Prevalence of psychological morbidity and its correlates among school-going adolescents of urban Puducherry, India.

Background Experiencing poor mental health during adolescence predisposes an individual to psychiatric morbid conditions in adulthood. We estimated the prevalence of psychological morbidity and its associated factors, among school-going adolescents in higher secondary schools of urban Puducherry. Methods We did this cross-sectional study among adolescents studying in classes 11 and 12 from selected schools of urban Puducherry, including one government and three private schools. Study tools used were the General Health Questionnaire-12 and Perceived Stress Scale-10 to assess psychological morbidity and perceived psychological stress in adolescents, respectively. Risk factors in academic, environmental, personal and health-related domains were captured using a structured questionnaire. Study questionnaires were self-administered by the participants in classrooms. Bivariate and multivariate analyses were done to identify risk factors for psychological morbidity. Results Of the 820 adolescents surveyed, the prevalence of psychological morbidity was 25.4% (95% CI 22.4- 28.5). Academic factors such as reporting peer pressure for academic performance and lack of extracurricular activities at school were associated with psychological morbidity. Among health-related factors, adolescents who reported having difficulty in coping with pubertal changes, being worried about their physical appearance, reporting substance abuse and experiencing sleep disturbances had greater chances of having screened with psychological morbidity. Of note, adolescents with psychological stress had 2.5 times higher chances of having psychological morbidity. Conclusions We estimated that 1 in 4 school-going adolescents in urban Puducherry suffered psychological morbidity. Reducing the academic burden and advocating health promotion through a life skills approach may improve mental wellness in Indian adolescents.

Prevalence of Food Insecurity at Household Level and Its Associated Factors in Rural Puducherry: A Cross-Sectional Study.

BACKGROUND: Malnutrition is a consequence of food insecurity. Food insecurity in India became a public health problem due to explosive population growth and widening gap between rich and poor. It also has a detrimental effect on factors related to health and social well-being of the family. OBJECTIVES: The study was conducted to determine the prevalence of food insecurity at household level in rural population and factors associated with it. SUBJECTS AND METHODS: A community-based cross-sectional study was conducted among the households of rural Puducherry. The adult females in the households were interviewed with a pretested semi-structured questionnaire in which, along with sociodemographic factors, food insecurity was assessed using the Household Food Insecurity Access Scale. Univariate and multivariate logistic regression analysis was done to identify the factors associated with food insecurity. RESULTS: Out of 299 households that were assessed for food insecurity, 31.7% (95% confidence interval [CI]: 26.6-37.4) had food insecurity. Out of 95 households with food insecurity, 51 (17%), 37 (13%), and 7 (2%) had severe, moderate, and mild food insecurity, respectively. In univariate analysis, the presence of children in the family, using below poverty line ration card, and socioeconomic status were significantly associated with food insecurity. In multivariate analysis, socioeconomic status was significantly associated with food insecurity (rate ratio: 3.59; P < 0.001 [95% CI: 1.68-7.67]). CONCLUSIONS: One in three families experienced the food insecurity, and it was more among households with children. It has to be addressed to prevent nutrition-related disorders in community, particularly in children.

Awareness and preference in utilizing primary health-care services from rural health center as first point-of-care: A community-based cross-sectional study in South India.

BACKGROUND: First point-of-care (FPC) at the primary health care (PHC) level is an important public health issue at the global level. Patients directly come to tertiary health centers without a referral. AIMS AND OBJECTIVES: Hence, the current study was done to assess the proportion of individuals availing health-care services from rural health center (RHC) as FPC and reasons for not availing it. METHODS: A community-based cross-sectional study was conducted in Puducherry, coastal South India, among 367 households with 1510 individuals. Sociodemographic details, recent FPC during the past 6 months, morbidity profile, and reasons for not seeking were collected from all the individuals. RESULTS: About 44.5% (672/1510) of individuals used any health facilities, of which 70.4% (473/672) used RHC as the FPC. About 33.2% of individuals had a respiratory illness, 22.3% had general signs and symptoms. About 24.6% (32/130) mentioned the reasons for not seeking care as lack of appropriate health facilities. CONCLUSION: More than one-fourth of the study population not utilized services at PHC level. Improving the health facilities may help to increase these services.

