Sri Manakula Vinayagar Medical College and Hospital

BACKGROUND: For more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions. METHODS: The GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010-23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution. FINDINGS: Total numbers of global DALYs grew 6·1% (95% UI 4·0-8·1), from 2·64 billion (2·46-2·86) in 2010 to 2·80 billion (2·57-3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0-14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31-1·61) global DALYs in 2010, increasing to 1·80 billion (1·63-2·03) in 2023, alongside a concurrent 4·1% (1·9-6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176-209] DALYs), stroke (157 million [141-172]), and diabetes (90·2 million [75·2-107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0-107·5]), depressive disorders (26·3% [11·6-42·9]), and diabetes (14·9% [7·5-25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837-917) in 2010 to 681 million (642-736) in 2023, and a 25·8% (22·6-28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7-61·0) for diarrhoeal diseases, 42·9% (38·0-48·0) for HIV/AIDS, and 42·2% (23·6-56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6-22·0) and 24·8% (7·4-36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7-19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18-1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation-with high SBP accounting for 8·4% (6·9-10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories-behavioural, metabolic, and environmental and occupational-risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8-37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0-11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023-eg, declining by 54·4% (38·7-65·3) for unsafe sanitation, 50·5% (33·3-63·1) for unsafe water source, and 45·2% (25·6-72·0) for no access to handwashing facility, and by 44·9% (37·3-53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [-2·7 to 15·6]; non-significant). INTERPRETATION: Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors-eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG-including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic-the complex interaction of multiple health risks, social determinants, and systemic challenges-will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity. FUNDING: Gates Foundation and Bloomberg Philanthropies.

BACKGROUND: Timely and comprehensive analyses of causes of death stratified by age, sex, and location are essential for shaping effective health policies aimed at reducing global mortality. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides cause-specific mortality estimates measured in counts, rates, and years of life lost (YLLs). GBD 2023 aimed to enhance our understanding of the relationship between age and cause of death by quantifying the probability of dying before age 70 years (70q0) and the mean age at death by cause and sex. This study enables comparisons of the impact of causes of death over time, offering a deeper understanding of how these causes affect global populations. METHODS: GBD 2023 produced estimates for 292 causes of death disaggregated by age-sex-location-year in 204 countries and territories and 660 subnational locations for each year from 1990 until 2023. We used a modelling tool developed for GBD, the Cause of Death Ensemble model (CODEm), to estimate cause-specific death rates for most causes. We computed YLLs as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. Probability of death was calculated as the chance of dying from a given cause in a specific age period, for a specific population. Mean age at death was calculated by first assigning the midpoint age of each age group for every death, followed by computing the mean of all midpoint ages across all deaths attributed to a given cause. We used GBD death estimates to calculate the observed mean age at death and to model the expected mean age across causes, sexes, years, and locations. The expected mean age reflects the expected mean age at death for individuals within a population, based on global mortality rates and the population's age structure. Comparatively, the observed mean age represents the actual mean age at death, influenced by all factors unique to a location-specific population, including its age structure. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 250-draw distribution for each metric. Findings are reported as counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2023 include a correction for the misclassification of deaths due to COVID-19, updates to the method used to estimate COVID-19, and updates to the CODEm modelling framework. This analysis used 55 761 data sources, including vital registration and verbal autopsy data as well as data from surveys, censuses, surveillance systems, and cancer registries, among others. For GBD 2023, there were 312 new country-years of vital registration cause-of-death data, 3 country-years of surveillance data, 51 country-years of verbal autopsy data, and 144 country-years of other data types that were added to those used in previous GBD rounds. FINDINGS: The initial years of the COVID-19 pandemic caused shifts in long-standing rankings of the leading causes of global deaths: it ranked as the number one age-standardised cause of death at Level 3 of the GBD cause classification hierarchy in 2021. By 2023, COVID-19 dropped to the 20th place among the leading global causes, returning the rankings of the leading two causes to those typical across the time series (ie, ischaemic heart disease and stroke). While ischaemic heart disease and stroke persist as leading causes of death, there has been progress in reducing their age-standardised mortality rates globally. Four other leading causes have also shown large declines in global age-standardised mortality rates across the study period: diarrhoeal diseases, tuberculosis, stomach cancer, and measles. Other causes of death showed disparate patterns between sexes, notably for deaths from conflict and terrorism in some locations. A large reduction in age-standardised rates of YLLs occurred for neonatal disorders. Despite this, neonatal disorders remained the leading cause of global YLLs over the period studied, except in 2021, when COVID-19 was temporarily the leading cause. Compared to 1990, there has been a considerable reduction in total YLLs in many vaccine-preventable diseases, most notably diphtheria, pertussis, tetanus, and measles. In addition, this study quantified the mean age at death for all-cause mortality and cause-specific mortality and found noticeable variation by sex and location. The global all-cause mean age at death increased from 46·8 years (95% UI 46·6-47·0) in 1990 to 63·4 years (63·1-63·7) in 2023. For males, mean age increased from 45·4 years (45·1-45·7) to 61·2 years (60·7-61·6), and for females it increased from 48·5 years (48·1-48·8) to 65·9 years (65·5-66·3), from 1990 to 2023. The highest all-cause mean age at death in 2023 was found in the high-income super-region, where the mean age for females reached 80·9 years (80·9-81·0) and for males 74·8 years (74·8-74·9). By comparison, the lowest all-cause mean age at death occurred in sub-Saharan Africa, where it was 38·0 years (37·5-38·4) for females and 35·6 years (35·2-35·9) for males in 2023. Lastly, our study found that all-cause 70q0 decreased across each GBD super-region and region from 2000 to 2023, although with large variability between them. For females, we found that 70q0 notably increased from drug use disorders and conflict and terrorism. Leading causes that increased 70q0 for males also included drug use disorders, as well as diabetes. In sub-Saharan Africa, there was an increase in 70q0 for many non-communicable diseases (NCDs). Additionally, the mean age at death from NCDs was lower than the expected mean age at death for this super-region. By comparison, there was an increase in 70q0 for drug use disorders in the high-income super-region, which also had an observed mean age at death lower than the expected value. INTERPRETATION: We examined global mortality patterns over the past three decades, highlighting-with enhanced estimation methods-the impacts of major events such as the COVID-19 pandemic, in addition to broader trends such as increasing NCDs in low-income regions that reflect ongoing shifts in the global epidemiological transition. This study also delves into premature mortality patterns, exploring the interplay between age and causes of death and deepening our understanding of where targeted resources could be applied to further reduce preventable sources of mortality. We provide essential insights into global and regional health disparities, identifying locations in need of targeted interventions to address both communicable and non-communicable diseases. There is an ever-present need for strengthened health-care systems that are resilient to future pandemics and the shifting burden of disease, particularly among ageing populations in regions with high mortality rates. Robust estimates of causes of death are increasingly essential to inform health priorities and guide efforts toward achieving global health equity. The need for global collaboration to reduce preventable mortality is more important than ever, as shifting burdens of disease are affecting all nations, albeit at different paces and scales. FUNDING: Gates Foundation.

