Indian State Of Kerala Research Articles

"How Universal is the Use of Facemask During COVID-19 Pandemic? A Photo-Epidemiology Study from the Indian State of Kerala"

Anand Marthanda Pillai1,2, Shaffi Fazaludeen Koya1,3*, Mini GK1, Jinbert A Lordson1, Grace A Chitra1, Minu Abraham1, Vinod VG Kumar1, Sandhya Bijumone1, Bindhya Vijayan1, Deepu KV1, Krishna SH1, Soji D Jose1, Rinsa Vaheed1, Revu J1, Archana K1, Salman R Khan1, Sunitha SB1, Greeshma J1, Shringa Sivanand1, Kapila VS1, Nissy VL1, Amrutha B1, Mithun TK1, Anjana VM1, Grace Wilson1, Lal Sreemathy Sadasivan1, Kesavan Rajasekharan Nayar1 and A Marthanda Pillai1,2 Author Affiliations 1Global Institute of Public Health, Thiruvananthapuram, Kerala, India 2Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India 3Boston University School of Public Health, Boston, Massachusetts, USA Received: April 22, 2021 | Published: May 03, 2021 Corresponding author: Shaffi Fazaludeen Koya, Global Institute of Public Health, Thiruvananthapuram, Kerala, India and Boston University School of Public Health, Boston, Massachusetts, USA DOI: 10.26717/BJSTR.2021.35.005712

COVID-19 and the Risk of Displacement of Migrant Workers: An Analysis of Media Framing in the Indian State of Kerala

Migration and migrant movement are a global scenario, in which one of the main drivers, which facilitates migrant movement, is the search for better living conditions. One of the most vulnerable communities in this regard is migrant workers, especially in the developing world, who conduct cross-country migration. Labour migration is a significant national phenomenon in India in which the workers migrate across the states, which were facilitated by the interstate movement. The recent outbreak of pandemic COVID-19 poses the greatest challenge to the migrant workers who face the challenge of displacement due to the restriction of movement and public perception. One of the significant actors facilitating public discourse is the media, which explores the migrant scenario through framing. This article analyzes how the Indian newspaper portrays the plight of the migrant workers in Kerala through media framing using qualitative case analysis. The study reveals that the media frames portray the plight of the migrant workers during the pandemic situation, and the result could be helpful for policy developers on immigrant’s integration.

Translation and Validation of University of Washington Quality of Life Questionnaire in Malayalam, an Indian Language

The purpose of the present study was to translate and culturally validate the University of Washington Quality of Life Questionnaire, Version 4.1 (UW-QOL v4.1) in Malayalam, a language commonly used in the state of Kerala in India. The tool underwent translation and adaptation. The translated instrument then underwent a pretest survey in 30 patients. The intention was to identify any problems with the questionnaire when applied to the participants and make any minor changes if required. This was followed by validation in 100 patients. The reliability was tested for internal consistency with Cronbach's alpha. Concurrent validity was tested by correlating it with the concurrently administered FACT-HN questionnaire scores. Construct validity was tested using 'Known-group validity.' Pretest survey did not identify any major problems. There was a moderate to strong correlation between the PF, SEF subscales and the composite scores on UW-QOL scores and the Head and Neck Cancer subscale and the FACT-H&N Total score. QOL scores were more in early staged patients and those who underwent no reconstructive procedure. This proved the construct validity. This study validates the Malayalam version of the UW-QOL instrument. It is reliable, valid and culturally adapted.

COVID-19 in Kerala: Health Index Theory

The recent surge in COVID-19 cases in the state of Kerala in India has been studied in this article. The dynamics of virus spread, sero-survey results, health index, and herd immunity concept have been applied. Kerala, with the highest score on the health index among all the states of India, is most susceptible to the SARS-CoV-2 virus. Kerala has nearly the same number of cases as Germany. The “Health Index Theory” established in this review article first has explained well the surge in the cases. Briefly, the concept of COVID-19 herd immunity has also been tested first.

Three new species and four new species records of earthworms of the genus emMoniligaster/em Perrier, 1872 (Clitellata: Moniligastridae) from Kerala region of the Western Ghats Biodiversity Hotspot, India.