Non-Scholastic Qualities and their Association with Social Media usage among Medical Students in Puducherry, India.

BACKGROUND: Non-scholastic qualities, namely personal characteristics, interpersonal activities, and communication skills, are needed for the effective functioning of a medical professional. The study aimed to assess non-scholastic qualities and their association with social media usage among medical students. METHODS: This is a descriptive, cross-sectional study in a tertiary care medical institution in Puducherry, coastal south India. The non-scholastic qualities were assessed by standard questionnaire and categorised as low, moderate and high qualities. Social media usage was assessed by SONTUS (Social Networking Time Use Scale) and the participants were categorised as low, average, high, and extremely high users. Multiple logistic regression analysis was done. RESULTS: Out of 270 medical students, 63% belonged to the moderate non-scholastic quality category. About 36% of the students had high non-scholastic quality. Most of the students were extremely high users of social media (60%). About 48% (47/98) of students with high non-scholastic qualities had extremely high social media usage, while 67% (115/172) of students with low and moderate non-scholastic qualities had extremely high social media usage, and both the associations were statistically significant (P = 0.003). Those with a high level of social media usage had 2.27 times (95% CI: 1.239-4.166) higher non-scholastic qualities compared to extremely high social media usage. CONCLUSIONS: The majority had moderate non-scholastic qualities and extremely high use of social media.

Prevalence of medication adherence and its associated factors among patients with noncommunicable disease in rural Puducherry, South India - A facility-based cross-sectional study.

BACKGROUND: Trends in morbidity and mortality due to noncommunicable diseases (NCDs) are rising because of poor control status. Medication nonadherence is one of the most common and modifiable causes of inadequate control status. OBJECTIVES: To determine the prevalence of drug adherence among patients with NCD in rural Puducherry. METHODS: A facility-based cross-sectional study was done among 260 patients with NCD receiving treatment from rural primary health center in Puducherry during February and March 2018. Information regarding sociodemographic profile and household was collected using pretested semi-structured questionnaire. Morisky Medication Adherence Scale was done to assess the adherence. We calculated adjusted prevalence ratios (aPRs) to identify the factors associated with medication adherence. RESULTS: Among the 260 participants, 42.7% belonged to elderly age group; 66.2% were females; 44% did not have any formal education; 70% were unemployed. The majority were suffering from hypertension (71.2%) followed by diabetes (56.2%). This study found that almost one-third (32.7%) of the study participants were not properly adherent to medications. Elderly [aPR 2.51 95% confidence interval (CI): 1.70-3.70] and female participants (aPR 1.64 95% CI: 1.04-2.58) were found to have more chance being nonadherent to medications after adjusting for possible confounding variables. CONCLUSION: This study reported that almost one-third of the study participants were nonadherent to medications. Elderly age group and female gender were found to be the determinants of nonadherence. Corrective measures need to be started at patient level first by motivating and educating them regarding the importance of drug intake.

A longitudinal study on high risk pregnancy and its outcome among antenatal women attending rural primary health centre in Puducherry, South India.

BACKGROUND: Almost 15% of all pregnant women can develop potentially life-threatening complications. As a result, identification of high-risk pregnancy at earliest stage will be useful in directing appropriate intervention. Hence, the current study was done to determine the prevalence and outcome of high-risk pregnancy among antenatal women in rural Puducherry. MATERIALS AND METHODS: A record-based longitudinal study was done during March 2018 among 569 antenatal women who have attended rural health center of tertiary care institute. High-risk pregnancy was classified based on the guidelines from Pradhan Mantri Surakshit Matritva Abhiyan and outcome assessment based on the obstetric and neonatal outcomes. RESULTS: Among 569 antenatal case record reviewed, 315 (55.3%) were in the age group of 20-25 years and majority (463, 81.4%) belonged to below poverty line families; 410 (74.3%) registered their current pregnancy within the first trimester. The prevalence of high-risk pregnancy among study participants was 18.3% (95% confidence interval: 15.3%-21.7%). Majority (81.9%) had term delivery. Regarding obstetric and neonatal outcomes, majority had spontaneous vaginal delivery (73.9%); about 10.4% gave birth to low-birth weight baby, and only 1.7% had stillbirth. Parity, socioeconomic status, and unfavorable outcomes such as low-birth weight, preterm, and postterm delivery were associated with high-risk pregnancy. CONCLUSION: The current study found that almost one-fifth of the pregnant women in rural area have high-risk pregnancy. Unfavorable obstetric and neonatal outcomes were common among high-risk cases. Hence, early detection of high-risk pregnancy needs to be done at primary health-care level to improve the maternal, obstetric, and neonatal outcomes.

