Screening for palliative care needs in the community using SPICT.

Background: The Worldwide Hospice Palliative Care Alliance has recommended integration of palliative care into primary health care. Diminished capacity to provide palliative care is a barrier for integration. The purpose of this study was to screen for palliative care needs in the community. Methods: A cross-sectional study was conducted in two rural communities of Udupi district. Supportive and Palliative Care Indicators Tool - 4ALL (SPICT-4ALL) was used to identify the palliative care needs. Purposive sampling was used to collect the individual information from the households for identifying the palliative care need. Conditions requiring palliative care and the sociodemographic factors associated with it were explored. Results: Out of 2041 participants, 51.49% were female, and 19.65% were elderly. Less than a quarter of them (23.08%) had at least one chronic illness. Hypertension, diabetes, and ischemic heart disease were commonly found. 4.31% had satisfied the requisite SPICT criteria, which indicated a need for palliative care. Diseases of cardiovascular system followed by dementia and frailty were the most common conditions requiring palliative care. Univariate analysis showed that age, marital status, years of education, occupation, and the presence of morbidities were significantly associated with the need for palliative care. Being unemployed and having one or more morbidities were factors independently associated with requirement of palliative care. Conclusions: The estimated palliative care need in the community survey exceeds the perceived need. Although palliative care is traditionally identified with cancer, the proportion of people with noncancer palliative care needs were significantly higher than cancer palliative care.

Health status of Koraga community: A pilot study among a particularly vulnerable tribal group of Udupi District, Karnataka, India.

Background & objectives: Undertaking tribe-specific assessment of health status provides the required data for planning appropriate interventions. Hence, a study was conducted to assess the health profile of the Koraga tribe. Methods: This community-based cross-sectional study was conducted among a particularly vulnerable tribal group, the Koragas residing in the Udupi district. Data were collected using a pro forma and were analyzed using the SPSS software version 16.0. Results: A total of 273 participants aged ≥18 yr and 94 children aged ≤17 yr were recruited through screening and referral services organized in Koraga hamlets of the Udupi district. Among the adults, 59.7 per cent were females and their median age was 35 yr. About 13.9 per cent had elevated blood pressure and 18.4 per cent had impaired/elevated random blood sugar levels. About 47.6 per cent were underweight and 35.2 per cent were anaemic. Multivariate logistic regression analysis showed that individuals with morbidities were more likely to be aged ≥45 yr [45-60 yr: adjusted odds ratio (AOR)=4.3; 95 per cent confidence interval (CI)=1.3-13.8 and >60 yr: AOR=6.4; 95 per cent CI=1.7-23.7] and overweight or obese [23-24.9 kg/m[2]: AOR=8.1; 95% CI=1.3-48.2 and >25 kg/m[2]: AOR=7.9; 95% CI=1.6-38.4]. Of the 26 Koraga children aged ≤5 yr, 30.7 and 42.3 per cent had their height for age and weight for age below the third percentile, respectively. Further, 15.3 per cent of under-five children and 27.9 per cent of 6-17 yr old children were severely wasted. About 21.2 per cent of the children aged ≤17 yr were found to be anaemic and 56.3 per cent had symptoms of respiratory tract infection in the past 15 days. Interpretation & conclusions: Malnutrition was prevalent among Koraga adults and children, which warrants designing and implementing appropriate social and health interventions in this population.

Characterization of age-related changes in sacculocolic response parameters assessed by cervical vestibular evoked myogenic potentials.

