A mixed method study to assess notification of tuberculosis patients by private practitioners in New Delhi, India.

Background: A staggering one million tuberculosis (TB) cases are missing from notification, most of them being diagnosed and treated in the private sector. To curb this issue, the Government of India declared TB as a notifiable disease and NIKSHAY was launched in 2012. However, even after years of implementation, as per the report published by TB India 2020, the proportion of private case notification of total TB cases is very low. Objectives: The objectives of the study were to assess the current practices related to TB Notification being followed by private practitioners of Delhi and to explore the enablers and barriers to TB notification among private-sector treatment providers. Methods: This cross-sectional study was done from January 2019 to January 2020. Six hundred doctors were line listed under the chosen TB unit, 375 gave consent and in depth interview was conducted among them. Data were collected on the reporting status and facilitators and barrier toward NIKSHAY reporting were assessed. For the qualitative component, focused group discussions were done. Results: Out of 375 private practitioners, over two-third (68%) practitioners reported that they were not treating TB patients. Out of 108 doctors treating patients only 50% were reporting the cases. Major reason cited for not reporting was "don't know how to" and major barrier considered was "lack of training." Conclusion: Strategies such as training and retraining, and one-to-one sensitization of private practitioners to address barriers may enhance TB notification.

Surveillance of bacteriological quality of drinking water in Chandigarh, northern India.

The study was carried out in Chandigarh, India with the following objectives: (1) to monitor the bacteriological quality of drinking water; (2) to collect data on bacteriological contamination of water collected at point of use; (3) to test both groundwater being supplied through hand pumps and pre-treated water; and (4) to determine the pattern of seasonal variations in quality of water. The community-based longitudinal study was carried out from 2002 to 2007. Water samples from hand pumps and tap water were collected from different areas of Chandigarh following a simple random sampling strategy. The time trends and seasonal variations in contamination of water according to area and season were analysed. It was found that the contamination of water was higher during the pre-monsoon period compared with the rest of the year. The water being used in slums and rural areas for drinking purposes also had higher contamination levels than urban areas, with highest levels in rural areas. This study found that drinking water supply in Chandigarh is susceptible to contamination especially in rural areas and during pre-monsoon. Active intervention from public health and the health department along with raising people's awareness regarding water hygiene are required for improving the quality of drinking water.

Assessment of frontline health workers in providing services for malaria elimination in the tribal district of Mandla, Madhya Pradesh.

Background: The Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs) are the frontline health staff that provide essential health care services, including diagnosis and treatment of malaria. To support India's malaria-free goal by 2030, a project known as the Malaria Elimination Demonstration Project (MEDP) in the tribal district of Mandla was initiated. This study assessed the capabilities of ASHAs and ANMs of Mandla district to diagnose and treat malaria. Methods: A cross-sectional study was conducted in the 71 sub-centers and their villages where at least one positive malaria case was diagnosed in 2019. Pre-designed and validated tools were used to assess the knowledge, attitude, and practices of ASHAs and ANMs. Analysis was performed using descriptive statistics and multivariate logistic regressions. Results: Malaria is the fifth priority of the ASHAs and ANMs of Mandla district. Good level of knowledge regarding malaria etiology, diagnosis, and prevention was found, but the ability to treat a malaria case as per the national drug policy was below expectations. Frequent and prolonged stockouts of drugs and diagnostics were found. Logistic regressions revealed better capacity of ANMs to dispense correct treatment as compared to the ASHAs. Improvement was seen in the ASHAs ability to interpret rapid diagnostic test (RDT) results following trainings by MEDP Mandla. Conclusion: There is a need to increase the capabilities of the frontline health staff of Mandla for malaria diagnosis and treatment. Continuous trainings and a robust supply chain management system is required to equip the ASHAs and ANMs to effectively deliver malaria diagnosis and treatment services.

Women and AIDS: awareness and attitudes in a peri-urban setting in Punjab.

