Rural Indian Population Research Articles

Factors predicting proper handwashing practice amidst the COVID-19 pandemic in India: a field-based cross-sectional study.

Proper handwashing is one of the effective ways to prevent many communicable diseases, including COVID-19. We explored the handwashing practices in a rural Indian population before the probable third wave of the COVID-19 pandemic. A data collection schedule was administered to eligible adult members of a rural community, selected by multi-stage sampling, to assess their pattern and practice of handwashing. All 176 respondents washed their hands after defecation, 82.4 and 80.7% washed hands after urination and before taking food, respectively, while 68.2% of respondents washed hands after coming back from outdoors. Among those who handwashed, 82.9% used soap water after defecation; 46.2, 45.8 and 50.8% washed hands with soap water after urination, before taking food and after visiting outdoors, respectively. Only a quarter (24.4%) of all the participants used soap water for handwashing consistently after defecation, after urination, before taking food and after coming home. The more educated, those coming from higher socioeconomic stratum and working from home, were more likely to report proper handwashing practice. Handwashing, as recommended by health agencies, for restraining COVID-19 infection, was not noticed in the majority of the participants. Better awareness of handwashing is recommended to help restrain COVID-19 in the Indian population.

WHO Non-Lab-Based CVD Risk Assessment: A Reliable Measure in a North Indian Population.

Introduction:Timely, affordable, and sustained interventions reduce the risk of heart attack or Stroke in people with a high total risk of cardiovascular diseases (CVD). Risk prediction tools are available to estimate the cardiovascular risk using information on multiple variables. CVD risk charts prepared by the World Health Organization (WHO) has laboratory-based and non-laboratory-based charts with the latter meant for use in resource limited settings. We conducted a study to determine concordance between the laboratory- and non-laboratory risk charts and to estimate the prevalence of selected CVD risk factors in a rural Indian population.Methods:A community-based cross-sectional study was conducted in rural area of Ballabgarh in district Faridabad, Haryana. Sample of 1,018 participants aged 30–69 years was selected randomly from study area. Information on CVDs risk factors was obtained using WHO STEPS questionnaire, anthropometry and laboratory investigation. Risk distribution among the study participants was observed. Concordance between laboratory- and non-laboratory-based WHO CVD risk charts was determined using agreement analysis.Results:The mean age of the study participants was 43.9 (8.9) years and 55.6% participants were women. Among various CVD risk factors, hypertension (39.4%) was the major factor followed by overweight (34.1%) was found to be major factor, followed by current smoking (23.6%) and hypercholesterolemia (18.7%). The concordance between the two charts was 83.3% with kappa value of 0.64. Considering laboratory-based charts as the gold standard, the sensitivity and specificity of non-laboratory-based risk charts at 5% risk as cut-off was 86.5% and 90.3% respectively.Conclusion:The study shows a good agreement between the laboratory-based and non-laboratory-based risk charts. Thus non-laboratory-based risk charts are suitable for risk estimation of CVDs for use in resource limited settings like India.

Systematic identification and characterization of clinical and socio-economical correlates of granulomatous nasal and para-nasal sinuses: A large-scale study among patients of Odisha, India

Granulomatous formation in the nose and paranasal sinuses still presents an unmet clinical challenge as it affects both the physical health and personality of patients, and the lack of a systematic diagnostic and disease management approach has further complicated the scenario. Occurrence of granulomatous nasal disorder in the rural Indian population is associated with several factors such as lack of proper medical care, lack of hygienic and clean working and living conditions, and limited financial abilities to access the already overburdened primary healthcare system. This study aims to understand the correlation disease incidence, manifestation of signs and symptoms and associated socio-epidemiological parameters for 104,000 patients over a period of 23 months in Odisha. Primarily the study used socio-epidemiological surveys collected, annotated, and curated independently for granulomatous nasal disorder patients and compared this with their clinical records for signs & symptoms and performed several statistical analyses to better understand the disease incidence correlation with age, socio-economic and gender based parameters. Overall results suggest that males from low socio-economic background living in rural areas are the most vulnerable population and commonly affected with granulomatous nasal disorder (commonly Rhinosporidiosis sub-type) with common origin of the disease reported at the nasal septum and floor. We also highlight that change in the mass of nose followed by bleeds on touch, nasal discharge and hanging mass in throat are the most common manifestations presented by patients with granulomatous nasal disorders. Together, this research work identifies and characterise clinical and socio-economic factors that lead to and exacerbate the incidence of granulomatous nasal disorders.