Essentials of medical physiology , Essentials of medical physiology , کتابخانه الکترونیک و دیجیتال - آذرسا

Big data is the collection and analysis of large set of data which holds many intelligence and raw information based on user data, Sensor data, Medical and Enterprise data. The Hadoop platform is used to Store, Manage, and Distribute Big data across several server nodes. This paper shows the Big data issues and focused more on security issue arises in Hadoop Architecture base layer called Hadoop Distributed File System (HDFS). The HDFS security is enhanced by using three approaches like Kerberos, Algorithm and Name node.

INTRODUCTION: The overall health and well-being of middle-aged women has become a major public health concern around the world. More than 80% of the women experience physical or psychological symptoms in the years when they approach menopause, with various distresses and disturbances in their lives, leading to a decrease in the quality of life. The aim of our study was to assess the quality of life and the impact of hormonal changes in perimenopausal and postmenopausal women and to correlate the prevalence of the symptoms with their duration since menopause. MATERIAL AND METHODS: A cross- sectional study was done at Sri Manakula Vinayagar Medical College and Hospital, Puducherry, from January 2012 to April 2012. Five hundred women who were in the age group of 40-65 years, who came from rural areas to our hospital, were included in the study. The women who were receiving hormonal treatment and those who refused to participate in the study were excluded. The data such as the socio-demographic information and the menstruation status, which were based on the reported length of time since the last menstrual period and the experience of the symptoms, as were tested in the Menopause Specific Quality of Life (MENQOL) questionnaire, were collected from each patient. The women who were included in the study were divided into three groups as the menopause transition, early postmenopausal and the late postmenopausal groups. All the data which were gathered were analyzed by using SAS 9.2. The Chi square test and the relative risk and the confidence interval calculations were applied to compare the frequencies of the symptoms among the women with different menopausal statuses. A p-value of less than 0.05 was considered to be statistically significant. RESULTS: Mean menopausal age in the study group was 45 years. The most common symptom within study subjects were low back ache (79%) and muscle-joint pain (77.2%). The least frequent symptoms were increase in facial hair (15%) and feeling of dryness during intimacy (10.8%). Scores of vasomotor domain were significantly more in menopause transition group. Scores of physical domain were significantly more in late postmenopausal group. CONCLUSION: The menopause related symptoms had a negative effect on the quality of life of the perimenopausal and the postmenopausal women. Such regional studies can help in creating awareness and in educating women on the early identification of the common menopausal symptoms.

