Rural South Indian Population Research Articles

Ophthalmic Artery Doppler as a Reliable Tool for Screening and Diagnosing Preeclampsia in a Rural South Indian Population

Ophthalmic Artery Doppler as a Reliable Tool for Screening and Diagnosing Preeclampsia in a Rural South Indian Population

IJCM_108A: A Community Based Cross-sectional Study on prevalence of Low Social Support Status of the Geriatric Age group in a Rural population of South India.

Background: The elderly above 60 years of age constituted 10.5% of India’s population according to the United Nations Population Fund India Ageing Report 2023. Objective: To estimate the prevalence of low social support of the geriatric age group in a rural population of South India. Methodology: A community-based cross-sectional study was carried out on 200 elderly individuals including both genders in two villages of the field practice areas of the Rural Health Training Center of MAPIMS during the month of September & October 2023 with the use of the Multidimensional Scale Perceived Social Support questionnaire (MSPSS). Univariate analysis and multivariate analysis were carried out using SPSS version 24 software. Results: The mean age of the study participants was 66.33 ± 8.02 years and the majority of the study participants were females (62%). Out of 200 study Participants, 110 (55%) elderly were found to have low social support, 71 (35.5%) had moderate social support and 19 (9.5%) had high social support. The result also showed that the farmers, Illiterates, people belonging to low socioeconomic status and those married were significantly having low social support. Conclusion: The study concluded the prevalence of low social support is high among the geriatric population and emphasizes the need to create awareness among the people regarding the provision of social support to the geriatric population.

RISK FACTORS AND PREDICTORS OF SEVERITY FOR ISCHEMIC STROKE IN THE RURAL SOUTH INDIAN POPULATION

Introduction: Stroke is a leading cause of death and disability worldwide. The risk factors contributing to stroke vary among geographical locations, ethnic populations, and also among genders. This study aims to identify the prevalence of risk factors among patients admitted for ischemic stroke, correlate the stroke severity, and identify risk factors in the rural South Indian population. Methods: One hundred and thirty patients admitted with acute ischemic stroke formed the study population. The demographic details and neurological examination at admission were noted. The presence of comorbidities such as diabetes mellitus, systemic hypertension, coronary artery disease, smoking, and quantity of alcohol consumed was documented. All patients underwent a series of investigations including computed tomography brain, fasting blood sugar, fasting lipid profile, complete blood count, and carotid Doppler. Stroke severity was graded as per the National Institutes of Health Stroke Scale. Results: This study of 130 stroke patients (65.4% male and 34.6% female) with a mean age of 61.10 years examined risk factors and their associations with stroke severity. Hypertension and diabetes mellitus were prevalent (51.5% and 50%, respectively). Significant associations were found between age, sex, and alcohol consumption with stroke severity. Overall, age emerged as a critical determinant of stroke severity. Conclusion: Tremendous research gaps persist despite significant progress in researching gender differences in stroke as well as particular factors impacting risk and outcomes which need to be addressed in future studies. Urgent health-care policies are needed to arrest the rapidly rising epidemic of metabolic diseases and combat alcoholism.

Assessment of the Risk of Type 2 Diabetes Mellitus Among a Rural Population in South India Using the Indian Diabetic Risk Score.

Objective The objective of our study was to assess the risk for diabetes using the Indian Diabetic Risk Score (IDRS) questionnaire and compare the components of IDRS between the risk groups. Methods It was a cross-sectional studyinvolving 270 male and female attendees who visited Melmaruvathur Adhiparasakthi Institute of Medical Sciences (MAPIMS) from December 2019 to May 2020. The diabetes risk was assessed using the IDRS questionnaire. Statistical Package for Social Sciences (SPSS) version 20 (IBM Corp., Armonk, NY) was used for statistical analysis. P< 0.05 was considered statistically significant. Results IDRS categorization showed 12.6%, 73.7%, and 13.7%in the low-risk, moderate-risk, andhigh-risk groups, respectively. Age, waist circumference, and body mass index(BMI) were significantly (P < 0.05) higher in the high-risk group when compared with the low-risk group. Subjects with a positive family history of diabetes and no/mild physical activity were higher in the moderate and high-risk group but there is no significant association present between them. Conclusion The current study estimates the effectiveness of IDRS in identifying people at high risk for diabetes in the community. This study also emphasizes the need for early identification of high-risk individuals and planning for the appropriate intervention to prevent, or delay, the onset of diabetes and thus reduces the burden of diabetes in India.

