Determinants of safety helmet use among motorcyclists in Kerala, India

Background: Motorcycles account for a large proportion of road traffic accidents in India and the riders of these vehicles run a high risk of injuries or death. This study aims to explore the determinants of helmet use among motorcyclists in Kerala, India. Methods: A cross-sectional study conducted in Kerala, India, over a period of six months. 309 motorcyclists in Kerala were interviewed for this study using a pretested structured questionnaire. Results: Among 309 motorcyclists, 80% were less than 40 years of age, and only 24% were females. Among the total, only 31.4% used a helmet. There was a statistically significant association between the use of helmet and gender, marital status, drunken driving, use of alcohol and attitude towards implementing legislative measures. Odds Ratios observed were 5.3 for female gender compared to male, 4.5 for those with a positive attitude towards the implementation of legislative measures on helmet use, 3.7 for those who were not drunk while driving and 2.3 for unmarried compared to married persons. Conclusions: The study concludes that the determinants associated with the practice of helmet use were gender, drunken driving, marital status and positive attitude towards legal measures

Prevalence of multidrug resistant uropathogens isolated from different age groups in South-India: a cross-sectional study

Background: Urinary tract infections (UTIs) continue to be one of the most common infections encountered by clinicians. The purpose of this study is to identify relevant multidrug resistance (MDR) patterns in South India.Methods: 401 urine culture samples with significant bacteriuria were collected from labs in South India between January 2019 and December 2020. Routine biochemical tests were conducted for primary identification of uropathogens. Antibiotic susceptibility testing was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical package for the social sciences (SPSS) 16 and Microsoft excel were used to analyse data and determine MDR patterns.Results: The results showed that 54% of cultures with significant bacteriuria exhibited an organism with multidrug resistance. Of these, extended-spectrum beta-lactamases (ESBL) resistance was confirmed in 34.9%. Furthermore, over half (54%) of significant cultures were from outpatients. The incidence of UTIs was highest during the summer and at the lowest in the second phase of the monsoon season.Conclusions: Although the sample collection was limited to a few centres in South India, the results of our study justifies the rationale behind stringent regulation of antibiotic use and careful monitoring of antimicrobial resistance

Evaluation of stress parameters in new medical entrants based on their admission criteria to a south Indian medical college

Objectives: Globally medical education is now recognized as a highly stressful course and students that enter this program are subject to multiple stress producing factors that affect their academic performance as well as their mental and physical well being. This study was done to determine the prevalence of stress among first year medical (MBBS) students based on their admission criteria and to identify the sources of stress among them. Material and method: A Cross sectional study. The study was conducted in a semi-government medical college, Kerala, India. Subjects included first year medical students (both male and female) enrolled in the college during the year of study. Interventions: GHQ-12 Questionnaire was used to assess the psychological stress. A pretested structured closed ended questionnaire to collect information regarding the academic and non-academic sources of stress was charted out. Result: A total of 100 students were admitted to the first year of which 85 consented to take part in this study. Of the 85 students, 42 (49.4%) were having stress. Of these, 35 (83.3%) were repeaters (attempted the medical entrance examination more than once) and among them, 26 (61.9%) were students who secured admission based on merit. A statistically significant association was seen between the number of attempts, admission criteria and stress (p<0.05). The main academic stressors identified were language of communication, peer competition, long working hours, frequent examinations and increased study work load. The main nonacademic stressors identified were parental pressures, decreased recreation period and stay away from home. Conclusions: This study found that stress was more among repeaters and those who secured admission based purely on merit. Nonresident Indian (NRI) students who secured admission through higher financial investments along with sudden displacement from home environment also suffered from significant stress levels. The possible sources of stress found in the study can be a preliminary step towards developing solutions for stress management and stress prevention in new medical entrants which could help in developing a new generation of stress free doctors capable of effectively providing high quality medical care to the community at large

Demographic and clinical characteristics of COVID-19 mortality in Southern India-A single centre observational study

Background: COVID-19 pandemic has spread worldwide with new variants of viruses and reinfections. As we have to live with COVID-19,public health efforts should focus on preventing avoidable mortalities. The mortality with COVID 19 shows marked regional variation; henceregional studies are needed. Objectives: Our study analyses the demographic and clinical characteristics of deceased COVID-19 patients, whichare critical for developing geographic-specific public health interventions to reduce mortality. Materials and methods: We conducted aretrospective observational study from 1 April 2020 to 31 August 2021 in Kerala, India. We analysed 1201 death summaries of laboratoryconfirmedCOVID-19 deaths and included 1076 cases for the study. Results: Mean age of the deceased was 65.7 years (SD: 14 years). Of thetotal deaths, 65.9% were males. The mean duration between the onset of symptoms to admission in our hospital was 4.9 days (SD 3.7 days, IQR5 days). The most frequent presenting symptoms were breathlessness (68.2%) and fever (57.3%). 90.1% in the study group had at least onecomorbidity. Diabetes (53.5%) was the most common comorbidity, followed by hypertension (52.3%). Diabetes was also the most frequentcomorbidity reported in COVID-19 deaths among young (≤40 years), pregnant and vaccinated groups. Conclusion: The elderly, males andpatients with underlying comorbidities, especially diabetes, die disproportionately due to COVID-19. Health intervention strategies likevaccination, promotion of healthy lifestyle to control comorbidities and awareness programmes for COVID appropriate behaviour should beprioritised in these vulnerable populations