Conventional stir casting process has been employed for producing discontinuous particle reinforced metal matrix composites for decades. The major problem of this process is to obtain sufficient wetting of particle by liquid metal and to get a homogenous dispersion of the ceramic particles. In the present study, aluminium metal matrix composites were fabricated by different processing temperatures with different holding time to understand the influence of process parameters on the distribution of particle in the matrix and the resultant mechanical properties. The distribution is examined by microstructure analysis, hardness distribution and density distribution.

The immense growth and penetration of electric vehicles has become a major component of smart transport systems; thereby decreasing the greenhouse gas emissions that pollute the environment. With the increased volumes of electric vehicles (EV) in the past few years, the charging demand of these vehicles has also become an immediate requirement. Due to which, the prediction of the demand of electric vehicle charging is of key importance so that it minimizes the burden on the electric grids and also offers reduced costs of charging. In this research study, an attempt is made to develop a novel deep learning (DL)-based long-short term memory (LSTM) recurrent neural network predictor model to carry out the forecasting of electric vehicle charging demand. The parameters of the new deep long-short term memory (DLSTM) neural predictor model are tuned for its optimal values using the classic arithmetic optimization algorithm (AOA) and the input time series data are decomposed so as to maintain their features using the empirical mode decomposition (EMD). The novel EMD—AOA—DLSTM neural predictor modeled in this study overcomes the vanishing and exploding gradients of basic recurrent neural learning and is tested for its superiority on the EV charging dataset of Georgia Tech, Atlanta, USA. At the time of simulation, the best results of 97.14% prediction accuracy with a mean absolute error of 0.1083 and a root mean square error of 2.0628 × 10−5 are attained. Furthermore, the mean absolute error was evaluated to be 0.1083 and the mean square error pertaining to 4.25516 × 10−10. The results prove the efficacy of the prediction metrics computed with the novel deep learning LSTM neural predictor for the considered dataset in comparison with the previous techniques from existing works.

OBJECTIVE: To explore the various perceived reasons for farmers' suicides in the Vidarbha region of Maharashtra, their common factors, and to suggest solutions. METHODS: The present formative research was undertaken in the 23 villages surrounding the Anji Primary Health Centre, located in the Vidarbha region of Maharashtra, India. A triangulation of free list and pile sort exercises was used. The data was analyzed by Anthropac 4.98.1/X software. This was followed by a semi-structured focus group discussion. To increase the validity of the results, these findings were presented to the participants and later they were circulated to the 26 farmers' clubs in the villages for comment and discussion during their monthly, village-based meetings. RESULTS: Farmers perceived debt, addiction, environmental problems, poor prices for farm produce, stress and family responsibilities, government apathy, poor irrigation, increased cost of cultivation, private money lenders, use of chemical fertilizers and crop failure as the reasons for farmers' suicides. Participants suggested solutions such as self-reliance and capacity building among farmers, a monitoring and support system for vulnerable farmers, support and counseling services, a village-level, transparent system for the disbursement of relief packages. CONCLUSIONS: Farmers' suicides in Vidarbha are caused by the complex interplay of social, political and environmental constraints. Hence, a comprehensive intervention to ensure self-reliance and capacity building among farmers in modern farming techniques , monitoring and support system for vulnerable farmers, a village-level, transparent system for disbursement of relief packages is required to prevent farmer suicides in the near future. Apart from this, there is a need to strengthen the National Mental Health Program at primary health care level to offer support and counseling to vulnerable farmers in rural area.