Secular trends in the prevalence of diabetes and prediabetes among the rural population of South India

Secular trends in the prevalence of diabetes and prediabetes among the rural population of South India

IDF2022-0527 Secular trends in the prevalence of diabetes and pre-diabetes among the rural population of South India

IDF2022-0527 Secular trends in the prevalence of diabetes and pre-diabetes among the rural population of South India

A study on self-medication in ophthalmic emergencies in the rural population of South India

ABSTRACT Background: Self-medication has been defined as the taking of drugs, herbs, or home remedies on one’s own initiative and advice from another person without consulting a medical specialist. The objective of the study was to identify the pattern of self-medication in ophthalmic emergencies in patients attending the emergency department in a peripheral rural setup in south India. Materials and Methods: This was a descriptive, cross–sectional, questionnaire-based observational study. The patients selected were above 18 years of age. Informed consent was taken. A questionnaire on the demographic characteristics, level of literacy, history of the ophthalmic condition for which the patient had self-medicated, type of self-medication resorted to , reasons for resorting to ocular self–medication, and the adverse effects reported were all noted in the study. Results: The study included 100 subjects. Fifty-three percent were male and 47% were female. Among the 100 subjects, 10% of the individuals were educated above primary school level. Thirty-five percent had only primary school level education and the remaining 55% had not been to a formal school and had no basic education. Among our respondents, the most commonly used self-medication was antibiotic drops (24%), followed by expired medication (23%). 20% used steroid drops. 15% had tried traditional eye medication (TEM). Herbal and other indigenous medications were used by 12% of the responders. 7% used oral nonsteroidal anti-inflammatory drug agents. None of the responders were aware of the adverse effects of self-medication. The most common ophthalmic emergency symptoms faced by our responders were excessive watering (37%), pain (28%), foreign body in the eye (14%), redness and discharge (12%), decreases vision (5%), and pain in the eye (4%). The common reasons given by our responders for not accessing health-care facilities were distance (living far from health-care facilities), advice from family and friends, belief if local healers, lack of finances and poverty, and lack of prioritizing health care. Following self–medication, 30% of the patients had infectious keratitis, 28% had conjunctivitis, 25% had epithelial defects, and 17% glaucoma. Conclusion: Irrational long-term use of drugs/traditional eye medicine or even the usage for ophthalmic emergencies can have dangerous visual outcomes. The study highlights the need of effective execution and establishment of high-quality accessible primary eye care services and health-care referral network in rural India.

Impact of polypharmacy in older patients with type 2 diabetes in rural population in South India

Background: The World Health Organization describes polypharmacy as a safe and efficient treatment that complies with evidence-based medicine and uses at least five different medications. Aims and Objectives: The aim of our study was to investigate the impact of polypharmacy in older patients with type 2 diabetes mellitus (T2DM) in rural population in South India. Materials and Methods: The study comprised a total of 100 patients, who were referred to the Government General Hospital, Nizamabad, between January 2020 and March 2022. The records of 50 randomly chosen non-diabetic patients who visited our hospital for other ailments were compared to those of the 50 T2DM patients. Results: In this study, a total of 100 patients were enrolled, out of which 62 were male (62%) and 38 were female (38%). The duration of diabetes was noted to be 0–5 years in 28 patients, 6–10 years in52 patients and &gt;10 years in 20 patients. In our study, we observed that more than five drugs were prescribed to 45 patients in the case group and only ten patients in the control group. Conclusion: Our study shows that older adults with diabetes have a high prevalence of polypharmacy and that this condition may have a significant impact on a number of health-related outcomes. Each patient should receive a customized course of treatment with the right number of medications for their particular ailment. The danger of side effects increases with the number of medications.

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.

Assessment of metabolic syndrome in infertile women with polycystic ovary syndrome in a rural population of South India: A cross-sectional study.