Three new species of Moniligaster Perrier, 1872, namely M. bahli Narayanan Julka, sp. nov., M. blakemorei Narayanan Julka, sp. nov. and M. keralensis Narayanan Julka, sp. nov. are described from materials collected from the Indian state of Kerala. Moniligaster cernosvitovi Gates, 1962, Moniligaster horsti Gates, 1940, Moniligaster michaelseni Gates, 1940 and Moniligaster stephensoni Gates, 1940 are recorded for the first time from the state. With the new findings, a total of 10 Moniligaster species are known from Kerala. Moniligaster species are restricted to southern peninsular India, except Moniligaster ivaniosi Manazhy, 2011, decribed from the Andaman Islands, outside the currently known distributional range of the genus. Hence we critically reviewed the original description and reinvestigated the holotype. As a result, Moniligaster ivaniosi is considered a junior synonym of Drawida nepalensis Michaelsen, 1907.

Initial Insights Into the Genetic Epidemiology of SARS-CoV-2 Isolates From Kerala Suggest Local Spread From Limited Introductions.

Coronavirus disease 2019 (COVID-19) rapidly spread from a city in China to almost every country in the world, affecting millions of individuals. The rapid increase in the COVID-19 cases in the state of Kerala in India has necessitated the understanding of SARS-CoV-2 genetic epidemiology. We sequenced 200 samples from patients in Kerala using COVIDSeq protocol amplicon-based sequencing. The analysis identified 166 high-quality single-nucleotide variants encompassing four novel variants and 89 new variants in the Indian isolated SARS-CoV-2. Phylogenetic and haplotype analysis revealed that the virus was dominated by three distinct introductions followed by local spread suggesting recent outbreaks and that it belongs to the A2a clade. Further analysis of the functional variants revealed that two variants in the S gene associated with increased infectivity and five variants mapped in primer binding sites affect the efficacy of RT-PCR. To the best of our knowledge, this is the first and most comprehensive report of SARS-CoV-2 genetic epidemiology from Kerala.

Occupational electrical accidents: Assessing the role of personal and safety climate factors

A research survey is conducted in the large public sector electrical utility in the Kerala state of India. The measurement scale for personal factors like self-esteem, job stress, personal stress, social supports, and fatigue are developed as per the targeted population. Personal safety climate factors of the utility are accessed using existing safety climate scales. 3017 electrical employee’s responses from all districts of Kerala state are collected by one to one interaction using the developed instrument. This data is analysed using statistical methods like reliability analysis, confirmatory factor analysis, ANOVA, and explanatory factor analysis. The measurement model shows a good model fit indices, convergent validity, and discriminate validity. Six research hypotheses are validated by statistical analysis. The study found that personal factors, safety climate factors, and health conditions of the workers were significantly correlated to occupational accidents. Personal Attributes - age, job role, education, and experience are significantly effecting the safety behaviour of the electrical workers. All the personal factors significantly correlated with safety climate factors. The results of the study highlighted the need for safety participation, safety knowledge, safety training, and interventions to reduce personal issues in the workplace. These findings provide valuable insights to future researchers to implement novel methods to ensure workplace safety.

Clinical and epidemiological spectrum of coronavirus disease 2019 in Central Kerala: a retrospective case series

Kerala state in India was known for its early response to the Covid-19 pandemic by public health mitigation measures through science-based advocacy. The objective of this study was to analyze epidemiological and clinical characteristics of COVID-19 patients admitted to a tertiary care center in central Kerala. This retrospective case series was undertaken by reviewing the medical records and extracting the epidemiological data, clinical symptoms and laboratory findings of consecutive patients admitted between April 1st and September 31, 2020. Clinical and demographic parameters of hospitalized patients were analyzed regarding their association with the severity of disease. The mean age of the patients was 35.8 years with significant male predominance. Shopkeepers represented 15.6% of the patients and healthcare workers represented 12.5%. Primary contact with a known case was documented in 62.5% of the patients. Asymptomatic patients constituted 25% of the patients and the most commonly experienced symptoms were fever, cough, breathlessness and diarrhea. Three patients had atypical presentations in the form of generalized seizures, intussusception and generalized anxiety with suicidal ideation. Neutrophilia and Lymphopenia were the most dominant laboratory finding. The clinical spectrum of COVID-19 in the study population is wider than previously described in literature.

