Northern Kerala Research Articles

Prevalence of spousal violence among married women in a rural area in North Kerala.

Background:Domestic violence has substantial public health consequences. More than one-third of women globally suffer from physical and sexual violence, mostly by an intimate partner with a lifetime prevalence of 10%–69%. In India, 28.8% of the ever-married women in the reproductive age group, reported domestic violence. Although Kerala, in southern India, performs better than other Indian states on a host of human development indicators for women, 15.8% among the women in this group have ever experienced physical or sexual violence in the past 12 months, the most common perpetrator being the husband.Methodology:A community-based cross-sectional study was carried out among the ever-married women, residing in a selected area of northern Kerala, who have been married for at least 1 year. One to one structured interview was conducted with a pretested structured questionnaire by the investigator. Spousal violence was defined as proportion of ever-married women with a lifetime experience of violence perpetrated by their spouse, manifested through acts of physical, sexual, and/or emotional violence, even threat.Results:A total of 290 women were interviewed. The age of the participants ranged from 18 years to 64 years; majority were Muslims. Only 16.5% were college-educated and over 90% were homemakers. 29% reported having experienced spousal violence; with the most common being emotional violence (19%) closely followed by sexual violence (18.6%) and physical violence (14.8%). A little over one-third (39.7%) reported controlling behaviour of their husband. Age of the participant (P = 0.019), absence of social support (P = 0.034), employment status of husband (P = 0.026), controlling behaviour of husband (P < 0.001), alcohol abuse by husband (P = 0.004) and extra-marital relationship of spouse (P < 0.001) were found to have significant influence on spousal violence experience.Conclusion:More than a quarter of the married women in this rural setting have experienced one or the other form of violence.Recommendation:A multifaceted approach needs to be employed which takes into consideration legal measures, social sciences, women empowerment, mental health systems and educate the men to curb this menace.

Weed dynamics in pulses cultivated in summer-fallows of double cropped lowland rice fields of Northern Kerala

A field study was undertaken to find the weed dynamics in different pulse crops in summer-fallows of lowland rice fields under varying nitrogen doses during summer 2018. Among grasses, sedge and broad-leaved weeds Oryza sativa, Cyperus rotundus and Boerhavia diffusa, respectively were dominant in the field where pulses are grown. Absolute density of weeds was lesser in plots where red gram was cultivated with 75% and 50% of the recommended dose of nitrogen (RDN). Blackgram (50% RDN) was effective in smothering weeds. The dry matter production of weeds was the highest in fallows. The N removal by weeds was higher in fallow and that of P and K were at par in all treatments. The leaf area index (LAI) (100 and 50% RDN), crop growth rate (CGR) (50% RDN), yield (50% RDN) were significant for cowpea. Cowpea and red gram performed better among the different pulses in terms of yield. There was no significant difference in yield of pulses under varying levels of N, indicating that the lower level of N (50% RDN) will be sufficient.

Gender Roles in Martial Art: A Comparative Analysis of Kalaripayattu Practices in India

76-year-old Meenakshi from northern Kerala, South India, grabbed national headlines in late 2017 when the nation honored her with a Padmashri, one of India’s highest civilian awards for her lifelon...

Ambient air quality of a less industrialized region of India (Kerala) during the COVID-19 lockdown

