Chythra R Rao

A study on the prevalence of type 2 diabetes in coastal Karnataka

Aim: To estimate the prevalence and study the socio-demographic correlates of type 2 diabetes among adults aged 30 years and above. Setting and Design: A cross-sectional community-based survey, among individuals of either sex, aged 30 years and above was carried out in the field practice area of a medical college. Methods and Materials: The study was carried out on 1,239 respondents, using a two-stage, stratified, random sampling technique. Data was collected by a personal, face-to-face interview followed by blood sugar estimation using a glucometer. Statistical Analysis: Was performed by using the Statistical Package for Social Sciences (SPSS) version 11.5. Results: The overall prevalence of diabetes was 16%. Self-reported diabetes was 11.2%, while 4.8% of previously normal people were found to have high fasting capillary blood glucose levels. Increasing age showed two-fold, four-fold, and six-fold higher odds for 40 – 49, 50 – 59, and ≥ 60 years age group, respectively, as compared to the 30 - 39 year age group (P < 0.001). Nineteen percent of the males had diabetes, (OR = 1.38, 95% CI = 1.01 – 1.88). In the high socioeconomic strata, 32% of the subjects had diabetes (P = 0.018 unadjusted odds ratio 3.29, 95% CI = 1.40 – 7.74). Conclusion: The high prevalence of diabetes in this coastal population needs further evaluation.

Clinical manifestations and trend of dengue cases admitted in a tertiary care hospital, udupi district, karnataka.

Background: India is one of the seven identified countries in the South-East Asia region regularly reporting dengue fever (DF)/dengue hemorrhagic fever (DHF) outbreaks and may soon transform into a major niche for dengue infection in the future with more and more new areas being struck by dengue epidemics Objective: To study the clinical manifestations, trend and outcome of all confirmed dengue cases admitted in a tertiary care hospital. Study Design: Record-based study conducted in a coastal district of Karnataka. Required data from all the laboratory confirmed cases from 2002 to 2008 were collected from Medical Records Department (MRD) and analyzed using SPSS 13.5 version. Results: Study included 466 patients. Majority were males, 301(64.6%) and in the and in the age group of 15-44 years, 267 (57.5%). Maximum number of cases were seen in 2007, 219 (47%) and in the month of September, 89 (19.1%). The most common presentation was fever 462 (99.1%), followed by myalgia 301 (64.6%), vomiting 222 (47.6%), headache 222 (47.6%) and abdominal pain 175 (37.6%). The most common hemorrhagic manifestation was petechiae 84 (67.2%). 391 (83.9%) cases presented with dengue fever, 41 (8.8%) dengue hemorrhagic fever, and 34 (7.3%) with dengue shock syndrome. Out of 66 (14.1%) patients who developed clinical complications, 22 (33.3%) had ARDS and 20 (30.3%) had pleural effusion. Deaths reported were 11(2.4%). Conclusion: Community awareness, early diagnosis and management and vector control measures need to be strengthened, during peri-monsoon period, in order to curb the increasing number of dengue cases.

Risk factors for preterm birth and low birth weight among pregnant Indian women: A hospital-based prospective study

