Awareness of gestational diabetes mellitus among antenatal women in a primary health center in South India

Background: Gestational diabetes mellitus (GDM) is a perfect window of opportunity for the prevention of DM in two generations, and its incidence is increasing in our country. Awareness of the condition among antenatal women will translate into prevention and early diagnosis of the disease. This study was done to determine the awareness of GDM among all the antenatal women who attend a Primary Health Center (PHC) for antenatal care. Materials and Methods: A pretested questionnaire consisting of details on background characteristics, 12 questions focusing on Type 2 DM and GDM, and a question on the source of knowledge was administered to all women attending the antenatal clinic. Their responses were scored and the women were graded as having good, fair, or poor knowledge about GDM. Results: One hundred and twenty antenatal women participated in the study. Mean age of the women was 23.8 years (SD: 2.94). Overall, 17.5% women had good knowledge, 56.7% had fair knowledge, and 25.8% women had poor knowledge about GDM. The major sources of awareness of GDM were reported to be television/radio, neighbors/friends, and family members. Discussion: Only a small proportion of rural antenatal women had good knowledge about GDM. The awareness that untreated GDM may pose a risk to the unborn child was high among the study women. Health care workers have to play a greater role in bringing about awareness about GDM among antenatal women

National health programs in the field of endocrinology and metabolism - Miles to go

The endocrine and metabolic diseases of childhood obesity, diabetes mellitus, hypertension, iodine deficiency disorders, vitamin D deficiency, and osteoporosis are major public health problems. Different programs including National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke address these problems although some are yet to be addressed. National surveys have shown high prevalence of these disorders and their risk factors. Most of the programs aim at awareness raising, lifestyle modification, (primary prevention) and screening (secondary prevention) for the disease conditions as these are proven to be cost-effective compared to late diagnosis and treatment of various complications. Urgent concerted full scale implementation of these programs with good coordination under the umbrella of National Rural Health Mission is the need of the moment. The referral system needs strengthening as are the secondary and tertiary levels of health care. Due attention is to be given for implementation of these programs in the urban areas, as the prevalence of these conditions is almost equal or even higher among urban poor people where primary and secondary prevention measures are scarcely available and treatment costs are sky-high

Blockchain and Building Information Modeling (BIM): Review and Applications in Post-Disaster Recovery

Blockchain Technology (BCT) is a growing digital technology that in recent years has gained widespread traction in various industries in the public and private sectors. BCT is a decentralized ledger that records every transaction made in the network, known as a ‘block’, the body of which is comprised of encrypted data of the entire transaction history. BCT was introduced as the working mechanism that forms the operational basis of Bitcoin, the first digital cryptocurrency to gain mainstream appeal. The introduction of decentralized data exchange technology in any industry would require strengthened security, enforce accountability, and could potentially accelerate a shift in workflow dynamics from current centralized architectures to a decentralized, cooperative chain of command and affect a cultural and societal change by encouraging trust and transparency. BCT aims at creating a system that would offer a robust self-regulating, self-monitoring, and cyber-resilient data transaction operation, assuring the facilitation and protection of a truly efficient data exchange system. In the state of Florida, climate change and unpredicted weather disasters have put pressure on state and local decision-makers to adapt quick and efficient post-disaster recovery systems. Part of the recovery efforts is the reconstruction of buildings and infrastructure. The introduction of new technologies in the Architecture, Engineering, and Construction (AEC) industry can contribute to addressing recovery and rebuilding after the event of a natural disaster. With parallel technological advancement in geospatial data and Geographic Information System (GIS), as well as worsening climatic conditions, concerns can be suitably addressed by employing an integrated system of both Building Information Modeling (BIM) and BCT. While several potential applications of BIM must provide solutions to disaster-related issues, few have seen practical applications in recent years that indicate the potential benefits of such implementations. The feasibility of BIM-based applications still rests on the reliability of connectivity and cyber-security, indicating a strong use case for using BCT in conjunction with BIM for post-disaster recovery. This research depicts a survey of BCT and its applications in the Architecture, Engineering, and Construction (AEC) industries and examines the potential incorporation within the BIM process to address post-disaster rebuilding problems. Moreover, the study investigates the potential application of BCT in improving the framework for automating the building permitting process using Smart Contract (SC) technologies and Hyperledger Fabric (HLF), as well as discussing future research areas. The study proposes a new conceptualized framework resulting from the integration of BCT and BIM processes to improve the efficiency of building permit processes in post-disaster events

Knowledge of hypoglycemia and its associated factors among type 2 diabetes mellitus patients in a Tertiary Care Hospital in South India