• Air quality of major cities of Kerala State (India) during the COVID-19 lockdown. • Substantial reduction of NO 2 (-48 %) NO x (-53 % to -90 %) and CO (-24 % to -67 %). • Significant decrease in PM 2.5 (-24 % to -47 %) and PM 10 (-17 % to -20 %) levels. • Increase of O 3 levels in Northern Kerala during lockdown period. • Indications of multiple sources (other than traffic and industry) of air pollution. This study assesses the effect of lockdown, due to the coronavirus disease (COVID-19) pandemic, on the concentration of different air pollutants and overall air quality of a less industrialized region (Kerala) of India. We analysed data from four ambient air quality stations over three years (January to May, 2018–2020) with pairwise comparisons, trend analysis, etc. Results indicated unprecedented reduction in the concentration of the air pollutants: nitrogen dioxide, NO 2 (-48 %), oxides of nitrogen, NO x (-53 % to -90 %), carbon monoxide, CO (-24 % to -67 %) and the particulate matter (-24 % to -47 % for particulate matter with a diameter of less than 2.5 μm, PM 2.5 ; -17 % to -20 % for particulate matter with a diameter of less than 10 μm, PM 10 ), as well as the reduction of the National Air Quality Index (NAQI). These reductions indicate an overall improvement of the ambient air quality due to restrictions on transportation, construction, and the industrial sectors during lockdown, even in an area considered less industrial. Despite the general decreasing trend of the concentration of various air pollutants from January to May, suggesting seasonal influences, the trend was intensified in the year 2020 due to the added effect of the lockdown measures. Comparison of the results with those from larger and more industrialized cities suggests that the effects of lockdown are more variable, and focused on the levels of gaseous pollutants. Findings from this study demonstrate the far-reaching effects and implications of the COVID-19 lockdown on ambient air quality, even on less industrialized and less urbanized regions.

Secondary attack rate of COVID-19: analysis of contacts of COVID-19 cases admitted in a tertiary care centre, Northern district of Kerala, India-a cross-sectional study

Background: Secondary attack rate is the proportion of primary contacts that develop infection or symptom within one incubation period after contact with an index case. The secondary attack rate will help in studying and understanding the transmission dynamics of infectious diseases. As coronavirus disease (COVID-19) is a novel disease which has resulted in a pandemic, understanding the transmission dynamics is very important for strengthening preventive measures.Methods: The present cross-sectional study was conducted to estimate the secondary attack rate among primary contacts of COVID-19 cases admitted in a tertiary care centre in Northern Kerala. Secondary attack rate was calculated as the percentage of primary contacts that tested positive for COVID-19 with RT-PCR test within 14 days of exposure.Results: Secondary attack rate was found to be 5.88%, secondary clinical attack rate 2.35% and secondary infection rate 3.53%. Among those contacts that developed disease, 80% were household contacts.Conclusions: Secondary attack rate was 5.88% and household contacts were the majority to get the disease.

Triterpenoids and fatty alcohols as indicators of mangrove derived organic matter in Northern Kerala Coast, India

Triterpenoids and fatty alcohols were identified from the sediments of five mangrove ecosystems (Kunjimangalam, Pazhayangadi, Pappinissery, Thalassery, and Kadalundi) in the northern Kerala coast, India, to illustrate the organic matter sources. Straight chain fatty alcohols in the range C12–32 were detected, and among these the long chain fatty alcohols (C20–32) were exclusively even chained compounds. Branched fatty alcohols (6,10,14-trimethyl-pentadecan-2-ol and 3,7,11,15-tetramethyl-2-hexadecanol) of bacterial origin were detected in a few observations. Twenty triterpenoids were detected from the study region in which 13 of them were sterols. Triterpenoids originated from higher plants such as stigmasterol, campesterol, β-sitosterol, taraxerol, lupeol, germanicol, β-amyrin, α-amyrin, and betulin were identified in the study. Brassicasterol, a diatom marker and dinosterol, a dinoflagellates marker were also detected in the study region. An elevated % composition of dinosterol and dissolved oxygen super-saturation were noticed in Kunjimangalam during pre-monsoon, which may suggest elevated input of algal organic matter in the mangrove system. Cholesterol transformation products such as coprostanol and epi-coprostanol were detected, which indicated the presence of fecal contamination in the sedimentary organic matter. From the ternary diagram, it was recognized that the organic matter contribution from marine algae was feeble as compared to terrestrial input.