Women account for 39.3% of HIV/AIDS infection in India. There are many biological and socio-cultural factors which make her highly vulnerable to HIV infection. Knowledge regarding HIV/AIDS can help her in protecting herself from the disease. This study was conducted to the level of awareness of young females with respect to knowledge of the HIV/AIDS, its modes of transmission, methods to prevent it, availability of testing and treatment and attitudes in relation to HIV/AIDS. A cross sectional study was done in a peri-urban setting in Patiala, Punjab among 1044 females in the age group 15-24 yrs using a self designed semistructured questionnaire. 93.9% had heard about AIDS. Television was the most common source of information (79.7%). Knowledge about the different modes of transmission was high (68-78%), but knowledge about preventive methods especially condom use was low (34-54%). Increase in educational status was seen to significantly increase the knowledge of the modes of transmission and preventive methods (p < .001). Knowledge of symptoms of HIV was low. (2-15%). Only 28.5% knew about the availability of HIV testing facility. 33.8% knew about treatment available for HIV. The study subjects were having favorable attitude towards people living with HIV/AIDS. There is a need to focus the education programs and the mass media towards preventive methods rather than just the knowledge of the modes of transmission. Greater emphasis needs to be placed on making people aware about the existence of HIV testing facility and availability of treatment.

Assessment of frailty and outcome of an ethnogeriatric population in periurban slums of Delhi, India - An interventional strategy in a primary health care setting.

INTRODUCTION: The burden of frailty and aging will have a profound impact on the economy along with the deteriorating clinical condition of the olds. AIM: This study aim was to assess frailty of an ethnogeriatric cohort and associate it with domains of quality of life in Delhi along with a follow-up outcome assessment. METHOD: Edmonton frail scale on an ethnogeriatric cohort of 200 individuals in periurban slums of Delhi was used and associated with quality of life, calculated by the WHO-BREF -QOL questionnaire. An interventional strategy for healthy aging was adopted, and a follow-up outcome assessment was done to look out for mortality or morbidity. RESULT: There were 37% frail with a mean score of 60 and 25% prefrails beyond 60 years with a significant increase in frailty with age. Females, single, working, and illiterate elderly were frailer as compared to their counterparts. Social domain followed by psychological domain of the QOL had least scores in the frail elderly. Olds, away from their place of origin were 25 times more likely to be frail and had lesser family integration, assessed by regression analysis. Nearly 6% died, with 21% of hospital readmissions after a 6-month follow-up. DISCUSSION: An earlier start of assessment would give us more time to react and respond and be pro-active for healthy aging besides taking into consideration the diverse ethnography in our country. CONCLUSION: Cross-cultural variations need the physicians to address the health care disparities and language barriers so as to make interventions more convenient.

Telemedicine in India: A tool for transforming health care in the era of COVID-19 pandemic.

Although telemedicine has been used spottily in Indian health care so far, the 2020 Covid-19 pandemic provided the nation's health systems an unprecedented opportunity to make a concerted effort to increase access and coverage. Health-care providers can incorporate telemedicine systems to reduce doctor-patient visits and help in breaking the chain of transmission of infections. Anticipating the increased need of telemedicine by health-care providers, the Medical Council of India released practice guidelines in March 2020. In this article, the literature pertinent to telemedicine and its applications with special reference to recently released practice guidelines were reviewed and summarized in a historical and current context. Telemedicine is bound to grow and be adopted by more health-care practitioners and patients in a wide variety of forms due to ease and availability. At the same time, it cannot replace in-person consultation or emergency medicine.

A sneak peek into the curriculum on disaster management medicine in India for health professionals: A mixed-methods approach.

INTRODUCTION: India being a disaster-prone country necessitates us to be able to act proactively for any sort of preparedness and prevention. This necessitates a curriculum which can bring all the aspects related to disaster under one umbrella and thus impart training. AIM: The aim of the study was to assess the responses of students about the importance of disaster management (DM) in their MBBS course, take up suggestions about the important inclusions to be made in their curriculum, and get an insight of the higher education and research of DM domain in the Indian context. METHODOLOGY: A cross-sectional study with a batch of 100 MBBS students purposively sampled were part of the questionnaire. Besides, a thorough Internet search for institutes providing training on DM was done, and relevant details were noted down. Later on, the students were given guest lectures and demonstrations by certified trainers and experts along with a know-how of where to go for getting a hands-on training and whom to respond to. RESULTS: Seventy-two percent of the students felt the portion of DM being taught to them to be insufficient, and 95% never got any training or demonstration for DM although 22% felt that it is not so important for them as a doctor. Only 23% of them knew about any sort of DM courses or certifications in India, and almost 16% of the students were confident enough to tackle any incidence of public health emergency. CONCLUSION: Making an earlier start will impart seriousness and accountability in the mindset of budding physicians.

Interplay of multimorbidity and polypharmacy on a community dwelling frail elderly cohort in the peri-urban slums of Delhi, India.