Age-related changes have been documented in anatomical studies on peripheral as well as central vestibular systems. Similar changes have also been observed for saccular responses evaluated through Cervical vestibular evoked myogenic potential (cVEMP) after the age of 60 years. Nevertheless, most of these studies have either made use of small sample sizes, considered inappropriate for normative studies of such kind, or incorporated wider age groups which might have confounded the conclusions. In order to overcome the above shortcomings, the present study aimed at evaluating the effect of age on cVEMP using larger sample size and distributing the participants to smaller age group divisions. A cross-sectional design was employed to record cVEMPs from 280 healthy volunteers in the age range of 10-85 years who were distributed to seven age groups (10-20, 20-30, 30-40, 40-50, 50-60, 60-70 and above 70 years). The latency, amplitude, inter-aural asymmetry ratio, and threshold were compared using one-way analysis of variance, whereas the response rate was calculated in terms of percentage of ears in which the responses were identifiable. The results revealed a steady decline in response rate and amplitude with advancing age beyond 5th decade (50-60 years). In addition, the latency of P13 and N23 was prolonged, while the thresholds worsened with increasing age also after 50 years. Hence, age-matched norms have to be considered while interpreting the results of cVEMP, especially in individuals above 50 years of age.

Utilisation of services provided at an outreach healthcare facility and its associated factors among residents in a coastal taluk of southern Karnataka: A cross-sectional study.

Introduction: Understanding the patterns of utilisation of primary health services can help to improve service delivery and utilisation, thereby reducing common morbidities in the community. The study aimed to assess the patterns of utilisation of services provided at an outreach healthcare centre. Methods: A community-based survey was conducted among families residing in the field practice area of an outreach centre for more than a year. Data were collected using a questionnaire administered to adults aged >18 years. Collected data were entered into and analysed using the Statistical Package for the Social Sciences version 16.0. Results: Approximately 65.1% of the respondents were aged 31-59 years, and 67.4% were women. Among 126 surveyed households, 50.7% had utilised services from the outreach centre. The facilitators of utilisation among 64 households included proximity to their area of residence (90.6%) and availability of good-quality services (40.6%). The most common barriers included a lack of awareness (30.9%) and inconvenient timings (18.2%) of the healthcare centre. The respondents aged <18 years (odds ratio [OR]=7.64; 95% confidence interval [CI]=4.37-13.37) and >45 years (OR=2.65; 95% CI=1.57-4.47) had higher odds of utilising services than those aged 18-45 years. The female respondents (OR=2.89; 95% CI=1.86-4.51) were more likely to utilise services than the male respondents. Conclusion: Creating awareness regarding the outreach healthcare centre and designing services based on the observed needs of the community can further improve the utilisation of services provided at the healthcare centre.

Common Mental Disorders and Their Correlates: A Community-based Survey Among Women in Southern Karnataka, India.

Background: About 10% of Indians have common mental disorders (CMDs) which include depression and anxiety. These disorders are common in women, which not only impacts on their quality of life but also their family members. The objective of the study was to estimate the prevalence of CMDs, and factors associated with them among women residing in coastal Karnataka. Methods: A cross-sectional study was carried out among 980 women aged between 18 and 60 years from 2019 to 2021. Women were administered a baseline questionnaire along with Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder questionnaire-7 (GAD-7) and Cohen's Perceived Stress Scale-4 (PSS-4). Data were collected using Epi-info and were analysed using SPSS version 15.0. Association between CMDs and socio-demographic, reproductive health and behavioural factors were expressed as crude and adjusted odds ratio (OR) with 95% confidence intervals (CI). Results: The prevalence of CMDs among women was 5.7%, with 4.6% having depression and 3.37% with anxiety disorders. Multivariate logistic regression analysis showed that residing in urban areas (OR = 2.15; 95% CI:1.10-4.17), having a chronic illness (OR = 2.38; 95% CI:1.14-4.97), history of recent bereavement in the family (OR = 2.20; 95% CI:1.02-4.75), early marriage (OR = 2.63; 95% CI:1.09-6.33), history of abortion (OR = 2.89; 95% CI:1.42-5.92), and exposure to domestic violence (OR = 3.08; 95% CI:1.14-8.33) were significantly correlated with CMDs in this sample. Conclusions: The study revealed that CMDs were prevalent among the surveyed women, which calls for routine screening of women for CMDs in primary care settings for early identification and appropriate interventions.

