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Article ; Online: Consequences of the epidemiologic transition in Kerala, India – A public–private-partnership model of health care

Jaideep C Menon / Aswathy Sreedevi / Chandrashekar Janakiram

Archives of Medicine and Health Sciences, Vol 11, Iss 2, Pp 287-

A critical analysis

2023 Volume 290

Abstract: The state of Kerala stands out as having the highest prevalence of diabetes and coronary artery disease in comparison to other states within India. This observation positions India as the global epicenter for noncommunicable diseases (NCDs), specifically ...

Abstract	The state of Kerala stands out as having the highest prevalence of diabetes and coronary artery disease in comparison to other states within India. This observation positions India as the global epicenter for noncommunicable diseases (NCDs), specifically diabetes, and cardiovascular ailments. Kerala is in a highly advanced stage of epidemiological transition, surpassing other states in India. This transition is characterized by factors such as an aging population, a high incidence of NCDs, and elevated levels of morbidity. Kerala boasts a robust health-care system encompassing a strong public sector, further reinforced by a network of private hospitals spread across the state. Moreover, the population of Kerala possesses a high literacy rate. It is well-informed about their rights, while local self-governance and nongovernmental organizations (NGOs) actively collaborate to promote community health. These factors have collectively contributed to the state's proactive approach toward addressing NCDs. In the domains of surveillance, monitoring, and prevention of NCDs, as well as the prevention of complications arising from these diseases, Kerala has implemented various schemes across the public, private, and NGO sectors. These initiatives encompass activities to raise awareness about NCDs, provide treatment options, and focus on preventive measures. By documenting and highlighting these schemes, Kerala's health-care system and its achievements can serve as a roadmap for the rest of the country, outlining strategies for prevention, monitoring, and therapeutic interventions. It is imperative that other states within India, as well as low- and middle-income countries (LMICs) at large, adopt and adapt the processes and practices established by Kerala to effectively combat the NCDs pandemic. By following this path, the nation and other LMICs can effectively confront the challenges posed by NCDs and work toward improving their populations' overall health and well-being.
Keywords	diabetes ; epidemiologic transition ; hypertension ; noncommunicable disease ; prevalence ; Medicine ; R
Subject code	320 ; 360
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: White paper on venomous snakebite in India.

Chakma, Joy Kumar / Menon, Jaideep C / Dhaliwal, R S

The Indian journal of medical research

2021 Volume 152, Issue 6, Page(s) 568–574

Abstract: Venomous snakebite is one of the leading preventable causes of mortality and morbidity with tremendous socio-economic impact on the family and nation. Venomous snakebite has been relisted as a neglected tropical disease after having been removed off the ... ...

Abstract	Venomous snakebite is one of the leading preventable causes of mortality and morbidity with tremendous socio-economic impact on the family and nation. Venomous snakebite has been relisted as a neglected tropical disease after having been removed off the list in 2013. This paper discusses the various reasons which could be attributed to the high mortality and morbidity due to venomous snakes and also provides recommendations on policy decisions, improvement on the quality of venom and anti-snake venom and in promoting awareness on how to avoid snakebite.
MeSH term(s)	Animals ; Antivenins/therapeutic use ; Humans ; India/epidemiology ; Snake Bites/drug therapy ; Snake Bites/epidemiology ; Snake Venoms ; Snakes
Chemical Substances	Antivenins ; Snake Venoms
Language	English
Publishing date	2021-06-18
Publishing country	India
Document type	Journal Article
ZDB-ID	390883-5
ISSN	0971-5916 ; 0019-5340
ISSN	0971-5916 ; 0019-5340
DOI	10.4103/ijmr.IJMR_3377_20
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Article: Personalized allocation of acetylsalicylic acid therapy for secondary prevention of coronary artery disease.

Hegde, Nischal N / Mathew, Navin / Thachathodiyl, Rajesh / Menon, Jaideep C

Frontiers in cardiovascular medicine

2022 Volume 9, Page(s) 1004473

Abstract: Background: A single-daily dose of 75 mg of acetylsalicylic acid inhibits 100% of thromboxane-B2 synthesis within 30-60 min. Thromboxane-B2 synthesis then recovers slowly as new platelets are released from the bone marrow. Normally, only 10% of the ... ...