The United Nations Population Fund suggests that the number of elderly persons is expected to grow to 173 million by 2026. The aging phase is further made adverse by conditions such as failty, multimorbidity and polypharmacy. AIM: To assess the status and associates of frailty among elderly (>60 years) residing in a peri-urban slum area in Delhi by using the EDMONSTON Frail scale and evaluate the interplay of multimorbidity (MM) and polypharmacy (PP) on the frail pre-frail spectrum of the community-dwelling elderly cohort. METHOD: A community study from Dec 2018 till July 2019 with a sample size of 300 participants who were willing and consented to the study. Frailty was assessed and the STOP criteria was used for PP assessment. RESULT: There were 76 frail, 51 pre-frail, and 173 non-frail elderly. A higher prevalence (51%) of multimorbidity among the pre-frails and a higher probability (74%) of polypharmacy among the frails were found. Of the total in the frail-prefrail spectrum (127), 29.1% had multimorbidity (MM) and 39.4% had polypharmacy (PP). MM and PP were significantly higher among the old. Factors such as sex, marriage, loneliness, social circle, and education also had a positive bearing on the frailty-prefrailty spectrum. The working group had an increased (86%) probability of PP with statistical significance. Regression analysis depicted significant increased odds of MM and PP among female, illiterate, very old, lone, and single subjects. DISCUSSION AND CONCLUSION: Thus, we recommend earlier and timely intervention for the frail-prefrail which can revert their adversities.

A Community-based Intervention Study to Assess the Effectiveness of Awareness Imparted on Earthquake Preparedness among the Residents of South Delhi, India.

BACKGROUND: New Delhi is located in seismic zone IV, and the occurrence of earthquake is fairly common. Previous disasters have shown that only sustained and timely action to reduce risk can prevent or mitigate the impact of a disaster. OBJECTIVES: The objective was to assess the knowledge and preparedness regarding earthquake among the residents of South Delhi and to impart the awareness and assess the effectiveness of the awareness imparted. METHODOLOGY: One group pretest-posttest quasi-experimental research was done among 300 respondents on earthquake preparedness. RESULTS: As per the study, 89% of participants felt that earthquake is a concern for Delhi. It was observed that majority of the population are not prepared to handle large scale disaster. Significant association was found between pretest and posttest knowledge assessment scores of the study population. CONCLUSION: Disasters due to their unpredictable occurrence are difficult to tackle, but awareness and preparedness to face the calamity will help to reduce the burden of disaster.

School absenteeism during menstruation amongst adolescent girls in Delhi, India.

BACKGROUND: Girls' health and education form the cornerstone of development and the gateway to full participation as women in political, economic, and cultural life of a country. Poor menstrual hygiene management has been shown to result in a sense of shame, anxiety, and embarrassment that contributes to absenteeism and poor performance at school. The objectives of this study were to determine the percentage of girls absent from school during menstruation, to evaluate the various factors associated with school absenteeism during menstruation, and to assess the practices regarding menstrual hygiene. MATERIALS AND METHODS: A mixed method research of combined cross-sectional study and qualitative research was conducted in six government schools of Delhi by means of a questionnaire survey and focus group discussions. The sample size was 600 adolescent girls. RESULTS: Out of 600, 245 (40%) girls remained absent from school during their menstruation. School absenteeism was significantly associated with the type of absorbent used, lack of privacy at school, restrictions imposed on girls during menstruation, mother's education, and source of information on menstruation. Nearly 65% reported that it affected their daily activities at school and that they had to miss their class tests and classes as a result of pain, anxiety, shame, anxiety about leakage, and staining of their uniform. CONCLUSION: Since mothers are the primary source of information, they should be counseled to dispose of their taboos about discussing issues related to menstruation. They should be taught about the ill effects of adhering to taboos related to menstruation. The curriculum on general biology should have more detail on menstruation.

Unmet Need and Nonacceptance of Usage of Contraceptive Devices in a Rural Area of Delhi: An Exploration of Facts.

