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Background: Malnutrition plays an important role in the economic burden of society as well as the country. This study aimed to identify the various risk factors and determinants of severe acute malnutrition (SAM) as defined by WHO growth reference standards in children aged 6 months to 59 months living in Vellore. Methods: A community-based case-control study matched for age (±2months), gender and location was done among the children of the age group 6- 59 months residing in both rural and urban Vellore. Children of age group 6-59 months with SAM according to WHO definition, i.e., weight for height of less than -3SD with or without nutritional oedema were classified as cases. Children with weight-for-height z-score more than -1 SD and MUAC ≥13.5cms were classified as controls. With 2 controls per case, the required sample size was 54 cases and 108 controls. A questionnaire used to identify the risk factors including dietary intake. Uni-variate and multivariate analysis was done to generate an odds ratio and 95% confidence interval for the risk factors. Results: Majority of the cases 64.8% and 50% of the controls belonged to low SES. After adjusting all confounders, Severe Acute Malnutrition was significantly associated with birth weight <2.499kg [AOR- 8.95 (95% CI: 2.98-26.85)], not exclusively breastfed for 6 months [AOR 4.67 (95% CI: 1.72-12.65)], inadequate calorie intake [AOR 8.09 (95% CI: 3.15-20.82)] and mother being underweight [AOR 6.87 (95% CI: 1.92-24.55)]. Conclusion: Programs should be implemented to reduce the poor nutritional status of young girls and women in the reproductive age group. The importance of exclusive breastfeeding for the first six months, the time of weaning and appropriate feeding practice for the child should be emphasized to postnatal mothers during their hospital visits.

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A community based cross sectional study was carried out in a rural block of north Tamilnadu to assess the knowledge; attitude and practice of general population of age group 18 to 35 regarding road safety rules. A semi structured interviewed administered questionnaire was administered among a 115 participants. 82.1% drove vehicle without a license. 75.7% did not know the side of the road to be used by pedestrians for walking. Only 15.7% could recognize all 5 traffic signals properly. Nearly 95.7% agree that helmets prevent accident, but only 37.5% use helmet/seat belt regularly. To prevent casualties due to road traffic accidents (RTA) mass public awareness campaigns should be initiated so that both the driver and the pedestrian will be aware of all the traffic rules properly. The ignorance of one can become fatal for the other.

The population of elderly is on a rise in India. According to the 2011 census by the government of India, senior citizens constitute 8% of the total population. 1 An analysis of the morbidity and mortality profile of the elderly has shown that they suffer equally from both communicable and non-communicable diseases, many with multiple diseases at the same time which inevitably lead to the use of multiple medications or polypharmacy. 2-4 This also encourages the tendency for self-medication, increase in the use of non-prescription drugs and purchase of medications showing the previous medication cover, especially in India where the health care is becoming expensive, especially for those who are poor. 5,6 Over the counter (OTC) drugs, otherwise known as non-prescription drugs are those medications that are bought without any prescription. It gives the patient, the freedom to self manage the symptoms. A study by United nations international drug control programme has revealed that use of such drugs is on a rise in South Asian countries like India. 7 Many consider it as an economic way of treatment for common self-limiting illnesses especially among the geriatric population. 8-10 The flip side of this practice is that the geriatric populations are more vulnerable to adverse drug events that are ABSTRACT Background: The geriatric population is on a rise in India, which is accompanied by an increase in their health care needs. As they are prone to have multiple diseases simultaneously the tendency for over the counter (OTC) or nonprescription drugs is much higher among the elderly population. A thorough knowledge about the medication practices among elderly is indispensable since the chances for adverse drugs events; drug interactions etc. are higher among them. The primary objective of the present study was to measure the prevalence of over the counter drug usage among those aged 60 years or above residing in a rural block of North Tamilnadu, India. Methods: A community based cross sectional study was conducted among those aged 60 years or above using an interviewer administered questionnaire and data was collected from 100 consenting participants who were selected using multi stage sampling. Results: The prevalence of the usage of over the counter drugs among the elderly population was found to be 51% (95% CI 41.1-60.9). It was shown that the usage of OTC drugs was associated with higher socio economic status (p value 0.015) and literacy (p value 0.003). Conclusions: Further studies need to done to identify whether such high prevalence of OTC drug usage among elderly is a reflection of drug practices among general population and if proven otherwise should explore the various reasons for the same so that necessary measures can be implemented to alleviate the situation.

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Objective: To identify predictors of recovery in children with uncomplicated severe acute malnutrition (SAM). Design: This is a secondary data analysis from an individual randomised controlled trial, where children with uncomplicated SAM were randomised to three feeding regimens, namely RUTF-C, RUTF-L, or A-HPF, under two age strata (6–17 months and 18–59 months) for 16 weeks or until recovery. Three sets of predictors that could influence recovery, viz. child, family, and nutritional predictors, were analysed. Setting: Rural and urban slum areas of three states of India, viz. Rajasthan, Delhi, and Tamil Nadu Subjects: In total, 906 children (age: 6–59 months) were analysed to estimate the adjusted hazard ratio (AHR) using the Cox proportional hazard ratio model to identify various predictors. Results: Being a female child [AHR: 1.269 (1.016–1.584)], better employment status of the child’s father [AHR: 1.53 (1.197–1.95)], and residence in a rental house [AHR: 1.485 (1.137–1.94)] increased the chances of recovery. No hospitalisation [AHR: 1.778 (1.055–2.997)], no fever, [AHR: 2.748 (2.161–3.494)], and ≤2 episodes of diarrhoea [AHR: 1.579 (1.035–2.412)] during the treatment phase; availability of community-based peer support to mothers for feeding [AHR: 1.61 (1.237–2.097)]; and a better weight-for-height Z-score (WHZ) at enrolment [AHR: 1.811 (1.297–2.529)] predicted higher chances of recovery from SAM. Conclusion: The probability of recovery increases in children with better WHZ, and with the initiation of treatment for acute illnesses to avoid hospitalisation, availability of peer support, and better employment status of the father.