Isolated Diffuse Cavernous Hemangioma of the Appendix with Acute Appendicitis

Cavernous hemangioma of the appendix (CHA) is a rare clinical entity. Since there are only a few case reports on CHA, clinical features, diagnosis, and management of a CHA are not adequately explained in medical literature. A thirty-three-year-old gentleman, hailing from northern Kerala, presented with right lower quadrant pain and nausea of 3-day duration. On clinical examination, he was diagnosed to have acute appendicitis, which was confirmed by ultrasound abdomen. He was planned for laparoscopic appendicectomy. Intra-operatively, he was found to have thick and edematous appendix with multiple elongated and tortuous vessels over the surface, with the rest of the bowel and intra-abdominal organs normal. He underwent laparoscopic appendicectomy, and the final histopathology (HPR) report showed acute appendicitis with diffuse cavernous vascular malformation of the appendix. The postoperative period was uneventful, and the patient was discharged on postoperative day 3. CHA is a rare clinical entity which is difficult to diagnose preoperatively. A laparoscopic approach may be used for both the diagnosis and treatment in CHA.

Impact of communication dyads on health-care service experience in Ayurveda

Purpose This paper aims to understand whether the perceptions of the patient’s in the health-care service experience differs in the Ayurveda, and to examine the impact of three critical communication dyads on the patient service experiences in Ayurveda health-care sector. Design/methodology/approach The study consists of 436 participants, recruited directly from the inpatients of Ayurveda establishments/hospitals/clinics in Northern Kerala, India. Data was collected through a structured questionnaire. An independent sample t-test was used to find out the differences in the perceptions of Ayurveda health-care consumers towards their health-care service experience. Multiple regression analysis is used to explain the dyadic relationship of patient–firm (PFR), patient–employee (PER) and employee–firm relation (EFR) on the health-care service experience (SE) in the Ayurveda sector. Findings The study highlights that the perception of patients on Ayurveda health-care service experience varies according to their socio-economic statuses such as age, gender, annual income and the number of inpatient days. Among the service communication dyads, PFR is the most effective dyadic phase that contributes significantly more towards an improved Ayurveda health-care SE, followed by the PER and EFR. Research limitations/implications The findings of the study will be more applicable to the Ayurveda health-care sector, where the doctors and the management have more role in the servicescape. Practical implications Health managers have to consider three stakeholders (customers, employees and firm) and the relationship between them. It is valued the PFR more, followed by the PER and EFR. Social implications Proper implementation of the suggestions given by the study can improve overall service communications of the different service providers of Ayurveda with good interpersonal manner to achieve better relationships among the three mentioned parties. Originality/value The empirical evidence from the study is relevant and timely to the health-care service providers of the country to aid them in providing a better health-care service experience. The study adds value given the increasing trend of lifestyle diseases and subsequent demand in health-care services, especially in the Ayurveda sector.

Trends of leptospirosis cases in a tertiary care center in Northern Kerala during January 2013 to October 2019

Background: Leptospirosis is a zoonosis endemic in tropical climates. Though overall incidence of leptospirosis has decreased during recent years, it continues to be a major public health problem, highly underreported in India. Various trends such as seasonal, geographical, mortality have to be studied in detail for proper planning of prevention and control programs. The objective of this study was to assess geographical, seasonal, mortality trends of leptospirosis cases attending a tertiary care centre in Northern Kerala, from January 2013 to October 2019.Methods: A record-based retrospective study was conducted where leptospirosis cases attending tertiary care centre were included. Data was entered into Microsoft Excel 2007, analysed using Epi Info 7. Results were expressed as frequencies, percentages.Results: Among 647 leptospirosis cases, 141 were confirmed and 506 were probable. Maximum number of cases were reported in 2014 and maximum deaths were reported in 2019. Majority belonged to 51-60 years age category; males outnumbered females. Maximum cases were reported during September, August. Major hotspots for leptospirosis were Kannur and Taliparamba Municipalities and Koothuparamba.Conclusions: During rainy season, probably younger individuals are at risk as they indulge in leisure like swimming, playing while post rainy season older individuals are at risk due to occupational exposure. The number of deaths showed a declining trend from 2013 to 2018, but increased in 2019. Few of the previous hotspots reported decline in cases probably due to improved surveillance and control activities.