Effectiveness of a community-based intervention on nutrition education of mothers of malnourished children in a rural coastal area of South India.

BACKGROUND: There is a paucity of evidence on improvement in malnutrition status after follow-up intervention among malnourished under-five children. OBJECTIVE: The objective of the study is to assess the effect of community-based follow-up health education intervention on the awareness level of mothers, calorie intake, protein intake, and weight gain of malnourished children. METHODS: This intervention study was conducted from December 2012 to October 2014 in three phases at rural Puducherry, coastal South India. The intervention group (57 mothers of 64 children) and control group (60 mothers of 64 children) included moderate and severely malnourished children aged 13-60 months. Children in the control group were taken from different areas and matched for age (±6 months) and sex. Health education intervention and follow-up supervision for 15 months were given to the mothers. RESULTS: Awareness level in all domains increased significantly in the intervention group. In the intervention group, 81% (52) of malnourished children turned out to normal, whereas in the control group, 64% (41) of them became normal. There was a statistically significant difference between the mean changes in the protein intake among boys (15.34 g to 19.91 g in the intervention group against 13.6 g to 16.24 g in the control group) and girls (15.09 g to 19.57 g in the intervention group against 13.36 g to 16.51 g in the control group) and calorie intake among girls (993.86 kcal to 1116.55 kcal in the intervention group against 992.65 kcal to 1078.75 kcal in the control group) between the two groups. CONCLUSION: There was comparatively marginal increase in protein intake, calories' intake, and weight gain in the intervention group.

Association between Indoor Air Pollution and Cognitive Impairment among Adults in Rural Puducherry, South India.

BACKGROUND: Recent evidences showed that outdoor air pollution had significant influence on cognitive functioning of adults. However, little is known regarding the association of indoor air pollution with cognitive dysfunction. Hence, the current study was done to assess the association between indoor air pollution and cognitive impairment among adults in rural Puducherry. METHODOLOGY: A community-based cross-sectional study was done among 295 adults residing in rural field practice area of tertiary care institute in Puducherry during February and March 2018. Information regarding sociodemographic profile and household was collected using pretested semi-structured questionnaire. Mini-Mental State Examination was done to assess cognitive function. We calculated adjusted prevalence ratios (aPR) to identify the factors associated with cognitive impairment. RESULTS: Among 295 participants, 173 (58.6) were in 30-59 years; 154 (52.2%) were female; and 59 (20.0%) were exposed to indoor air pollution. Prevalence of cognitive impairment in the general population was 11.9% (95% confidence interval [CI]: 8.7-16.1). Prevalence of cognitive impairment among those who were exposed to indoor air pollution was 27.1% (95% CI: 17.4-39.6). Individuals exposed to indoor air pollution (aPR = 2.18, P = 0.003) were found to have two times more chance of having cognitive impairment. CONCLUSION: About one-fourth of the participants were exposed to indoor air pollution, out of which more than one-fourth was found to have cognitive impairment which is twice that of the general population. Hence, prevention of exposure to indoor air pollution needs to be done through increased availability to cleaner fuels for household usage.

How Multipurpose Health Workers Spend Time During Work? Results from a Time-and-motion Study from Puducherry.