Perceptions of and challenges faced by primary healthcare workers about preconception services in rural India: A qualitative study using focus group discussion.

BackgroundProviding preconception care through healthcare workers at the primary health care level is a crucial intervention to reduce adverse pregnancy outcomes, consequently reducing neonatal mortality. Despite the availability of evidence, this window of opportunity remains unaddressed in many countries, including India. The public health care system is primarily accessed by rural and tribal Indian population. It is essential to know the frontline healthcare workers perception about preconception care. The study aimed to identify barriers and suggestions for framing appropriate strategies for implementing preconception care through primary health centers.MethodsThe authors conducted a qualitative study using focus group discussions (FGDs) with 45 healthcare workers in four FGDs (8–14 participants in each), in four blocks of Nashik district. The transcribed discussions were analyzed in MAXQDA software using the Socio-Ecological Model as an initial coding guide, including four levels of factors (individual, interpersonal, community, and institutional) that influenced an individual's behavior to use preconception care services.ResultsHealthcare workers had some knowledge about preconception care, limited to adolescent health and family planning services. The interpersonal factors included heavy workload, stress, lack of support and co-operation, and paucity of appreciation, and motivation. The perceived community factors included poverty, migration, poor knowledge of preconception care, lack of felt need for preconception services, the influence of older women in the household decision, low male involvement, myths and misconceptions regarding preconception services. The identified institutional factors were lack of human resources, specialized services, logistics, and challenges in delivering adolescent health and family planning programs. Healthcare workers suggested the need for program-specific guidelines, training and capacity building of human resources, an un-interrupted supply of logistics, and a unique community awareness drive supporting preconception care services.ConclusionMulti-level factors of the Socio-Ecological Model influencing the preconception care services should be considered for framing strategies in the implementation of comprehensive preconception care as a part of a continuum of care for life cycle phases of women.

Sustainable Agricultural Business Model: Case Studies of Innovative Indian Farmers

Agriculture and allied sectors are the mainstays of the Indian rural population and yet, the vast majority is still poor. The Indian government has introduced pro-farmer schemes and policies for their quality of life, but the improvement rate of their quality of life is still relatively slow. In this context, this paper presents a sustainable agricultural business model (SABM), which defines contexts, practices, and outcomes. This SABM is compared with the conventional agricultural business model (CABM). Innovative farmers were selected from different parts of India. Their practices are examined with key performance indicators (KPIs) regarding strategic focus, labor productivity, vital resources usage, soil maintenance, output quality, and revenue performance. Case study results suggest that farmers that adopt SABM are innovative and productive with a better quality of life. In contrast, those who follow CABM are characterized by relatively low productivity and continuous hardships. Lessons and implications, along with future study topics, are discussed.

Medical student’s attitude towards serving rural areas: A cross sectional study in Maharashtra, India

Rural population of India is grossly underserved by healthcare professionals. Gap exits between health services for urban and rural communities. 1) To determine the attitude of medical students towards serving rural areas and factors affecting it. 2) To explore reasons behind willingness and unwillingness to work in rural areas.It was a cross-sectional study conducted in medical colleges. Among three medical colleges in city, two medical colleges were selected by simple random sampling using lottery method. All 450 undergraduate medical students in both selected medical colleges were included into the study. Binary logistic regression analysisOdds ratio,Chi-square test and percentages were used to analyse the data.35.82% medical students were interested in working at rural areas. Age, parental education, place of residence, type of college and year of undergraduation of medical students had significant association with their preference towards rural practice. Social service was commonest reason students being interested in working rural area while scarcity of health facilities was major cause for negative attitude towards rural practice. Majority of medical students were not in favour of working in rural areas. Urban rural disparity was more obvious among Allopathy students. There is need to focus on working environment at rural areas as lack of amenities in the rural areas was a common reason behind unwillingness of students towards rural practice.