CRITICAL indicators for assessment of capacity development for disaster preparedness in a pandemic context

Disaster management protocols are applicable to pandemics as they fall under biological category of disasters [1,2]. “Capacity development for effective response and recovery” [3] is critical to disaster preparedness. The alarming pace at which pandemics spread demands continuous assessment and monitoring of disaster response capacity. Absence of a metric to assess pandemic disaster response capacity calls for identification of measurable indicators of capacity to gauge it. Through a literature review on different assessment frameworks in the realm of disaster management across the globe; six categories of indicators for capacity development from a generic disaster preparedness perspective were drawn. Questionnaire Surveys among 151 expert respondents ascertained the relative weightings and criticality of indicators. Measurable indicator attributes were identified through key informant interviews, and a metric was modelled as a linear function of these variables. To arrive at a fewer set of measurable, manageable and actionable critical indicators sensitive to the pandemic context, model reduction was performed through l2 norm-based sensitivity analysis and using coefficient of variation on pertinent data from 123 districts of India. Results show that critical attributes are number of relief and health service personnel, road density, percentage literacy, efficacy of operational procedures and active NGOs. A case study of Kerala state in India is presented to demonstrate the results. The authors formulate a tool-kit with measurable critical indicators to assess pandemic preparedness of a region; applicable to wider contexts; which would help sensitize decision makers on the capacity of emergency management systems to handle a pandemic.

Status of crop plants of agricultural importance in Kerala state, India: an update

The state of Kerala in India, a part of the Western Ghats–Sri Lanka biodiversity hotspot, is blessed with rich biodiversity including agrobiodiversity. Richness in crop diversity is attributed to the wide topographic and climatic niches, long history of outside contacts, personal craving for experimenting new crops, practice of high-density multi-species cropping system, etc. Evidence from several field exploration trips, herbarium survey, reliable literature and other sources has revealed that 306 crop taxa (excluding medicinal and aromatic plants, ornamentals and forestry species) belonging to 290 species coming under 179 genera and 61 families, are being cultivated in different areas of this state. This includes crops belonging to crop-groups—cereals and millets (11), pseudocereals (2), pulses (7), oilseeds (7), fibres (3), forages (14), fruits and nuts (107), vegetables (86; 18-being tuber crops), spices and condiments (20), plantation crops (10) and others (29). Of 306 taxa, 63 occur in the wild state as well; 43 are of only recent cultivation (< 15 years) or under trial cultivation by innovative farmers; and 43 are confined only in (sub)temperate hills. This is more than double (104% increase) the earlier estimate of crops made during 2011, which also included species of medicinal/aromatic/ornamental value (5), not under cultivation in Kerala (3), mistaken identity (3) and synonym (1). We provide here user-friendly crop-group wise categorization of taxa with their vernacular names for easy cross reference. This communication also discusses about the issue of botanical misidentification of crop plants, species of doubtful cultivation status, specialty crops, potential exotic crops, etc.

Long-Term Climate Variability and Drought Characteristics in Tropical Region of India

AbstractThis work reports climate change signals and long-term trend analysis of climate variables, meteorological drought, and extreme climate indexes over the tropical state of Kerala in India. T...

Leading by Example: The Work of Minister K. K. Shailaja of Kerala State, India in Combating COVID-19

In recent months, much public attention has been given to the women leaders of developed countries who have done well in containing the coronavirus and ensuring a low rate of infection and death. Such leaders include Jacinda Ardern, Prime Minister of New Zealand; Angela Merkel, Chancellor of Germany; Erna Solberg, Prime Minister of Norway; Katrin Jacobsdottir, Prime Minister of Iceland; Sanna Marin, Prime Minister of Finland; and Tsai Ing-wen, President of Taiwan. In addition to their own expertise, these leaders have been fortunate in being able to rely on the support of well-trained public officials and scientists, adequate financial resources, and well-equipped health facilities. Little has been written, however, about women leaders from developing countries who are trying hard to contain the pandemic. Sadly, in Africa, a continent with 54 states, only Namibia and Togo have women prime ministers, while the only African woman president hails from Ethiopia.This paper briefly examines the work of K.K. Shailaja, Minister of Health and Social Welfare of the state of Kerala in India, and proposes how lessons from her work could be useful for other parts of the developing world, especially in Africa.