BACKGROUND: A multipurpose health worker (MPHW) is the key functionary and the first contact person in a subcenter. This study explores the workload of MPHWs in the multifarious domains of their activities and also assesses their time utilization pattern. METHODS: A time and motion study was conducted among 19 auxiliary nurse midwives (ANMs) and 10 HWs male (M) from six selected primary health centers of Puducherry. Participants self-reported their daily activities on a time measurement sheet for 6 days in a week. Data were entered in EpiData software and analyzed using Excel. Calculations are based on a total of 646 and 340 person-hours of observation by ANMs and HWs (M), respectively. RESULTS: Time utilization pattern revealed that ANMs spent half of their time on maternal and child health activities. HWs (M) utilized 45% of their time for vector control programs and 11% for other programs. Documentation constituted nearly 16% and 10% time spent by ANMs and HWs (M), respectively. Other activities that constituted multipurpose workers' time utilization include traveling (8-10%), patient education (5-10%) and personal activities (6-12% ). The proportion of time spent in community activities was around 54% by HWs (M) and 32% by ANMs. Observations on self-reporting were comparable with that of participant observations. CONCLUSIONS: This study reflects the workload in different domains of MPHWs' activities and the "multipurpose" nature of their work, relevance of their job responsibilities in the context of national programs, and changing profile of their job.

Prevalence of malnutrition and its associated factors among elderly population in rural Puducherry using mini-nutritional assessment questionnaire.

BACKGROUND: Nutritional status of the elderly population has become an important issue but often gets neglected. Both undernutrition and over nutrition are important public health priorities in this vulnerable group. OBJECTIVES: To determine the prevalence of malnutrition and factors associated with it among elderly population in rural Puducherry using mini-nutritional assessment (MNA) questionnaire. MATERIALS AND METHODS: A community-based cross-sectional study was conducted among 279 elderly population between November and December 2016 in four villages of rural Puducherry, India. Information on sociodemographic characteristics and nutritional status of the elderlies were collected using validated MNA questionnaire. Body mass index was used to report obesity based on Asia-Pacific guidelines. RESULTS: Among 279 participants, 178 (63.8%) were in the age group of 60-70 years, 190 (68.1%) were females, and 208 (74.6%) had no formal-education. Prevalence of malnutrition among elderly was found to be 17.9% (95% CI: 13.7-22.7) and about 58.8% (95% CI: 52.9-64.4) were at risk of malnutrition which was assessed using MNA questionnaire. Prevalence of obesity was found to be 32.5% (95% CI: 27.3-38.3) and 38.4% had inadequate fruits and vegetables intake. About 250 (89.6%) are living independently according to ADL score. CONCLUSION: Both undernutrition and over nutrition are important health issues to be considered among elderly population in this area. Primary healthcare strengthening to address and prevent this health issue by balanced dietary practices may improve their nutritional status, thereby enhancing their quality of life.

Awareness of health warnings and factors predicting awareness and perceived effectiveness of pictorial health warnings on tobacco products among adults in rural Puducherry, India.

BACKGROUND: Limited information exists in India about the awareness and perception of the people regarding pictorial health warnings (PHWs) and text warnings on tobacco products, more so from rural areas. Objectives were to report the awareness of these warnings, factors predicting awareness and perceived effectiveness of PHWs, and understanding of their content in a rural population. MATERIALS AND METHODS: A community-based cross-sectional study was conducted in two villages (chosen randomly out of total four) in the rural field practice area of a tertiary care teaching hospital in Puducherry. Households were selected by systematic random sampling. All persons ≥18 years and residing in the area for at least 6 months were included. Data regarding awareness and perception of participants was collected through a semi-structured interview schedule. RESULTS: A total of 428 participants were recruited; 197 (46%) were male, and 231 (54%) were female. The mean age of the participants was 38.9 (standard deviation 15.0) years. Awareness of PHWs and text warnings was 39.5% (169/428) and 21% (90/428), respectively. Only 11.2% participants perceived PHWs as effective. Most (45%) of the participants had a vague understanding of the content of PHWs. On multivariate logistic regression, male gender, current tobacco use, and better education emerged as predictors of greater awareness of PHWs. Extended family predicted greater perceived effectiveness of PHWs, whereas, high socioeconomic class and middle school completion predicted lower perceived effectiveness of PHWs. CONCLUSION: Awareness and perceived effectiveness of adults in rural Puducherry regarding PHWs were low. There is a need to create awareness through education and using meaningful, larger pictures.