Investigation of hepatitis A outbreak in a municipality in Northern Kerala

Background: Viral hepatitis A is a contagious viral disease affecting liver that can result in mild to severe illness. It can occur sporadically and in epidemics with a tendency of cyclical recurrence. India is considered to be hyper endemic region for HAV infection with very high infection rate in early years of life.Methods: An outbreak investigation was conducted in a municipality in Northern Kerala were a sudden rise in hepatitis A cases was reported by health authority to describe the outbreak in terms of person, place and time. Different sources were also inspected to identify probable cause for an outbreak in the area.Results: A total of 267 households were surveyed which included 84 households with at least one hepatitis A case and 183 household without cases. Individuals with hepatitis A counted up to 157. Mean age of the cases were 14.09±7.34 years. 89.1% took allopathic treatment and 7% took Ayurveda treatment. The total attack rate of the population was 0.29% and attack rate of ward 31 was 4.96%.Conclusions: Results of the outbreak investigation indicates that there is a need for establishment of an efficient water quality surveillance system and bringing about intervention for behavioural change in the population.

A fuzzy based MCDM–GIS framework to evaluate groundwater potential index for sustainable groundwater management - A case study in an urban-periurban ensemble, southern India

The study encompasses the application of fuzzy based multi-criteria decision making (MCDM)- geospatial framework (GIS-Fuzzy-AHP) for evaluating index based groundwater potential assessment in two differently urbanized clusters of Northern Kerala, Southern India. The framework presents a very powerful way of managing groundwater at a regional and global level due to its succinct performance. The study area is characterized by a coastal zone with a high rate of urban development and relying on groundwater supply to meet their basic needs. In the Fuzzy-analytic hierarchy process (Fuzzy-AHP), a three-level hierarchical model is built using 8 criteria and 34 subcriteria of groundwater controlling factors. Weights and ratios of these factors have been generated by pairwise comparisons of fuzzified values in Saaty's 9-point fundamental scale, taking relative importance into account. Finally, the integration of spatial and non-spatial data into the GIS platform created a groundwater potential zone map with a unique integer value known as the groundwater potential index (GWPI). The resulting groundwater potential map classified the study area into four zones using quantile method and has shown that the very good potential zone occupies 34% and 10% of the urban and peri-urban zones of the study area, respectively. Gentle slope gradient with coastal alluvium formation, sandy loam to sandy clay textured soil type with moderate to rapid permeability favours aquifer recharge in these zones, resulting in a very high potential zone. The consistency analysis using the Eigenvector method showed that the consistency was well within the tolerance limit and validation analysis using the average depth of water level data checked the statistical efficiency and reliability of results in the overall decision-making phase. A well-balanced fuzzy framework has allowed the rapid and reliable assessment of hydrological behaviour of two differently urbanized environments.

A study on the distribution and hydrolytic enzyme potential of yeasts in the mangrove sediments of Northern Kerala

Mangrove sediments, due to their unique environment, are considered to be a crucial habitat in identifying yeast strains with potent industrial, biotechnological and bioremediation properties. The present study investigates the distribution and hydrolytic enzyme potential of yeast isolates from North Kerala with respect to changes in seasonal and sediment characteristics. Sediment samples were collected from 8 locations spreading in 5 districts along the northern coast of Kerala during monsoon and post monsoon seasons of a year. The pH of the sediments varied between 6.4 to 7.0, temperature between 21°C – 29°C and organic matter content between 1.7% ± SD – 4.2% ± SD. The number of Colony Forming Units per milliliter of the sample (CFU/ml) of the cultivable yeasts varied drastically between the seasons. A total of 233 isolates were studied during the specified period of study, out of which 82% of the isolates showed various hydrolytic enzyme activities during monsoon while 89% in post monsoon. Lipase and Ligninase activity was shown by maximum number of isolates. It was found from this study that as the moisture content and organic matter of the sediment decreased, the CFU/ml of cultivable yeasts decreased considerably while the number of potent isolates with hydrolytic enzyme activity increased. The extracellular enzymes produced by yeasts possess variety of applications in industrial processes and are also very important in the environment due to their capacity of biodegradation. Hence, the present work attempts to understand the ecological and seasonal influence on the distribution and the bioactivity of cultivable yeast strains from a unique yet least studied environment like mangroves.

