Prevalence of Selected Cardiovascular Risk Factors and Their Associated Factors among People Living with HIV/AIDS in India.

Background: Low- and middle-income countries face the dual problem of infectious and non-infectious diseases. Persons living with HIV/AIDS (PLHIV) are also at risk of cardiovascular diseases. Hence, we did this study to determine the prevalence of cardiovascular risk factors (CVRF) among PLHIV and to find the factors associated with it. Methods: We carried out a cross-sectional analytical study among all adults aged ≥18 years registered at a facility-integrated anti-retroviral therapy center in Puducherry, India, from September 2016 to February 2018. After obtaining informed consent, we interviewed the participants to assess physical activity, alcohol, and tobacco use. We measured weight, height, abdominal circumference, and blood pressure, with biochemical investigations such as blood glucose and lipid profile. Results: Of the total 316 adults PLHIV studied, the most common cardiovascular risk factor found was dyslipidemia (82.7%), followed by inadequate physical activity (74.4%). Other behavioral risk factors studied, such as current tobacco use and current alcohol use, showed a prevalence of 12.8% and 5.4%, respectively, among male participants. The prevalence of hypertension among adult PLHIV studied was 15.8%, and diabetes was 12.3%. In the multivariate analysis, diabetes, and hypertension were significantly associated with age and literacy. Obesity was found to be associated with diabetes and abdominal obesity with dyslipidemia. Conclusion: Dyslipidemia was the most common cardiovascular risk factor, followed by inadequate physical inactivity among PLHIV. Regular screening with blood glucose, blood pressure, and lipid profile, and timely cross-referrals can help in the early detection of CVRF among PLHIV and hence improve their quality of life through appropriate treatment.

Facilitators and Challenges in Patient's Satisfaction with Quality of Cervical Cancer Care in a Tertiary Care Hospital, Puducherry, India: A Qualitative Study.

Shikha YadavBackground Chronic diseases require more attention in terms of patient satisfaction due to their physically and mentally exhausting nature. Cancer burden in India for 2021 was 26.7 million disability-adjusted life years (DALYs), and is projected to rise to 29.8 million by 2025. The second most common cause of cancer DALYs among females was cervix uteri (98.6 per 100,000). Evaluation of factors that influence satisfaction can assist in finding solutions to improve the quality of services provided. Methods This study was conducted in the Regional Cancer Centre, Puducherry. One focused group discussion (FGD) was conducted among seven cervical cancer patients and eight key informant interviews (KII) with their healthcare providers (HCPs). The details collected included perceptions of patient satisfaction, difficulties they faced in achieving patient satisfaction, and possible recommendations for improvement. Thematic analysis was done after preparing transcripts. Results The major facilitating factors reported were proper information exchange, the approachability of staff, and assisting patients with transportation concession certificates. Obstacles highlighted by patients included lack of family support, side effects of treatment, inability to do routine work, and long travel time. HCP reported misalignment between and within departments, overworked staff, lack of equipment for smooth telemedicine services, and inadequate space for OPD, counseling, and waiting as barriers to providing satisfactory services to patients. Conclusions Most challenges were attributed to overworked staff, inequitable distribution of cancer center, and patients' knowledge and understanding of disease. Therefore, it is important to make patients aware of the disease, treatment, and value of the quality of life. It can enable them to make better use of resources, in addition to improvements in the health system.

Association between common mental disorder and glycemic control in women with gestational diabetes: A mixed-method study.