Cardiac Magnetic Resonance Imaging to Detect Right Atrial Thrombus in Right Ventricular Endomyocardial Fibrosis

Tropical endomyocardial fibrosis (EMF) is endemic in southern districts of Kerala state in India, and sporadic cases are reported from other parts of Kerala. Transthoracic echocardiogram (TTE) is the initial imaging tool and is diagnostic for this condition. The inherent limitation of TTE is its limited sensitivity in the detection of intracardiac thrombus. Transthoracic echocardiography, contrast-enhanced cardiac computed tomography, and cardiac magnetic resonance imaging (CMR) are the imaging modalities for the detection of intracardiac thrombus. This report describes a 46-year-old male with right ventricular EMF (RVEMF) who presented with right heart failure. The TTE diagnosed RVEMF but failed to demonstrate the right atrial thrombus which was clearly seen on CMR. The merits of different imaging modalities for the detection of intracardiac thrombus are discussed.

Health achieving societies: Past discourses, present predilections, and possible future contradictions

Economic growth is not an essential prelude to better health as some countries like Sri Lanka and the Indian state of Kerala have shown. Progressive social policies and investments in the social sector have helped some of these countries in the past. This may be unrelated to the present predilections which could certainly lead to future contradictions, especially in giving rise to new scenarios in public health. We have seen that unrealistic setting of goals, ambitious targets given to an ailing health system, together with a lack of clarity regarding activities can result in poor achievements even with incentives. This is more relevant in the future with the complexity of an epidemiological scenario involving both communicable and noncommunicable diseases. Mere techno-centric packages cannot tackle the complex health issues that India face today, as they ignore the larger structural dimensions of the problem. This is especially important with prolonged old age. This necessitates a focused futuristic vision for the population in general and the elderly in particular with a focus on primary care.

MARITIME TOURISM: GLOBAL SUCCESS STORIES AND THE CASE OF PAKISTAN

The coastal / maritime tourism is an important segment in a multi-trillion dollars and multivariate global tourism industry. It offers one of the new avenues and fastest growing areas for significant role in global economies. Various countries such as Maldives, Indian State of Kerala, Singapore and Thailand etc. have focused on maritime tourism with good governance practices evolved over period of time to earn substantial revenues from it. Pakistan has also immense maritime tourism potential with diversified natural, religious, and cultural tourism resources. But Pakistan’s maritime tourism is considered very weak due to various issues. With qualitative research, this paper attempts to explore and suggest solutions for the development of maritime tourism sector of Pakistan by analysing the tourism governance of global success stories and evaluating the nationwide potential and challenges. Arguments are developed that the factors behind the success stories of Maldives &amp; Kerala state in India can act as guidance for taking initiatives on the proposed potential sites in order to uplift the maritime tourism sector in Pakistan. It is anticipated that the effective implementation of this paper’s recommendations would be instrumental in gearing up Pakistan’s Maritime economy.

Comparing verbal and aided single sentence productions in Malayalam-speaking adults with aphasia: a preliminary investigation

ABSTRACT The primary aim of the study was to investigate the semantic and syntactic aspects of verbal and aided single sentence productions in adults with aphasia and neurotypical adults to determine which mode allowed the exchange of information more effectively. The participants of this study included 20 adults with aphasia and 20 neurotypical adults who were native speakers of Malayalam, an Indo-Dravidian language spoken in the south-western state of Kerala in India. Thirteen action picture stimuli were constructed to elicit single sentences. The participants were expected to describe the action picture in a single sentence using spoken language as well as using Picture Communication Symbols (PCS). The semantic aspect of each sentence produced was analysed using Correct Information Unit (CIU) analyses, and the syntactic aspects were measured using (i) percentage of grammatically complete sentences, (ii) percentage of the correct number of verbs, and (iii) total number of syntactic errors. A sentence production accuracy scale was constructed to obtain a combined score for semantic and syntactic aspects of each sentence produced. The results suggested that while both verbal and aided modes were effectively used for the exchange of information by neurotypical adults and adults with anomic aphasia, the aided mode was used more effectively by adults with Broca’s aphasia. To conclude, the study highlights the importance of (a) using visual symbols even for those with mild aphasia as it tends to improve phonological and articulatory abilities, (b) use of symbols to construct simple sentences to communicate in adults with severe aphasia, (c) evaluation of the ability to use alternate modes of communication and also the preferred mode of communication in adults with aphasia.

