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Eye care programs, in developing countries, are often planned using the prevalence of blindness and visual impairment, often estimated from Rapid Assessment of Avoidable Blindness (RAAB) surveys. A limitation of this planning approach is that it ignores the annual overall eye care requirements for a given population. Moreover, targets set are arbitrary, often influenced by capacity rather than need. To address this lacunae, we implemented a novel study design to estimate the annual need for comprehensive eye care in a 1.2 million populations. We conducted a population-based longitudinal study in Theni district, Tamil Nadu, India. All permanent residents of all ages were included. We conducted the study in three phases, (i) household-level enumeration and enrollment, (ii) basic eye examination (BEE) at household one-year post-enrollment, and (iii) assessment of eye care utilization and full eye examination (FEE) at central locations. All people aged 40 years and above were invited to the FEE. Those aged <40 years were invited to the FEE if indicated. In the main study, we enrolled 24,327 subjects (58% aged below 40 years and 42% aged 40 years and above). Of those less than 40 years, 72% completed the BEE, of whom 20% were referred for FEE at central location. Of the people aged ?40 years, 70% underwent FEE. Our study design provides insights for appropriate long-term public health intervention planning, resource allocation, effective service delivery, and designing of eye care services for resource-limited settings.
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Throughout the post-independence period, the state of Tamil Nadu has consistently performed better than most other states in several major healthcare indicators, including infant mortality rate and total fertility rate. At the same time, it has received praise for the deep penetration and robust functioning of its public health system. Tamil Nadu’s achievements in healthcare have been analysed in a number of scholarly studies in the past, and a recent book by Kalaiyarasan A and Vijayabaskar M, titled “The Dravidian Model: Interpreting the Political Economy of Tamil Nadu,” is the latest addition to this literature. The authors argue that the state’s uniqueness in human and social development primarily originates in the egalitarian politics and radical social movements of the early twentieth century which constituted a “Dravidian common-sense” that has since “shaped the development trajectory of the state.” Their arguments on the significance of egalitarian politics in improvements in health and wellbeing receive ample support from existing social sciences literature on health, equity, and justice.
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Public distribution system has been an important welfare programme of government aimed to ensure food security in India ever since independence. PDS had been striving hard to provide subsidized essential commodities to the poor and needy of the country. Tamil Nadu has been implementing universal public distribution system to ensure food security for all its citizens. This paper tries to analyze the present status of Public Distribution System in Tamil Nadu. PDS had been under the wrath for many decades for the level of corruption, bogus purchases and leakage the system has. Reformation of the system was the need of the time. This paper also tries to evaluate the recent reforms introduced by the government of Tamil Nadu to make the functioning of PDS efficient.
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One lung ventilation (OLV) with collapse of the ipsilateral lung is a prerequisite for most thoracic surgical procedures. Double?lumen tube (DLT) is still the preferred method to isolate the lungs and fiberoptic bronchoscopy (FOB) is the gold standard for the confirmation of correct placement of the DLT. However, both these procedures are considered as a high?aerosol?generating procedures and are hazardous to the health workers, particularly at this time of the COVID?19 pandemic. We did nine thoracic surgery cases categorized as essential, requiring OLV during the ongoing period of the COVID?19 between April 2020 and May 2020 where we used Full view DLT for lung isolation. We present our case series which shows that the Full view VDLT can minimize or circumvent the use of FOB during OLV, and reduce the time taken to isolate the lungs thus reducing aerosol in the theater. None of the nine patients required FOB for confirmation of initial positioning nor for diagnosis of intraoperative malposition. The time taken to isolate the lungs was significantly less and the surgical positioning was done under real?time monitoring by visualizing the blue cuff distal to carina at all times. The real?time monitoring by the Full view VDLT offers the additional advantage of detecting any malposition even before it results in loss of isolation or desaturation. We conclude that the Full view VDLT is an efficient and safe alternative for lung isolation at this time of the COVID?19 pandemic.