Background: Gestational diabetes mellitus (GDM) is associated with an increased risk of mental health disorders among pregnant women. Poor mental health can negatively impact glycemic control in women with GDM, leading to adverse outcomes for both the mother and the baby. Aim: To determine the prevalence of common mental disorder (CMD) in women with GDM and its association with poor glycemic control. Additionally, to explore the reasons and coping strategies for CMD in women with GDM. Methods: A sequential explanatory mixed-method study was conducted among 351 women with GDM visiting a tertiary care hospital. The prevalence of CMD was assessed using Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Perceived Stress Scale (PSS). Glycemic control was determined based on two-hour postprandial blood glucose levels. In-depth interviews were conducted with six women who screened positive for CMD and had poor glycemic control. Data were analyzed using SPSS v23 and stats v12. Chi-square test and Poisson regression were performed, and adjusted prevalence ratios (aPRs) were reported. Results: The prevalence of CMD was found to be 19.08% (95% CI: 15.32%-23.52%), with 18.2% (95% CI: 14.5%-22.6%) anxiety symptoms 8.3% (95% CI: 5.8%-11.6%) depressive symptoms and stress each. CMD was significantly related to poor glycemic control (aPR: 1.58; 95% CI: 1.23-2.03; P value <0.001). The qualitative analysis revealed individual, family, health, and facility factors influencing mental health and glycemic control. Conclusion: Common mental health disorders are prevalent in women with GDM. It has a negative association with glycemic control. Implementing a routine screening program in the ANC clinic can aid in early identification and prompt management of the CMD and its associated complications.

Correlation between retinal nerve fiber layer thickness and anterior segment parameters in patients with pseudoexfoliation: A cross-sectional comparative study.

PURPOSE: The purpose of this study was to assess the retinal nerve fiber layer (RNFL) thickness in patients with pseudoexfoliation (PXF) and to correlate it with anterior segment parameters such as intraocular pressure (IOP), central corneal thickness (CCT), pigments in angle structures, and grades of PXF. METHODOLOGY: This was a cross-sectional comparative study in a tertiary care center. Patients having unilateral PXF were categorized as group 1. Age- and sex-matched healthy controls were categorized as group 2. All subjects underwent IOP measurement, CCT measurement, and retinal nerve fiber thickness measurement. Subjects in group 1 also underwent gonioscopy and perimetry. Data were entered and analyzed using the IBM-SPSS program (version 20.0); Chicago, IL. RESULTS: Mean RNFL thickness in group 1 was 85.91 ± 22.237 µ and in group 2 was 106.65 ± 6.1 µ. The mean RNFL thickness in patients with PXF syndrome was 103.38 ± 5.815 µ and in patients with PXF glaucoma was 67.82 ± 17.984 µ. The mean CCT in patients with PXF syndrome was 516.41 ± 23.03 µ and in patients with PXF glaucoma was 507 ± 33.05 µ and control group was 526.6 m. The mean IOP in patients with PXF syndrome was 8 ± 6.01 mmHg; in patients with PXF glaucoma was 17.21 ± 7.33 mmHg; and in the control group was 14.12 ± 2.693 mmHg. There was a negative correlation between IOP and RNFL thickness, and a positive correlation between CCT and RNFL thickness, but it was not statistically significant. A statistically significant correlation was found between grades of PXF and RNFL thinning with a correlation coefficient of 0.437 (P = 0.001). CONCLUSION: Patients with PXF have a lower CCT, higher mean IOP, and RNFL thinning compared to normal subjects. The presence of grade 3 PXF (on the lens surface edge) showed a statistically significant correlation with RNFL thinning.

Barriers and facilitating factors of postnatal blood glucose monitoring after structured intervention among mothers with gestational diabetes mellitus receiving care from a tertiary health centre, Puducherry - A qualitative study.