Abstract	Background: A single-daily dose of 75 mg of acetylsalicylic acid inhibits 100% of thromboxane-B2 synthesis within 30-60 min. Thromboxane-B2 synthesis then recovers slowly as new platelets are released from the bone marrow. Normally, only 10% of the platelets are replaced daily by new platelets entering circulation. Hence, 24 h after a dose of acetylsalicylic acid, thromboxane-B2 synthesis is still suppressed by more than 90%. Hence, there is an adequate anti-platelet effect even after 24 h of acetylsalicylic acid intake. However, some patients treated with once-daily acetylsalicylic acid may have an incomplete 24-h suppression of thromboxane-B2 synthesis due to increased platelet turnover. The response could be improved in such patients by twice-daily acetylsalicylic acid administration. This study aimed to identify such a group of patients who would benefit from a twice-daily dose of acetylsalicylic acid. Materials and methods: Serum thromboxane-B2 levels were measured in 79 patients with coronary artery disease receiving 75 mg of acetylsalicylic acid for secondary prophylaxis. Serum levels of thromboxane-B2 were measured after 4 and 24 h of acetylsalicylic acid intake. Patients were then classified into three groups: steady suppression group (serum thromboxane B2 is adequately suppressed at 4 and 24 h), i.e., adequate response to acetylsalicylic acid; fast recovery group (more than 10% rise in serum thromboxane-B2 levels at 24-h when compared to at 4-h) and non-responders (serum thromboxane-B2 levels of >3,100 pg/ml after 4 h of acetylsalicylic acid intake). Patients in the fast recovery group were given twice-daily acetylsalicylic acid and thromboxane-B2 levels were re-measured. Results: A total of 20 patients (24.3%) had steady suppression of thromboxane-B2 and 11 patients (13.9%) belonged to the fast recovery group, i.e., thromboxane-B2 levels were adequately suppressed at 4 h but had recovered by more than 10% at 24 h; which was adequately suppressed by twice-daily acetylsalicylic acid (p 0.004). A total of 48 patients (60.8%) were non-responders. Conclusion: Twice-daily acetylsalicylic acid may be beneficial if serum thromboxane-B2 levels at 4 h are <3,100 and >3,100 pg/ml at 24 h. If thromboxane-B2 levels at 4 and 24 h is <3100 pg/ml but if there is a >10% rise in serum thromboxane B2 at 24 h as compared to that at 4 h, then twice-daily acetylsalicylic acid should be considered. However, if thromboxane-B2 at 4 and 24 h is >3,100 pg/ml consider switching over to a P2Y12 inhibitor.
Language	English
Publishing date	2022-09-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2022.1004473
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Article: Sibling Risk Factor Study in Premature Coronary Artery Disease.

Subramanyan, Shruthi / Pai, Rema / Menon, Jaideep C

The Journal of the Association of Physicians of India

2021 Volume 69, Issue 8, Page(s) 11–12

Abstract: Background: Family history of premature coronary artery disease as a risk factor in first degree relatives has been well established by various studies. This study aims at identification and assessment of the presence of risk factors in asymptomatic ... ...