Assessment of Quality of Life in Patients of Mastectomy With Chemotherapy.

Background: Breast cancer is one of the most common cancers in India as well as the world. In India, 48% of patients with breast cancer are below 50 years of age, indicating a huge age shift in the last 25 years. Breast cancer in an early age group increased the five-year survival rate and increased life expectancy has created a large group of breast cancer survivors who battle scars of disease as well as treatment. Standardized multimodal treatment is either not affordable or not available, so the breast conservation surgery rate is very low. Mastectomy is still the most common modality of treatment, particularly in rural areas. In addition to psychological, social, economic, and family barriers to obtaining the diagnosis and treatment needed, economic barriers like the cost of travel and lost wages are important factors influencing the choice of treatment. Mastectomy represents a deep burden for women with breast cancer. Very little is known about the psychological consequences over time and the quality of life (QOL) of women so treated, with or without breast reconstruction. Conflicting literature is available regarding QOL after mastectomy. The survival rates of breast cancer are increasing. They are reported in the range of 80-90% in western countries while in the range of 60% in the Indian scenario. With high survival rates in cancer, the focus needs to shift from mortality indicators to QOL indicators. The QOL that these survivors experience is a comparatively newer domain of study. Though there are many instruments for assessment of breast QOL of breast cancer patients with numerous studies in western literature, QOL studies in Indian rural population are far less, and urban studies cannot be extrapolated because the method of treatment differs, with breast conservation being more common in urban population. Hence, the present study is undertaken to assess the QOL in patients who have undergone mastectomy and ongoing chemotherapy or completed chemotherapy recently using a relatively newer instrument, i.e., the Quality of Life Instrument - Breast Cancer Patient version.Methodology: The present study was a cross-sectional study conducted at a rural tertiary healthcare center on mastectomy patients attending the outpatient department and admitted to the hospital. All the female patients of carcinoma breast treated with a mastectomy who were receiving the adjuvant or neoadjuvant chemotherapy or were within one year of completion of chemotherapy irrespective of age at diagnosis were included in this study. The assessment was performed by interview method using a questionnaire.Results: In this study, 44.90% of the patients were <50 years old and 55.10% were more than 50 years old. Among them, 28.57% were illiterate while only 20.41% had graduate education. The majority (61.22%) were from the low socioeconomic class. Majority of women presented in the late stages of the disease, with 61.22% presenting in the third stage and only three (6.12%) presenting in the first stage of the disease. The overall global QOL score was 49 ± 2.6 and fear was assessed. Patients scored better in the physical, psychological, social, and spiritual domains, with an average score of more than 50. The worst scores were observed among distress of illness or treatment.Conclusions: The present study shows that the average QOL scores in rural Indian women after mastectomy are moderate. Global scores and other indicators show moderate QOL.

The association of sun exposure, ultraviolet radiation effects and other risk factors for pterygium (the SURE RISK for pterygium study) in geographically diverse adult (≥40 years) rural populations of India -3rd report of the ICMR-EYE SEE study group.