BACKGROUND: In India, women with GDM are at an increased risk of developing type 2 diabetes mellitus (T2DM). Despite this, the rate of postnatal blood glucose monitoring is low, and the reasons are not well known. Hence, our study explored the barriers and facilitating factors associated with T2DM postnatal screening six weeks after delivery. MATERIALS AND METHODS: We conducted a qualitative study among 21 mothers with GDM in obstetrics and gynecology department, women and child hospital (WCH), JIPMER, from December 2021 to January 2022. Mothers with GDM were selected purposively between 8 and 12 weeks after delivery to explore the barriers and facilitating factors associated with postnatal screening six weeks after getting mobile call reminders and health information booklet interventions. In-depth interviews were transcribed; manual content analysis with deductive and inductive coding was done. RESULTS: We identified two themes; three categories and subcategories that illustrated barriers and five categories that illustrated facilitators to postnatal blood glucose monitoring. Lack of awareness and misconceptions about GDM, knowledge practice gap, lack of family support, and perception of health system failure by mothers with GDM were barriers to postnatal blood glucose monitoring. Concerns about health, standard advice on postnatal screening, information in health education booklet, mobile reminders, and family support were found to be facilitators. CONCLUSION: We found several barriers and facilitating factors that showed mobile call reminders and booklet interventions had improved postnatal blood glucose monitoring. Our qualitative study has strengthened the findings of the previous RCT, and it would provide more insights to develop further interventions which we must focus on improving postnatal blood glucose monitoring.

Protocol of Randomized Controlled Trial to Evaluate the Effectiveness of Nurse-Led Intervention on Weight Reduction among Adults with Obesity in Urban Areas of Puducherry.

Background: A large percentage of non-communicable diseases are preventable through the reduction of behavioral risk factors which is due to physical inactivity and unhealthy diet. Reducing the burden of obesity is likely to make a substantial impact on mitigating the mortality and morbidity due to non-communicable diseases. This study aims to evaluate the effectiveness of a nurse-led intervention on weight reduction among urban adults. Methods: This trial is a two-arm parallel group randomized controlled trial comparing the intervention arm-nurse-led intervention (NLI, n = 219) with the control arm-general care (GC, n = 219). Participants randomized to the NLI group will receive the interventional package for 12 months which includes health education and motivational strategies during follow-up. Baseline, 6-month and 12-month follow-ups will be conducted to assess primary and secondary outcomes for both arms using the WHO Steps questionnaire. The analysis will use an intention-to-treat approach to examine the change in behavioral and physical and biochemical parameters. Conclusion: The nurse-led intervention aims to provide an evidence-based acceptable and flexible support strategy for weight reduction in obese adults. This will impart healthy life skills to adults and also improve their health status and enable an adult to take charge of their health and this will ultimately prevent or delay non-communicable diseases. Trial Registration: Clinical Trials Registry India, CTRI/2021/12/038785. Registered prospectively with CTRI on 21/12/2021.

Adherence to medical nutrition therapy and it's challenges among antenatal women with gestational diabetes mellitus in South India- A sequential explanatory mixed-method study.

BACKGROUND: Globally, one in ten pregnant women have diabetes; out of which, 90% contribute to gestational diabetes mellitus (GDM). Medical Nutrition Therapy (MNT) is the cornerstone for GDM treatment yet adherence to MNT among the masses is not adequately monitored as part of the routine antenatal services. The study aimed to estimate the proportion of adherence to MNT and determine the factors related toadherence among antenatal women with GDM. This study also explores the facilitators, barriers, and possible suggestions for improving adherence. MATERIALS AND METHODS: This facility-based sequential explanatory mixed-method study was conducted among 341 antenatal women with GDM at, Puducherry. The study was conducted in 2021. Dietary adherence was evaluated using Perceived Dietary Adherence Questionnaire and based on the scores obtained they were selected for in-depth interviews to explore the facilitators and barriers. Collected data wereanalysed by Chi-square test using STATA version 16. RESULTS: Out of 341 participants, the proportion of participants adherent to MNT was 135 (39.6%) with 95% CI of 34%-44%. Thepredictors for poor adherence were unemployment (PR: 0.65; 95%CI: 0.48-0.88) and good adherence was antenatal women in the 2nd trimester (PR: 1.541; 95%CI: 1.18-2.025). Barrierstonon-adherence were financial crisis, lack of awareness ofthe need for MNT, and joint family pressure. CONCLUSIONS: About two-thirds of antenatal women with GDM are non-adherent to MNT. Unemployment and period of gestation were found to be theirdeterminants. Appropriate action has to be implemented for improving the adherence rate.