Prevalence of hepatitis C among haemodialysis patients in a tertiary care hospital in south India.

Background and Objectives:Hepatitis C is the most common hepatotropic viral infection that affects patients on maintenance hemodialysis. Most of the laboratories in India depend on HCV antibody detection by ELISA. PCR based studies on detection of HCV RNA among haemodialysis patients are very scanty in India. The current study was undertaken to find the prevalence of HCV among haemodialysis patients by ELISA and PCR.Materials and Methods:This prospective study was conducted from January to May 2018 in a total of 100 samples. Patients more than 18 years of age, who had undergone at least 15 sessions of dialysis were enrolled in the study. All samples were screened for HCV antibody by ELISA and HCV RNA by PCR. Data regarding age and gender of the patients, history of blood transfusion, duration of hemodialysis, total bilirubin levels were collected from medical records.Results:Among the 100 samples, only one was positive for HCV antibody by ELISA. Eight samples were positive for HCV RNA by PCR. In this study 62.5% of the HCV positives had a previous history of blood transfusion. Duration of dialysis was more among the HCV positive group but there was no statistical significance.Conclusion:This is the first study from the southern state of Kerala in India showing the prevalence of HCV among hemodialysis patients by PCR. Our study showed an overall HCV prevalence of 8% by PCR. All the PCR positive samples were negative by 3rd generation ELISA which is an alarming finding and further justifies the need for PCR for detecting HCV.

PIN119 Effectiveness of Counseling in Ensuring Prophylactic Medication Adherence to Prevent Post Flood Communicable Diseases in Indian State of Kerala

PIN119 Effectiveness of Counseling in Ensuring Prophylactic Medication Adherence to Prevent Post Flood Communicable Diseases in Indian State of Kerala

Reformulation and Appropriation of Traditional Knowledge in Industrial Ayurveda: The Trajectory of Jeevani

In India, the industrial sector that specializes in the invention, production, and marketing of neotraditional therapeutic specialties has been rapidly growing for two decades. In addition to standard pharmaceutical laboratory knowledge, it heavily mobilizes local medical knowledge. This article follows the trajectory of a new formulation called Jeevani, originating in the mining of both the classical Ayurveda texts and the tribal healing practices in the Indian state of Kerala. We investigate the strong coupling established by the reformulation regime between the invention of complex polyherbal therapeutic preparations with local forms of appropriation, namely Indian patents and benefit-sharing agreements.

Health related quality of life in pediatric onset Type 1 diabetes mellitus in Kerala, India.

To study the health-related quality of life (HRQoL) in pediatric onset Type 1 diabetes mellitus (TIDM) in the state of Kerala in India. Diabetes specific HRQoL was determined in 107 subjects with onset of T1DM less than 21 years using the Pediatric Quality of Life Inventory (PedsQL) 3.2 questionnaire of which 69 also completed the PedsQL 4.0 generic questionnaire. The parents of these patients completed the proxy scoring questionnaire. The generic HRQoL of T1DM was compared with control population without diabetes. Mean age of onset of T1DM was 8.2 ± 4.6 years and mean duration was 8.2 ± 5.6 years. The median HbA1c was 8.7% (72 mmol/mol). Microvascular complications were present in 14.9% of the patients. The generic HRQoL was lower in patients with T1DM compared to peers without diabetes (77.43 vs. 87.45; p < 0.001). Parents reported lower scores in diabetes management, treatment barriers, physical functioning and generic scales compared to patients. Parents reported greater worry about the disease with lesser age of onset of diabetes and with presence of complications. Those using insulin vials and on splitmix regimen had lower HRQoL compared to those using insulin pens. The patients belonging to lower socioeconomic status (SES) reported lower diabetes scores (73.7 vs. 58.7; p = 0.015). The generic HRQoL was lower in children with T1DM compared to peers without diabetes. Parents and children had different perception about HRQoL in many aspects. The diabetes specific scores were lower in those belonging to lower SES.