Antibiofilm and quorum sensing inhibitory activity of Achyranthes aspera on cariogenic Streptococcus mutans: an in vitro and in silico study.

CONTEXT: Traditionally, many cultures use chewing sticks for oral hygiene maintenance. When properly used, these chewing sticks are found to be efficient due to the combined effect of mechanical cleaning, enhanced salivation and the antimicrobial action of leached out plant compounds. OBJECTIVE: Achyranthes aspera L. (Amaranthaceae), an ethanomedicinal herb was evaluated for its potential to inhibit growth and biofilm formation by cariogenic isolate Streptococcus mutans as an alternative means of caries management by quorum quenching (QQ). MATERIALS AND METHODS: Biofilm forming cariogenic isolates were isolated and their susceptibility to the petroleum ether, benzene, methanol, aqueous extracts of A. aspera was evaluated. Gas chromatography-mass spectrometry (GC-MS), phytochemical analyses and structure-based virtual screening for their quorum sensing (QS) inhibitory activities, drug-likeness and bioavailability were also carried out. RESULTS: The biofilm inhibition percentage obtained for methanol, benzene, petroleum ether and aqueous extracts (125 µg/mL) were ≤94%, ≤74%, ≤62% ≤42%, respectively. GC-MS analyses indicated 61 compounds, of which betulin recorded efficient interaction exhibiting comparable binding energy of -8.72 with S. mutans glycosyltransferase (GTF-SI) whereas 3,12-oleandione exhibited binding energy -5.92 with OmpR subfamily QS regulatory DNA-binding response regulator. Computer-assisted molecular descriptor and Lipinski's rule violation calculation uncovered the presence of more drug-like compounds. DISCUSSION AND CONCLUSION: Anticaries bioactive compounds of A. aspera with higher QS response regulator binding energy, low toxicity and optimal pharmacokinetic properties were revealed. These compounds with possible QQ ability hold the potential for use as anticaries drug leads and antibiofilm preventative medicine.

Tracing the Disparity Between Healthcare Policy-Based Infrastructure and Health Belief-Lead Practices: a Narrative Review on Indigenous Populations of India.

Most Indian tribes have limited access to healthcare facilities and rely heavily on traditional healing practices. This narrative review aimed to identify the disparities in the implementation of healthcare services and in accessing and availing these services by the indigenous population in India. We also have tried to throw light on the plausibility in strengthening the efficiency and efficacy of the public health system, by utilizing the available resources to its maximum potential, so that there will be a measurable outcome in the health status of these populations in India, coherently with the relevant sustainable development goals (SDG). The evidence from published literatures supports the fact that the disparity exists in the health status of indigenous populations in India as compared to the general populations. It emphasizes the need to address the key determinants such as the lack of knowledge, traditional healing practices and poor utilization of healthcare services provided to them. Various factors such as accessibility to healthcare resources, traditional healing practices, lack of awareness regarding healthcare services and schemes provided by the government, insufficient data regarding their issues and challenges and cultural and language barriers worsen the health status of indigenous people. However, our review reiterates that a well-structured and sustainable policy with reframed infrastructure and administration of healthcare system might bring a positive change in the health status of indigenous population in India.

Time trends in tuberculosis mortality across the BRICS: an age-period-cohort analysis for the GBD 2019.