Introduction: Hypoglycemia being the rate limiting complication in the attainment of strict glycemic control in diabetes management, in this study, we intended to study the knowledge of its symptoms, target blood levels during treatment and ways of prevention among type 2 diabetes patients attending Outpatient Department (OPD) of a medical college hospital. Materials and Methods: Every fifth patient attending the OPD during the 4 months between March and June 2013 was interviewed using a questionnaire. Results: The study included 366 type 2 diabetic patients, of which 76.5% were females. The target fasting and postprandial blood glucose levels while on treatment was known to 135 (36.9%) and 126 (34.4%) patients, respectively. The common symptoms of hypoglycemia known to the study subjects were dizziness (81.4%), weakness (73.8%), and drowsiness (72.1%). Overall, 242 (66.1%) diabetic patients had good knowledge on hypoglycemia (knowledge of at least three symptoms of hypoglycemia together with at least one precipitating factor and at least one remedial measure). Higher age, illiteracy, low socioeconomic status were associated with poor knowledge whereas treatment with insulin along with oral hypoglycemic agents was associated with good knowledge on hypoglycemia. Sex and duration of disease were not associated with knowledge on hypoglycemia. Conclusion: Although the knowledge on symptoms of hypoglycemia, precipitating factors, remedial measures are high in this study, the target blood levels, complications were known to just a third of them. There is a knowledge gap on important aspects of hypoglycemia among type 2 diabetic patients

An Experimental and Numerical Study on Decayed Azobé Sheet piles

Given the desire to construct more structures using sustainable building materials, demand for wood and other bio-based building materials has risen dramatically over the decade. While timber itself is a carbon-neutral material and can sometimes even be carbon-negative, reusing wooden structural members made that have been in service for several years can widen the approach to structural design using wood. In the extensive network of rivers and canal systems that the Netherlands has, the banks are often covered with sheet-pile walls and a majority of these are made of timber. Tropical hardwood, especially Azobé (Lophira alata), due to its high biological resistance to decay, is used to make these sheet-piles. However, when exposed to the groundwater table for a long period of time, the wood undergoes decay due to bacteria destroying the cellulose slowly, while the lignin remains constant, and over decades the large cellulose molecules are replaced by water making the walls weaker.In this study, the characteristic mechanical properties of Azobé sheet-piles that have been in service for 57 years have been found, so that they can be assigned with an appropriate strength class and reused. Destructive, quasi-destructive and non-destructive tests have been performed on the sheet-pile boards to understand the correlation between them and to also ascertain to what level tests on timber specimens that do not affect their usability can be reliable. Since the knowledge of how visual grading can be performed on used, decayed structural timber, especially hardwood specimens is limited, a methodology has been developed in line with NEN-EN 14081-1:2019 along with the definition of a visual decay score. The results from the RPD tests are quantified in terms of the resistographic measure value to identify whether, in tropical hardwood, is there any effect in the drilling direction and whether this value can qualitatively or quantitatively describe the actual mechanical strength of the sheet-pile boards. The stress-wave tests and the four-point bending test are used to calculate the strength and stiffness of the boards, which determine the characteristic values, that are also based on their wet density (at which the tests are conducted). The results obtained are also analyzed for occurring patterns in terms of the location of the board in the sheet-pile wall (top or bottom), testing configuration (E-side or W-side-up) and variation in thickness within the boards due to decay.The bending test performed on the boards is modelled numerically in multiple iterations with curved-shell, layered-shell and 3D brick elements also varying the respective material models to find which one of them is best suitable to model bending of timber. The load-sharing mechanism observed when grouping multiple timber specimens has been simulated numerically to predict the characteristic load-sharing factor of the sheet-pile wall system.Civil Engineering | Structural Engineerin

Socio-cultural dimensions of congenital adrenal hyperplasia: An ethnographic study from Chennai, South India

Aim: This study aims to provide a medical anthropological perspective on how congenital adrenal hyperplasia (CAH) is perceived and constructed by parents and doctors in India. It aims to put forth the complexities that are associated with CAH and the various experiences that parents and doctors share as a result, while also exploring the influences that culture and medicine have on each other. Methods: An ethnographic approach was taken to understand CAH in this study, in which families and doctors of children with CAH were interviewed. Fieldwork was done for 2 months in Chennai, Tamil Nadu. Results: A major finding of this study was the faith that parents had on biomedicine in general and doctors in particular. While parents continued to follow the instructions provided by the doctors, they also exercised their agency by questioning the decisions taken by the doctors. The research also revealed that there is constant worry and fear in parents about the future of their children due to the stigma attached to CAH. Conclusion: A constant discourse between medicine and culture can be noticed while analyzing the complexities associated with CAH. The study tries to show that medical decisions that doctors take in matters concerning CAH are culturally driven. Surgical corrections done in order to categorize the child into one of the two sexes is an example for the same. Similarly, various structures of family, marriage, and kinship have been medicalized owing to the strong influence medicine and culture have on each other