Effectiveness of Mobile Call Reminders and Health Information Booklet to Improve Postnatal Blood Glucose Monitoring among Mothers with Gestational Diabetes Mellitus Receiving Care from a Tertiary Health Centre, Puducherry - A Randomized Controlled Trial.

Background: In India, around 10% of mothers with gestational diabetes mellitus (GDM) develop diabetes within months after delivery. But only 29% of them undergo blood glucose testing in the postnatal period. Our study aimed to compare the proportion of mothers with GDM who got postnatal blood glucose checked at 8 weeks among mothers who received health education booklets and mobile reminders. Methods: We conducted a randomised controlled trial among 165 mothers with GDM receiving care from a tertiary health centre between January 2020 and June 2021. Mothers with GDM in the intervention 1 arm received a health education booklet in the third trimester, those in intervention 2 arm received mobile call reminders at the fourth and fifth weeks postpartum, control arm received standard care advised in the hospital; they were followed up at 8 weeks postnatally. We used Chi-square test to compare the effectiveness of intervention and standard care. Relative risk with a 95% confidence interval was calculated to measure the strength of association. A P value <0.05 was considered statistically significant. Results: A total of 161 participants (97.58%) completed the study; Out of 55 mothers with GDM in each arm, 30 (56.60%) in the booklet arm, 23 (42.59%) in the mobile reminder arm, and 13 (24.07%) in the standard care arm had undergone postnatal blood glucose monitoring at 8 weeks. There was a statistically significant difference in the postnatal blood glucose monitoring in the booklet arm (RR: 2.21 [1.35-3.64], P value <0.002) compared to the control arm, but the difference was not significant in the mobile reminder arm (1.65 [0.96-2.86], P value 0.072). Conclusion: Health education booklet and mobile call reminders effectively improved postnatal visit compliance compared to standard care. We can diagnose mothers with GDM progressing to diabetes in the postnatal period by implementing these interventions.

The burden of the probable polycystic ovarian syndrome and its associated factor among college going late adolescents and young adults: a cross sectional analytical study in urban Puducherry, South India.

OBJECTIVES: Polycystic Ovarian Syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. In low income and developing countries like India, there are very high chances of developing PCOS due to marked variation between culture, ethnic groups, diet, lifestyle and genetic factors. This study aims to determine the burden of probable PCOS among college going students in Puducherry. METHODS: A cross sectional study was carried out among students aged 18 years and above in a Government College for Women located in urban Puducherry. A total of 610 students were selected through a cluster random sampling technique. A pretested validated proforma was administered after obtaining informed consent. RESULTS: 25.1% (21.8-28.7) of women were having probable PCOS, 18.7% (15.8-22.0) had irregular menstrual history, 8.4% (6.4-10.8) had Hirsutism and 2% (1.8-3.3) had both the symptoms. Regarding food habits, 43.1% were vegetarians and were having probable PCOS and this association was found to be statistically significant. No significant association was found between prevalence of probable PCOS and factors such as higher age, parental income, higher BMI and physical inactivity. CONCLUSIONS: The present study found a high prevalence of probable PCOS among college going students, especially among study respondents who were obese, physically inactive and vegetarians compared to the counterpart. Earlier detection and proper management of the symptoms can avoid some major co-morbidity in the future. Therefore, screening is an important part in the diagnosis and management of PCOS among adolescent girls.

Economic Burden of Cancer Treatment in a Region in South India: A Cross Sectional Analytical Study.