BackgroundPolycystic ovary syndrome (PCOS) is known to be associated with metabolic syndrome (MS). It is characterised by insulin resistance, hyperinsulinemia, dyslipidemia, obesity and hypertension. Data related to MS in infertile women with PCOS are limited in Indian populations.ObjectiveThis study aims to compare the prevalence of MS in infertile women with and without PCOS in a rural population in South India.Materials and Methods130 women with PCOS and 130 women without PCOS were enrolled in this cross-sectional study. A detailed history was taken and a physical examination was done for all women. Anthropometric parameters, a glucose tolerance test, fasting glucose / insulin levels, trigylcerides, high-density lipoprotein cholesterol and blood pressure were assessed in all participants. The International Diabetes Federation criteria were applied for assessment of MS.ResultsMS was more prevalent in infertile women with PCOS (42.3%) compared to women without PCOS (19.3%). 56.9% of women with PCOS had low high-density lipoprotein cholesterol levels, 46.2% had high triglycerides, 71.5% had a high waist circumference, 31.5% had high blood pressure and 37.7% had high blood glucose levels. 26.0% of the women with PCOS had a healthy weight, and MS was seen in 6.9% of these women.ConclusionThe prevalence of MS was higher in women with PCOS in comparison to women without PCOS. Among the women with PCOS, the prevalence of MS increased with age ( 27 yr), body mass index and waist circumference (71.5%), and even healthy women with PCOS contributed to 7% of MS. Hence it becomes necessary to screen all women with PCOS for metabolic profile risk factors at young age itself to prevent long term cardiovascular complications.

Revised Glycemic Index for Diagnosing and Monitoring of Diabetes Mellitus in South Indian Population.

Aim: To find the optimal threshold of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) for diagnosis of diabetes mellitus (DM) and to evaluate the association with diabetic retinopathy (DR) in the South Indian population.Settings and Design: A retrospective population-based study.Methods and Materials: A total of 909 newly detected type 2 DM patients were selected from our two previously conducted studies, which include an urban and a rural population of South India. All underwent estimation of fasting, postprandial plasma glucose (PPG), and other biochemical tests. A comprehensive and detailed ophthalmic examination was carried out. The fundi of patients were photographed using 45°, four-field stereoscopic photography. Based on receiver operating characteristic (ROC) curves, sensitivity and specificity were derived.Results: The optimal cut-off values determined by maximizing the sensitivity and specificity of FPG and HbA1c using the Youden index were ≥ 6.17 mmol/L and ≥ 6.3%, respectively. By distributing the cut-off points into deciles and comparing them to the WHO criteria, we found that our HbA1c level of 6.60% was more than the WHO threshold (6.5%), with higher sensitivity (81.6%) and lower specificity (48.3%). The FPG level of 6.80 mmol/L was lower to the WHO criteria (7 mmol/L) with increased sensitivity (77.0%) and lower specificity (45.7%). Prevalence of DR by HbA1c levels between 6.5% and 6.9% was 15.3%. The prevalence of DR was more in the FPG category between 6.4 and 6.9 mmol/L and ≥ 7.5 mmol/L.Conclusion: Our population-based data indicate that for the South Indian population HbA1c value of ≥63 % and FPG value of ≥6.17 mmol/L may be optimal for diagnosing DM with a high level of accuracy and will be useful for the identification of mild and moderate DR.

The incidence of Orientia tsutsugamushi infection in rural South India.

Scrub typhus is a common bacterial infection in Asia caused by Orientia tsutsugamushi. This serological cohort study estimated the incidence of infection in a rural population in South India. Participants were enrolled through systematic sampling in 46 villages at baseline, and revisited the following year. Blood samples were tested for IgG antibodies using ELISA, followed by indirect immunofluorescence assays (IFA) in those positive for ELISA at both rounds. A case was defined as sero-conversion (ELISA), or at least a 4-fold titre increase (IFA), between the two time points. In addition to crude incidence rate estimates, we used piecewise linear rates across calendar months, with rates proportional to the monthly incidence of local hospital cases to address seasonality and unequal follow-up times. Of 402 participants, 61.7% were female. The mean age was 46.7 years, (range 13-88). 21 participants showed evidence for serological infection. The estimated incidence was 4.4 per 100 person-years (95% CI 2.8-6.7). The piecewise linear rates approach resulted in a similar estimate of 4.6 per 100 person years (95% CI 2.9-6.9). Considering previous estimates of symptomatic scrub typhus incidence in the same study population, only about 2-5% of infections may result in clinically relevant disease.

