INTRODUCTION Globally, diarrhea accounts for 2 million deaths per year. Health is affected by environmental conditions and economic status. The public health importance of some practices like hand washing and food hygiene are important in reduction of diarrhea. Socioeconomic factors may directly or indirectly affect environmental, behavioral and nutritional risk factors. The prevalence of hand washing practice in Kerala was found to be 35%. 1 Low socioeconomic status, scarcity of potable water, behavioural factors such as unhygienic practices, inadequate sanitation, faulty feeding practices, all may cause diarrhoea in children. 2,3 According to WHO 2012 data, diarrhoeal disease alone amounts to an estimated 3.6 % of the total DALY global burden of disease and is responsible for the deaths of 1.5 million people every year. It is estimated that 58% of that burden, or 842 000 deaths per year, is attributable to unsafe water supply, sanitation and hygiene and includes ABSTRACT Background: Diarrhoea remains an important cause of morbidity and mortality among underfive children. Globally it accounts for 2 million deaths per year. Diarrhoea is the third most common cause of death in underfive children, responsible for 13% deaths in India each year. Behaviour can also depend upon the socioeconomic status. Socioeconomic factors affect environmental, behavioral and nutritional risk factors. Proper nutrition, especially exclusive breast feeding is one of the most important interventions for its control .Inadequate personal hygiene along with other environmental factors are responsible for 90% of diarrhea. The objective is to assess behavioral factors of mothers influencing diarrhoea in underfive children. Methods: Community-based cross-sectional study was conducted in a rural area among 103 mothers of underfive children with acute diarrhoea in the past six months. Results: Most mothers were in the higher income 80 (77.6%) group. Those who practised handwashing after toilet and before cooking was 96 (93.2%). Proportion of mothers using boiled water for drinking was 99(96.1%); bottle feeding 77(74.8%); and practised sanitary waste disposal methods 93(90.3%). The practice of using boiled water was statistically significant among higher income group (P =0.047). Occupation of the mother was significantly associated with the habit of child's eatingout (P=0.019). Conclusions: This study shows that the practice of handwashing and use of boiled water for drinking was lower among lower socioeconomic families. This warrants need to create awareness about it among low socioeconomic families in rural areas.

Background: Asymptomatic bacteriuria (ASB) has higher incidence in pregnant than in non-pregnant women and is difficult to diagnose. It is associated with fetomaternal complications like prelabour rupture of membranes, preterm labour, low birth weight and increased perinatal mortality. The aim of this study is to analyse various risk factors and the maternal and fetal outcome following treatment of asymptomatic bacteriuria in early versus late gestation.Methods: This is a prospective study. The study population comprises all pregnant women attending antenatal clinic for their 1st antenatal visit.Results: Total of 800 antenatal women were enrolled in 2 groups based on gestational age <20 weeks (n=394) and between 28 to 32 weeks (n=406) at the time of their 1st antenatal visit. Incidence of asymptomatic bacteriuria was 13.6% and 84.4% were in the age group of 21-30 years. High prevalence was noted in primigravidae (47.7%) and in lower socioeconomic class (70.9%). Commonest organism isolated was E. coli (42.2%) and most of the organisms were sensitive to gentamycin (89.9%) and cefotaxime (84.4%). Despite treatment of asymptomatic bacteriuria, complications like anaemia, gestational hypertension & preterm labour were higher in late detected group than in early detected group.Conclusions: This study shows high prevalence of asymptomatic bacteriuria in pregnant women. The chances of developing maternal complications were significantly reduced after antibiotic therapy of asymptomatic bacteriuria. Hence, early screening and treatment of asymptomatic bacteriuria need to be incorporated in routine antenatal care.