INTRODUCTION: The rising cost of cancer diagnosis and treatment has imposed a huge financial burden on the affected households. Understanding the nature of this burden will help us to formulate plans to avoid financial distress among the same. OBJECTIVE: The study aims to estimate the Out of Pocket Expenditure (OOPE) for the management of selected solid cancers among the Out-Patient Department (OPD) of Regional Cancer Centre in South India and to determine the proportion of families experiencing Catastrophic Health Expenditure (CHE) due to the same. METHODS: A hospital based cross sectional analytical study was undertaken in the authors' institute in South India. 474 solid cancer patients were interviewed in OPD of Radiation Oncology by a trained data collector. Sociodemographic variables, costs incurred under various headings and expenditure details of participants were obtained. Direct Medical and Direct Non-Medical costs were calculated, and its total was used as the OOPE. Costs were presented as mean with its standard error. Incidence of CHE was calculated using the 40% threshold on the Capacity to pay and was expressed as proportions with 95% confidence interval. Appropriate statistical tests were used to look for statistically significant differences in the study groups. RESULTS: The average OOP expenditure incurred by a cancer patient was INR 35,817 (USD 523.6) for male and INR 20,496 (USD 299.6) for female. Males had a significantly higher OOPE than females. The prevalence of catastrophic health expenditure (CHE) was 61.6% at the 40% CTP threshold. Patients who used insurance schemes had higher prevalence of CHE than those who did not use insurance schemes (65.5% vs 60.7%, p value 0.351). CONCLUSION: Cancer care provided through public institutions had a low direct medical cost, but the indirect cost seemed to be extremely high. Public based financial assistance is the need of the hour to help the cancer affected families.

Perceived Stress and Its Determinants among Postmenopausal Women in Urban Puducherry.

BACKGROUND: Menopause characterized by a gradual decline in ovarian hormones takes its toll on the women both physically and mentally. These health problems can negatively impact the mental status. Hence, the current study was done to determine the level of stress and its associated factors among postmenopausal women in urban Puducherry, India. MATERIALS AND METHODS: A facility-based cross-sectional study was done among 219 postmenopausal women attending the outpatient department in urban primary health center during May 2017-June 2017. Information regarding sociodemographic profile was collected using pretested semi-structured questionnaire and Cohen's Perceived Stress Scale was used to assess the stress level. We calculated adjusted prevalence ratios (aPRs) to identify the determinants of stress. RESULTS: Among 219 participants, 46.6% were in the age group of 60-74 years; 32.9% had primary to secondary level of education; 56.2% were unemployed; 42.5% belonged to lower socioeconomic class; and 32.9% had both diabetes mellitus and hypertension. The prevalence of stress among the postmenopausal women was 26.0% (95% confidence interval: 20.7-32.2). Postmenopausal woman with higher education (aPR - 2.18), belonging to nuclear family (aPR - 1.93), lesser parity (aPR - 1.18), and current alcohol/tobacco users (aPR-2.32) were found to have a significant association with stress among the study participants. CONCLUSION: The current study showed that more than one-fourth of the postmenopausal women had high to very high level of stress. Education, religion, parity, and substance abuse were the significant determinants of stress. However, further longitudinal research needs to be done to determine whether the factors informed in the current study are truly associated with stress and develop interventions accordingly.

Time to reach health-care facility and hospital exit outcome among road traffic accident victims attending a tertiary care hospital, Puducherry.

BACKGROUND: In India, most of the deaths due to road traffic accidents (RTAs) occur within 24 h of the accident. Hence, this study aimed to assess the proportion of RTA victims reaching the health-care facilities within the golden hour. MATERIALS AND METHODS: This cross-sectional study was conducted in a tertiary care center in South India between August and September 2017. All RTA victims who were admitted for treatment in the emergency department during the study period were included. Data were collected using structured, pretested, and validated pro forma. Hospital exit outcomes between those who reached within 1 h and those who did not were expressed as proportion with a 95% confidence interval (CI). The factors associated with hospital exit outcomes were analyzed using a Chi-square test. RESULTS: Among 626 RTA victims, the mean (standard deviation) age was 37.4 (2.6) years, and about 83% (n = 521) were male. More than one-third (37%) of the RTAs occurred on urban roads (n = 235, 37.5%). A total of 424 (67.7%) were referred from other hospitals. The mean time taken for RTA victims to reach any health-care facility was 3 h. More than half (n = 346, 55% [95% CI: 51.3-59.2]) of the RTA victims had reached a health-care facility within the golden hour. Among those who reached beyond the golden hour, one-fourth (n = 77, 27.5%) were delayed due to the unavailability of transporting vehicles. Delay in communication (n = 59, 21.1%), prolonged travel (n = 41, 14.6%), lack of knowledge about nearby facilities (n = 39, 13.9%), nonavailability of attenders (n = 35, 12.5%) and financial issues (n = 29, 10.4%) were the other reasons for the delay. CONCLUSION: Almost half of the RTA victims reached the health-care facilities after the golden hour. Unavailability of ambulances or vehicles for transport and delay in communication were the important factors that played a role in the delay.