To determine the prevalence and risk factors for pterygium in geographically diverse regions of India. A population-based, cross-sectional multicentric study was conducted in adults aged ≥40 years in plains, hilly and coastal regions of India. All participants underwent a detailed questionnaire-based assessment for sun exposure, usage of sun protective measures, exposure to indoor smoke, and smoking. Detailed ocular and systemic examinations were performed. Pterygium was diagnosed and graded clinically by slit-lamp examination. Association of pterygium with sociodemographic, ophthalmological, and systemic parameters was assessed. Physical environmental parameters for the study period were estimated. Of the 12,021 eligible subjects, 9735 (81% response rate) participated in the study. The prevalence of pterygium in any eye was 13.2% (95% CI: 12.5%-13.9%), and bilateral pterygium was 6.7% (95% CI: 6.2-7.2). The prevalence increased with age (<0.001) irrespective of sex and was highest in those aged 60-69 years (15.8%). The prevalence was highest in coastal (20.3%), followed by plains (11.2%) and hilly regions (9.1%). On multi-logistic regression, pterygium was positively associated with coastal location (P<0.001), illiteracy (P = 0.037), increasing lifetime sun exposure (P<0.001), and negatively associated with BMI ≥25 kg/m2 (P = 0.009). Pterygium prevalence is high in the rural Indian population. The association of pterygium with several potentially modifiable risk factors reflects its multifactorial etiology and provides targets for preventive measures.

Fistula in Ano—A 2-Year Prevalence Study on North Indian Rural Population

AbstractPerianal fistula (PF) is a common inflammatory condition affecting the perianal region including the sphincter muscles, ischioanal fossae, and the perianal skin. It is notorious to recur and, as a result, causes significant morbidity in both urban and rural population. Magnetic resonance imaging (MRI) has revolutionized imaging in PFs as it provides excellent anatomical visualization of the fistulous tracts, their origin, course, number, chronicity, opening in the external and internal anal sphincter, length of sphincter, evidence of active disease and abscess formation along the tract. It is also very useful in presurgical mapping and reduce the chances of recurrence. Most of the studies done on PFs are based on the urban population. Rural population have a completely different lifestyle which makes them susceptible to various diseases, less prevalent in the urban population. Hence, the purpose of this article is to find the prevalence of different grades in North Indian rural region close to the NCR (National Capital Region). In the study including 98 patients, the maximum number of patients were classified into grade 1 and grade 4 by MRI according to St. James' University Hospital MRI classification. This is the second reported study on prevalence of different grades of PFs in rural population in India. The higher prevalence of grade 4 PFs in our study might be secondary to illiteracy, social stigma, poor hygiene, or higher recurrence rate. Closely understanding the difference in dynamics of urban and rural population, our goal of the study is to determine the prevalence of different grades of PFs in the rural population. We also aim to familiarize physicians, radiologists, and surgeons with the MRI evaluation and grading of PF to help in presurgical mapping and thus, reducing the chances of recurrence. We also recommend further studies to evaluate psycho-social factors as a barrier in seeking early medical care in rural population.

LOW GRADE LUMBAR SPONDYLOLISTHESIS AT L4&amp;L5 AND L5&amp;S1 VERTEBRAE IN RURAL SOUTH INDIAN POPULATION

Objectives: In heavy workers incidence of low back ache is common. Low grade spondylolisthesis has more options of treatment than high grade spondylilosthesis. Therefore, this study was done to find out clinical profile of low-grade spondylolisthesis at L4-L5 and L5-S1 vertebrae in rural south Indian population. Co-relation between Modic change (MC) and grades of spondylolisthesis was also assessed. Material and Methods: Study was carried out for a period of 2 years in 40 patients with age 20-70 years with single-level L4/L5 and L5/S1 low grade spondylolisthesis (Meyerding’s grade I and II), with clinical and neurological examination, assessment of pain by Visual Analogue Score (VAS) and investigations like X ray, CT scan &amp; MRI. Results: Out of 40 cases, 27.5% were males and female were 72.5%. The most affected age group was 40-60 years (65%). Lower back pain (LBP) was the most common symptom (100%). Straight leg raise test was positive in 81.25%. Sensory and motar deficit was seen in 45% of patients. L4-L5 level is affected in 60% of low grade spondylolisthesis cases. Incidence of Meyerding’s grade I &amp; II were 67.5% &amp; 32.5% respectively. In both grades females were more in distribution than males and L4-L5 vertebral level was involved significantly. Isthmic (IS) &amp; Degenerative (DS) spondylolisthesis was 82.5% &amp; 17.5% respectively and both incidences were more in females. In IS the level affected was L5-S1 and in DS L4-L5 level. Incidence of MC type1 is 15%, type 2 is 85% and in type3 incidence was not found in any cases. Females showed higher incidence in type1 (83.3%)&amp;type 2 (70.6%) as compared to Males (16.6% &amp; 29.4% respectively) but this difference was not significant(p value&gt;0.05).Type2 Modic changes were found significantlyhigh in grade II spondylolisthesis 70%compared to 30% intype 1(p value=0.02). Summary: Incidence of low spondylolisthesis was more in females and at L4-L5. Modic changes were gender non-specific and grade specific.This study elucidates the clinical presentations of low-grade spondylolisthesis and specific changes associated with it and that will help in tracing factors responsible for it and assessing treatment outcome.