Objectives: The present study was undertaken to study the maternal risk factors for preterm birth (PTB) and low birth weight (LBW) with a special emphasis on assessing the proportions of maternal genitourinary and periodontal infections among Indian women and their association with adverse pregnancy outcomes. Methods: A hospital-based prospective study comprising 790 pregnant women visiting the obstetrics clinic for a routine antenatal check-up was undertaken. Once recruited, all study participants underwent clinical and microbiological investigations for genitourinary infections followed by a dental check-up for the presence of periodontitis. The study participants were followed up until their delivery to record the pregnancy outcomes. Infectious and non-infectious risk factors for PTB and LBW were assessed using univariate and multivariate Cox regression analysis. Independent risk factors for PTB and LBW were reported in terms of adjusted relative risk (ARR) with the 95% confidence interval (CI). Results: Rates of PTB and LBW in the study population were 7.6% and 11.4%, respectively. Previous preterm delivery (ARR, 5.37; 95% CI, 1.5 to 19.1), periodontitis (ARR, 2.39; 95% CI, 1.1 to 4.9), Oligohydramnios (ARR, 5.23; 95% CI, 2.4 to 11.5), presence of Nugent’s intermediate vaginal flora (ARR, 2.75; 95% CI, 1.4 to 5.1), gestational diabetes mellitus (ARR, 2.91; 95% CI, 1.0 to 8.3), and maternal height <1.50 m (ARR, 2.21; 95% CI, 1.1 to 4.1) were risk factors for PTB, while periodontitis (ARR, 3.38; 95% CI, 1.6 to 6.9), gestational hypertension (ARR, 3.70; 95% CI, 1.3 to 10.8), maternal height <1.50 m (ARR, 2.66; 95% CI, 1.3 to 5.1) and genital infection during later stages of pregnancy (ARR, 2.79; 95% CI, 1.2 to 6.1) were independent risk factors for LBW. Conclusions: Our study findings underscore the need to consider screening for potential genitourinary and periodontal infections during routine antenatal care in developing countries.

A cross-sectional analysis of obesity among a rural population in coastal Southern Karnataka, India

BACKGROUND Obesity is a disease condition that is highly prevalent in both developed and developing countries. Obesity accounts for 60% of cases of diabetes, 40% cases of hypertension and 20% of coronary heart disease and stroke. Although obesity is a silent killer in the third world countries, there is less focus on the problem, as the nations are still staggering with problems due to infectious and parasitic diseases. So, the current study was undertaken to highlight the problem. METHOD A cross-sectional community based survey, among individuals of either sex, aged 30 years and above was carried out on 1,239 respondents, using a two-stage stratified, random sampling technique. Data was collected by personal face to face interview using a pre-designed questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) version 11.5. RESULTS The overweight category included 21.4% of the subjects. Obesity as per Body Mass Index (BMI) criteria was seen in 6.6% of the individuals but abdominal and truncal obesity was present among 51.7% and 62.1% respectively. Literacy up to secondary education and graduation were identified by the multivariate analysis to be associated with obesity. CONCLUSION The prevalence of central obesity was found to be high, and hence, lifestyle changes and improved physical activity needs promotion among the general population.

Mass drug administration to eliminate lymphatic filariasis in Southern India

Background Lymphatic filariasis is an important public health problem in India. Inspite of National filarial control programme (NFCP) being in place for lymphatic filariasis (LF) elimination,several important issues need to be addressed. There is uncertainty about the coverage and compliance to treatment in order to achieve elimination. Method A community based cross-sectional study was conducted as per the National Vector Borne Disease Control Programme (NVBDCP) directions. The study included survey of 200 households of Dakshina Kannada District, South India where the Mass drug administration (MDA) program was conducted. The main objective of the study was to assess the coverage and compliance to MDA. Results Out of the total 1050 eligible people, 876 (83%) received the DEC tablets; so, the coverage was 83%. Among those who received the tablets, only 777 (88.7%) received the adequate dose and only 670 (76.8%) people actually consumed the tablets. Hence, compliance rate was only 76.8%. Conclusion The planning and implementation of MDA programme needs to be strengthened by efficient micro planning, inter sectoral co-ordination and motivating the community to participate in the MDA programme

Superionic Phase Transition in KHSO4: A Temperature-Dependent Raman Investigation

Temperature-dependent Raman spectroscopic studies have been carried out on KHSO4 single crystals in the temperature range 298-493 K. A structural phase transition driven by the lattice and molecular disorder is observed at 473 K. The spectral data enable an understanding of the nature of the lattice disorder across the phase transition leading to the superionic phase. The disorder in the HSO4- polymeric hydrogen-bonded chain leading to a higher symmetry in the high temperature phase is clearly captured from our Raman results. The internal S-OH and S−O stretching modes and, to a limited extent, the external modes throw light on the disorder mechanism and the enhancement of conductivity after transition.