Abstract	Background: Family history of premature coronary artery disease as a risk factor in first degree relatives has been well established by various studies. This study aims at identification and assessment of the presence of risk factors in asymptomatic siblings of patients with documented premature coronary artery disease. Prevalence of Systemic Hypertension in siblings (both male and female) of patients with premature coronary artery disease (males <45yrs, females <55yrs, confirmed by coronary angiography) was analysed. Other risk factor prevalence estimation was also done which included, dyslipidaemia, diabetes mellitus, tobacco use, alcohol intake, obesity, passive smoke exposure, diet and exercise. The study also estimated the percentage of sibling awareness regarding the risk factors for cardiovascular disease. Materials and methods: This was a cross sectional study where all patients (both In and Out patient), visiting Amrita Institute of Medical Sciences, Kochi and diagnosed as having angiographically proven Premature Coronary Artery Disease from December 2014 to June 2016 were identified and risk factor screening was done for both male and female siblings of any age of these patients. Laboratory tests included fasting blood sugar and fasting lipid profile were analysed after sample collection. Results: 47.6% of male siblings and 35.7% of female siblings were found to be hypertensive, 17.3% of the male siblings and 18.7% of the female siblings were found to have abnormal levels of LDL cholesterol, 22.7% of male siblings and female siblings were found to have abnormal fasting plasma sugar levels, 30.5% of male siblings and 20% of male siblings were found to be overweight. 19.1% of male siblings and 21.4% of female siblings were found to be obese. Only 18.1% of male siblings and 5.7% of female siblings performed any kind of exercise on a regular basis. Among male siblings, 21.9% of male siblings were currently using tobacco in some form. Among non-smokers in both sexes, as many as 36% were exposed to some form of passive smoke. Almost half of the male siblings (49.5%) consumed alcohol containing beverages on a regular basis. Conclusions: Previously undetected risk factors were found to be highly prevalent among the studied siblings. Significant number of siblings were was found to be hypertensive and in addition some had elevated fasting blood sugar levels. Other modifiable risk factors like obesity, alcohol consumption, tobacco use, passive smoking and lack of exercise were also found to be widely prevalent. An important aspect that the study highlighted is the widespread lack of awareness in the study population about risk factors for disease.
MeSH term(s)	Cholesterol, LDL ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Risk Factors ; Siblings
Chemical Substances	Cholesterol, LDL
Language	English
Publishing date	2021-09-02
Publishing country	India
Document type	Journal Article
ZDB-ID	800766-4
ISSN	0004-5772
ISSN	0004-5772
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Article: Fluorodeoxyglucose-positron emission tomography (FDG-PET) of carotid arteries and non-alcoholic fatty liver disease (NAFLD): An analytical cross-sectional study from a teaching hospital, Kerala, South India.

Rane, Sameer / Thachathodiyl, Rajesh / Palaniswamy, Shanmuga S / Menon, Jaideep C / Sudevan, Remya

Journal of family medicine and primary care

2022 Volume 11, Issue 7, Page(s) 3766–3770

Abstract: Introduction: Evidence related to carotid artery F-fluorodeoxyglucose-positron emission tomography (FDG -PET) and non-alcoholic fatty liver disease (NAFLD) is limited from a low-resource setting. The present study aims to examine the association between ...

Abstract	Introduction: Evidence related to carotid artery F-fluorodeoxyglucose-positron emission tomography (FDG -PET) and non-alcoholic fatty liver disease (NAFLD) is limited from a low-resource setting. The present study aims to examine the association between FDG-PET uptakes by the carotid arteries in patients having different grades of NAFLD. Materials and methods: An analytical cross-sectional study was done in a tertiary care center in South India for 1 year. Sonographically confirmed NAFLD patients of the age group 18 years and above were consecutively enrolled for the study after getting informed consent. Anthropometric measurements, ultrasonography for identifying the grades of fatty liver and FDG-PET were performed in the study participants. The data for the study were collected by the research personnel and entered in Microsoft Excel. The data were analyzed in the IBM SPSS version 20.0 software. Results: A total of 24 patients were in the final analysis. The mean age of patients in this study was 56.79 (11.26) years. Among the 24 patients, 95.83% ( Conclusion: The findings of this study showed increased uptake of FDG-PET in carotids in subjects with moderate fatty liver when compared with those with mild fatty liver.
Language	English
Publishing date	2022-07-22
Publishing country	India
Document type	Journal Article
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_2291_21
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Article ; Online: Estimating epidemiological and economic burden and community derived disability weights for snake bite in Kerala: a study protocol.

Menon, Jaideep C / John, Denny / Menon, Geeta R / Joseph, Joseph K / Suseela, P Rakesh / Pillay, V V / Banerjee, Amitava

F1000Research

2021 Volume 10, Page(s) 167

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Adult ; Cost of Illness ; Cross-Sectional Studies ; Humans ; Incidence ; India/epidemiology ; Snake Bites/epidemiology
Language	English
Publishing date	2021-03-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2699932-8
ISSN	2046-1402 ; 2046-1402
ISSN (online)	2046-1402
ISSN	2046-1402
DOI	10.12688/f1000research.50970.2
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Article: Variations and Associated Factors in Symptom-to-Balloon (STB) Time and Door-to-Balloon (DTB) Time Before and After the COVID-19 Lockdown: A Hospital-Based Cross-Sectional Study.