BACKGROUND: An important cause of high fertility rates in Delhi is the low availability and use of family planning services. Fostering family planning practice alleviates poverty, accelerates socioeconomic development, increases child schooling, promotes gender equality, and decreases maternal and infant mortality. The study objective was to find out the perception of potential users, health workers, and health professionals on the reasons for nonusage of contraceptive services provided and to recognize possible solutions to the identified barriers. METHODS: This cross-sectional study was done using qualitative methods among three groups of people by focus group discussion and in-depth interviews. The study was conducted in the rural health center of Madanpur Khaddar, Department of Community Medicine, Jamia Hamdard Institute of Medical Sciences and Research, from June to August 2016. RESULTS: The median age group of the participants was 27 years, and the participants were majorily less educated and were homemakers. Description of key thematic issues found out that contraceptive nonusage was due to lack of accessibility, lack of availability, as well as issues with privacy and autonomy. Out of 25 women, 3 had never heard the term Copper-T (CuT). Twelve out of the rest 22 women had heard about CuT, but knew no more than that. CONCLUSION: The findings that have emerged from this study thus provide some recommendations to increase the demand for contraception. Effective information, education, and communication should be promoted continuously with the help of community health workers for better acceptance of CuT because it is believed that no single child should be born into the world unplanned.

Predictors of intention to quit tobacco among construction site workers in Delhi, India.

BACKGROUND: Information on predictors of quitting behavior among construction site tobacco users is scarce in India. Hence, this study was conducted to assess the intention of tobacco users toward quitting and its predictors with reference to sociodemographic profile. METHODOLOGY: A community-based, observational study was conducted on adult 172 construction site workers in a university campus of Delhi. Data were collected by an interview using the WHO-adopted, pretested, semi-structured questionnaire. Chi-square test was used for univariate analysis. Pearson's correlation coefficient and multivariate logistic regression model were used to identify the predictors. RESULTS: Of the 172 users, 73% had intention to quit. More than half of smokers (56.5%) and 81% of smokeless tobacco users intended to quit. Majority of the tobacco users who intended to quit were literate (75.0%), started tobacco use >15 years of age (75.4%), occasional tobacco users (78.9%), and less dependent on nicotine (74.4%). CONCLUSIONS: Suitable plan for quitting keeping in mind this vulnerable group of workers should be developed depending on the literacy, type of tobacco used, and nicotine dependency.

Effectiveness of Awareness Package on Occupational Health Hazards among Ragpickers of New Delhi, India.

BACKGROUND: Ragpickers are informal workers who collect recyclable materials to earn a small wage on daily basis. They work in vulnerable conditions and awareness regarding occupational and environmental hazard is essential for them. OBJECTIVE: To study the effectiveness of awareness program on various occupational health hazards among the ragpickers. MATERIALS AND METHODS: This interventional study was conducted from May through October 2016 among the ragpickers living near field practice area of Department of Community Medicine and those living in slum areas around HAHC Hospital, New Delhi, India. The awareness regarding occupational and environmental health hazards was assessed using a pretested and predesigned pro forma. Snowball sampling technique was used to select the ragpickers from the various areas. Health awareness and education package was designed for the ragpickers. The package was delivered by medical officers and health workers. A posttest assessment was done 2 weeks after the awareness activity. RESULT: Among 150 ragpickers, there was significant improvement in knowledge immediate post training on knowledge of occupational hazard and hygiene. CONCLUSION: Efforts should be put to develop training materials on occupation and environmental health and injury issue relating to waste management.

The intergenerational transmission of tobacco habit: Role of parents and the family.

INTRODUCTION: Tobacco pandemic has become one of the greatest public health challenges of all time. The socio-environmental factors prevailing at home have been identified as one of the most important causes of adopting smoking and other types of smokeless tobacco. OBJECTIVES: The present study was conducted to find out the prevalence and pattern of tobacco use in the patients registered in the clinic and to study the role of parental and family influence on tobacco use. MATERIALS AND METHODOLOGY: This cross-sectional study was performed in a Tertiary Care Hospital in Delhi. The study included all 307 patients who were registered in a cardiac clinic between January and December 2014. The history of tobacco use in siblings, offspring, and parents was taken from these patients. Pedigree profiles provided detailed information about tobacco use in the family. The association between the use of tobacco among parents and tobacco habits was assessed by odds ratio and Chi-square test. RESULTS: Among the patients, 48% were tobacco users and family history of tobacco use was present in 81% of users. Odds ratio of tobacco use in parents, offspring, siblings, and three generations was 3.477, 1.987, 2.626, and 7.626 than that of nontobacco users. CONCLUSION: Previous anti-smoking campaigns have concentrated much of their effort on discouraging individuals from smoking with the aim of creating a nonsmoking generation. This approach does not take sufficient account of the fact, reconfirmed by our findings that children are influenced by the behavior and attitudes of adults, especially their parents.

Prevalence and correlates of nicotine dependence among construction site workers: A cross-sectional study in Delhi.

