Background: Lifestyle changes have fuelled the epidemic of obesity, diabetes, hypertension (HTN), dyslipidemia and cardiovascular diseases. Hypertension is a global public health problem Even though it can be controlled by early diagnosis, lifestyle modifications and adequate treatment; many remain unaware of their hypertension, especially in rural areas where not many studies have been done. The objective of this study was to determine the prevalence and risk factors of hypertension among adults in rural Kerala.Methods: A community-based cross-sectional study was conducted from December 2011 to May 2012 in the rural field practice area of Amala Institute of Medical Sciences, Thrissur. 423 adults, aged 25–64 years, were selected by multi-stage sampling. An interview was conducted using a pretested proforma and anthropometric measurements were recorded using standard guidelines. Diagnosis of hypertension was based on Joint National Committee (JNC) VII guidelines that included both new and previously diagnosed cases (on anti-hypertensive treatment) of hypertension (Systolic BP >140mmHg and/or Diastolic BP >90mmHg).Results:  Among the 155 males and 268 females in this study, the prevalence of HTN was 43.3%, of which 98 (53.6%) were previously diagnosed hypertensives and 85 (46.4%) new HTN cases. In the multivariate analysis, the significant risk factors of HTN were age {Adjusted Odds Ratio (AOR)=2.03, (95% CI=1.48-2.79), p=0.001}, male sex {AOR=3.65, (95% CI=1.55-8.62) p=0.001}, central obesity or waist-hip ratio {AOR=23.78,(95% CI =4.47-126.42), p=0.001}, sedentary lifestyle {AOR=2.96, (95% CI=1.48-5.90), p=0.001}, high salt intake {AOR=37.37,( 95% CI=18.04-77.45), p=0.001} and current smoking {AOR=3.25, (95% CI =1.15-9.24), p= 0.001}.Conclusions: In this study, the prevalence of hypertension was 43.3%. Pre-hypertension was found among 26.5% of the study population. The risk factors associated with HTN were male gender, increasing age, central obesity, sedentary lifestyle, excess salt intake and current smoking.

To assess whether there is sexual dimorphism in the location of mental foramen from base of mandible in South Kerala population.A two-year retrospective study was conducted in 200 subjects [100 males and 100 females] using digital radiographs. The location of mental foramen mandible was assessed from digital orthopantomogram. The vertical distance was measured from the superior border of the mental foramen to the lower border of the mandible and the inferior border of the mental foramen to the lower border of the mandible. The obtained data statistically analyzed using SPSS software version 20. Descriptive statistics was analyzed. Independent t-test was done to determine the association between gender and different parameters. The level of significance set at p ≤ 0.05.The average value of the distance of lower border of mandible from the superior and inferior border of mental foramen is found to be significantly higher in males than females.The study revealed that there is sexual dimorphism in the location of mental foramen in South Kerala population.

INTRODUCTIONProblem-based learning (PBL) is a novel Teachinglearning (TL) method that employs "triggers" to stimulate self-directed learning among students.1 A hands-on approach, it promotes team-work, communication skills, problem-solving skills, and boosts confidence while providing an environment to apply theoretical knowledge to practice. [1][2][3][4][5][6] We introduced PBL as a TL method in 2016, and used the approach to teach semester 7 students how to approach a problem, and devise a reasoned solution to the same. The primary aim was to promote generic skills and attitudes that, although listed as desirable competences by the Medical Council of India (MCI), do not receive due focus in routine training. These skills included teamwork; self-directed learning; literature review; communication skills; planning; budget preparation; interaction with various intramural and extramural functionaries; etc. The PBL program was conducted as follows: Prior to the commencement of the semester 7 posting, faculty identified suitable topics, and developed problem statements. The problems selected were important public ABSTRACT Background: Although a problem based learning (PBL) program in community medicine was introduced over a year ago, student perceptions about the same had not been elicited. This study was conducted to ascertain the perceptions regarding the PBL program from a representative sample of students completing the same. Methods: This cross-sectional study was conducted among 32 semester 7 medical students in a private medical college in south India. Data were collected anonymously after obtaining written informed consent. Students rated their own involvement in the PBL program; confidence across broad PBL areas before and after the program; usefulness of the broad PBL areas; and how likely they were to use the broad PBL areas, using a 10-point rating scale. Statistical analyses were performed using EZR (version 1.36). Descriptive statistics, Mann-Whitney U test, Wilcoxon signed-rank test, Cronbach"s alpha were employed. Results: Of the participants, 20(62.5%) were female. There was a statistically significant difference in perceived confidence across all broad PBL areas following the program, compared to ratings before the program. The median overall rating for the program was 8/10. Greater student involvement was significantly associated with higher ratings for confidence following the program; usefulness in most broad PBL areas. Male gender was significantly associated with high ratings in some broad PBL areas. Conclusions: A PBL approach can improve student perceptions of confidence in generic skills. High student involvement is key to good student perceptions regarding a PBL program.

Background: Wells are a common ground water source readily explored to meet community water requirement. Open wells of Kerala have the problem of bacterial contamination, which causes diarrhea diseases especially in children. Close proximity of well to septic tank, waste pit and cattle shed can be considered as a leading cause of contamination of water. The present study had gone into the details of dependence of dug well, possible source of contamination and protective measures taken for drinking water safely by various households in both urban and rural population.Methods: Cross sectional study design applied in order to address the objectives of the study. Using systematic random sampling techniques 80 households were selected from urban and rural areas. Pretested interview schedule were used as the data collection tool.Results: 100% of households are depending on dug well for all their use like drinking, cooking, cleaning etc. 95% households treat water and among them 93.4% boil water before drinking. 40% of houses followed well protection measures. Significant association was found between urban and rural set-up in the distance of well from septic tank (p value is 0.004<0.01). There is statistically significant association in frequency of chlorination in urban and rural population (p value is 0.015<0.05). Occurrence of diarrhea was found to be nil in past two weeks from the time of data collection among under-fives.Conclusions: Disease like diarrhea can be prevented in under-fives by following well protection measures and boiling water before drinking in both urban and rural areas.

Background: Puberty is the period during which human development progresses, from the first pubertal sign to full sexual maturation. Precocious puberty is a common problem affecting up to 29 per 100 000 girls per year. The objective of this study is to find out the prevalence of precocious puberty among school going girls and to find out relation with various risk factors.Methods: A cross sectional study was conducted by enrolling 250 school going girls by selecting one school each from urban and rural setup. Prevalence of precocious puberty was expressed in percentage and Chi square test was applied to check association. P value for statistical significance was fixed at P<0.05.Results: The prevalence of precocious puberty was found to be 10.4%. In urban it was found to be 12.35% and in rural it was 8.43%. Girls whose fathers have primary education are risky to have precocious puberty (P<0.049). Those students who take fish occasionally, that is once or thrice in a week were more prone to have precocious puberty (P<0.000). Prevalence of Precocious puberty is more in rural area when compared to urban area. Parents, especially fathers who were less educated should take of care of their daughter’s health by not giving them dried and junk foods. It is better to take fish daily, rather than once or thrice in a week, occasional consumption of fish is found to be a reason for precocious puberty.Conclusions: Prevalence of Precocious puberty was 10.4%. Fathers of the girls, who are not well educated and occasional fish consumption of girls was found to be the significant reason for Precocious puberty.