Background: Tuberculosis is the leading cause of death from a single infectious agent among the HIV-negative population and ranks first among the HIV-positive population. However, few studies have assessed tuberculosis trends in Brazil, Russia, India, China and South Africa (BRICS) or with an emphasis on HIV status. This study assesses the time trends of tuberculosis mortality across the BRICS with an emphasis on HIV status from 1990 to 2019. Methods: We obtained tuberculosis data from the Global Burden of Disease 2019 study (GBD 2019). We calculated the relative proportion of tuberculosis to all communicable, maternal, neonatal, and nutritional diseases by HIV status across the BRICS. We used age-period-cohort modelling to estimate cohort and period effects in tuberculosis from 1990 to 2019, and calculated net drift (overall annual percentage change), local drift (annual percentage change in each age group), longitudinal age curves (expected longitudinal age-specific rate), and period (cohort) relative risks. Findings: There were 549,522 tuberculosis deaths across the BRICS in 2019, accounting for 39.3% of global deaths. Among HIV-negative populations, the age-standardised mortality rate (ASMR) of tuberculosis in BRICS remained far higher than that of high-income Asia Pacific countries, especially in India (36.1 per 100 000 in 2019, 95% UI [30.7, 42.6]) and South Africa (40.1 per 100 000 in 2019, 95% UI [36.8, 43.7]). China had the fastest ASMR reduction across the BRICS, while India maintained the largest tuberculosis death numbers with an annual decrease much slower than China's (-4.1 vs -8.0%). Among HIV-positive populations, the ASMR in BRICS surged from 0.24 per 100 000 in 1990 to 5.63 per 100 000 in 2005, and then dropped quickly to 1.70 per 100 000 in 2019. Brazil was the first country to reverse the upward trend of HIV/AIDS-tuberculosis (HIV-TB) mortality in 1995, and achieved the most significant reduction (-3.32% per year). The HIV-TB mortality in South Africa has realised much progress since 2006, but still has the heaviest HIV-TB burden across the BRICS (ASMR: 70.0 per 100 000 in 2019). We also found unfavourable trends among HIV-negative middle-aged (35-55) adults of India, men over 50 in the HIV-negative population and whole HIV-positive population of South Africa, and women aged 45-55 years of Russia. China had little progress in its HIV-positive population with worsening period risks from 2010 to 2019, and higher risks in the younger cohorts born after 1980. Interpretation: BRICS' actions on controlling tuberculosis achieved positive results, but the overall improvements were less than those in high-income Asia Pacific countries. BRICS and other high-burden countries should strengthen specified public health approaches and policies targeted at different priority groups in each country. Funding: National Natural Science Foundation of China (82073573; 72074009), Peking University Global Health and Infectious Diseases Group.

Healthy ageing and occupational therapy in South Asian countries: a scoping review protocol.

INTRODUCTION: The increasing population of older adults is one of the most significant challenges faced by various countries across the world. South Asian region is accommodating almost a quarter of the world's population, with nearly 6% of them being >65 years of age. There is a lack of awareness regarding the role of occupational therapists in community settings, the assessments and interventions used by occupational therapists to facilitate healthy ageing among community-dwelling older adults. This scoping review is planned to systematically identify the literature from the last two decades, related to various assessments and interventions provided by occupational therapists to promote healthy ageing among older adults in South Asia. METHODS: This scoping review will be based on the methodological framework given by Arksey and O'Malley and Levac et al. and will include data from January 2000 onwards. The following databases will be included in the search-SCOPUS, MEDLINE (PubMed), Web of Science, CINAHL, EBSCO, Clinical key, Wiley Online, ProQuest and Cochrane library. Screening of titles and abstracts and full texts will be carried out by two reviewers independently in consultation with the third reviewer. Both quantitative and qualitative data will be analysed separately to identify the assessments carried out, interventions provided and factors that influence healthy ageing among community-dwelling older adults aged ≥60 years in South Asia. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will be used for collating and reporting the results. ETHICS AND DISSEMINATION: As this scoping review uses data from already available literature, it does not require ethics approval. Results will summarise and present the existing literature related to healthy ageing among community-dwelling older adults. We plan to disseminate the results through a peer-reviewed journal, targeting occupational therapists, other rehabilitation workers and researchers from South Asia.

Knowledge, Attitude and Practices Towards Cervical Cancer and its Screening Among Women from Tribal Population: a Community-Based Study from Southern India.