Assessment of nonscholastic abilities and its associated factors among medical students: An exploratory study.

BACKGROUND: Nonscholastic abilities among medical students are an important area of concern for the health professionals. Very few studies had been conducted in the past with regard to it. OBJECTIVE: This study was an exploratory study aimed to assess the nonscholastic abilities among medical students in a medical institution in coastal South India. MATERIALS AND METHODS: This study assessed three broad domains of nonscholastic abilities namely personal qualities, interpersonal activities, and communication skills among 106 medical students using a structured questionnaire (27 questions with a total score of 27). The data were analyzed by independent t-test and linear regression model. RESULTS: About 41.5% (44) of the subjects were males and 52.8% (56) of them were belonged to 18-19 years age group. Overall mean score of nonscholastic abilities was found to be 19.40 (standard deviation = 3.27). Percentile distribution of subjects is at score 17 (25th percentile), 20 (50th percentile), and 22 (75th percentile). Mean personal quality domain score was found to be proportionately lesser than other domains of nonscholastic abilities. Nonscholastic ability score was significantly associated with marks obtained in the previous examination (P = 0.006). However, linear regression analysis revealed that the presence of family problems (P = 0.005) and alcohol use (P = 0.026) were associated with low nonscholastic ability score among medical students. CONCLUSION: Nonscholastic abilities are still a required need in medical student's career. Further analytical studies will help in identifying the in-depth evaluation of factors associated with it.

Prevalence of depression and its relation to stress level among medical students in Puducherry, India.

BACKGROUND: Currently, depression among medical students is an important health issue at the global level. There is also a paucity of information on its relation to the stress level. OBJECTIVE: The aim of this study is to assess the prevalence of depression and its relation to stress level and other factors among medical students. MATERIALS AND METHODS: A cross-sectional study was conducted among medical students at a tertiary care medical institution in Puducherry, coastal south India. Beck Depression Inventory Scale was used for screening of depression and Cohen's Perceived Stress scale to assess perceived stress level. Data on associated factors were collected by self-administered questionnaire. RESULTS: The overall prevalence of depression was found to be 48.4% (215/444). According to the cutoff scores, 229 (51.6%) students scored as normal (0-9), 149 (33.6%) as mild (10-18), 60 (13.5%) as moderate (19-29), 3 (0.7%) as severe (30-40), and 3 (0.7%) students scored as very severe (>40) depression. Depression was significantly less among those with mild stress (adjusted odds ratio [OR] = 0.010) and moderate stress level (adjusted OR = 0.099) compared to severe stress level and those without interpersonal problems (adjusted OR = 0.448). CONCLUSION: Depression is more common among medical students. Stress coping mechanisms and improvement of interpersonal relationship may help to reduce depressive symptoms among medical students.

Quality of medication services for morbidities in a rural health center in Puducherry, India.

BACKGROUND: Client satisfaction on quality of medication services perceived by the patients is an important measure of the health services and needs to be addressed to improve the utilization of primary health-care services. METHODS: This is a descriptive study on quality of medication services perceived by the patients attending a rural health center in Puducherry. The data were collected with pretested semi-structured questionnaire. The study population consisted of 365 patients. RESULTS: The mean age of the study population was 44.73 years and 61.6% were females. Majority of the participants (340, 93.2%) had visited the clinic at least six times in the last 6 months. The main presenting conditions included hypertension (22.7%), pregnancy (11.8%), bronchial asthma (9%), diabetes (12%), skin infections (7%), myalgia (7%), and other ailments. Average waiting time to collect drugs was 11 min (ranging from 3 to 30 min). Around half of them were advised to consume medications regularly and on time as per prescriptions (n = 199, 54.5%). Around one-fourth of the participants were advised regarding the timing of medication with respect to food (n = 96, 26.3%). Overall satisfaction was moderate in 73% participants and extremely satisfied in 25%. Around 86% of the participants told that their doubts regarding medication use were clarified by the pharmacist at the counters while 5% felt that it was not addressed. Around two-thirds were highly satisfied with the quality of drugs received (65%) and availability of drugs (64.4%). Around 52% were highly satisfied with the behavior of the pharmacy staff and 55% were moderately satisfied with timing of the pharmacy facility. Around 60% of the participants were moderately satisfied with the discipline in the queue system. CONCLUSIONS: The quality of medication services perceived by the participants is high in comparison with other studies. However, a few areas of dissatisfaction have been noted. There is a need to improve the services at the rural health centers with more satisfaction of patients availing such public health facilities.

