Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the world. The determinants of CVD in an urban population using conventional and geographic information system techniques were attempted as a community-based census-type cross-sectional study in Kerala, India, among 1649 individuals residing in 452 households. Sociodemographic details, risk factor exposures, and self-reported disease prevalence were determined. Location of houses, wells from which subjects drew drinking water, and distances of the house from the outer road (proxy for air pollution) were mapped using differential global positioning system and pH of water samples determined. Prevalence of CVD was 5.8%. Significant predictors of CVD were male gender, diabetes mellitus, hypertension, and hypothyroidism. Statistically significant spatial association was found between CVD and groundwater pH. Geographic information system technology is useful in identification of spatial clustering and disease hotspots for designing preventive strategies targeting CVD.

Background: Chronic obstructive pulmonary disease (COPD) is the second leading cause of death in India. The objective of this study was to map COPD cases and its risk factors and to determine the association between them using geographic information system (GIS) in a semi-urban area of Trivandrum, South India. Materials and Methods: This community-based cross-sectional, descriptive study (n = 494) was conducted in a subcenter area of a primary health center. Location was mapped and COPD population screener questionnaire was administered to all the study subjects enrolled by census method. Lifetime firewood exposure (person-hours) and tobacco smoking were enquired and distance from road was mapped using portable differential global positioning system. The association with COPD was assessed by kriging and hotspot analysis using ArcGIS software. Results: The prevalence of COPD (6.5%) was comparable to national prevalence estimates. Spatial maps showed COPD case clustering in areas with higher firewood exposure, greater smoking exposure, and in households with closer proximity to local roads. A particular high-risk cluster was obtained which had a significant association with all the risk factors. Conclusion: GIS technology is useful in identification of spatial clustering of COPD cases and its environmental risk factors, making it an important tool for targeted interventions for COPD.

Background: The term "liver abscess" refers to a collection of pus in the parenchyma of the liver mainly due to the infection of microorganisms. If a liver abscess is not diagnosed early or not treated, it can be fatal, resulting in significant morbidity and mortality. Aim of the study was to study the clinical manifestations, aetiologies, and management of liver abscesses in tertiary care hospital patients.Methods: From March 2015 to August 2016, 99 patients with liver abscesses were studied in the general surgery wards of government Rajaji hospital in Madurai. In the beginning, routine examination history and blood tests were documented. Then, an ultrasound was performed in selected cases, and further treatment was performed.Results: In the current study, the most cases (48%) were from the age group of 41-50 years. We discovered that this disease is more common in men (97.97%), mainly with a history of alcohol intake, with an amoebic liver abscess (ALA) in 95% of cases. Abdominal pain (100%) and fever (57%) were the most common symptoms observed in the patients. For treatment, we used single aspiration in 30 (30.3%) cases, percutaneous catheter drainage in 25 (25.25%) cases, laparotomy and drainage in 22 (22.22%) cases, multiple aspirations in 19 (19.09%) cases, and conservative management in 3 (3.03%) of the cases.Conclusions: Liver abscesses are most commonly found in young males with a history of alcohol consumption. Unfortunately, it is still a disease that causes significant morbidity. To successfully manage the liver abscess aspiration, catheter drainage and laparotomy with drainage can be used, whether single or multiple.

Background: Laparoscopic and open surgery techniques have been explored, and each technique has its advantages and pitfalls. Therefore, this study intended to carefully evaluate and compare the outcome of operative duration, post-operative pain, post-operative analgesic requirement, and post-operative complications between laparoscopic inguinal hernia repair and open incisional inguinal hernia repair surgery.Methods: In this comparative study, patients were divided into 2 groups, 25 patients underwent laparoscopic inguinal hernia repair, and 25 patients underwent open inguinal hernia repair. Visual analog scale (VAS), post operative analgesic requirement and complications were analyzed between groups.Results: The mean age of open surgery patients was 43.12±12.51, while it was 44.67±18.22 in the laparoscopic group. Forty-five of the cases presented with unilateral hernia, of which 28 showed right laterality and 17 displayed left laterality. In 05 cases, bilateral representation was observed. The average duration of open inguinal hernia repair was 54.23±9.41 minutes, while laparoscopic took 68.94±12.35 minutes, which was statistically significant (p<0.0001). The post-operative pain in VAS just after and post 6, 12 and 24 hours were significantly lower with laparoscopic surgery. Seroma was the most commonly noted post-operative complication, especially in laparoscopic casesy.Conclusions: The study found that the laparoscopic inguinal hernia repair technique was statistically superior to the open incision method in reducing post-operative pain and analgesic requirements. However laparoscopic method had a longer surgery duration as compared to the open surgery procedure.