Turmeric (Curcuma longa L.) is an integral part of Asian culture and cuisine. It has been used in traditional medicine since centuries. A myriad of health benefits have been attributed to it. Curcumin, the most biologically active curcuminoid in turmeric, is being investigated in pre-clinical and clinical trials for its role in disease prevention and cure. It has antioxidant, anti-inflammatory, antineoplastic, anti-proliferative and antimicrobial effects. We review the chemistry of this plant, its cultural relevance in Indian skin care, and its uses in dermatology.

BACKGROUND: Cervical cancer is one of the most common cancers among women worldwide, with highest mortality in India. The incidence and mortality of cervical cancer can be reduced by screening women for precancerous lesion and by administration of human papilloma virus vaccine to adolescent girls. Knowledge of the women about cervical cancer and awareness about its prevention are the key factors that determine their utilization of screening services. METHODS: A cross sectional survey of women attending Gynaecology Out-Patient Department (OPD) in a tertiary care hospital in Puducherry was conducted. Information about their knowledge of cervical cancer, awareness of its prevention and their socio demographic characters were collected. RESULTS: Mean age of the study population was 40.45 ± 12 years. Less than half of the study population (178, 44.5%) knew about cervical cancer. Less than one-fourth of the population knew about screening services for prevention of cervical cancer, and majority (389, 97.2%) were not aware of vaccination as prevention for cervical cancer. CONCLUSION: Our study population shows poor knowledge about cervical cancer and is unaware of the concept of prevention. Hence extensive health education to the public is needed regarding cervical cancer and its prevention.

The molecular geometry, the normal mode frequencies and corresponding vibrational assignments, natural bond orbital analysis and the HOMO-LUMO analysis of 7-Amino-2,4-dimethylquinolinium formate in the ground state were performed by B3LYP levels of theory using the 6-31G(d) basis set. The optimised bond lengths and bond angles are in good agreement with the X-ray data. The vibrational spectra of the title compound which is calculated by DFT method, reproduces vibrational wave numbers and intensities with an accuracy which allows reliable vibrational assignments. The possibility of N-H⋯O hydrogen bonding was identified using NBO analysis. Natural bond orbital analysis confirms the presence of intramolecular charge transfer and the hydrogen bonding interaction.

CONTEXT: Adolescence is the transitional phase of physical and mental development between childhood and adulthood and is characterized by immense hormonal changes.75% of girls experience some problems associated with menstruation. AIM: We tried to find out the prevalence of menstrual abnormalities in school going girls in Pondicherry and their association with dietary and exercise habits. SETTING AND DESIGN: A cross-sectional questionnaire based study was conducted in adolescent girls who attained menarche in four secondary schools of Pondicherry, India. MATERIAL AND METHODS: All students who attained menarche and willing to participate in the study were invited to answer the questionnaire, which dealt with anthropometric data, socioeconomic data, menstrual history, and diet and exercise pattern. STATISTICAL ANALYSIS: Chi-square test and Fisher's exact test was used to compare the dietary and exercise patterns among students having menstrual abnormalities and those who do not have menstrual abnormalities. RESULTS: A total of 853 students participated in the study. Dysmenorrhea and premenstrual symptoms were the most frequent problems encountered. Premenstrual symptoms were significantly more common among girls who were overweight, in girls who were eating junk food regularly, in girls who were eating less food (dieting) in order to lose weight and in those who were not doing regular physical activity. Dysmenorrhea was significantly more common in the girls who were dieting to lose weight. Passage of clots was also significantly high in the girls who were dieting. CONCLUSION: Lifestyle modifications like regular physical activity, decreasing the intake of junk food and promoting healthy eating habits should be emphasised in school health education programs to improve their menstrual health.

BACKGROUND: In India, a new care package consisting of (i) daily regimen with fixed-dose combination drugs, collected once-a-month and self-administered by the patient, (ii) 'one stop service' at antiretroviral treatment (ART) centre for both HIV and tuberculosis (TB) treatment and (iii) technology-enabled adherence support (99DOTS, which required patients to give a missed phone call after consuming drugs) was piloted for treatment of TB among HIV-infected TB patients. Conventional care included intermittent regimen (drugs consumed thrice-weekly) delivered under direct observation of treatment supporter and the patients needing to visit TB and HIV care facilities, separately for treatment. OBJECTIVE: To assess the effect of new care package on TB treatment outcomes among HIV-TB patients registered during January-December 2016, as compared to conventional care and explore the implementation challenges. METHODS: A mixed-methods study was conducted in four districts of Karnataka, India where new care package was piloted in few ART centres while the rest provided conventional care. Quantitative component involved a secondary cohort analysis of routine programme data. Adjusted relative risk(aRR) was calculated using Poisson regression to measure association between new care package and unsuccessful treatment outcome. We conducted in-depth interviews with healthcare providers and patients to understand the challenges. RESULTS: Unsuccessful TB treatment outcomes (death, loss to follow-up and failure) were higher in new care package (n = 871) compared to conventional care (n = 961) (30.5% vs 23.4%; P value<0.001) and aRR was 1.3(95% CI: 1.1-1.7). Key challenges included patients' inability to give missed call, increased work load for ART staff, reduced patient-provider interaction, deficiencies in training and lack of role clarity among providers and reduced involvement of TB program staff. CONCLUSION: With new care package, TB treatment outcomes did not improve as expected and conversely declined compared to conventional care. TB and HIV programs need to address the operational challenges to improve the outcomes.