Mohandas, Neeraj V / K, Vijayakumar / Sreedevi, Aswathy / George, Neethu / Eapen, Koshy / Subramanian, Saji / Raj, Himal / Menon, Jaideep C

Cureus

2023 Volume 15, Issue 10, Page(s) e47658

Abstract: Introduction: During the COVID-19 lockdown, India saw a major restriction in the movement of people. Patients with acute myocardial infarction (MI) required early interventions and follow-up of independent predictors like symptom-to-balloon (STB) time ... ...

Abstract	Introduction: During the COVID-19 lockdown, India saw a major restriction in the movement of people. Patients with acute myocardial infarction (MI) required early interventions and follow-up of independent predictors like symptom-to-balloon (STB) time and door-to-balloon (DTB) time. This study aimed to determine changes in STB and DTB time before and after the COVID-19 lockdown and its associated risk factors. Methods: A hospital-based cross-sectional study of 105 patients admitted to the cardiac care units (CCU) of two tertiary care centers in a district of Southern India for six months was conducted to compare the changes in STB and DTB time before and after the COVID-19 lockdown (three months before March 2020 and three months after March 2020), and data was collected from medical records. The data collected was then entered into Microsoft Excel (Microsoft Corporation, Washington, USA), numerically coded, and analyzed using SPSS Statistics version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.). The Chi-square and Mann-Whitney U tests assessed the association between the dependent and independent variables. The STB/DTB time (before and after the COVID-19 lockdown) was the dependent variable, while the age, gender, co-morbidities, smoking status, and date of admission of patients (before and after the COVID-19 lockdown) were taken as the independent variables. A p-value of <0.05 was considered statistically significant. The predictor variables were identified using the regression method, where all variables with a significance of <0.2 were taken. Results: The overall mean (±SD) STB time was 408.7 (±307.1) minutes, and the mean (±SD) DTB time was 161.7 (±261.6) minutes. The pre-lockdown mean STB time was 404.6 minutes, and the mean DTB time was 153 minutes, whereas the post-lockdown mean STB and DTB time were higher at 413.3 minutes and 171.6 minutes, respectively. Out of the total 105 patients, 95 (90.5%) had an STB time of ≥120 minutes, and 77 (73.3%) had an ideal DTB time of <90 minutes. There was no statistically significant variation in the STB and DTB time before and after the lockdown. Only the age group >60 years (38 (97.4%)) was found to be statistically significant with an STB time of ≥120 minutes after the lockdown (p-value=0.040), and patients referred from primary and secondary care centers (AOR (95% CI)=4.669 (1.129-19.298)) were found to be an independent factor in reducing DTB time before and after the COVID-19 lockdown. Conclusion: The efficiency of the health system, irrespective of the COVID-19 lockdown, was observed; nevertheless, a delay in the overall recognition of symptoms of MI was perceived. The importance of time factors in identifying the symptoms of non-communicable diseases (NCDs), especially MI and stroke, has to be ascertained among the general population.
Language	English
Publishing date	2023-10-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.47658
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Article ; Online: ICMR task force project- survey of the incidence, mortality, morbidity and socio-economic burden of snakebite in India: A study protocol.

Menon, Jaideep C / Bharti, Omesh K / Dhaliwal, Rupinder S / John, Denny / Menon, Geetha R / Grover, Ashoo / Chakma, Joy K

PloS one

2022 Volume 17, Issue 8, Page(s) e0270735

Abstract: Background: Snakebite is possibly the most neglected of the NTDs (Neglected Tropical Diseases). Half of the global deaths due to venomous snakebites, estimated at 100,000 per year, occur in India. The only representative data on snakebite available from ...

