Background: Sweepers and sanitary workers are getting exposed to hazardous dust during their work. The health profile of the sanitary workers and utilization of health services are not clearly known. This study aimed to assess the health profile and associated risk factors among street sweepers and sanitary workers.Methods: A community based cross sectional study was conducted among 73 street sweepers and sanitary workers in a zone of Greater Chennai Corporation by multistage sampling method, during November 2016 to December 2016 using a semi structured questionnaire.Results: Among the respondents 67.1% were females, 2/3rd of them belonged to the age group of 30-40 years. Majority of them (82.2%) had reported to have musculoskeletal problems followed by respiratory problems (61.6%), ophthalmic problems (53.4%), skin problems (38.4%), mental health problems (39.7%). Most of the respondents had multiple problems. Musculoskeletal problems were more common among the female workers (p=0.002). Health problems like headache, fatigue, giddiness were more common among the workers who worked for >5 years (p=0.006). The utilization of health services was better among those workers who had formal school education (p=0.042).Conclusions: This study concludes majority of them have musculoskeletal problems followed by respiratory problems and ophthalmic problems. Usage of personal protective equipments and utilization of health services by the sweepers and sanitary workers were poor. Hence steps have to be taken to improve the health status by subjecting them to periodic screening and sensitization programs on usage of PPE.

Background: The proportion of the elderly persons is increasing, most of the people lives in rural areas and depression among the elderly impairs the functioning in daily life. As people age, they experience multiple chronic health problems. Health problems when compounded with depression, worsens the clinical outcome still further. Objectives:To assess the prevalence of depression and its associated factors among the elderly. Materials and methods: This is a part of a larger study, conducted as a community based cross sectional study on nutrition and health status of the elderly.Data was collected on an interview schedule in the local language among 496 the elderly persons (60 years and above) selected by multi stage sampling technique from Kancheepuram District in Tamil Nadu using semi -structured questionnaire. Nutritional assessment done using Mini Nutritional Assessment (MNA) scale, hemoglobin estimation by Cyano-methemoglobin method and depression scaleusing Geriatric Depression Scale -Short Form (15 questions).Results:Nearly half (47.8%) of the elderly were depressed. It was found that depression is high in labourers, poorly educated, females, those living alone, without their spouse, financially dependent and lower socio economic status and with co -morbidities, anemia and malnutrition. Multi variateanalysis revealed a significant association of depressionin the elderlywith lower socio economic status (OR = 1.97), those not living with their spouse (OR= 4.5), who were malnourished or at risk of malnutrition (OR = 5.8) and who had co-morbidities including anemia and Malnutrition (OR = 1.79). Conclusion: There is an urgent need to address depression among the elderly. Mental health services to the elderly should be incorporated in the screening services rendered in primary health care settings for a proper care and support to improve their quality of life.

Background: Gestational diabetes mellitus (GDM) is one of the risk factors associated with type 2 diabetes mellitus. Hence early detection by screening and management of GDM is very essential to reduce the burden of type 2 diabetes. Objectives was to evaluate the strength of association of GDM and type 2 diabetes among women aged 30 to 35 years in Thiruvallur District, to find the association of other risk factors with type 2 diabetes.Methods: A study was conducted among 160 women with 44 cases and 116 controls aged 30-35 years attending NCD clinics in Thiruvallur District between March and September 2016. The cases and controls were matched for age and time period between last delivery and the time of screening as 5 years or more. GDM exposure was ascertained if their venous blood glucose levels during their antenatal and postpartum period exceeded the oral glucose tolerance test criteria recommended by national guidelines.Results: In the study it was found that women with history of GDM are 4.65 times higher at risk of developing type 2 diabetes. There was significant association (p=0.000) between type 2 diabetes and risk factors like family history of diabetes, co-morbidities like hypertension, hypothyroidism.Conclusions: Gestational diabetes is a predictor of type 2 diabetes, as the women are registered in the pregnancy and infant cohort monitoring and evaluation system, it has the potential to identify women at risk of type 2 diabetes and intervene at the earliest.

Background: Diabetes Mellitus is a long term disease which require higher medical expenditure. If inadequately treated or undiagnosed, it leads to multiple chronic complications, which again increase the expenditure multi-fold. Gender has got implications in diabetes care due to sex differences as well as that of social inequities entrenched within gender. This study is done to compare quarterly Out of Pocket expenditure (OOPE) on diabetes care with gender as a covariate. Methods : Quarterly OOPE is defined as any expenditure incurred by households as a payment to health practitioners and suppliers of pharmaceuticals, therapeutic appliances and other goods and services during the last three months due to diabetes. A cross sectional study was done in Thoothukudi Corporation among 180 diabetic patients using a semi structured questionnaire. Results: Among the study participants, 49.2%were males and 50.8% were females. The median quarterly OOPE for males was Rs.2387 with an interquartile range of Rs.2742 and that of females was Rs.1249.42 with an interquartile range of Rs.2836 which was statistically significant(p value -.0.01). The proportion of family monthly income spent on diabetes care was also significantly lower for women(2.6%) compared to men (4.48%). Conclusion: The quarterly OOP expenditure was significantly lower among women compared to men. In a country like India, where larger share of health expenditure is contributed through OOPE, this finding is revealing that gender equity in diabetes care is nowhere near its reach.

Background: Diabetes is a life-long commitment both to the patient and to the provider. Healthcare cost of diabetes is high since it requires close monitoring to prevent dangerous complications that may further increase the healthcare cost. Aim: To assess the out-of-pocket expenditure on diabetes among diabetic patients in urban Tamil Nadu. Methods: A cross-sectional study was conducted among 180 diabetic patients in Thoothukudi Corporation. Study tool used was a semi-structured interview based questionnaire. Multistage sampling was used. Results: The median quarterly OOPE for the study population was ₹ 1710 with an interquartile range of ₹ 2958. Male gender, higher education and socio-economic status, economical dependency, presence of co-morbidities and complications and hospitalization were significantly associated with increased OOPE on diabetes. Conclusion: Effective intervention should be done at all levels to diagnose the disease early so that occurrence of complications is delayed, thus reducing the household financial burden.