Morbidity pattern and its relation to functional limitations among old age rural population in Kerala, India.

BACKGROUND: In the present era of demographic transition, morbidity pattern among geriatric population and its relation to functional limitations is an important health issue in developing countries. OBJECTIVE: The objective of this study was to assess the reported morbidities and its relation to functional limitations among rural geriatric population. MATERIALS AND METHODS: A community-based cross-sectional study was carried out among 167 old age participants aged ≥60 years to assess morbidities and its relation to functional limitations in a rural area of Kerala, India. Sociodemographic details, blood pressure, diabetes, visual impairment, and other reported diagnosed morbidities were assessed by interview using structured pro forma. Functional limitations for activities of daily living were assessed by 10-item Barthel index scale. RESULTS: Overall prevalence of any morbidity was 89.2% (149/167) and moderate or severe functional limitation was 9% (15/167). One morbidity was reported by 34.1% (57), two morbidities 24% (40), three or more 31.1% (52) of the participants. Most common morbidities include hypertension (63, 37.7%), diabetes and visual impairment (61, 36.5% in each), joint pains or backache (51, 30.5%). Age group was significantly associated with joint pain/backache and visual impairment while gender with diabetes, hypertension, and chest diseases. Higher functional limitation is significantly more among those with joint pain or backache (P < 0.05). Among those with moderate and severe functional limitation, majority (12, 80%) had ≥3 morbidities. CONCLUSION: The reported morbidities are high, but moderate or severe functional limitation is more common among those with joint pain or backache and ≥3 morbidities.

Proportion of beneficiaries and factors affecting Janani Suraksha Yojana direct cash transfer scheme in Puducherry, India.

INTRODUCTION: Janani Suraksha Yojana (JSY) direct benefit transfer scheme was launched in the year 2013 in India and there is a paucity of information affecting it. The study aimed to assess the proportion of eligible beneficiaries utilizing JSY direct cash benefit transfer in Puducherry and to identify its barriers and facilitating factors. METHODS: This cross sectional study was conducted from January to March 2015 among 152 eligible JSY beneficiaries residing in rural and urban field practice areas of a tertiary care institution in Puducherry, India. Data were collected using a pretested semi structured questionnaire and presented as proportion or percentages. RESULTS: About 144 beneficiaries participated in the study with a response rate of 94.7%. About 46% (66) of them availed cash transfer benefit. The mean time of receiving the benefit is 95.8 days (interquartile range 60-120 days). Among those who have not received (78), about 49 (62.8%) had not applied and 29 (37.18%) filled applications were rejected due to various reasons. About 77.1% (111) of beneficiaries were informed about JSY scheme through health workers. About 52.1% (75/144) still preferred direct bank transfer through the bank. The reasons for not availing benefits includes not having a bank account (24.3%), followed by not having Aadhaar number (9.7%), 11.8% had no ration card, and 13.8% stayed in their mother house. CONCLUSION: Majority of the beneficiaries did not receive direct cash transfer benefits in urban area than rural area and there is a need to simplify the procedures to improve the uptake of services to this group.

Does audit improve diabetes care in a primary care setting? A management tool to address health system gaps.