INTRODUCTION: Workers represent half the world's population and are major contributors to economic and social development. Tobacco consumption in construction site workers has been considered a big challenge. OBJECTIVES: (1) To assess the prevalence of nicotine dependence among tobacco users. (2) To study the correlates of nicotine dependence among the construction site workers. METHODOLOGY: A cross sectional study was conducted using a predesigned and pretested structured proforma. The study was conducted among all construction site workers aged 18yrs and above in campus of Hamdard Institute of Medical Sciences and Research and associated HAH centenary hospital, New Delhi. Karl Fagerstrom Nicotine Dependence Questionnaire was used to assess dependence on nicotine. RESULTS: The mean age of construction site workers was 32.04±11.6 years. Among the workers, majority (91%) were tobacco user. Among the users, 60% found it difficult to refrain from smoking/chewing in places where use of tobacco is not allowed (e.g. hospitals, government offices, cinemas, Libraries etc). 55% of the users smoked or chewed tobacco during the first hours after waking than during the rest of the day. On multivariate analysis, the factors which were found to be significantly associated with nicotine dependence were lower income group (OR 2.57, CI:1.66-3.99), smokeless tobacco use (OR 2.36, CI:1.30-4.27) and lower education (OR = 2.86 (95% CI 1.97-4.16) for illiterate). DISCUSSION: The prevalence of tobacco use (91%) among construction workers is very high compared to that in the general population. Recognition of construction sites as work places and proper implementation of law is needed.

A community-based case-control study to investigate the role of iron deficiency in the persistence of goiter.

OBJECTIVES: To find out the magnitude of iron deficiency anemia in the age group of 6-12 years and investigate the role of iron deficiency as a possible contributor to endemic goiter in school children in Ambala. MATERIALS AND METHODS: The present study was conducted as a subset of a cross-sectional study among 2700 children from 6 to 12 years of age to find out the prevalence of goiter. All the subjects who were found to be suffering from goiter in the cross-sectional study were enrolled in the case-control study as cases and were compared with age- and sex-matched controls (children without goiter) from the same cohort. The study was conducted from February 2011 to January 2012. RESULTS: Out of total, goiter was observed in 12.6% of the subjects. Urinary iodine excretion was found to be <100 µg/L in 57 (10.5%) children. Mean hemoglobin (Hb) level of the study population was 11.9 g/dL. It was noted that 71% of the goitrous children had anemia (Hb <12 g/dL) as compared to 63.7% of the control group. Serum ferritin (SF) was <15 ng/mL in 70% of the children. The mean ± standard deviation of SF in the goitrous and nongoitrous children was 19.65 ± 32.51 µg/L and 27.55 ± 21.07 µg/L, respectively (P = 0.012). CONCLUSION: The findings in the study suggest that iron deficiency anemia in children is contributing toward the persistence of goiter in the postiodization phase.

Performance evaluation of hematologic scoring system in early diagnosis of neonatal sepsis.

OBJECTIVES: The present study was undertaken to evaluate and highlight the importance of hematological scoring system (HSS) in the early detection of neonatal sepsis. MATERIALS AND METHODS: The cross-sectional study enrolled 110 neonates who were clinically suspected of infection (study group) and normal neonates for comparison (controls), during the 1(st) week of life. All peripheral blood smears were analyzed using HSS of Rodwell et al., by pathologists blinded to the infection status of the newborns. HSS assigns a score of 1 for each of seven findings significantly associated with sepsis: Abnormal total leukocyte count, abnormal total polymorphonuclear neutrophils (PMN) count, elevated immature PMN count, elevated immature: Total (I:T) PMN ratio, immature: Mature (I:M) PMN ratio ≥0.3, platelet count ≤150,000/mm(3), and pronounced degenerative or toxic changes in PMNs. Score of ≤2 was interpreted as sepsis unlikely; score 3-4: Sepsis is possible and ≥5 sepsis or infection is very likely. Blood culture was taken as a standard indicator for septicemia. The perinatal history, clinical profile and laboratory data were recorded and correlated in each case. Each hematological parameter was assessed for its individual performance and also with the culture-proven sepsis. Sensitivity, specificity, positive and negative predictive values (NPVs) were calculated for each parameter and for different gestational ages. P value was also calculated for different parameters. RESULTS: Out of the 110 infants, based on clinical findings and laboratory data were classified into three categories: Sepsis (n=42), probable infection (n=22) and normal (n=46). Out of these, 42 (38.2%) newborns had positive blood culture. 63 (57%) neonates were preterm and 47 (43%) term. Male: female ratio was 0.96:1. The P value was significant for the different gestational ages (0.0002) and sex ratio (0.003). Immature polymorphonuclear neutrophils (PMN) count was the most sensitive and I:M PMN ratio, the most specific indicator of sepsis. For sepsis and probable sepsis, I:T PMN count and immature PMN count have highest sensitivity whereas I:T and I:M PMN ratio have highest specificity. HSS has much higher sensitivity and specificity in preterms than in term neonates. Positive predictive value and NPV is also higher in preterm than term for HSS. It was also seen that with increasing scores, the likelihood of sepsis also increased. CONCLUSION: The sensitivities of the various screening parameters were found to be satisfactory in identifying early onset neonatal sepsis. It is a simple and feasible diagnostic tool to guide towards the decision-making for a rationale treatment.

