Advancing our Understanding of Heat Wave Criteria and Associated Health Impacts to Improve Heat Wave Alerts in Developing Country Settings.

Health effects of heat waves with high baseline temperatures in areas such as India remain a critical research gap. In these regions, extreme temperatures may affect the underlying population's adaptive capacity; heat wave alerts should be optimized to avoid continuous high alert status and enhance constrained resources, especially under a changing climate. Data from registrars and meteorological departments were collected for four communities in Northwestern India. Propensity Score Matching (PSM) was used to obtain the relative risk of mortality and number of attributable deaths (i.e., absolute risk which incorporates the number of heat wave days) under a variety of heat wave definitions (n = 13) incorporating duration and intensity. Heat waves' timing in season was also assessed for potential effect modification. Relative risk of heat waves (risk of mortality comparing heat wave days to matched non-heat wave days) varied by heat wave definition and ranged from 1.28 [95% Confidence Interval: 1.11-1.46] in Churu (utilizing the 95th percentile of temperature for at least two consecutive days) to 1.03 [95% CI: 0.87-1.23] in Idar and Himmatnagar (utilizing the 95th percentile of temperature for at least four consecutive days). The data trended towards a higher risk for heat waves later in the season. Some heat wave definitions displayed similar attributable mortalities despite differences in the number of identified heat wave days. These findings provide opportunities to assess the "efficiency" (or number of days versus potential attributable health impacts) associated with alternative heat wave definitions. Findings on both effect modification and trade-offs between number of days identified as "heat wave" versus health effects provide tools for policy makers to determine the most important criteria for defining thresholds to trigger heat wave alerts

Spatiotemporal Distribution of Harmful Algal Flora in the Tropical Estuarine Complex of Goa, India

Mandovi and Zuari estuarine complex is monsoon-influenced estuaries located along the central west coast of India. During the past few years, there has been an increase in nutrient loading specially during monsoonal runoff which is responsible for the growth of harmful algal flora. To understand occurrence and distribution of harmful algal blooms species, daily/alternate day samplings were carried out in Mandovi and Zuari estuaries during 2007-2008 and 2008-2009 periods, respectively, comprising of monsoon (June–November) and nonmonsoon (December–May). In Mandovi, total 54 HAB species with 49 in monsoon and 36 during nonmonsoon period were reported. In Zuari, total 46 HAB species with 38 in monsoon and 41 were reported during nonmonsoon period. Bray-Curtis cluster analysis based on log-transformed phytoplankton density detected seven well-defined groups revealing spatiotemporal variability. The density of the dominant harmful algal species was significantly positively correlated with nutrients, but negatively correlated with salinity. The results of the study indicate that monsoon plays an important role in occurrence and distribution of harmful algal species having direct correlation with salinity variations and nutrient loading

Perception and practice of self-medication amongst second year medical students in a tertiary care teaching hospital

Background: Management of medical ailments requires sound knowledge of diseases and drugs. Medical students are more likely to practice self-medication due to easy access to information. Inappropriate and inadequate treatment can lead to morbidity and mortality. Thus, the current study was carried out to understand the perception and practice of self-medication in medical students so that habit of ethical practice can be inculcated in them.Methods: A self-developed and prevalidated questionnaire was distributed amongst 145 students of second MBBS after approval from Institutional ethics Committee. Data was collected; analysed using MS Excel and the results were expressed as counts and percentages.Results: In this study authors noted 136 (93.79%) out of the 145 students practised self-medication. The commonest reason being effectiveness of medications for similar conditions in the past 92 (69.17%). 111 (81.61%) students reported fever as the most common indication. Analgesics/anti-pyretics 117 (86.02%) were the most frequently used drug groups. Majority 87 (63.97%) obtained information from friends and relatives. Adverse effects of self-medication were noted in 20 (14.70%).Conclusions: This study indicates higher prevalence of self-medication in medical students of Goa. Students can be sensitised and made aware about possible adverse effects and drug interactions with self-medication and how simple looking illness may take an ugly turn. Students being future doctors will continue this chain of spread of awareness of self-medication. Easy access to healthcare can also solve these problems

A descriptive study of gender preference and its relation to willingness for sterilization in pregnant women in a tertiary hospital in Goa

Background: There is an association between male gender preference and avoidance of ligation if preferred sex is not born. We therefore undertook this study to systematically analyze this association between the gender preference and willingness for sterilization in Goan women.Methods: A hospital based cross sectional descriptive study was undertaken among 216 women attending antenatal clinic at a tertiary hospital in Goa between August to December 2015. The data was analyzed in SPSS for Windows, version 14.0. The results are described as percentages and assessment of statistically significant difference was done using the Chi-Square test at 95% level of significance (p<0.05).Results: Of the 216 women who participated in the study, 50 (23.1%) had a male preference. Age, education of the women and religion were not found to be having a statistically significant association with the male preference. Occupation, socio-economic status of the women and parity were found to be having a statistically significant association with the male preference. The women with one surviving male child did not mind if the second child was female but those with previous female child desired for male child in most instances. Eighty three percent of women with preference for female child were willing for ligation even if their preference was not met compared to only 50% of those with male preference.Conclusions: The decision on completion of family as evident from willingness for sterilization is influenced by the sex preference and the outcome of pregnancy in terms of the sex of the child

Pulmonary functions in type 2 diabetes mellitus patients: an observational study at a tertiary level hospital in Mumbai, Maharashtra, India