Anemic status in patients requiring multiple extractions: A prospective study in rural population in South India

Anemic status in patients requiring multiple extractions: A prospective study in rural population in South India

Real World Evaluation of the Use of a Novel Artificial Intelligence Enhanced Breast Thermography Technique, Thermalytix, in Screening for Breast Abnormalities at the Community Level in a Rural Population of South India

Real World Evaluation of the Use of a Novel Artificial Intelligence Enhanced Breast Thermography Technique, Thermalytix, in Screening for Breast Abnormalities at the Community Level in a Rural Population of South India

Prevalence of bacteriologically confirmed pulmonary tuberculosis and associated risk factors: A community survey in Thirvallur District, south India.

Tuberculosis (TB) prevalence surveys add to the active case detection in the community level burden of TB both national and regional levels. The aim of this study was to assess the prevalence of bacteriologically confirmed pulmonary tuberculosis (PTB) in the community. Household community-based tuberculosis disease survey was conducted targeting 69054 population from 43 villages of 5 blocks in Tiruvallure district adopting cluster sampling methodology of ≥15 years old adult rural population of South India during 2015-2018. All eligible individuals with suspected symptoms of PTB were screened with chest X-ray. Two sputum specimens (one spot and the other early morning sample) were collected for M.tb smear and culture examination. Conversely demographical, smoking and alcohol drinking habits information were also collected to explore the risk factor. Stepwise logistic regression was employed to associate risk factors for PTB. A total of 62494 were screened among 69054 eligible population, of whom 6340 were eligible for sputum specimen collection. Sputum for M.tb smear and culture examination were collected in 93% of participants. The derived prevalence of PTB was 307/100000 population (smear-positive 130; culture positive 277). As expected that PTB has decreased substantially compared to preceding surveys and it showed that older age, male, low BMI, diabetes, earlier history of TB and alcohol users were significantly associated (p < .0001) with an increased risk of developing PTB. Upshot of the active survey has established a reduction in the prevalence of PTB in the rural area which can be accredited to better programmatic implementation and success of the National TB Control Programme in this district. It also has highlighted the need for risk reduction interventions accelerate faster elimination of TB.

Study on Association between BMI and Vitamin D Levels in South Indian Rural Population

Introduction: Vitamin D deficiency is a global health problem worldwide and is considered to be apandemic with implications for compromised bone health and other chronic diseases. A few studieshave examined the association between vitamin D status and body mass index (BMI). However,prospective data using the biomarker serum 25-hydroxyvitamin D 25(OH) D3 are limited andtherefore examined in the present study. Methods: Participants were selected from subjectsattending to Medicine Outpatient Department (OPD) in Sri Venkateshwara Medical College Hospital &amp;Research Centre (SVMCH &amp; RC) willing to participate in the present study between Jan 2020 to Dec2020. Anthropometric measurements, personal, medical history questionnaire, food frequencyquestionnaire (FFQ) for vitamin D, and sun exposure questionnaire were collected from all theparticipants in the present study, blood samples for serum 25(OH)D3 were collected from allsubjects. Results: Our study showed that the majority of healthy individual cases of the study i.e.,68.0% have a deficiency in vitamin D status, while 68.0% have ≤20 ng/dl in vitamin D, and 32.0%in &gt;20 ng/dl. Moreover, the study showed a negative association between the level of circulating25(OH) D3 and BMI. Conclusion: This study demonstrated that the association between BMI and25(OH)D concentrations in populations from south India can be seen across different age groups andin both men and women. The study also exemplified that higher BMI leads to lower vitamin D status,providing evidence for the role of obesity as a causal risk factor for the development of vitamin Ddeficiency.