Menstrual Pattern among Unmarried Women from Northern India.

BACKGROUND: Menstruation disorders are also responsible for emotional, physical, behavioural and dietary practice changes. These changes affect their normal functioning and social life. The present study was carried out to find the prevalence of menstrual problems among unmarried girls of Chandigarh, India and to compare their knowledge and beliefs regarding menstruation in different sub-groups. METHODOLOGY: A community based cross-sectional study was conducted among 744 unmarried females in Rural, Urban and Slum strata of UT Chandigarh, India. Data were collected using a self-administered structured questionnaire on menstruation. Chi-square value was used for testing statistical significance. RESULTS: The mean age of the respondents was 16.84±3.05 years. Maximum respondents (40.9%) were educated up to 10th standard/High school. 448 (60.2%) were aware of menstruation before starting of menarche. Awareness was found to be significantly associated (p=0.02) with age. Socio-economic status and prior knowledge of respondents was also found to be significantly associated (p< 0.001). 61% (454) of the respondents had a regular flow during menses. Normal flow was reported by 70.2 %(522) of the respondents. Dysmenorrhea was found to be the most common problem suffered by 429 (57.7%) respondents. CONCLUSION: Menstrual hygiene is an issue that needs to be addressed at all levels. A variety of factors are known to affect menstrual behaviors, the most influential ones being economic status. It is essential to design a mechanism to address and for the access of healthy menstrual practices.

Patterns of glycemic control using glycosylated hemoglobin in diabetics.

AIM: Till now estimation of blood glucose is the highly effective method for diagnosing diabetes mellitus but it provides a short-term picture of control. More evidence is required to prove that plasma glucose and glycosylated hemoglobin levels together gives a better estimate of glycemic control and compliance with treatment. Indian diabetes risk score (IDRS) is a simplified screening tool for identifying undiagnosed diabetic subjects, requires minimum time, and effort and can help to considerably reduce the costs of screening. OBJECTIVE: To study patterns of glycemic control using glycosylated hemoglobin in diabetic patients. To find out correlation between levels of plasma glucose and glycosylated hemoglobin in diabetics and to calculate IDRS of the study population. MATERIALS AND METHODS: A cross sectional study was conducted among 300 known diabetic patients attending outpatient department of a rural medical college in Haryana, India. Following standard procedures and protocols FPG and glycosylated hemoglobin were measured to find out a pattern of glycemic control in them after taking their written and informed consent. A correlation between the levels of glycosylated hemoglobin and fasting blood glucose was also calculated. These patients were made to fill a performa and their demographic and clinical risk factors were noted and based on this, their IDRS was calculated. This was done to validate the IDRS in Indian rural population. RESULTS: Fifty-two percent of the population had fasting plasma glucose level between 125-150 mg/dl, 21% had this level between 151-175 mg/dl. Thirteen percent of the study subjects had HbA1C between 6.5-7.5, more than half (57.3%) had this value between 7.5-8.5, 12% and 18% had values between 8.5-9.5 and 9.5-10.5, respectively. Twelve percent of the participants had HbA1C level higher than 10.5. Correlation of fasting plasma glucose level and HbA1C was also studied and found that correlation coefficient came out to be .311. This correlation was found to be statistically significant (P = .007). Sixty-five percent of the case had IDRS higher than 60. CONCLUSIONS: Glycaemic control in diabetics can be better assessed with glycosylated hemoglobin and FPG together. A positive correlation between FPG and HbA1c allows for the use of HbA1c along with FPG in diagnosing type 2 DM but the two should not be used interchangeably. IDRS can be used as a screening tool for diabetes.