Impact of COVID-19 on the Livelihood of Indian Rural Population

COVID-19 spread has impacted all shards of life of larger population around the world, the effect remained devastating in developing countries with poor to average health infrastructure. In many developing countries like India where agriculture always remain backbone of economy and power livelihood to large segment of rural masses, COVID-19 spread created huge consequences on general health, livelihoods, and sustainability of rural economy. Unrehearsed mechanism, processes, and policies has given a big blow to informal rural economy. The paper is an attempt to comprehensively measure the effect of COVID-19 on agriculture, economy, and livelihood of rural India. Research material, including secondary data available for various aspect of rural economy, has been explored along with various village centric studies conducted and published by different researchers. Researcher also tried to suggest how the livelihood and economy can be protected.

Sero-Surveillance to Monitor the Trend of SARS-CoV-2 Infection Transmission in India: Study Protocol for a Multi Site, Community Based Longitudinal Cohort Study.

IntroductionLarge-scale sero-prevalence studies with representation from all age groups are required to estimate the true burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the community. Serial serological surveys in fixed cohorts enable study of dynamics of viral transmission and correlates of immune response over time in the context of gradual introduction of COVID-19 vaccines and repeated upsurge of cases during the pandemic.MethodsThis longitudinal study will involve follow-up of a cohort of 25,000 individuals (5,000 per site) aged 2 years and above recruited from five existing demographic surveillance sites in India. The cohort will be tested for the presence of IgG antibodies against S1/S2 spike protein subunits of SARS-CoV-2 in four rounds; once at baseline and subsequently, at intervals of 4 months for a year between January 2021 and January 2022. Neutralization assays will be carried out in a subset of seropositive samples in each round to quantify the antibody response and to estimate the durability of antibody response. Serial serological surveys will be complemented by fortnightly phone based syndromic surveillance to assess the burden of symptomatic acute febrile illness/ influenza like illness in the same cohort. A bio-repository will also be established to store the serum samples collected in all rounds of serological surveys.DiscussionThe population based sero-epidemiological studies will help to determine the burden of COVID-19 at the community level in urban and rural Indian populations and guide in monitoring the trends in the transmission of SARS-CoV-2 infection. Risk factors for infection will be identified to inform future control strategies. The serial serological surveys in the same set of participants will help determine the viral transmission dynamics and durability of neutralizing immune response in participants with or without symptomatic COVID infection.

Effect of Smoking on the Healing of Tibial Shaft Fractures in a Rural Indian Population.