We present a simple dual band absorber design and investigate it in the terahertz (THz) region. The proposed absorber works in dual operating bands at 5.1 THz and 11.7 THz. By adjusting the graphene chemical potential, the proposed absorber has the controllability of the resonance frequency to have perfect absorption at various frequencies. The graphene surface plasmon resonance results in sharp and narrow resonance absorption peaks. For incident angles up to 8°, the structure possesses near-unity absorption. The proposed sensor absorber's functionality is evaluated using sensing medium with various refractive indices. The proposed sensor is simulated for glucose detection and a maximum sensitivity of 4.72 THz/RIU is observed. It has a maximum figure of merit (FOM) and Quality factor (Q) value of 14 and 32.49, respectively. The proposed optimal absorber can be used to identify malaria virus and cancer cells in blood. Hence, the proposed plasmonic sensor is a serious contender for biomedical uses in the diagnosis of bacterial infections, cancer, malaria, and other diseases.

BACKGROUND: World Health Organization/International Society of Hypertension (WHO/ISH) charts have been employed to predict the risk of cardiovascular outcome in heterogeneous settings. The aim of this research is to assess the prevalence of Cardiovascular Disease (CVD) risk factors and to estimate the cardiovascular risk among adults aged >40 years, utilizing the risk charts alone, and by the addition of other parameters. METHODS: A cross-sectional study was performed in two of the villages availing health services of a medical college. Overall 570 subjects completed the assessment. The desired information was obtained using a pre-tested questionnaire and participants were also subjected to anthropometric measurements and laboratory investigations. The WHO/ISH risk prediction charts for the South-East Asian region was used to assess the cardiovascular risk among the study participants. RESULTS: The study covered 570 adults aged above 40 years. The mean age of the subjects was 54.2 (±11.1) years and 53.3% subjects were women. Seventeen percent of the participants had moderate to high risk for the occurrence of cardiovascular events by using WHO/ISH risk prediction charts. In addition, CVD risk factors like smoking, alcohol, low High-Density Lipoprotein (HDL) cholesterol were found in 32%, 53%, 56.3%, and 61.5% study participants, respectively. CONCLUSION: Categorizing people as low (<10%)/moderate (10%-20%)/high (>20%) risk is one of the crucial steps to mitigate the magnitude of cardiovascular fatal/non-fatal outcome. This cross-sectional study indicates that there is a high burden of CVD risk in the rural Pondicherry as assessed by WHO/ISH risk prediction charts. Use of WHO/ISH charts is easy and inexpensive screening tool in predicting the cardiovascular event.

BACKGROUND: Micro and macro-vascular complications of Type 2 Diabetes mellitus (DM) could be decreased by maintaining a good glycaemic control, which is dependent on adherence to medication and self care. AIM: (1) To assess medication adherence and adherence to self care among type 2 diabetics who were admitted to a tertiary care hospital (2) To identify factors which were associated with medication adherence. MATERIALS AND METHODS: This descriptive study involved 150 in-patients of Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), a teaching hospital in Puducherry, southern India. Subjects who had type 2 DM for more than 1 month were included in the study, irrespective of their diagnoses at admission. They were interviewed within 24 hours of their admissions by using a pre-designed, pre-tested, structured questionnaire. The questionnaire included Morisky Medication Adherence Scale (MMAS) and questions for assessing adherence to self care activities. The factors which were associated with medication adherence were identified by Chi-square test and logistic regression. RESULTS: The mean age of the subjects was 54 years. Only 49.3% (95% CI: 41% to 57%) of the diabetics had high medication adherence (MMAS score = 8). Only 22.7% of the diabetics were involved in physical exercise for at least 30 minutes, for at least 4 days in a week. Only 16.7% of them regularly inspected their feet. Around 67.3% of the subjects reported about consuming a diabetic diet for at least 4 days/week. Poor family support showed a significant association with low medication adherence. CONCLUSION: Only 49.3% of the subjects adhered to anti-diabetic medications. Less than 25% of the diabetics adhered to self care activities such as exercising/walking for 30 minutes on at least 4 days in a week, regularly inspected their feet and provided feet care. Family support played a vital role in medication adherence among the diabetic subjects. Hence, it is important to regularly assess patients for medication adherence and include their families also in counseling sessions.

