Prevalence of hypertension among fisherman community in Chennai, Tamil Nadu, South India: a descriptive cross-sectional study

Background: Hypertension, often referred to as the "silent killer," usually presents no symptoms, making many people unaware of their condition. Fishing, as a profession, poses unique health risks due to harsh environmental conditions, irregular work patterns, and strenuous physical demands. Fishermen are particularly vulnerable due to unhealthy diets, sleep disturbances, physical inactivity, tobacco and alcohol use, and obesity. Estimating the prevalence of hypertension among fishermen is crucial for understanding the extent of this hidden health issue within this high-risk group and for implementing targeted interventions to improve their health outcomes. Methods: A cross-sectional study was conducted among Chennai's fishermen using systematic random sampling. Data were collected using a semi-structured questionnaire, and blood pressure was recorded following JNC criteria. Results: The study included 180 fishermen with a mean (SD) age of 49 (12). The prevalence of hypertension was 38.9%. Significant associations were found between hypertension, age, and years of fishing experience. Notably, 77.2% of fishermen lacked knowledge about hypertension, and 86.1% were unaware of its risk factors. Isolated systolic hypertension was found in 16% of participants, while 36% had isolated diastolic hypertension. Conclusions: In Chennai, hypertension is highly prevalent among fishermen and is significantly associated with age, years of fishing experience and smoking. There was no significant association with family history of hypertension, stress, or fried fish consumption. Awareness and knowledge about hypertension were very low among the fishermen. Although isolated systolic and diastolic hypertension were relatively minimal, regular hypertension screening for this community is essential.

The universal immunization programme coverage and determining factors among tribal children under the age of five in the Wayanad district of Kerala, South India

Background: Globally an estimated two to three million deaths occur every year in all age groups, from six major vaccine-preventable diseases and accounts for almost a quarter of all deaths in children under the age of five years. As Immunization is one of the most successful and cost-effective methods for preventing infectious diseases, the Indian government initiated a vaccination programme to reduce infant mortality and morbidity owing to vaccine-preventable diseases, and achieve vaccine self-sufficiency. In Kerala, about 1.5% of the total population makes up Scheduled Tribes, a socioeconomic group with continuously poor health indicators. Methods: Through a community-based cross-sectional study using cluster sampling technique, this study intends to determine the coverage of the universal immunization programme among tribal children (0-59 months), the factors affecting vaccination coverage as well as the reasons for partial immunization in Noolpuzha Panchayat, Wayanad. A semi-structured questionnaire was used to collect information from caregivers/mothers. Results: Out of 289 study population, 64.4% were fully immunized and 35.6% were partially immunized. Children's age and the father's education were found to affect immunization. Conclusions: As a lack of knowledge about immunizations and subsequent doses was the primary reason for partial immunization. There is a need to create awareness about the importance of vaccination and the subsequent doses among the tribal people of Wayanad.

India’s sustaining challenges to combat rabies elimination: a comprehensive review

Rabies is one of the fatal zoonotic diseases wreaking havoc on humanity since antiquity. India continues to suffer the greatest rabies burden of any country, both in terms of annual human deaths and disability-adjusted life years. While modern rabies management emphasizes the importance of achieving zoonotic disease control and prevention through a One Health approach, the disease remains challenging as its persistence is invariably multifaceted. Therefore, it is imperative to examine the enduring reasons for the increasing incidence of rabies in India. Between 2012- 2022, a systematic search of scientific publications, popular search engines like Google, as well as in the grey literature regarding rabies was carried out. Since rabies elimination boils down to addressing the reasons, it is first seen related to the large and unvaccinated stray dog population, where 97% of cases are by dog bites. A second finding is that many bite victims resorted to indigenous treatment practices due to insufficient awareness and knowledge about the disease. Incomplete treatment practices also led to some deaths, especially because rabies vaccines are not affordable or accessible to poverty-stricken populations. Rarely, vaccine failures were caused by a lack of vaccine potency, a wound type, or ineffective administration methods. Even with all these data incorporated, there was no information on prevalence/incidence estimates of dog bites in recent years through national data. Therefore, without intensified surveillance, sustained political commitment, enormous mobilization of resources, and rabies education, the epidemic waves of this fatal disease will continue in India.

Nutritional status of rural school-going children (11-13 years) of Dharmapuri district, Tamil Nadu, South India

Background: The childhood years are characterized by rapid growth and development on both a physical and mental level. Compared to adults, they require a greater amount of nutrition per unit of body weight. The prevalence of undernutrition among schoolchildren is one of the foremost public health problems in developing countries such as India. Various studies have highlighted the burden of undernutrition nationwide among different groups in India. The objective of the present study was to assess the nutritional status of school children attending schools in Dharmapuri, Tamil Nadu. Methods: A descriptive cross-sectional study was carried out among 972 school children of 11 to 13 years of age for 6 months by consecutive sampling technique. The children were assessed for nutritional status by clinical examination as well as anthropometric assessment and were compared with the WHO growth standards. Statistical analysis was conducted using SPSS version 22 on the data obtained. Results: The mean age of the children was 12.11±0.8 of which 491(51%) were boys and 481 (49%) were girls. Among children, the prevalence of underweight, overweight, and obesity was 565 (58%), 25 (2.6%), and 23 (2.4%) respectively. Conclusions: The burden of undernutrition is indeed a serious concern in the rural school children of Dharmapuri district in Tamilnadu. The importance of routine school health visits is stressed and this issue needs to be addressed promptly through a multipronged approach.

Research priorities in medical education in the Eastern Mediterranean Region

Ways are needed to effect quality improvement in medical education research in the Eastern Mediterranean Region [EMR]. This study aimed to determine the principle themes and to draw up a list of priorities in medical education research in EMR. Using the nominal group technique with a group of 30 experts, a list of major themes in medical education research was prepared. In a 2-round Delphi survey the list was sent to another 47 experts in the Region with a questionnaire that included open questions about change and reform in medical education. In the final list of 20, the 5 highest priorities identified were: training physicians to be effective teachers; community-driven models for curriculum development; clinical teaching models; education about professionalism and ethics; and education for evidence-based medicine. Themes determined by this survey can help researchers in EMR to focus on priority areas in research

[Risk factors associated with forth-degree laceration during vaginal delivery]

To identify the risk factors of fourth-degree laceration during vaginal delivery. This is a retrospective, case control study. We reviewed 131802 records of vaginal deliveries within 14 years period from 1990 to 2004 in two obstetric center. Cases were 93 vaginal deliveries with fourth-degree laceration and 7 cases were delivered at home, control subjects were 200 vaginal deliveries without third- or fourth-degree lacerations and were identified with the use of random selection. We studied the effects of: maternal age, nationality, parity, gestational age, hour of delivery, birth attendants, episiotomy use and duration of second stage of labor, use of oxytocin, use of forceps or vaccum, Infant birth weight, presentation and postion of fetus, previous severe perineal injury, maternal medical illness and place of delivery. We found 93 cases [%0.07] of documented fourth-degree laceration in 131802 deliveries This study identified several factors associated with fourth-degree laceration. Median episiotomy should be avoided. Nulliparity, fetal macrosomia and OP position are significant risk factors that require caution by birth attendants during delivery