&lt;p&gt;&lt;strong&gt;A new species of &lt;em&gt;Ceropegia&lt;/em&gt; (Apocynaceae) from northern Kerala, India&lt;/strong&gt;&lt;/p&gt;

A new species, Ceropegia ariyittaparensis P.Biju et al. is described from the low-lying lateritic plateaux of northern Kerala, SW India. This species belongs to Ceropegia sect. Tiloris H.Huber. It is most similar to Ceropegia vartakii (Kambale &amp; S.R.Yadav) Bruyns, but differs by its elongated buds, maroon, longitudinally folded and lanceolate corolla-lobes, its taller outer coronal lobes and longer connivent inner coronal lobes, which rise in a short column above the style-head.

Utricularia sainthomia (Lentibulariaceae), a new remarkable carnivorous species from the lateritic plateau of northern Kerala, India

Utricularia sainthomia (Lentibulariaceae), a new remarkable carnivorous species from the lateritic plateau of northern Kerala, India

A checklist of angiosperm flora of low elevation lateritic hills of northern Kerala, India

An inventory to prepare the checklist of angiosperm species in the lateritic hillocks of northern Kerala was conducted in five sampling sites during April 2013–March 2015. In total, we recorded 364 genera with 535 species, of which 334 are native and 201 are non-native. Native species were represented in 102 families, namely, Poaceae (28), Fabaceae (25), Acanthaceae (22), Rubiaceae (17) Euphorbiaceae (14), Commelinaceae (11), Phyllanthaceae (7), etc., whereas, non-native species were represented in 99 families. Among the native species herbs are the predominant habit with 147 species (44%). Out of the 72 endemic species, three taxa namely, Syzygium travancoricum, Santalum album and Hopea ponga are red listed species documented from the study area. Twenty-seven invasive species were also recorded and major threats to the laterite ecosystems are by Lantana camara, Mikania micrantha, Pennisetum polystachyon, Ipomoea spp., and Senna spp. Most part of the laterite has been converted to plantations, building sites and mining sites. The indiscriminate mining for laterite, soil and demolishing the hillocks have severely threatened the very existence of the flora.&#x0D;

Early stages of Nilgiri Grass Yellow Eurema nilgiriensis (Yata, 1990) (Lepidoptera: Pieridae), with a note on its range extension in the Kerala part of the Western Ghats, India

Complete documentation of the early stages of Eurema nilgiriensis (Yata) on the larval host plant Ventilago bombaiensis (Rhamnaceae) is presented in this paper. In addition to this, notes on the range extensions of this species in southern Western Ghats in Kannur, Kozhikode, Wayanad, Malappuram, and Palakkad districts in Kerala is also provided. Field records from the northern Kerala part of the Western Ghats and the complete biology are reported for the first time since its description in 1990. Photographic records from seven locations since 2011 were confirmed by comparing with the original descriptions and in consultation with the author of the species. Eggs collected from field were reared at home, and every stage observed is also reported, as well as the discovery of the host plant Ventilago bombaiensis. It is concluded that the species is widespread in forested areas at elevations from 70m to 1,000m.

Isotope mass balance estimation of groundwater recharge in a hard rock tropical river basin in Kerala, India

To better assess the groundwater recharge pattern of the Kuttiyadi River Basin (KRB) situated in Northern Kerala, the oxygen (δ18O ‰) and hydrogen (δD‰) isotopic compositions of river water, reservoir water and groundwater were determined. Isotopic characterization of the waters of the basin showed that river water experienced altitude effect from lowland (elevation: <7 m) to midland (elevation: 7–75 m) and highland (elevation: >75 m). Isotopic enrichment of river water near the mouth during premonsoon and post-monsoon can be due to the influence of sea water ingress especially during tidal events. Additionally, correlation of 18O and electrical conductivity (EC) further highlights the role of evaporation in isotopic modification of surface water. The regression plot of δ18O and δD of groundwater with LMWL (Local Meteoric Water Line) and surface water samples clearly showed the meteoric origin of groundwater. Using oxygen isotope mass balance method it is estimated that surface water contribution to groundwater was up to 17% in the lowland physiographic zone and it was up to 14% in the midland zone and only 7% surface water is contributing to groundwater regime in highland zone of the KRB. This study demonstrates the usefulness of stable isotopic ratios for baseline assessments of water resources of a river basin or watershed.