BackgroundTibial shaft fractures account for 17% of all lower limb fractures. Nonunion and infection rates are estimated to be between 2% and 10%. Bone healing is a complex process that is influenced by biological, mechanical, and systemic factors. Adverse smoking effects on cardiovascular and respiratory systems have been well documented. An increasing interest in the effect of smoking on fracture healing following trauma has been noted in recent years. The biological consequence of smoking is relevant, especially in trauma surgery where no way of preventing presurgical smoking has been noted, hence increasing the patient’s risk of nonunion. Cigarette smoking has been shown to impair fracture union and wound healing and lead to an increased risk of fracture site infection. Smoking and high-energy trauma are considered important risk factors for the delayed union of tibial shaft fractures.ObjectivesThis study aims to assess the adverse effects of smoking in patients with tibial shaft fractures following trauma and fracture fixation.Materials and methodsA retrospective cohort study was done on 110 (55 smokers and 55 nonsmokers) patients treated with intramedullary nailing or plating for tibial shaft fractures between July 2017 and January 2021 in the hospital of the current study. Fracture healing was assessed at the end of months 1, 3, and 6 and year 1.ResultsThe mean time of healing in smokers was >48 weeks, whereas the average time to union was 24 weeks in nonsmokers. The majority (54.6%) of smokers took >48 weeks to heal, whereas 81.8% of patients in the nonsmoking group took 24-28 weeks to heal.ConclusionSimilar to the results obtained in previous studies, our study showed that smoking hinders fracture healing after surgical fixation, and smokers have a higher chance of developing surgical site infection and osteomyelitis. Smokers take a longer time for radiological union and also have a high chance of delayed union and nonunion when compared with nonsmokers, which was shown in our study and is consistent with the results obtained in previous studies. Postoperative smoking cessation is as important as preoperative smoking cessation, and patients should be strictly counseled regarding the same.

Prospects of Agriculture as a Lifelong Livelihood Option for Young Indian Rural Population

There is a huge untapped reservoir of employment opportunities in agriculture which requires cultivating the young generation of farmers, food entrepreneurs, etc. Due to agricultural innovations made at the global and national level, the young population can leverage technology, leading to increase in productivity, efficiency and output and addressing the issue of food security. For promoting employment for youths in agriculture and making farming a remunerative economic activity, initiatives have been taken by FAO and by Government of India. The present study focuses on demographic profile of the youth, explores agriculture as an economically viable livelihood option for the youth and highlights the Indian Government policy measures and technological interventions for making agriculture an attractive employment option; discusses the initiatives taken by FAO for promotion of employment in agriculture and finally paper concludes by examining the role of rural youth in addressing the challenge of food security at the national level.

Association between physical activity knowledge and attitude on diabetes among normal weight and overweight/obese type-2 diabetic patients: a rural community-based cross-sectional study.

Physical activity is one of the most important regimens for the treatment of diabetes. Hence, we aimed to examine the association between physical activity knowledge (PAK), knowledge and attitude on diabetes among rural T2DM patients. The PAK, knowledge and attitude on diabetes were targeted to evaluate in rural Indian T2DM patients. A cross-sectional community-based survey was carried out with eighty-four patients with known T2DM in rural population of India. Among 84 patients, 46 were overweight/obese and 38 patients with normal weight were participated in our study. The odds of smoking were found to be a significant socio-demographic risk factor (OR: 4.42, 95% CI 0.93-20.33 and P<0.001) compared to non-smokers. The PAK categories such as A, B & D had associated with BMI. The OR, 95% CI and P. Value are (5.610, 2.18-14.38 and P<0.001; 1.72, 0.72-4.12 and P 0.030; 2.55, 1.05-6.20 and P 0.047) except in category C. Iilliterates, low annual income, poor knowledge on T2DM and negative attitude, OR (4.50; 12.87; 10.80 and 47.66) were reported disagree or don't know with PAK questionnaire. The results have impact on the design of new education programs will assist in preventing and managing complications related to T2DM.

Normative data for three physical frailty parameters in an aging, rural Indian population.