Background: Pulmonary complications of diabetes mellitus (DM) have been poorly characterized. A reduction in lung capacity has been reported previously in diabetics. We undertook a study to check the association between pulmonary function tests in type 2 DM. Also to determine their correlations with body mass index (BMI), glycemic control and other clinically evident complications like peripheral neuropathy.Methods: The study was conducted at tertiary care BYL Nair hospital, Mumbai where diabetic patients without any hypertension, cardiovascular disease, primary respiratory abnormalities and without any microangiopathic complications were enrolled. They were clinically evaluated for pulse, blood pressure, skin changes, BMI and various biochemical investigations. Blood sugar- fasting and post prandial, serum cholesterol, serum triglyceride, urinary proteins, electrocardiograph, X- ray chest were noted. Pulmonary function test was performed by spirometry. Peripheral neuropathy was looked for an association with pulmonary function tests (PFT).Results: Out of 200 patients 68% (136) patients had normal PFT, mild obstruction 10.0% (20), mild restriction 10% (20) moderate obstruction 2% (4), moderate restriction 4% (8) and mixed 6% (12) were noted. FEV1, FVC values were statistically significantly reduced in patients with peripheral neuropathy and FEV1/FVC % significantly decreased with increasing duration of diabetes.Conclusions: The present study shows that there is a statistically significant association between PFTs and type 2 DM in Indian patients. Pathologically it may be attributed to microangiopathic complications.

Observational evidence for remote forcing of the West India coastal current

Circulation in the north Indian Ocean is influenced by both local and remote wind forcing. So far, however, determining the contribution of these two forcing mechanisms at a location has been possible only in numerical experiments. Here we separate remote and local forcing in observations. Using field measurements (current, sea level, and wind) for a month during March-April 2003 off Goa in the near-coast regime of the West India Coastal Current (WICC), we show that the current was driven by local winds only at periods less than ∼10 days, with remote forcing contributing at longer periods. The high-passed (HP; period less than ~10 days) component of the along-shore current was strongly correlated with the HP component of the along-shore wind, the current lagging the wind by half a day. The low-passed (LP) components of the wind and current were not correlated: the former was unidirectional, but the latter reversed during the period of observation. The relationship between the HP wind and current was used to estimate the locally forced LP current, permitting an estimate of the remote current, the LP residual. This separation of locally forced and remotely forced currents showed that remote forcing contributed as much as local forcing to the WICC. The local current behaved like a classical eastern boundary current forced by local winds. The reversal in the remote current was due to winds 700 km farther south along the coast; frictional damping had an impact only at periods less than 10 days, there being no remotely forced HP current

Tobacco use or body mass - do they predict tuberculosis mortality in Mumbai, India? Results from a population-based cohort study

Tobacco use and under-nutrition are major public health concerns and tuberculosis is a major cause of morbidity and mortality in India. Using a cohort of 148,173 persons (recruited 1991–1997 and followed-up 1997–2003) the joint effects of tobacco use and BMI on tuberculosis mortality was studied. Tobacco use in any form and low-BMI had joint effect on tuberculosis mortality and the interaction effect was synergistic in men and antagonistic in women. Self-reported tuberculosis was associated with increased risk of tuberculosis mortality. In contrast, no such association was observed for self-reported diabetes persons. The risk pattern remained unchanged even after excluding tuberculosis deaths occurred within 1st two years of follow-up. This study highlights importance of age consideration of individual while excluding early deaths. Around 27% male tuberculosis deaths were attributable to their being underweight and smoker, while 22% male and 37% female deaths were attributable to their being underweight and smokeless tobacco user.Public Library of Science open acces

First record of patchy coral reef off Terekhol, North Goa, India

This study reports the first time record of the patchy coral reef (~ 2 km2) of Terekhol in North Goa, the western coast of India during January – February 2020. There were more than 07 genera/species of hard corals in the reef and is dominated by a reef building Turbinaria mesenterina (Dendrophylliidae), which is considered as a sediment tolerant coral species. A total of 25 fish species were counted and the major species recorded were Chromis viridis, Chromis sp., Dascyllus sp., Abudefduf saxatilis, Abudefduf bengalensis, Acanthurus blochii, Acanthurus nigroris, Acanthurus sp., and Odonus niger that contributed 80 % of the total fish community. The documentation and record of the reef area could give identity to the ecosystem in the spatial platform and the conservation efforts can be planned for the reef by limiting the anthropogenic activities in and around the ecosystem

Illiteracy, low educational status, and cardiovascular mortality in India

Background: Influence of education, a marker of SES, on cardiovascular disease (CVD) mortality has not been evaluated in low-income countries. To determine influence of education on CVD mortality a cohort study was performed in India. Methods: 148,173 individuals aged ≥ 35 years were recruited in Mumbai during 1991-1997 and followed to ascertain vital status during 1997-2003. Subjects were divided according to educational status into one of the five groups: illiterate, primary school ( ≦ 5 years of formal education), middle school (6-8 years), secondary school (9-10 years) and college (&gt; 10 years). Multivariate analyses using Cox proportional hazard model was performed an

Antimicrobial activity of leaf and root methanolic extracts from Vinca pusilla Murr.

Vinca pusilla Murr. is a traditional medicinal plant used to treat several diseases. To substantiate the traditional medicinal utility of the plant, the present study aims at screening the antimicrobial activity of methanolic extracts of leaves and roots against five Gram positive, five Gram negative bacterial and four fungal strains. The minimum inhibitory concentration (MIC) were determined by two fold dilution assay. The results indicated that, leaf and root extracts were more effective on Bacillus subtilis and Staphylococcus aureus strains (MIC &lt; 1 mg/mL). The tested organisms were sensitive to root extract compared to leaf extract. Fungal strains were resistant than the bacterial strains to both the extracts. Thus the present study illustrates the antimicrobial potential of the plant.