BACKGROUND Skin problems are usually not considered and never attended in diabetics. They are usually neglected and they are only taken note of when they pose problems. Many of these skin problems that go undiagnosed diabetic patients later complicate diabetes and its treatment. The common skin infections that can cause major problems and are associated with increased blood glucose levels and Advanced Glycation Products (AGPs). Skin disorders in diabetics are usually consistent as in the medical literature, but the data is limited with respect to early stage skin disorders in diabetic patients. Awareness is needed for better understanding the importance of skin disorders in diabetes patients for prevention and management. MATERIALS AND METHODS This study was done in the Department of Dermatology, Travancore Medical College, Kollam. The study was done from June 2015 to December 2015. Sixty patients were identified and the study was conducted. INCLUSION CRITERIA The patients were known diabetic for at least five years. EXCLUSION CRITERIA Patients who were treated with immune suppressant drugs were not included in the present study. Skin scrapings were taken and were subjected to KOH preparation. The result that was available was taken for statistical analysis. The statistical analysis was done using the latest SPSS software 2015 (California). RESULTS In the present study, maximum number of fungal infections was seen in male sex, which amounted to forty one cases and was as in the female sex the number was nineteen. Out of the forty one male cases, maximum number of cases belonged to age group of forty to sixty years, which amounted to sixteen cases followed by age group sixty to eighty years, which amounted to fourteen cases followed by twenty to forty years, which amounted to seven cases. Age group zero to twenty years and age group of more than eighty years amounted to two cases each. In cases of females, age group forty to sixty years had maximum number of cases, which amounted to seven in number followed by sixty to eighty years, which amounted to five in number followed by age group of twenty to forty years, which amounted to four cases, followed by more than eighty years, which amounted to two cases. Least number of cases was seen in age group of zero to twenty years, which amounted to one case. Based on the type of fungal infections, total of twenty four patients suffered from tinea pedis infection out of which seventeen were males and seven were females. Eleven patients suffered from onychomycosis, out of which, ten were males and one was female. A total of four patients suffered from Candidal skin infection, out of which three were males and one was female. Four patients suffered from Candida angular cheilitis out of which male and female amounted to two cases each. Six males were noted to have Candidal balanitis and three females suffered from vaginal yeast infections. A total number of eight patients suffered from Candidal intertrigo out of which three cases were males and five cases were female. CONCLUS...

Urinary tract infections are the most common bacterial infection in pregnancy. Urinary tract infections may present as asymptomatic bacteriuria, acute cystitis, pyelonephritis. Untreated urinary tract infections cause serious maternal and neonatal complications, such as preterm labour, premature rupture of membrane, preeclampsia, anemia, low birth weight. Urine culture and sensitivity is the gold standard method of screening. E.coli is the most commom organism causing urinary tract infection. Treatment of urinary tract infection with appropriate antibiotics has been shown to reduce these complications. Therefore, pregnant women should be screened for the presence of bacteriuria early in pregnancy.

Background: India is the diabetes capital of the world. The burden of diabetes mellitus is increasing daily. If people with higher risk for diabetes are identified before the disease has developed, then some interventions could be undertaken to reduce the modifiable risk factors. Objective of the study was to identify the high risk subjects by using Indian diabetes risk score (IDRS) for detecting undiagnosed diabetes among people aged above twenty five years in rural area of Thrissur.Methods: A cross-sectional study was conducted among 262 inhabitants above 25 in Thrissur. Fasting blood sugar within 3 months prior was noted. The risk of diabetes was assessed using Indian Diabetes Risk Score and grouped into low, moderate and high risk.Results: Majority were females (58.4%) and (80.5%) reported either of their parents as diabetic. Waist circumference was higher for majority. Most (62.2%) people had regular exercise. 199 (76%) had moderate risk. 92% were at moderate to high risk of developing diabetes. Higher the risk score higher was the FBS, and was statistically significant (p=0.035). IDRS was statistically significant with the educational status (p=0.023) and sex (0.000). Forty four (16.8%) were diabetic, 60 (22.9%) hypertensive and 12 (4.6%) had coronary artery disease.Conclusions: There is a shift in age of onset to younger age groups. Hence, the early identification of at risk individuals and appropriate intervention help to prevent, or delay, the onset of complications. This definitely suggests the importance of IDRS for identifying undiagnosed high risk diabetes.