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Background: In recent times, one of the factors implied in poor school performance in children is increasing screen time. Objective of the study was to find the association of screen time duration with school performance among primary school children in the state of Tamil Nadu, India.Methods: This cross-sectional observational study was conducted among 134 primary school students at the state of Tamil Nadu, India from June 2019 to August 2019. Data regarding screen time were collected from the parents and school performance from teachers using a predesigned questionnaire. The data collected were analyzed with suitable statistical methods using SPSS 25 software.Results: Of the 134 children, 72(53.7%) were male and 62(46.3%) female children. 52(38.8%) were in the age group of 6 to 7 years, 47(35.1%) in the age group of 8 to 9 years and 35(26.1%) in the age group of 10 to 11 years. Majority of the children (56.7%) had an average daily screen time of >120 minutes followed by 61 to 120 minutes (29.1%) and ?60 minutes (14.2%). Based on composite academic performance, 23(17.2%) children were categorized as having poor academic performance, 71(52.9%) as average and 40(29.9%) as good academic performance. There was no statistically significant correlation of screen time duration with composite academic performance and academic performance in mathematics, science and language. (p Value >0.05).Conclusions: There was no significant correlation between screen time duration and school performance in primary school children in this study. Further studies are required to find the influence of screen time on various domains of learning and on long term cognition and educational achievement.
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Background: Screen time behavior in young children is highly influenced by parental attitude towards screen time.The objective of this study is to assess the awareness and attitude among parents of primary school students in the state of Tamil Nadu, India towards screen time in children.'Methods: This cross-sectional observational study was conducted in the state of Tamil Nadu, India among 134 parents of primary school children. Data collected using a predesigned questionnaire were analyzed using suitable statistical methods.Results: Of the 134 participants, 48.5% were fathers and 51.5% mothers. Majority (77.6%) were in the age group of 24 to 35 years. Only 3.7% of the participants were aware of the exact screen time guidelines in children. 93.3% of the participants felt that it was important to limit screen time in children. 84.3% of the participants believed that the content of screen time should be controlled in children. 82.1% of parents felt that they should co view media with their children. 65.7% of the participants believed that the ideal screen time in children per day is 1 to 2 hours. 82.1% of the participants believed that using screen time as a replacement for caretaker was an important reason for increasing screen time. The awareness of adverse effects of increased screen time was high among the participants. 91.8% of the participants believed that establishing limits for screen time in children was the most efficient way to limit screen time in children. 89.6 % believed that increasing awareness among children was important.Conclusions: In this study, we conclude that majority of the parents were aware of the adverse effects of increasing screen time and want to establish healthy screen time behaviours in children.
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Background: Now a days the whole World is submerged with digital electronics devices round the clock for all utilities. Even the doctor community also is not spared by these digital gadgets. Almost every doctor in India is permanently having and operating a smart phone and laptops or desktops plus vide computer applications.Methods: This cross-sectional study was conducted among 45 doctors across 7 departments of Government Medical College, Vellore. Mean, median, mode, standard deviation was used for quantitative data and Pearson chi square test and logistic regression was used for qualitative data using trial version of SPSS 22.Results: The mean score was 11.2±2.8 with mean scoring percentile of 38.8±6.5. There was Pearsons Chi square significance for Variables like exposure to external resources and, Books related to cyber security, age less than 34 years and average spending time with electronic devices >2.5 hours per day, designation MD versus MBBS, gender difference.Conclusions: On running logistic regression the multivariate analysis for study variables with statistical significance was seen for four variables- exposure to external resources, and books related to cyber security, age <34 years, average spending time with electronic devices >2.5 hours per day. Designation and gender variables lost their significance on logistic regression analysis.
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Background: Adolescents represent about 21.8 percent of India’s population. Various health risks with potentially life-threatening consequences become prominent in this age group. This study was undertaken with the objective to determine the morbidity profile of school going adolescents in Tamil Nadu.Methods: This descriptive, cross sectional study was planned and conducted from January 2016 to August 2017. The study population included 987 adolescent boys and girls aged between 10 to 19 years studying in high and higher secondary Government schools of Thiruvallur district of Tamil Nadu. Semi-structured questionnaire was used as data collection tool.Results: The mean age groups of this school going adolescent are 14.2 yrs. In the present study 583 (59%) of the study participants were affected by one or more morbidity condition. Among them, 395 (67.7%) were in the age group 10-14 years and 188 (32.2%) in the age group 15-19 years. 122 (21%) and 461 (79.1%) of male and female were affected respectively. In the present study, fever (21%) was the commonest reported morbidity followed by acute respiratory infection (15.7%) and acute gastrointestinal disease (13. 4%).Conclusions: This study shows that adolescents are prone to a wide range of morbidity conditions. Apart from respiratory and gastro intestinal diseases, reproductive tract infections and sexual health problems are important morbidities affecting this age group. There is strong need to sensitize health care practitioners at all levels, in both government and private sectors towards health problems in adolescent age groups.
