Prevalence of pain among rural adults seeking medical care through medical camps in Tamil Nadu

Background: One of the most common complaints of the patient seeking medical care is pain, and it has been recognized by the World Health Organization as a problem of global importance. Objectives: The aim was to estimate the prevalence of pain among people above the age of 40 years, to identify the common sites of pain complaints and to study the association of body mass index (BMI) with musculoskeletal pains. Materials and Methods: A cross-sectional study was carried out among 1246 participants through our weekly medical camp in 12 villages of Kattankulathur block in Kancheepuram District of Tamil Nadu from August 2013 to October 2013. Individuals over the age of 40 years who had attended our medical camp with complaint of pain (intermittent or continuous) for 1 month or longer were included in the study. Descriptive data were presented as measures of central tendency and dispersion. Chi-square test was used for analyzes of categorical variables. Results: Nearly 51.1% of the respondents reported some form of pain. The prevalent sites of pain include knee pain (18.6%), low back pain (8.9%), generalized body pain (7.8%), multiple joint pain (4.9%) and pain in the legs (2.7%). Prevalence of musculoskeletal pain in men and women were 32.7% and 53.7%, respectively. Respondents with BMI more than 25 are at higher risk of suffering from knee pain, hip pain, low back pain and leg pain and it was found statistically significant for Knee pain and low back pain. Conclusion: An appropriate strategy and guidelines have to be developed to manage the problem of pain among above 40 years age group at primary care level of the rural communities in India

Comparative assessment of methylcobalamin and ascorbic acid on cognitive function in post-menopausal women - A randomized, double-blind trial

Introduction: A decline in cognitive function occurs as women progress through the menopausal transition. Objective: The present study was designed to compare the effect of Methylcobalamin and Ascorbic Acid on Cognitive Function in post-menopausal women. Methods: A randomized, double-blind trial was conducted in postmenopausal women with mild to moderate cognitive dysfunction. Eligible 56 subjects were randomized, the effect of ascorbic acid (500 mg OD) and methylcobalamin (50 mcg OD) was compared after 12 weeks of treatment. MMSE Questionnaire was used to assess the cognitive function, and β-amyloid42 was estimated in serum by enzyme-linked immunosorbent assay (ELISA). Results: In MMSE score, delayed verbal recall (P = 0.027), naming (P = 0.042) and repetition (P = 0.031) scores were significantly improved in ascorbic acid group when compared to baseline. The β-amyloid42 level was decreased significantly in subjects receiving ascorbic acid (P = 0.04) when compared to Methylcobalamin group (P = 0.31). The inverse relationship between β-amyloid42 levels and the MMSE score was found in ascorbic acid treatment (r = 0.6324, P = 0.0004). Conclusion: Based on MMSE and β-amyloid42 results, ascorbic acid showed improvement in cognitive function among post-menopausal women when compared to methylcobalamin supplement

Prevalence of prediabetes and its associated risk factors among rural adults in Tamil Nadu

Background: Considerable number of people in the prediabetic stage will go on to develop type 2 diabetes. Early diagnosis and intervention of prediabetic and their cluster of risk factors can prevent the cardiovascular events and other complications of diabetes. Objectives: To estimate the prevalence of prediabetes and associated factors among adults attending fixed mobile clinic in a rural block in Tamil Nadu. Materials and Methods: A cross-sectional study was carried out among 544 individuals over the age of 20 years through our fixed mobile clinic among 30 villages of a block in Tamil Nadu with a structured interview schedule. Results: A total of 544 participants above the age of 20 years were studied of which 72.6% were women and 27.4% were men. The prevalence of prediabetes was 8.5% and diabetes was 10.1%. Higher risk of being prediabetic and diabetic was noted above the age of 40 years (odds ratio [OR] = 7.79, 2.17), male gender (OR = 1.46, 2.34), body mass index of more than 23 kg/m 2 (OR = 1.52, 2.13), waist hip ratio of men >1 and women >0.8 (OR = 1.49, 2.28), alcohol intake (OR = 1.59, 2.45), and systolic blood pressure of more than 140 mm of Hg (OR = 2.23 and 2.15). Conclusion: Identifying people with prediabetes and creating awareness on the prevention of diabetes by lifestyle modification and development of cost-effective strategy to prevent or delay the progression of the prediabetic stage to diabetic stage is the need of the hour for the prevention of diabetes in country like India

Clinical presentation and prognosis of non valvular mitral regurgitation-A single institution experience

Background: Non valvular, ischemic regurgitation (MR) occurs secondary to myocardial infarction or acute ischemia. The presence of ischaemic MR is associated with increased morbidity and mortality. The severity of ischaemic MR is directly proportional to the severity of the LV dysfunction causing the MR. The present study was carried out to estimate the burden, clinical presentation and prognosis of non valvular MR among patients with coronary artery disease. Methods: This cohort study was carried out among 75 adults aged over 25 years with electrocardiographic evidence of coronary artery disease. Clinical examination and periodic electrocardiography was done for evaluating the ischemic status and echocardiogram was done to assess the status of mitral regurgitation. Ejection fraction was measured by Simpsons method and regional wall motion abnormality was qualitatively evaluated. Results: In this study, 60% of the participants had mild MR while 22.9% had moderate MR. In correlation with STEMI, inferior/posterior wall MI with right ventricular extension showed presence of MR in 100% of the cases. There was a statistically significant difference in the incidence of congestive cardiac failure among the patients with severe MR (66.7%) and mild MR (25%) compared to those without CCF (p < 0.01). Conclusion: Ischemic MR is characteristically dynamic and can change substantially with changes in loading conditions. This study has laid down the basis for evaluating future role of new adjunctive surgical techniques and of percutaneous interventions

Ten Years Risk Prediction of a Major Cardiovascular Event in a Rural Block in Tamil Nadu

Background: India has a high burden of cardiovascular diseases (CVDs). High-risk interventions can be initiated only when individuals at high-risk have been identified. Objectives: The objective was to estimate the prevalence and the sociodemographic pattern of cardiovascular risk factors and to predict the 10 years risk of fatal and nonfatal major cardiovascular events in a rural population in Tamil Nadu. Materials and Methods: A cross-sectional study was conducted among 30 villages of a rural block in Tamil Nadu from March 2012 to February 2013 in the age group of 40-79 years attending our fixed mobile clinics using structured interview schedule and subsequently, the World Health Organization/International Society of Hypertension (WHO/ISH) risk charts were used to predict the 10 years absolute risk of fatal or nonfatal cardiovascular event. Results: A total of 482 individuals were studied of which 68.3% were women and 31.7% were men. Prevalence of overweight, diabetes, and systolic hypertension was found to be 60%, 22.8%, and 34.6%, respectively. A majority (79.9%) of the study population had 10 years cardiovascular risk of <10% while only 2.5% had a risk of more than 40%. As the age advances, the proportion of participants with high-risk also increased and this trend was statistically significant (P = 0.001). Conclusion: Less than 10% of the population had a high-risk of CVD based on WHO/ISH risk score. These charts help identify the high-risk groups in the population in resource-scarce setting and thus an appropriate action can be taken

Epidemic Varicella Zoster Virus among University Students, India

We investigated a yearlong varicella zoster virus outbreak in a highly susceptible young adult population at a large university in India. Outbreaks of varicella infection among adults are not well described in the literature. Infection control measures and vaccination policy for this age group and setting are needed