BACKGROUND: Cervical cancer continues to be a leading cancer among women in India. Despite availability of various screening techniques, majority of Indian women remain unscreened for cancer cervix. The increasing incidence could be attributed to the lack of awareness regarding cervical cancer screening and paucity of organized screening facilities in the country. This study assessed the knowledge, attitude and practices (KAP) towards cervical cancer screening among tribal women of coastal Karnataka, southern India. METHODS: A community-based cross-sectional study was conducted among 1140 women aged 20-65 years from three tribes. Information on their KAP towards cervical cancer screening was collected using a semi-structured questionnaire. RESULTS: Mean age of the participants was 39.8 ± 10.1 years. Although 82.9% of the participants reported to have heard of cervical cancer, 51% were aware that the disease could be prevented, and only 2.3% knew that it can be detected at an early stage. Over 75% of the participants did not have adequate knowledge regarding cervical cancer. However, majority of them (99.9%) had a favourable attitude towards cervical cancer screening. None of them had undergone cervical cancer screening prior to the study. The knowledge scores were significantly associated with age group, marital status, education level, socioeconomic status and tribal community of the participants (p < 0.05). CONCLUSION: Overall knowledge regarding cervical cancer among the surveyed women was poor, though they exhibited a positive attitude. This calls for a sustained health education and screening program to create awareness and improve the uptake of cervical cancer screening among these women.

Cervical cytology and associated factors among tribal women of Karnataka, India.

BACKGROUND: Reproductive well-being is a crucial element of women's health. Due to the asymptomatic nature of gynaecological morbidities, women rarely seek medical advice in the initial period leading to delayed diagnosis and poor prognosis of subsequent disease. The present study aimed to explore the cervical cytology and its associated risk factors among women from tribal communities of the southern part of coastal Karnataka, India. METHODS: Papanicolaou (Pap) smear test was performed among 1140 women from three tribal populations, to detect cervical lesions, infections and reactive changes. A semi-structured questionnaire was administered to collect data on socio-demographic and reproductive characteristics of the study population. RESULTS: The most predominant gynaecological complaint among the participants was severe lower back ache (77.6%), followed by white discharge per vagina (29.0%) and menstrual irregularities (25.9%). Of the 1140 women screened, 12.4% showed cervical microbial infections, 23.6% were reported to have reactive changes, and 0.2% had epithelial cell abnormalities in the cervix. Cervical microbial infections were found to be associated with younger age group, low socio-economic status and younger age at sexual debut. CONCLUSION: Most of the symptoms suggestive of gynaecological morbidities reported in this study are preventable or treatable. Strengthening ongoing cervical cancer screening programme and implementation of health education programmes among tribal population would be the right policy approach to prevent, detect and treat these symptoms at an early stage and to achieve acceptable health outcomes among tribal women.

Opportunities and Barriers to Breast Cancer Screening in a Rural Community in Coastal Karnataka, India: A Qualitative Analysis.

BACKGROUND: Breast cancer is reported to be the most common cancer among women in India with a high mortality to incidence ratio. Late presentation, driven by lack of awareness and limited accessibility to health services are some of the stated reasons for this. Given this context, this qualitative study was carried out to understand the perception of rural women towards the disease and factors that influenced utilization of available screening services among them. METHODS: Forty-four rural women aged 20-60 years from a coastal province in southern India participated in four Focus Group Discussions (FGDs) that were conducted to understand their perception, attitudes and barriers towards breast cancer screening. Participants were identified from the community through purposive sampling and constituted of home makers and working women. The FGDs were led by trained facilitators and the discussions recorded. Ideas and concepts that emerged were listed as codes. Related and similar codes were grouped to form six themes. RESULTS: Women in the study belonged to low- and middle-income households with a mean age of 42.8 ± 7.8 years and almost all had attended school. Although the respondents exhibited fairly good knowledge about the disease, cultural inhibitions, forgetfulness, economic constraints and apprehension towards tertiary health care facility were some of the barriers reported in the uptake of screening services. Participants hailed the role of female health care providers as motivational figures and stressed the need for easily comprehensible information dissemination strategies besides expecting an equal participation of men in issues involving women's health. CONCLUSION: Involving cancer survivors as educators and empowering men on women's health in addition to the felt need of a patient advocate to improve accessibility were some of the highlights of the discussions. Addressing these could go a long way in improving the cancer care continuum in the region.
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Household cooking fuel use and its health effects among rural women in southern India-A cross-sectional study.