Abstract	Background: Snakebite is possibly the most neglected of the NTDs (Neglected Tropical Diseases). Half of the global deaths due to venomous snakebites, estimated at 100,000 per year, occur in India. The only representative data on snakebite available from India is the mortality data from the RGI-MDS study (Registrar General of India- 1 Million Death Study) and another study on mortality from the state of Bihar. Incidence data on snakebite is available for 2 districts of the state of West Bengal only. Hospital-based data on snakebite admissions and use of ASV are gross underestimates as most snakebite victims in rural India depend more on alternate treatment methods which do not get represented in National registries. The proposed study is a multi-centric study to determine the incidence, morbidity, mortality and economic burden of snakebites in India covering all 5 geographical zones of the country. Protocol: A community level surveillance for snakebite covering 31 districts in 13 states of India in order to obtain annual incidence of snakebites from the community. Frontline health workers will be trained to gather information on new cases of snakebite over the study period of 1-year, from "wards "(smallest administrative subunit of a village or town) that they represent in the study districts. Dedicated field officers would collect data on snakebites, victim characteristics, outcomes, utilization of health facilities on a questionnaire sheet designed for this purpose. The study duration is for 18 months from April 2022 to October 2023. Discussion: The study would be the first of its kind in India looking prospectively at the incidence of snakebite covering 13 states in 5 zones of India and a population of 84 million. Our study covers 6.12% of the total population of the country as compared to the incidence study conducted in Sri Lanka which covered 1% of the total population.
MeSH term(s)	Financial Stress ; Humans ; Incidence ; India/epidemiology ; Multicenter Studies as Topic ; Snake Bites/epidemiology ; Surveys and Questionnaires
Language	English
Publishing date	2022-08-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0270735
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Article ; Online: What was right about Kerala’s response to the COVID-19 pandemic?

Amitava Banerjee / Jaideep C Menon / PS Rakesh / Denny John / Rajesh Thachathodiyl

BMJ Global Health, Vol 5, Iss

2020 Volume 7

Keywords	Medicine (General) ; R5-920 ; Infectious and parasitic diseases ; RC109-216 ; covid19
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: ICMR task force project- survey of the incidence, mortality, morbidity and socio-economic burden of snakebite in India

Jaideep C Menon / Omesh K Bharti / Rupinder S Dhaliwal / Denny John / Geetha R Menon / Ashoo Grover / Joy K Chakma

PLoS ONE, Vol 17, Iss 8, p e

A study protocol.

2022 Volume 0270735

Abstract: Background Snakebite is possibly the most neglected of the NTDs (Neglected Tropical Diseases). Half of the global deaths due to venomous snakebites, estimated at 100,000 per year, occur in India. The only representative data on snakebite available from ... ...

Abstract	Background Snakebite is possibly the most neglected of the NTDs (Neglected Tropical Diseases). Half of the global deaths due to venomous snakebites, estimated at 100,000 per year, occur in India. The only representative data on snakebite available from India is the mortality data from the RGI-MDS study (Registrar General of India- 1 Million Death Study) and another study on mortality from the state of Bihar. Incidence data on snakebite is available for 2 districts of the state of West Bengal only. Hospital-based data on snakebite admissions and use of ASV are gross underestimates as most snakebite victims in rural India depend more on alternate treatment methods which do not get represented in National registries. The proposed study is a multi-centric study to determine the incidence, morbidity, mortality and economic burden of snakebites in India covering all 5 geographical zones of the country. Protocol A community level surveillance for snakebite covering 31 districts in 13 states of India in order to obtain annual incidence of snakebites from the community. Frontline health workers will be trained to gather information on new cases of snakebite over the study period of 1-year, from "wards "(smallest administrative subunit of a village or town) that they represent in the study districts. Dedicated field officers would collect data on snakebites, victim characteristics, outcomes, utilization of health facilities on a questionnaire sheet designed for this purpose. The study duration is for 18 months from April 2022 to October 2023. Discussion The study would be the first of its kind in India looking prospectively at the incidence of snakebite covering 13 states in 5 zones of India and a population of 84 million. Our study covers 6.12% of the total population of the country as compared to the incidence study conducted in Sri Lanka which covered 1% of the total population.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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