INTRODUCTION: Diabetes mellitus is one of the emerging epidemics. Regular clinical and biochemical monitoring of patients, adherence to treatment and counseling are cornerstones for prevention of complications. Clinical audits as a process of improving quality of patient care and outcomes by reviewing care against specific criteria and then reviewing the change can help in optimizing care. OBJECTIVE: We aimed to audit the process of diabetes care using patient records and also to assess the effect of audit on process of care indicators among patients availing diabetes care from a rural health and training center in Puducherry, South India. MATERIALS AND METHODS: A record based study was conducted to audit diabetes care among patients attending noncommunicable disease clinic in a rural health center of South India. Monitoring of blood pressure (BP), blood glucose, lipid profile and renal function test were considered for auditing in accordance with standard guidelines. Clinical audit cycle (CAC), a simple management tool was applied and re-audit was done after 1-year. RESULTS: We reviewed 156 and 180 patients records during year-1 and year-2, respectively. In the audit year-1, out of 156 patients, 78 (50%), 70 (44.9%), 49 (31.4%) and 19 (12.2%) had got their BP, blood glucose, lipid profile and renal function tests done. Monitoring of blood glucose, BP, lipid profile and renal function improved significantly by 35%, 20.7%, 36.4% and 56.1% over 1-year. CONCLUSION: CAC improves process of diabetes care in a primary care setting with existing resources.

Sensorless load torque estimation and passivity based control of buck converter fed DC motor.

Passivity based control of DC motor in sensorless configuration is proposed in this paper. Exact tracking error dynamics passive output feedback control is used for stabilizing the speed of Buck converter fed DC motor under various load torques such as constant type, fan type, propeller type, and unknown load torques. Under load conditions, sensorless online algebraic approach is proposed, and it is compared with sensorless reduced order observer approach. The former produces better response in estimating the load torque. Sensitivity analysis is also performed to select the appropriate control variables. Simulation and experimental results fully confirm the superiority of the proposed approach suggested in this paper.

Prevalence of acute respiratory infection among under-five children in urban and rural areas of puducherry, India.

INTRODUCTION: The incidence of Acute respiratory infections (ARI) is high among under-five children, especially in developing countries. However, the data on ARI from rural and urban areas in India are scarce. OBJECTIVE: To estimate the prevalence of ARI and selected associated factors among under-five children. MATERIALS AND METHODS: A community-based cross-sectional study was conducted in urban and rural areas of Puducherry, India. Data were collected from 509 parents of under-five children regarding ARI incidence along with socio-demographic and selected associated factors. RESULTS: Overall prevalence of ARI was observed to be 59.1%, with prevalence in urban and rural areas being 63.7% and 53.7%, respectively. Bivariate analysis indicated that overcrowding, place of residence, and mother's education were significantly associated with ARI. Multiple logistic regression analysis suggested that presence of overcrowding (adjusted odds ratio [AOR] = 1.492), urban residence (AOR = 2.329), and second birth order (AOR = 0.371) were significant predictors of ARI. CONCLUSION: The prevalence of ARI is high, particularly in urban areas. Improvement of living conditions may help in reduction of burden of ARI in the community.

Malnutrition among under-five children in India and strategies for control.

Malnutrition among under-five children is an important concern for the health authorities in India. The aim of the present review was to assess the burden of under-nutrition and over-nutrition, its determinants and strategies required to tackle malnutrition among under-five children in India. Recent data were collected from Google search, Medline, and others. The information retrieved was reviewed and analyzed for discrepancies. Existing evidence shows that the prevalence of under-nutrition among under-five children was high and varied widely (under-weight: 39-75%, stunting: 15.4-74%, wasting: 10.6-42.3%) depending on the assessment methodology adopted. Studies on assessment of over-nutrition status among under-five children were limited. Distribution of various types of risk factors and its influence on nutrition status of children in a given set up should be analyzed for planning the control measures. Strengthening public health interventions for mild malnutrition cases and vulnerable groups, effective implementation and evaluation of the strategies at regional level, research on overweight, obesity and its etiological factors and steps for improving socioeconomic development are the prerequisites for tackling malnutrition among under-five children in India.