The use of biomass fuel is associated with the deterioration of human health and women are more likely to develop health conditions due to their exposure to indoor air pollution during cooking. This study was conducted to assess the pattern of fuel used for cooking in households as well as to determine the association between the types of fuel used with respect to socio-demographic characteristics and health status of women. A community based cross-sectional survey was conducted between August 2016 and September 2018 in four rural areas and one semi-urban area of Udupi district, Karnataka, India. The study comprised 587 families including 632 women. A pre-tested semi-structured questionnaire was used to collect data on the type of fuel as well as self-reported health conditions. Overall, 72.5% of the families used biomass, where 67.2% families were currently using both biomass and liquefied petroleum gas while only biomass was used in 5.3% of the families for cooking. Among women, being ever exposed to biomass fuel was significantly associated with their age, literacy level, occupation and socio-economic status (p < 0.001). Those who were exposed to biomass fuel showed a significant association with self-reported ophthalmic (AOR = 3.85; 95% CI: 1.79-8.29), respiratory (OR = 5.04; 95% CI: 2.52-10.07), cardiovascular (OR = 6.07; 95% CI: 1.88-19.67), dermatological symptoms /conditions (AOR = 3.67; 95% CI: 1.07-12.55) and history of adverse obstetric outcomes (AOR = 2.45; 95% CI: 1.08-5.57). A positive trend was observed between cumulative exposure to biomass in hour-years and various self-reported health symptoms/conditions (p < 0.001). It was observed that more than two-thirds of women using biomass fuel for cooking were positively associated with self-reported health symptoms. Further longitudinal studies are essential to determine the level of harmful air pollutants in household environment and its association with various health conditions among women in this region.

Increasing Engagement for Breast Cancer Screening and Treatment: The "ICANTREAT" Community of Expertise Initiative.

BACKGROUND: Incidence of breast cancer and associated mortality are on the rise globally. Breast cancer incidence in India is on the rise and also accounts for a staggering 50% mortality rate among women. Health illiteracy, socio-economic and cultural barriers in addition to lack of an organized nationwide screening and prevention programme contribute to poor patient outcomes. Thus, it is imperative to strengthen the existing screening and treatment facilities to address the increasing cancer burden. In this regard, we conducted a workshop to investigate the scope of a multi- stakeholder engagement in breast cancer screening and treatment. METHODS: A stakeholder workshop grounded in an established co-design methodology  was convened in a semi-urban coastal district in South India with active participation of physicians, surgeons, occupational therapists, community leaders, programme officers, public health professionals and breast cancer survivors. Shiffman and Smith's framework was adapted to highlight barriers to screening and role of stakeholders in the co-design of solutions. RESULTS: Deliberate and active discussions marked the workshop proceedings resulting in the identification of   individual and systems level barriers, facilitators and implementation strategies. Social stigma and non-existent standard protocols for screening and referral were recognised as critical barriers, while community engagement and a dedicated patient advocate were the proposed facilitators. CONCLUSION: This workshop was an important step in bringing together key stakeholders and marked the beginning of the ICANTREAT initiative and a Community of Expertise. The outcomes highlight the importance of stakeholder involvement in the cancer- care pathway for breast cancer screening, diagnosis and treatment.

Detection of carbapenemase production in Enterobacteriaceae and Pseudomonas species by carbapenemase Nordmann-Poirel test.