IntroductionPhysical frailty is associated with multiple adverse health outcomes. Since physical characteristics markedly vary with different populations, population‐specific norms for physical frailty parameters are necessary. Such norms are lacking for the Indian population, especially for older, rural Indians. We aimed to develop normative values for three quantitative, frailty parameters—handgrip strength, “Timed Up‐and‐Go” (TUG) test time, and physical activity in an aging, rural Indian population.MethodsThe study sample is from an ongoing, prospective, cohort (Srinivaspura NeuoSenescence and COGnition, SANSCOG) comprised of rural, community‐dwelling, cognitively healthy, aging Indians. Subjects are recruited through area sampling strategy, from villages of Srinivaspura, Kolar district, Karnataka state, India. Three physical frailty parameters of Fried's phenotype—handgrip strength (n = 1787), TUG time (n = 1863), and physical activity (n = 1640) were assessed using digital hand dynamometry, TUG test, and General Physical Activity Questionnaire (GPAQ), respectively.ResultsThe 10th, 25th, 50th, 75th, 90th percentiles for the three frailty parameters were: right‐hand grip strength (kg): males—13.9, 18.6, 23.8, 28.7, 33.7 and females—7.8, 10.6, 14.2, 17.9, 21.3; left‐hand grip strength (kg): males—13.3, 18.3, 23.6, 28.9, 32.9 and females—7.9, 10.5, 14.3, 17.8, 21.2; TUG time (s): males—9.1, 10.1, 11.4, 13.4, 15.5 and females—9.5, 10.7, 12.4, 14.5, 16.6; physical activity (MET‐minutes/week): males—1680; 4320; 8880; 15,840; 23,352 and females—1680; 4320; 9240; 15,120; 20,160.DiscussionOur findings show that from 45 years onwards, overall grip strength decreases and TUG time increases, with women performing significantly poorer than men across all age groups, except >75 years, where no differences were seen. Physical activity did not show any consistent trend according to age or gender. Reference values for this aging, rural Indian population were substantially lower for grip strength and higher for TUG time than aging populations in several Western and other Asian countries.

A survey-based comparison of cardiovascular health risk behaviours in Indian men and women during the pandemic

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiovascular disease (CVD), the leading cause of mortality globally, is caused by a combination of behavioral, clinical and genetic risk factors. The rising prevalence of unhealthy diet, inadequate exercise, psychosocial factors and tobacco use in urban and rural populations of India has posed a major epidemiological and healthcare threat in the recent past. Purpose This study aims to understand the cardiovascular health risk behaviors in Indian men and women during the pandemic. Methods A survey-based study was conducted at different time points between April 2020 and August 2021. A pre-tested anonymized self-administered questionnaire was distributed online as a pre-program assessment of participants registering for the health awareness webinars conducted by our team. Demographic data and CVD risk behaviors pertaining to dietary consumption, exercise routine, sedentary behavior, psychosocial factors, sleep pattern, tobacco use and alcohol consumption were collected. Not meeting daily intake of whole grains and at least 4 portions of vegetables and fruits, non-performance of at least 150 minutes of brisk aerobic exercise per week, chronic stress and use of tobacco were considered risky behaviors, as per the international guidelines. Results Of the 573 subjects, 305 (53%) were women and 236 (41%) were 15-30 years old. Majority of subjects were not meeting their requirements pertaining to whole grains (76%) and fruits/vegetables (72%). Inadequate exercise (48%), chronic stress (31%) and tobacco use (5%) were noted. Significantly more women than men (p = 0.0001) were falling short in their exercise requirement. Significantly more men than women (p = 0.0001) were using tobacco products (Figure). Conclusion Cardiovascular risk behaviors are highly prevalent in Indian men and women during the pandemic calling for a coordinated effort to increase awareness and modify to a healthy behavior. Abstract Figure. Risk behaviors in study subjects Abstract Figure. Comparison of risk behaviors