Prevalence, Awareness and Control of Hypertension among Sanitary Workers Employed in a Tertiary Care Centre in Puducherry, South India.

BACKGROUND AND AIMS: Sanitary workers have higher tendency to develop hypertension as they spend most of their time in polluted or stressful environments. Hence, the current study was done to determine the prevalence, awareness and control of hypertension among sanitary workers in tertiary care centre in Puducherry. METHODS: A cross sectional study was conducted among the sanitary workers in tertiary care centre from May to December 2019. Socio-demographic, work related and behavioural characteristics was obtained using a pretested semi-structured questionnaire. Individuals was diagnosed as hypertensive if systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg. RESULTS: Prevalence of hypertension among the sanitary workers was 36.6% (95% CI: 31.3-41.3%). Amongst them, only 34 (29.8%) participants were aware of their hypertension status. Prehypertension was present in 114 out of 277 participants (41.1%; 95% CI: 35.3-47.2%) without any history of hypertension. Among the 34 patients with known hypertension, only 12 (35.3%) had controlled BP. Workers in age group of 40 years (aPR = 1.22), unmarried workers (aPR-1.65), obese workers (aPR-1.25), current tobacco users (aPR-1.61) and alcohol users (aPR-1.25) had significantly higher association with hypertension. CONCLUSION: Current study found that more than one-third of the sanitary workers had hypertension. However, almost three fourth of the hypertensives were not aware about their status and only one-third of the known hypertension cases had controlled BP. Hence, it is important to conduct periodic screening and awareness sessions about the possible risk factors for better prevention and control of hypertension.

Patient's Experiences and Satisfaction in Diabetes Care and Out-of-Pocket Expenditure for Follow-Up Care Among Diabetes Patients in Urban Puducherry, South India.

INTRODUCTION: Type 2 diabetes mellitus has huge economic burden for both patient and health-care system. Management of the condition in India faces multiple challenges such as paucity of trained medical and paramedical staff, poor quality, lack of satisfaction with services, and unaffordability of services. OBJECTIVE: To determine the level of satisfaction and the out-of-pocket expenditure for type 2 diabetes patients receiving treatment from public and private sectors in urban Puducherry. METHODS: This was a cross-sectional analytical study conducted in Urban Health Centre area of tertiary care center from August to September 2016. A total of 200 patients suffering from type 2 diabetes mellitus for 1 year or more and resided for at least a year in Puducherry were included in the study. Among the 200 participants, 100 were receiving care from government and 100 from private facility. RESULT AND CONCLUSION: Median cost of diabetes care in government facility was 2000 INR while in private facility was 13050 INR. About 70.1% of the patients were satisfied with the health-care services received. There was no significant difference in the level of satisfaction between government and private health facility. Almost three-fourths of the diabetes patients are satisfied with the care received irrespective of the type of health facility. The cost of diabetes care is more for patients seeking care from private sector than public sector. Availability of insulin and free syringes in the primary health center, provision of specialized footwear, and spectacles free of cost can help in reducing the out-of-pocket expenditure.

Effectiveness of multipurpose health-worker-led exercise therapy on pain reduction among patients with chronic nonspecific low backache in primary health-care setting: A randomized control trial.