PURPOSE: Multidrug-resistant organisms causing community-acquired and hospital-acquired infections are increasing at a dangerous rate. Carbapenemase-producing Enterobacteriaceae and Pseudomonas species are an important source of concern since these organisms are not only resistant to beta-lactam antibiotics but also show cross-resistance to other groups of antibiotics. In the present study, rapid detection of these carbapenemase-producing Enterobacteriaceae and Pseudomonas species by carbapenemase Nordmann-Poirel (Carba NP) test was evaluated by comparing with modified Hodge test (MHT). MATERIALS AND METHODS: Imipenem-resistant Enterobacteriaceae and Pseudomonas species isolated from various samples such as pus, blood, sputum, urine, and endotracheal aspirates were processed for carbapenemase detection by MHT and Carba NP test. Kappa analysis was done to evaluate the percentage agreement between the two tests. RESULTS: Seventy imipenem-resistant Enterobacteriaceae and Pseudomonas isolates were analyzed in the present study for carbapenemase production. 63.41% of Enterobacteriaceae and 34.48% of Pseudomonas species were carbapenemase producers considering both the methods. By MHT, 36 (51.42%) isolates and, by Carba NP test, 35 (50%) isolates were positive for carbapenemase production out of the 70 isolates. CONCLUSION: Carba NP test when compared to MHT is a simple, rapid, cost-effective biochemical test which can be used in all laboratories in the identification of life-threatening carbapenemase-producing Gram-negative bacteria.

Human papilloma and other DNA virus infections of the cervix: A population based comparative study among tribal and general population in India.

BACKGROUND: Despite being preventable, cervical cancer remains a major health concern among women. Persistent Human Papillomavirus (HPV) and other viral co-infections may influence cervical dysplasia. We determined and compared the prevalence and risk factors of cervical viral infections among the tribal and general population of southern coastal Karnataka, India. METHODS: A population-based cross-sectional survey was conducted among 1140 and 1100 women from tribal and general population, respectively. Cervical infections with HPV, Epstein-Barr Virus (EBV), Cytomegalovirus (CMV) and Herpes-Simplex Virus (HSV) were examined using polymerase chain reactions (PCR) and DNA sequencing. RESULTS: HPV prevalence was higher among tribal women (40.6%) than general population (14.3%) while the prevalence of EBV (55.1%) and CMV (49.4%) were lower among tribal women than general population (74.3% and 77.5%, respectively). HSV infection was observed in tribal women only (1.8%). Among HR-HPV strains, HPV-18 was predominant among tribal population (28.3%) while, HPV-16 was predominant among the general population (9.1%). Infections were associated with age, educational status, unemployment and personal hygiene of tribal women. Phylogenetic analysis revealed that HPV-16 variants of tribal participants were closely related to non-European sublineages indicating greater risk of HPV persistence and carcinogenesis. CONCLUSION: The study provides a comparative estimate for DNA virus infections of the cervix among women from general as well as tribal population in this region and also reveals a different type-specific pattern of viral infection. Further research is required to delineate the role of specific interactions between multiple virus infections and their role in carcinogenesis.

Prevalence of Oral Premalignant Lesions and Its Risk Factors among the Adult Population in Udupi Taluk of Coastal Karnataka, India

