Background: The recommended interval between pregnancies is at least 24 months in order to reduce the risk of adverse maternal, perinatal and infant outcomes. Ministry of Health & Family Welfare, Government of India has taken initiative for provision of IUCD in immediate postpartum period. Several training programs and awareness camps are conducted by NHM for health service providers and also for the public.  The aim of the study was to determine proportion of women accepting post placental intrauterine Contraceptive Device insertion, and to describe the factors associated with acceptability and non-acceptance.Methods: The study was conducted at the Government Medical College Thrissur, Kerala, India and study period was 1 year (2014-2015). The study population included women who planned to deliver at Government Medical College, Thrissur during the study period including vaginal and caesarean section.Results: The awareness regarding PPIUCD was only 11.1% whereas for interval IUCD it was 94.9%. The acceptance rate of PPIUCD was very low (10.5%). The most common reason to accept was its long action (68.5%) The most common reason for rejection was that they wanted permanent sterilisation. The other reasons for non-acceptance include unwillingness of husband, fear of complications etc.Conclusions: The acceptance rate was very low even though majority of the study population were well educated. The most common reason for acceptance was long action followed by reversibility.The reasons for refusal like unwillingness of husband, fear of complications etc. can be overcome by proper counselling and public awareness programs.

Background: Substance abuse in various forms has been a social problem in various forms for many centuries. Kerala shows a high prevalence in alcoholism and is ranked top in India. This study is aimed at finding the prevalence and determinants of substance abuse among youth in central part of Kerala in South India.Methods: A community based study was done with 402 college student participants using a self- administered pretested semi structured questionnaire. Data was entered into microsoft excel and analysed using Epiinfo3.5.3.Results: Out of 402 students, 31.8% used or abused any one of the substances (alcohol, smoking, pan chewing) irrespective of time and frequency in lifetime. Age, gender, place of residence, attitude towards ban were significantly associated with substance abuse.Conclusions: The alarming trend of substance abuse among the youth reveals the urgent need to curb the menace. Adolescent counselling sessions might ensure preventing such behaviour from being inculcated in early adolescence.

Context:Chronic kidney disease is an upcoming public health problem characterized by premature mortality and expensive treatment in low resource settings where diabetes is highly prevalent.Aim:To find out the causes and comorbidities and to explore the community support systems for treatments availed.Settings and Design:Community based cross sectional design.Materials and Methods:Interview of known chronic kidney disease patients above 18 years registered under palliative clinics.Statistical Analysis Used:Mean, SD, proportions, and 95% Confidence interval, chi square test at significance level P = 0.05.Results:Majority of patients were males, below 60 years. Mean duration was 5.26 years and mean age at onset was 48.6 years and 62% were in advanced stages of disease. The commonest cause was diabetic nephropathy (44.6%) followed by hypertensive nephropathy (33.3%). The comorbidities included hypertension (61.4%), diabetes (47.3%), cardiovascular disease (30.6%), Chronic obstructive pulmonary disease (10%) malignancies (2.6%), and retinopathy (28%). Considering treatment status 60.6% were on dialysis 13.3% had undergone transplantation, mostly from private institutions with help of public donations and both at significant underutilization by women. Though 44.6% were protected by social security schemes, the median monthly cost of disease management amounted to Rs. 10,500 which was unaffordable for the majority who were below the poverty line.Conclusions:There is an impending need for strengthening management, high-risk screening among diabetic and hypertensive patients and provision for specialist care to delay the onset of end-stage renal disease. The social security support system should be improvised for our setting to facilitate dialysis and transplantation to minimize out of the pocket expenditure.

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Introduction: High blood pressure is both preventable and treatable. Community based studies on the prevalence of hypertension is now necessary to assess the prevalence of hypertension & its risk factors. Epidemiological studies to assess the prevalence of hypertension are essential to plan preventive strategies & promote the health of population. A study of the prevalence of hypertension among adults (>19 years), the association between socio-demographic and behavioral risk factors in hypertension and the treatment seeking behavior in the population in Thrissur district of Kerala was conducted. Methods: In this community based cross sectional study, 740 adults were studied for 1 year. The sampling technique used was Multi Stage Cluster sampling. Using standard questionnaire and interview, information was collected. Blood pressure was measured twice in each subject using a mercury sphygmomanometer adopting standardized techniques and their averages were taken. Results: Maximum prevalence of hypertension was in the age group 50-69 years, showing increasing trend after 40 years onwards. Of the hypertensives 43.9% were males. Among the hypertensive group, 227(79%) had an educational qualification of 12 th standard and below. Statistically significant associations of hypertension were found with educational status and BMI. Conclusion: We conclude that age group and education status were associated with hypertension.