Clinical Profile and Outcome of Acute Pancreatitis in Rural Population in South India

Introduction: Acute pancreatitis is one of the most common cause of acute abdominal pain with awide range of presentation from mild to multi-organ failure; hence we intended to study the clinicalprofile of acute pancreatitis in our study. Methods: All subjects admitted with acute pancreatitisabove the age of 18 years; both male and female willing to participate were included in the study.60 subjects were studied where males dominate the study. Results: Alcohol intake and gall stonebeing the etiological cause for the illness. Conclusion: The recovery rate was 95% with no mortalitywas observed in our study.

Knowledge, Attitude and Practice of COVID 19 and the factors influencing them among a Rural Population in South India

Background: Mitigation measures to control the novel coronavirus disease 2019 (COVID-19) depends on the public adherence to preventive measures which is influenced by their knowledge and attitude. Aim: To find the knowledge, attitudes and practices (KAP) of the rural population toward COVID-19 and to establish its socio-demographic influencing factors. Material and methods: KAP study regarding Covid-19 was done among the rural population during August 2020 using a semi-structured questionnaire. Results: Among 500 participants, the mean knowledge, attitude and practice score was 21.55± 2.9 ( Range 0- 30 ), 30.0± 2.88 ( Range 12- 36 ) 9.4± 1.25 ( Range 0-13 ) respectively. Higher knowledge was associated with higher education and employed individuals. Favourable attitude was among those aged &lt;35 years and having higher education. Optimistic practices were exhibited by employed individuals and when children &lt;12 years are present in their home. Conclusions: Study participants preceded good knowledge, positive attitude towards COVID-19 but practice is not sufficient enough to win the battle against the dreadful disease due to considerable knowledge- practice gap.

Prevalence and phenotypic characterization of ESBL producing E.coli and Klebsiella among the fecal isolates of normal population

Introduction: Prevalence of extended spectrum beta lactamase producing bacteria has been increasing worldwide despite of outbreak situations. ESBLs occupying the gastrointestinal tract are spread across other bacteria and humans through the environment. The present study is a report on the prevalence of ESBL producers among normal individuals of a rural population in south India. Materials and Methods: 1000 normal individuals were selected from the villages of Salem district. Stool samples were collected and processed in MacConkey agar plates supplemented with Cefotaxime 5ug/ml. Morphological and biochemical methods were used to identify the colonies initially. ESBL producing organisms were identified by Double Disk Synergy Test – DDST and Phenotypic Confirmatory Disk Diffusion test- PCDDT. Results: From the total number of samples, 37.9% has shown bacterial growth. The rate of ESBL producing Enterobacteriaceae was found to be 33.8% with E.coli (29.3%) being the predominant species followed by klebsiella (8.6%). Conclusion: The results of our study gives a brief information about the multidrug resistance and also the prevalence of ESBL producing bacteria in the community faecal flora. Phenotypic methods were successfully applied to screen large number of samples. The rate of ESBL producers in the community is notably high. Routine surveillance programmes and awareness of hygienic practices among the rural population are highly recommended to monitor and control the spread. Keywords: Beta lactams, E.coli, Enterobacteriaceae, Klebsiella.

Association between iron deficiency anaemia and simple febrile seizure in South Indian rural population

Background: Simple febrile seizure is a common problem worldwide, many studies have investigated the etiology and natural history of febrile seizures and evaluated various management strategies, but very little information is available about iron deficiency as a risk factor. Hence, we aimed to determine the association between iron deficiency anaemia and simple febrile seizures in south Indian rural population. Methods: It is an observational study done in paediatrics department at Sri Venkateshwaraa medical college hospital and research centre. A total 120 (60 cases and 60 control) were included in the study. Children with febrile seizures and controls were included fever without seizures. Informed consent was taken from parents of each child. Children were divided into two groups, cases and controls. Serum ferritin level, Hb, HCT and MCV levels were assessed.Results: Mean Hb level in cases and controls were 9.1±1.2 and 12.7±1.7 mg/dl respectively. Mean MCV value in cases and controls was 78.1±6.2 and 81.4±6.9 respectively. Mean serum iron level in cases was 29.9±4.9 and in controls mean serum iron level was 42.8±7.4. Conclusions: Iron deficiency anaemia is considered as a risk factor for febrile seizures in children.