OBJECTIVE: The trial aimed to study the effectiveness of multipurpose health-worker-led exercise therapy on women patients of 30-50 years of age with chronic nonspecific low backache (LBA) in a primary health center. MATERIALS AND METHODS: The multipurpose health worker had undergone 2 days training for exercises to relief chronic nonspecific LBA in the Department of Orthopaedic, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry. Patients were allocated to either intervention arm (who received exercise therapy) or control arm (who received pharmacological therapy of analgesics). Patients with less than 3 months of pain, acute onset of pain, localized pain, or straight leg raising test positive were excluded. The pain score on three different positions (motion, sitting, and standing) was assessed on visual analogue scale before starting the exercise therapy or the pharmacological therapy and after 1 month of the exercise therapy or pharmacological therapy. STATISTICAL ANALYSIS: Data were analyzed using SPSS Software. Wilcoxon sign-rank test is used to compare the scores before and after intervention depending upon normality of distribution. Difference in difference analysis is used to compare the scores between the two groups. RESULTS: Multipurpose health-worker-led exercise therapy is found to be equally effective as compared to pharmacological therapy. Significant difference in reduction of pain score was not obtained between control and intervention arm (P value: 0.343, 0.819, and 0.335 in motion, standing, and sitting position). However, significant reduction in pain score in all the three positions was obtained in intervention (P value < 0.001, <0.001, <0.001 in motion, standing, and sitting, respectively). Therefore, it can be suggested that multipurpose health-worker-led exercise therapy may be implemented in a primary health-care setting which will help to reduce the analgesics load on the health center and prevent the adverse effect profile of the drugs on patients.

Assessment of Quality of Life Based on Psychological, Somatovegetative, and Urogenital Health Problems among Postmenopausal Women in Urban Puducherry, South India: A Cross-Sectional Observational Study.

BACKGROUND: An average Indian woman spends almost one-third of her lifespan in the postmenopausal phase enduring the consequences of hormonal decline. This can have a significant impact on quality of life (QOL). Hence, this study was conducted to assess the QOL and health problems among postmenopausal women in urban Puducherry, South India. METHODS: A cross-sectional study was carried out among postmenopausal women attending urban primary health center between April and May 2017. Information about social, economic, and demographic characteristics was collected using a semi-structured questionnaire, and menopause rating scale was used to assess the QOL. RESULTS: Among 204 participants, 55.4% belonged to elderly age group (≥60 years); 61.3% did not have any formal education; 55.9% of the participants were unemployed; 68.7% were widowed, separated, or divorced; 89.7% belonged to Hindu religion; and 42.2% belonged to lower socioeconomic class. Majority (78%) suffered from psychological problems followed by somatovegetative (62%) and urogenital problems (33%). The prevalence of poor QOL was 37.2% (95% confidence interval: 30.8%-44.0%). Participants belonging to Hindu religion (annual percentage rate [aPR]-4.14), in nuclear family (aPR-2.31), and with chronic comorbidity (aPR-5.52) and alcohol/tobacco users (aPR-6.03) had significantly higher risk of poor QOL. CONCLUSION: The current study found that more than one-third of the postmenopausal women in urban Puducherry have poor QOL with majority suffering from psychological problems. Hence, more focus needs to be given to this target population to achieve physical, social, and mental well-being among females.

Household survey on public awareness and attitudes toward dengue infection in rural Tamil Nadu, South India.

