to 13.21). Conclusion Morbidity among salt workers is high. Intervention programs are needed to alleviate the health problems in the salt workers.

Background: Medical schools all over India mainly have lectures as the most widely used teaching and learning methods. Current medical education imparts knowledge in a disjointed manner and does not allow students to develop the skills to perceive the patient as a whole. There is a need to teach the students by correlating the various subjects to create interest and promote active learning. Aim: This study was conducted to find out the scope of integrated teaching in the undergraduate medical curriculum. Setting and Design: A cross-sectional study was conducted in a medical college in the coastal region of South India. Methodology: Objectives that are to be achieved by the end of the integrated teaching were clearly drafted, a detailed lesson plan was drafted and was circulated among the faculty and students, and it was decided that the integrated teaching would be conducted in coordination between Department of General Medicine, Department of Microbiology, and Department of Community Medicine. Statistical Analysis: Collected data were entered into MS Excel, and analysis was done using SPSS software. The students' feedback of the session was assessed using Likert scale. Results and Conclusion: The pre- and post-test scores showed that there was statistically extremely significant increase in the knowledge. Overall, 56.7% (38) students gave a feedback of very good for the integrated teaching on a whole. This method is an improvisation in the teaching methods to meet the expectations of the students and to improve the quality of teaching and has the ability to make the teaching–learning process more effective.