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Background: Globally, acute diarrhoea claims around 1.5 million lives of under-five children. In India, ADD accounts for 8% of deaths in <5yrs age group. Child may be pushed into an irreversible outcome as stunting because of inadequate nutrition and repeated bouts of infection during the first 1000 days of life. Oral rehydration therapy is the most effective treatment intervention which can avert about 14% of deaths in under five children. Methods: A cross sectional study was done among 270 mothers of under five children from our urban health centre service area of PSGIMSR. Results: Among 270 mothers of under five children most of them belonged to the age group of ≤25 years. Only 10.7% of the mothers were aware that infection or germs cause diarrhea, signs of dehydration were not known by 80% of mothers. Mothers’ with more than one child and mothers with education more than 8th class were emerged as the factors affecting ORS preparation. Conclusions: The knowledge on diarrhoea was low. Although awareness regarding spread of diarrhoea and ORS was adequate in this community, knowledge regarding continuation of feeding and signs of dehydration were deficient. Thus educating the mothers of under-five children regarding correct practices of home management of diarrhoea is likely to further reduce diarrhoea morbidity and mortality.
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Background: Lifestyle changes have increased the epidemic of obesity, diabetes, hypertension (HTN), dyslipidemia, and cardiovascular diseases in the 20th century. In India, the estimated adult prevalence of coronary artery disease (CAD) is increasing which leads to a huge economic loss. Objectives: The objective of the study is to measure the prevalence of risk factors for CAD among population aged 30 years and above in a rural area of Tamil Nadu. Materials and Methods: A community-based cross-sectional study was done in 16 villages under the field practice area of the Department of Community Medicine, Pondicherry Institute of Medical Sciences. 631 participants were selected by multistaged random sampling and interviewed using modified WHO-STEPS questionnaire. The variables studied were age, sex, socioeconomic status, smoking, alcohol, diet, physical activity, obesity, diabetes, and HTN. Data analysis was done using SPSS version 20. Results: Out of 631 participants interviewed in this study, the prevalence of smoking was 13.8%. 29.6% respondents had consumed alcohol once in their lifetime. Almost all the respondents (99.5%) did not consume fruits and vegetables adequately. Majority of the participants consumed salt dense foods and used unsaturated oil for cooking. Only 17.8% were sedentary workers. 32.5% were pre-hypertensives and 25.8% were hypertensives. 28.2% were overweight and 6.6% were obese. Conclusion: The prevalence of various risk factors for CAD such as unhealthy diet, obesity, alcohol consumption, and comorbidities was found to be high among our study population. Hence, concerted efforts should be taken by various stakeholders to reduce the risk of developing CAD.
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Background: The occupational hazards faced by salt pan workers during their occupation are myriad, a fact compounded by the lack of basic amenities at their workplace and lack of awareness regarding usage of personal protection equipment.Methods: This cross-sectional study was carried out among fifty-six salt pan workers in Marakkanam, Tamil Nadu to assess their common health problems and a qualitative component was added to assess their felt needs in work place and daily living. Data was collected using pre-designed data collection sheet for assessing the common morbidities. For the qualitative aspect of the study, in-depth interviews were conducted among twenty workers based on convenient sampling, using open ended questions. Data was collected after obtaining informed consent and steps were taken to ensure confidentiality at all stages.Results: The most common health problem of the workers in present study area included dental caries (41.7%), skin conditions (38.1%) musculoskeletal problems (36.7%) and anemia (35.1%) being other significant health problems. The qualitative aspect of the study revealed that the felt needs were improvement of their working conditions and more social support from the Government and the employers. There was very little awareness among the workers regarding use of PPE and none of them used any form of PPE.Conclusions: Salt pan workers had dental problems, dermatological problems and musculoskeletal problems as most common morbidities among them. Harsh working conditions, financial insecurity etc. are some of their work-related problems. Provision of housing facility and financial assistance during off- season by the government, basic amenities at the work place, paid leave in case of injuries, and insurance schemes for them by employer are their main felt needs. They also had no awareness regarding usage of personal protective equipment at the work place.