Objective: Globally oral cancer is one of the ten most common cancers with prevalence being high in Central and South East Asian countries. This survey was conducted to estimate the prevalence of oral pre-malignant lesions (OPML) and to identify their risk factors. Methods: A community based cross-sectional study was carried out among 2033 individuals aged ≥18 years. A questionnaire was administered to collect socio-demographic characteristics, various risk factors for oral cancer and presence of its symptoms. Oral cavity of all the participants was examined in detail by the study investigator as per WHO guidelines for the early diagnosis of oral neoplasia. Result: The prevalence of OPML was found to be 3.73%. Among those with OPML, all were ever tobacco consumers and had poor oral hygiene. A significant association was observed between OPML and younger age group (OR=2.56, 95% CI 1.08-6.02), males (OR=26.76, 95% CI 8.40-85.19) and low socio-economic status (OR = 1.91, 95% CI 1.20-3.02). Tobacco (p<0.001), alcohol (OR= 7.92, 95% CI 4.77-13.14) and areca nut consumption (OR = 5.48, 95% CI 3.42-8.77) were strongly associated with OPML. On multivariate analysis among ever tobacco users, OPML was associated with younger individuals, males and those using smokeless forms of tobacco (p <0.05). The study showed that the participants with OPML were more likely to be never married (OR=1.6, 95% CI 0.92-2.96),to be unskilled workers (OR= 1.45, 95% CI 0.61-3.43), to have suffered from oral trauma (OR =1.30, 95% CI 0.75-2.26), to have consumed hot and spicy food frequently (OR=1.53, 95% CI 0.96-2.24), to have consumed fruits infrequently (OR=1.53, 95% CI 0.90-2.59) and to report family history of any cancer (OR = 1.29, 95% CI 0.58-2.87) . However, these associations were statistically insignificant. Conclusion: The study reinforces that use of substances such as tobacco, alcohol and areca nut are the modifiable risk factors for OPML.

Structural and optical properties of Purpurin for dye-sensitized solar cells.

In this work, we reported a combined experimental and theoretical study on molecular structure, vibrational spectra and Homo-Lumo analysis of Purpurin and TiO2/Purpurin. The geometries, electronic structures, molecular orbital analysis of natural dye sensitizer Purpurin were studied based on density functional theory (DFT) using the hybrid functional B3LYP. Fourier transform infrared (FT-IR) and FT-Raman spectra have been recorded and extensive spectroscopic investigations have been carried out on Purpurin. The optimized geometries, wave number and intensity of the vibrational bands of Purpurin have been calculated using density functional level of theory (DFT/B3LYP) employing 6-311G (d,p) basis set. Based on the comparison between calculated and experimental results, assignments of the fundamental vibrational modes are examined. Features of the electronic absorption spectrum in the visible and near-UV regions were assigned based on TD-DFT calculations. The calculated results suggest that the three excited states with the lowest excited energies in 1,2,4, trihydroxy 9-10 anthraquinone was due to photo-induced electron transfer processes. Frontier molecular orbitals (FMO), LUMO, HOMO, and energy gap, of these dyes have been analyzed to show their effect on the process of electron injection and dye regeneration. Interaction between HOMO and LUMO of Purpurin are investigated to understand the recombination process and charge transfer process involving these dyes. We also performed analysis of I-V characteristics to investigate the role of charge transfer and the stability of the dye molecule.

DFT and TD-DFT study on geometries, electronic structures and electronic absorption of some metal free dye sensitizers for dye sensitized solar cells.

The geometries, electronic structures, polarizabilities and hyperpolarizabilities of 2-hydroxynaphthalene-1,4-dione (henna1), 3-(5-((1E)-2-(1,4-dihydro-1,4-dioxonaphthalen-3-yloxy) vinyl) thiophen-2-yl)-2-isocyanoacrylic acid (henna2) and anthocyanin dye sensitizers were studied based on density functional theory (DFT) using the hybrid functional B3LYP. The Ultraviolet-Visible (UV-Vis) spectrum was investigated by using a hybrid method which combines the properties and dynamics of many-body in the presence of time-dependent (TD) potentials, i.e. TDSCF-DFT (B3LYP). Features of the electronic absorption spectrum in the visible and near-UV regions were plotted and assigned based on TD-DFT calculations. Due to the absorption, bands of the metal-organic compound are n→π(*) present. The calculated results suggest that the three lowest energy excited states of the investigated dye sensitizers are due to photoinduced electron transfer processes. The interfacial electron transfer between semiconductor TiO2 electrode and dye sensitizer is owing to an electron injection process from excited dye to the semiconductor's conduction band. The role of linking the henna1 dye with a carboxylic acid via a thiophene bridge was analyzed. The results are that using a stronger π-conjugate bridge as well as a strong donator and acceptor group enhances the efficiency.