Diaspora, religion, and identity: the case of Theyyam in the Indian diaspora

ABSTRACT Globalization associated with development in information and communication technologies ushered diasporas to play an important role in marketing the homeland culture globally. Among the many traditional Indian art forms that are getting visible transnationally today is the Theyyam. Theyyam is a traditional ritual art form of worship observed in the Kannur and Kasargod districts of Northern Kerala state in India. It is the folk God for North Malabaris which is accompanied by dance and other rituals. There are approximately four hundred varieties of Theyyams and several of them are performed in the diasporas. This article argues that when the Theyyam is performed transnationally, the true essence of the ritual art form changed compared to its performance in the original settings and thereby opens up for commodification. Ethnographic data for this study derives from in-depth interviews with Theyyam artists, informal conversations with Theyyam devotees and villagers besides observation of Theyyam performances.

Knowledge and Attitude towards Organ Donation among Medical Students of a Government Medical College in Northern Kerala

Knowledge and Attitude towards Organ Donation among Medical Students of a Government Medical College in Northern Kerala

SUN-210 IMPACT OF FLOODS IN DIALYSIS SERVICE DELIVERY IN NORTH KERALA

The heavy rains of monsoon season in two successive years have created catastrophic floods culminating in loss of life and property across Kerala state in South India. Patients undergoing dialysis have also suffered in myriad ways. In 2019 the floods were mainly restricted to northern Kerala which had the highest number of dialysis facilities. We aim to study the impact of floods of year 2019 on dialysis patients in northern Kerala. This is a cross-sectional observational study. All dialysis facilities from 6 districts of northern Kerala – Kannur, Kasargode, Kozhikode, Wayanadu, Malappuram and Palakkad were included in the study. Data was collected by telephonic interview with the staff or Nephrologist in-charge of each dialysis unit. The study was conducted with the permission of District administration - Kozhikode Jilla Panchayat - with the understanding of sharing the data to the administration for facilitating improvement strategies in the future. There are 111 dialysis centers in north-Kerala. Kannur and Kozhikode had the most number of centers-30 and 35 respectively, other 4 districts together had 46 centers. Of the 111 centers, 69 were hospital-based (HBC) and 42 were stand- alone-centers (SAC); they collectively catered to 5721 patients for regular maintenance HD. Fifty two centers were providing ≥ 3 shifts of service whereas 59 centers had ≤2 shifts. Twenty one of 111 (19 %) centers and 409 out of 5721 (7%) patients were affected by the floods. Of the 21 centers, 15 were water-logged, source water was contaminated in 17 centers and RO facility disrupted in 4 centers. KSEB power failure occurred in 28 of 110 centers. Forty centers of 111 (36.5%) had accessibility issues for patients and staff. Of the affected 409 patients, 154 (38%) had to skip HD session; 166 (42%) were accommodated in other units without getting their schedule curtailed. Eleven patients had to be hospitalized and four patients died during the period. The affected units returned to normal functional status within 2-14 days except one unit. Successive years of flood warrants us to ascertain the safety of our dialysis centers in providing uninterrupted service to our needy patients. Around 19% of centers and 7% of patients were directly affected whereas nearly 40% of centers had accessibility issues. Of the affected patients 40% received inadequate dialysis whereas remaining could be accommodated with help of nearby centers, which highlights the need of net-working for contingencies. Detailed cost analysis of the damages has to be done to formulate remedial measures for the future.