BACKGROUND: Dengue is the most common life-threatening arboviral infection contributing to 92 million infections worldwide. India alone contributes for 34% of the global burden. Success of dengue control depends largely on adequate knowledge and good practices of preventive measures. However, there is a need to find the existing awareness among the general population, especially in rural areas. Thus, our present study was done to determine the awareness, attitude, and practice measures regarding dengue fever in rural Tamil Nadu. MATERIALS AND METHODS: A community-based cross-sectional survey was done among 303 individuals belonging to the selected village in rural Tamil Nadu during November 2016. Information regarding sociodemographic details and awareness, attitude, and practice toward dengue were collected using a semi-structured questionnaire. Adequacy of knowledge and attitude was summarized as proportion with 95% confidence interval. RESULTS: Among 303 participants, 204 (67.3%) were above 30 years of age; 196 (64.6%) were females; 255 (84.1%) were ever married; 149 (49.1%) were employed and most of them 93 (30.6%) were educated up to secondary level; 103 (33.9%) belonged to the Class 4 socioeconomic status. About 33.3% (95% confidence interval [CI]: 28.2-38.8) of the study participants had adequate knowledge and 56.1% (95% CI: 50.5-61.6) had positive attitude toward dengue prevention. About 57.7% (95% CI: 52.1-63.2) were practicing preventive measures. CONCLUSION: The current study found that only one-third of the participants had adequate knowledge regarding dengue but more than half of them had positive attitude toward dengue prevention and practicing mosquito control measures. Hence, large-scale information, education, and communication campaigns need to done at frequent intervals for rural population.

Burden of Proteinuria and Risk Factors of Chronic Kidney Disease among Adult Population in Urban Puducherry, India.

INTRODUCTION: In the recent times, Chronic Kidney Diseases (CKDs) are emerging as a serious problem all over the world along with diabetes mellitus and hypertension. The presence of proteinuria is considered as an indicator of increased risk of progressive kidney diseases. AIM: To determine the prevalence of proteinuria among an adult population of a tertiary care institute of Puducherry, India. MATERIALS AND METHODS: A cross-sectional study was carried out in the field practice areas of an urban health centre of a tertiary care institute, in Puducherry, India. A total of 215 study respondents were selected by systematic random sampling. All adults aged above 18 years who were residing for at least a year in Puducherry were included in the study. The study period was from July 2015 to October 2015. All the categorical variables were described as proportions. Chi square test was done to compare between two proportions. Univariate analysis was done to estimate the Odds Ratio (OR) with 95% CI. RESULTS: The mean age of the study participants was 38.5±12.8 years. Majority, 145 (67.4%) of the study participants were females. The prevalence of proteinuria was found to be 9.3%. While 4.7% and 11.2% of participants used tobacco and alcohol respectively, 13.5% and 27.9% had diabetes mellitus and hypertension respectively. Elderly age, diabetes mellitus and hypertension were found to be statistically significant predictors for proteinuria. CONCLUSION: The prevalence of proteinuria was high in our study population (9.3%) and hypertension and diabetes mellitus were also found to be risk factors for CKD. Routine screening among the general population for proteinuria in community-based settings might be an effective step to bring down the rate of progression of CKD.

Effectiveness of Mind Mapping Technique in Information Retrieval Among Medical College Students in Puducherry-A Pilot Study.

BACKGROUND: The traditional teaching learning methods involve a one way process of transmission of knowledge leaving the students lacking behind in creative abilities. Medical schools need to change their teaching strategies to keep the interest of students and empower them for future self- learning and critical thinking. OBJECTIVE: To assess the impact of mind mapping technique in information retrieval among medical college students in Puducherry. METHODS: A pilot study was conducted using experimental study design among sixth semester MBBS students (n = 64) at a medical college in Puducherry, India. One group (n = 32) followed the text reading method and another group (n = 32) followed the mind mapping technique to learn the same passage given to them. The knowledge about the topic was assessed using a pre designed questionnaire at baseline, day 0 and day 7. The knowledge gain is the primary outcome variable and is compared between two groups. The feedback regarding the teaching methods was obtained from the participants. RESULTS: Mean knowledge score in the text group was lesser than the mind map group at baseline (2.6 Vs 3.5; p = 0.08). On Day 0, the mean score in text group was slightly lesser than the mind map group (8.7 Vs 9.0; p = 0.26). On Day 7, the mean score in mind map group is significantly more than the text group (8.9 Vs 8.5; p = 0.03). CONCLUSION: The mind mapping technique is an innovative and effective method in remembering things better than the routine way of reading texts.