Nutritional status assessment of under -five beneficiaries of Integrated Child Development Services program in rural Karnataka

Background The prevalence of underweight children in India is among the highest in the world, and is nearly double that of Sub- Saharan Africa. The effect of malnutrition is high morbidit and mortality among young children. The objective of this study was to determine the nutritional status of children aged between 3-6 years registered in government sponsored maternal and child care Anganwadi centres in India. Method A cross-sectional study was conducted in 35 centres in 11 villages situated in the field practice area of Community Medicine Department of a Medical College situated in Southern India. Results Of the 585 children in the study, 46.5% of the children were aged between 36 to 48 months. Assessment of nutritional status using the ICDS growth chart revealed malnourishment to be present among 189 (32.3%) children, of whom 166 children were grade I malnourished and 23 children were grade II malnourished. Proportionally girls (46.2%) were more malnourished than boys (33.6%). No significant association was found between the nutritional status of children and their duration of stay in an Anganwadi centre (p-value=0.56).Conclusion The findings of this study indicate that malnutrition is still an important problem even among children attending Anganwadis. Further improvements in functioning of Integrated Child Development Services need to be made in order to address the problem of malnutrition

Lower genital tract infections during pregnancy and adverse pregnancy outcomes: a hospital based observational cohort study

Background Maternal lower genital tract during pregnancy is a complex niche of microbes that normally inhabit or cause infections in few instances. Association of various microbial flora and adverse pregnancy outcomes is being increasingly explored. The study was aimed to determine the prevalence of lower genital tract infections (LGTI) among pregnant women and to determine the common etiologies of LGTI and their association with adverse pregnancy outcomes, Pre term birth (PTB) and Low birth weight (LBW).

Study of Clinical Profile and Antibiotic Sensitivity Pattern in Culture-positive Typhoid Fever Cases

Background: Salmonella enteric serotype Typhi has created a significant therapeutic problem as these strains have developed resistance to the commonly used antimicrobials for the treatment of typhoid fever. Objectives: To assess the clinical profile and sensitivity patterns to anti-typhoid drugs. Materials and Methods: A retrospective analysis of 106 culture-positive typhoid cases admitted in a tertiary care hospital during the years 2005-2008. Results: Records of 106 patients were evaluated, 83 (78.3%) males and 23 (21.7%) females. Fever was present in all patients. Headache in 63 (59.4%) patients and generalized body ache in 53 (32.5%) patients were the most common symptoms, while spleenomegaly in 47 (44.3%) patients and hepatomegaly in 42 (39.6%) patients were the common presenting signs. A maximum sensitivity of 96.6% was observed with cephalosporins, whereas a resistance of 29.2% was seen with fluoroquinolones. Conclusion: A high degree of sensitivity was noted to chloramphenicol, ampicillin and sulphonamides, showing a trend of roll-back of sensitivity to conventional antibiotics.

Detection of Anti‑basement membrane zone antibodies in the blister fluid in subepidermal autoimmune bullous diseases

Background: Subepidermal autoimmune bullous diseases (sAIBD) are diverse of conditions with clinicopathological overlap. Circulating autoantibodies in the serum can be demonstrated using indirect immunofluorescence (IIF) microscopy. Artificially split normal human skin is considered as an optimum substrate for the demonstration of anti-basement membrane zone (BMZ) antibodies using IIF in sAIBD; it not only helps to detect the presence of circulating antibodies in the serum but also helps to subclassify these conditions into “roof” and “floor” binding disorders. Aim: In this study, we evaluated the utility of IIF to detect anti-BMZ antibodies in the blister fluid of patients with sAIBD. Materials and Methods: Twenty-two patients with a clinical diagnosis of sAIBD were enrolled in the study. IIF of serum and blister fluid were done simultaneously using salt-split skin as a substrate. Results: Anti-BMZ antibodies could be detected in the blister fluid using IIF in all patients in the study group. Limitation: We could not do enzyme-linked immunosorbent assay of blister fluid. This would have given us the quantitative data of circulating antibodies in the blister fluid. Conclusion: Blister fluid offers an alternate source for the detection of autoantibodies in patients with sAIBD. It may be of particular help in children and in elderly with poor venous access.