INTRODUCTION: Harmful use of alcohol was the cause for 5.9% of all deaths and 5.1% of the global burden of disease and injury. India is the third largest market for alcoholic beverages in the world with estimated 62.5 million alcohol user in 2005. The objective of this study was to know the prevalence of alcohol consumption, pattern of drinking, and its effect on people's health and social consequences. METHODS: This cross-sectional study was conducted in 850 households selected from 19 villages of two Primary Health Centers. A total of 30 clusters were selected, and from each cluster, 28 houses were surveyed by random walk method. Information was collected on predesigned and pretested questionnaire forms and analyzed using Epi Info 3.4.3. Chi-square test was used for statistical significance. RESULTS: The overall prevalence of alcohol use among ≥18 years of age was 9.7% and exclusively among males was 17.1%. The highest prevalence (17.1%) was among 46-55 years age groups and the residents of joint families (37.0%). One-third of the users began drinking before 20 years of age and half of them consumed for getting relief from pain/strain/tiredness. About half of the users had strained relations with their family members and neighbors both. The majority had alcohol dependence problems and about one-fifth had chronic health problems, diabetes mellitus, and hypertension. CONCLUSION: The prevalence of alcohol use in Puducherry was low and restricted to males only. The prevalence was high among low uneducated farmers and labors. About one-third of users had alcohol dependence problems and one-fifth had chronic health problems.

Gestational diabetes mellitus (GDM) is on the rise globally. In view of the increasing prevalence of GDM and fetal and neonatal complications associated with it, there is a splurge of research in this field and management of GDM is undergoing a sea change. Trends are changing in prevention, screening, diagnosis, treatment and future follow up. There is emerging evidence regarding use of moderate exercise, probiotics and vitamin D in the prevention of GDM. Regarding treatment, newer insulin analogs like aspart, lispro and detemir are associated with better glycemic control than older insulins. Continuous glucose monitoring systems and continuous subcutaneous insulin systems may play a role in those who require higher doses of insulin for sugar control. Evidence exists that favors metformin as a safer alternative to insulin in view of good glycemic control and better perinatal outcomes. As the risk of developing GDM in subsequent pregnancies and also the risk of overt diabetes in later life is high, regular assessment of these women is required in future. Lifestyle interventions or metformin should be offered to women with a history of GDM who develop pre-diabetes. Further studies are required in the field of prevention of GDM for optimizing obstetric outcome.

Bowen's disease (BD) is an in-situ squamous cell carcinoma of epidermis. The etiology of BD is multifactorial with high incidence among Caucasians. BD is common in photo-exposed areas of skin, but other sites can also be involved. Lesions are usually solitary. The morphology of BD differs based on age of the lesion, site of origin, and the degree of keratinization. BD is considered as the "lull before the storm," which precedes an overt squamous cell carcinoma. Histopathology is the gold standard diagnostic modality to confirm the diagnosis. Immunohistochemistry, dermoscopy, and reflectance confocal microscopy are the adjuvant modalities used in the diagnosis of BD. The treatment depends on various factors like site, size, immune status, patient's age, esthetic outcome, etc. The available therapeutic modalities include topical chemotherapy, surgical modalities, light-based modalities, and destructive therapies. It requires a combined effort of dermatologist, oncosurgeon, and plastic surgeon to plan and execute the management in various presentations of BD.

This work is to construct a model for testing the soil fertility. It also suggests the crop which has to be planted depending upon the value obtained from the sensor. It also provides the regional wise information about the crop in the form of graph. We have farmer chat where the farmers can share and get idea from the expert by registering in this application. It also suggests the fertilizer which has to be added to the soil in order to increase the crop productivity. It helps the farmer to analyze the fertility of their yard and plant the better crop to increase their productivity and profit. It also provides the information about the fertilizer to be added in the soil and also provide the information about the nearby fertilizer shop.