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Background: Women empowerment is vital for decision making on nutrition, health-seeking, family planning and economic issues for the family as a whole. In reality, there is prevalence of unequal gender norms among the women in India in urban and rural area. The objective of the study was to compare the empowerment of women in urban and rural setting in Tamil Nadu.Methods: A cross-sectional study was conducted in Nandivaram (RHTC) and Shenoy Nagar (UHTC) attached to Government Kilpauk Medical College among 200 married women of age 15-49 years with a semi-structured questionnaire during June 2018. Data was entered and analyzed in SPSS 16. Chi Square test and logistic regression was used for statistical analysis.Results: Mean age in rural group was 26.74±6.45 years and 30.4±7.35 in urban. Illiterates were 27% in rural and 14% in urban. About 67% were homemakers in rural vs. 43% in urban. About 33% were BPL in rural vs. 21% in urban. Decision making regarding household decisions, about73% in rural vs. 87% urban had participated. In health seeking behavior, 77 % in rural had no say while only 45% in urban. For Family planning, 33% in rural vs. 74% in urban had decision making which were statistically significant. Only 33% contributed to family income in rural vs. 47% in urban.Conclusions: Women empowerment is better in urban setting than rural setting. There is a strong need to create awareness and training in rural setting for better productive life.
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A cross sectional study was conducted to determine the dynamic prevalence of bovine tuberculosis amongst bovine using single intra dermal cervical comparable test (SICCT or CIDT) in North-Eastern agro-climatic zone of Tamil Nadu. In the present study, Out of 1119 blood samples tested from four selected districts of North-Eastern agro-climatic zone of Tamil Nadu, the overall prevalence of M. bovis infection in North-Eastern agro-climatic zones of Tamil Nadu was found to be 8.46 per cent by CIDT and highest prevalence was noticed in Vellore (10.86%) district followed by Kancheepuram (8.20%), Thiruvallur (7.92%) and Chennai (6.86%) districts, which shows the potential to increase the incidence as well as prevalence of the disease since the “test and slaughter” or “culling policy” are yet to be strengthened intensively or warranting the calf-hood immunization against tuberculosis
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Background: Risk factor modification remains as the principal aspect of care for stroke prevention. Understanding of risk factors has advanced and several options are now available to treat modifiable risk factors. Prevention of stroke begins with awareness of risk factors by patients and clinicians. Aim: The aim of our study was to study the association of various risk factors for acute ischemic stroke. Materials and methods: A total of 50 patients who presented with acute ischemic stroke were enrolled into the study after confirmation by CT scan. A detailed history regarding age, smoking, alcohol intake, diabetes, hypertension, dyslipidemia and ischemic heart disease were taken. Blood sugar, lipid profile and CRP estimation were done.50 normal persons without any evidence of stroke were taken as control subjects. The prevalence of risk factors in patients with ischemic stroke was studied and compared with control subjects. Results: Mean age of stroke patient was 60.62 years and control was 58.22 years. Smokers and alcoholic were 32% (case -21%, control 11%) and 36% (case -26%, control 10%) respectively. Diabetes, hypertension and IHD patients constituted 27% (case -20%, control 7%),37% (case -30%, control 7%) and 20% (case -13%, control 7%) respectively. High CRP level was found in 47% (case - 35%, control 12%) of patients. Dyslipidemia was found in 44% (case -38%, control 6%) of patients. Conclusion: In our study smoking, alcohol, diabetes, hypertension, IHD, dyslipidemia and high CRP levels correlated well with ischemic stroke. Age and sex were not correlated with ischemic stroke.
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Background: Viral infection with Herpes Simplex Virus (HSV) is one of the commonest opportunistic infection in HIV seropositive patients. Studies have confirmed that genital herpes caused by HSV-2 has been associated with twofold to threefold increased risk of HIV acquisition. This study was designed to determine the seroprevalence of HSV-2 in HIV positive patients. Methods: This was a prospective, cross sectional study conducted from July 2012 to January 2013. After obtaining written informed consent, HIV positive patients were enrolled into the study. Demographic characteristics were recorded. Serology test was performed using HSV-2 IgG ELISA test kit from Calbiotech, USA. Results were analyzed using Chi-squared test. Results: Out of two hundred and seventy three HIV positive patients enrolled, 67% were males, 33% were females and one transgender. Average age was 38.8 years. Overall 50% of HIV positive patients had HSV-2 IgG antibodies. Seroprevalence of HSV-2 among HIV positive men and women were 47% and 57% respectively. The highest HSV-2 seropositivity was detected in the age group of 36 to 45 years. Chi-squared analysis showed a statistically significant association between HSV-2 and HIV infection (X2 = 55.900, P = 0.0076). The median CD4 counts estimated in 100 patients were 563.50 cells/mm3. There was no significant difference in CD4 counts of those with or without HSV-2. Conclusions: HSV-2 prevalence was higher in HIV positive women than in men. The implementation of continuous interventions for STIs and HIV will bring down the prevalence and spread of both HSV-2 and HIV infection.