Crop Recommendation and Yield Estimation Using Machine Learning

In most developing countries like India, Agriculture is seen as one of the most widely followed habitations and contributes majorly to the country’s economy. Agriculture provides the primary source of food, income, livelihood and employment to the majority of rural populations in India. Many crops are destroyed every year due to a lack of technical knowledge and unpredictable weather patterns such as temperature, rainfall, and other atmospheric parameters, which play a massive role in deciding the crop yield and profit. Therefore, choosing the right crop to grow and enhancing crop yield is an essential aspect of improving real-life farming scenarios. One of the motives is to collect and integrate the agricultural data from specific regions that may be used to analyse the optimal crop and estimate the crop yield. This script is novel by using simple crop, soil and weather parameters like crop, the area under cultivation, nitrogen, phosphorus and potassium content of the soil, season, average rainfall and temperature of a district in Karnataka, India. The user can predict the most suitable crop and its estimated yield for a chosen year. This model uses primary classification, techniques like the random forest, k-NN, logistic regression, decision tree, XGBoost, SVM and gradient boosting classifier for determining the most suitable crop and regression algorithms like Linear Regression, k-NN, DBSCAN, Random Forest and ANN algorithm to estimate the yield of the most optimal crop identified earlier. The algorithm that has the least mean error is chosen for prediction and estimation and thus gives better results than the particular machine learning algorithm domain. There is a web interface for ease of use for end-users. Therefore, this project assists the farmers in choosing the suitable crop that can be grown in a particular region during a specific season or specific period and estimate its yield and predict if the recommended crop is profitable. Hence this project helps the farmers in preserving their time by assisting them in the decision-making process.

A model for sustainable, partnership-based telehealth services in rural India: An early process evaluation from Tuver village, Gujarat

BackgroundTelehealth can improve access to high-quality healthcare for rural populations in India. However, rural communities often have other needs, such as sanitation or employment, to benefit fully from telehealth offerings, highlighting a need for systems-level solutions. A Business of Humanity approach argues that innovative solutions to wicked problems like these require strategic decision-making that attends to a) humaneness, e.g., equity and safety and b) humankind, or the needs and potential of large and growing markets comprised of marginalized and low-income individuals. The approach is expected to improve economic performance and long-term value creation for partners, thus supporting sustainability.MethodsA demonstration project was conducted in Tuver, a rural and tribal village in Gujarat, India. The project included seven components: a partnership that emphasized power-sharing and complementary contributions; telehealth services; health promotion; digital services; power infrastructure; water and sanitation; and agribusiness. Core partners included the academic partner, local village leadership, a local development foundation, a telehealth provider, and a design-build contractor. This early process evaluation relies on administrative data, field notes, and project documentation and was analyzed using a case study approach.ResultsFindings highlight the importance of taking a systems perspective and engaging inter-sectoral partners through alignment of values and goals. Additionally, the creation of a synergistic, health-promoting ecosystem offers potential to support telehealth services in the long-term. At the same time, engaging rural, tribal communities in the use of technological advances posed a challenge, though local staff and intermediaries were effective in bridging disconnects.ConclusionOverall, this early process evaluation highlights the promise and challenges of using a Business of Humanity approach for coordinated, sustainable community-level action to improve the health and well-being of marginalized communities.

Study of noninduction immunosuppression in intermediate-risk living donor kidney transplantation in rural population of India - A retrospective observational study

Introduction: Kidney transplant is a costly affair, especially in a developing country like India. The current study was carried out with the aim to analyze the clinical outcome retrospectively in terms of acute rejection (AR), graft survival, and patient survival in intermediate-risk recipients undergoing first renal transplant with Tacrolimus (TAC), Mycophenolic acid (MPA), and corticosteroid based triple maintenance immunosuppression in one of the most underprivileged population of the country who has to bear the cost of the induction agent not covered by any government scheme. Materials and Methods: It is a retrospective observational study. We included 101 patients, out of which 42 were in basiliximab group and 59 patients did not receive any induction agent. Apart from the induction, agent rest of the Immunosuppression protocol was same in all patients. The primary endpoint of the study was number of biopsy-proven AR within 1st year of transplantation. The secondary endpoints were patient and graft survival by 1 year. Results: Human leukocyte antigen mismatch and mean age of the patients in basiliximab group were significantly higher than noninduction group; otherwise, both groups were similar in all other baseline parameters. There was no significant difference between AR (21.43% v/s 18.64%), graft survival (97.30% v/s 98.15%), and patient survival (88.10% v/s 91.52%) at 1 year. Conclusion: Our study suggests that Induction immunosuppression may not be necessary for patients undergoing intermediate-risk living donor kidney transplant in the current scenario of TAC and MPA-based maintenance immunosuppression.