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Background: Perceived organizational support (POS) measures the employee perception of support from the organization and helps to understand the employer-employee relationship better. The aim of the study is to understand the healthcare professionals’ perception of support from public health department and to examine thehealthcare professionals’ difference in perception of support across various demographics variables. Methods: A survey is conducted among healthcare professionals including medical offi cers and staff nurses working in primary health centres (PHC) in the state of Tamilnadu. In the study, public health department refers to the Directorate of Public Health and Preventive Medicine. Mann Whitney U test and Kruskal Wallis H test are used to assess the difference in POS across demographic variables. Results: The results of the study indicated that the healthcare professionals perceive a moderate levelof support from public health department. The healthcare professionals’ POS is found to differ across their age, role and total work experience but not across gender and work experience in the current PHC. Further, the POS of healthcare professionals is found to differ with respect to PHC location and does not differ with respect to PHC type. Conclusion: The results emphasize the need to enhance POS of healthcare professionals. The health policy makers and mangers have to consider the difference in POS of healthcare professionals and make amendments in the human resource policies related to selection and training.
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The study aimed to find the living status and the emotional intelligence of the women police constables in Coimbatore city, TamilNadu. This descriptive research was covered randomly selected two hundred women police constables. The questionnaire method was used to collect the data.The personal information sheet was used to obtain the demographic information and Schutte Emotional Intelligence Scale (Schutte et al. 1998) was applied to measure emotional intelligence. The results showed that the majority of the respondents (62.5%) are in the age group of 21-25 years and nearly half of the respondents (44%) had less than two years of experience. Half (52%) of the respondents had a moderate level of emotional intelligence and education, monthly salary, experience, No. of training programmes attended and the type of family played a significant role in emotional intelligence of women police constables on the other hand age and marital status doesn‟t make any impact.
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Background: The development of antibiotic resistance has become a global health challenge which is causing ineffectiveness of the available antibacterial agents leading to increase in diseases and death rate. Therefore this study intends to investigate the antibacterial action of Aqueous Garlic Extract (AGE) against 9 multidrug-resistant gram-positive and gram-negative bacterial isolates, including Staphylococcus aureus, Enterococcus species, ß hemolytic streptococcus, Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumoniae, Escherichia coli, Vibrio cholerae and Serretia marscenes. Methods: Antibacterial activity of different concentrations of AGE by well-diffusion method was recorded by measuring the diameter of zone of inhibition. The Tamil Nadu garlic cloves as well as Jowai region garlic cloves showed antibacterial activity against both GPC and GNR. Results: The maximum zone of inhibition was observed in Tamil Nadu garlic than that of Jowai region, but the only bacteria which showed a better zone of inhibition with Jowai region than Tamil Nadu garlic was Pseudomonas aeruginosa. Conclusion: Thus our study reveals that garlic not only makes the food more spicy & edible with its flavour but can also be used as an effective antibacterial agents against MDR gram positive & gram negative bacteria.
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The study mainly focused on the plants used as food as well as medicine by Kani tribals in Kalakad Mundanthurai Tiger Reserve in Southern Western Ghats, India. An ethnobotanical survey was carried out among the Kani tribals through questionnaires and consultations with age-old and knowledgeable tribals during June 2007 to September 2009. A total of 59 species of plants were recorded in this study with their vernacular names, parts used as food either raw or cooked and medicinal uses. Among all the edible plants, unripe fruits of Artocarpus heterophyllus and tubers of Manihot esculenta are favorite edibles and these are the main food for the Kani tribal community. Due to indiscriminate exploitation, destruction of forests and changing scenario of rural life, the oral folklore of plants is on the way of extinction. The present investigation underlines the potential of ethnobotanical research and the need for documentation of traditional knowledge pertaining to the utilization of plants for greater benefit of mankind.
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Incidence of dengue is reported to be influenced by climatic factors. The objective of this study is to assess the association of local climate with dengue incidence, in two geographically distinct districts in Tamil Nadu. The study uses climate data, rainfall and mean maximum and minimum temperature to assess its association if any, with dengue incidence in two districts of Tamil Nadu, South India. According to this study while precipitation levels have an effect on dengue incidence in Tamil Nadu, non-climatic factors such as presence of breeding sites, vector control and surveillance are important issues that need to be addressed.