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Introduction Hazardous healthcare waste produced at home contributes to approximately 0.5% of biomedical waste, and although potentially infectious, is often discarded with other domestic wastes. The study aimed to quantify and compare types and patterns of biomedical waste generated in homes and to assess the knowledge, attitude, and practices regarding biomedical waste among selected urban and rural households in the coastal area of Mangalore city in Karnataka. Methods A cross-sectional study was conducted in households consisting of rural and urban field practice areas of a tertiary care hospital in coastal Karnataka from November 2017 to February 2018. A pretested semi-structured questionnaire on knowledge, attitude, and practice regarding healthcare waste generated at home was assessed. Qualitative variables of the waste segregation practice, types of biomedical waste, the knowledge, perception, and attitude to practices regarding biomedical waste were expressed in percentages proportions and analyzed using SPSS v.20. Results Baby diapers were the most common hazardous waste. The number of baby diapers produced daily in rural and urban areas was 32 (42.7%) and 64 (85.3%), respectively. The urban households had better knowledge of possible hazardous healthcare waste at home, 28 (37.33%) compared with 7 (9.3%) in rural households. Seventy-one (94.7%) urban and 49 (65.3%) rural households had a favorable attitude toward the disposal of hazardous domestic biomedical waste. Conclusion The knowledge, attitudes, and practices regarding hazardous healthcare waste produced at the household level were better among urban households compared with rural households.

A pandemic leads to disruption and stretching of an existing health care system and its resources. Coronavirus disease 2019 (COVID-19) data show distinct and severe manifestations in children necessitating critical care. Children need prioritization as they are susceptible to COVID-19 as part of the family cluster, varied presentations, and mortality. The purpose of this report is to discuss the optimization of the health care system for pediatric care. The key initiatives were to identify our objectives, bring out changes to the organizational processes, and integrate the same into the existing system. A systems approach to health care delivery by optimizing infrastructure, human resources, materials, funding, leadership, and governance was undertaken. This resulted in creation of distinct COVID-19 and non-COVID-19 service areas, management protocols, and trained health care workers. Partnership was forged with the public health system. This preparedness and continued responses to the demands of the health care system helped us manage children ranging from neonates to adolescents efficiently. Though the health care system is mostly open, acting upon the modifiable factors gave better preparedness in a short time.

The global burden of injuries in 2017 showed that 57.2 million people were affected. The study aimed to assess the patterns of injuries and costs related to the treatment of injuries. Injury in rural areas tends to be under-reported, which hinders estimation of the true prevalence of physical injuries for implementing injury prevention strategies at the community level. A community-based, cross-sectional study was conducted in the field practice area of a private medical college from May to August 2019. Physical injuries sustained by 1723 individuals over three months were collected and were classified based on ICD-10. Descriptive data were expressed using frequencies and percentages and median (Interquartile Range). Independent T-test, Mann Whitney U test, Chi-square test was used to determine statistical differences between the variables. The total number of injuries recorded was 105(6.9%) among 1723 individuals. The most common injuries were superficial injuries in 77 (70.0%), of which 98(89.1%), of which the upper 55(50.0%) limb was more affected than lower limbs 43(39.1%). The overall 3-month injury rate was 60.94(49.6-72.23) per 1000 persons. The median amount of money spent on the treatment of injuries was INR 225.0(50.0-1000.0).

Introduction Lung cancer is one of the most common forms of malignancies worldwide. It is usually diagnosed in late stages due to overlapping symptoms with other respiratory illnesses. Identifying the stage at presentation to tertiary care determines the prognosis of a patient to large extent. Methods Histologically/cytologically confirmed cases of nonsmall cell lung cancer subjects were included for prospective observational study. Stages of the disease at presentation and survival duration in the patients were studied and the data were compared between two groups: those that accepted and those that refused standard treatment. Results Ninety-two percent of our patients presented either stage IIIB or stage IV disease at the time of diagnosis. Median duration of survival in the group that took standard treatment was 6 months, whereas in the group that refused standard treatment, it was 4 months. Based on their smoking status, the median duration of survival was 4 months among smokers, whereas it was 9 months among nonsmokers with a log rank test value of 3.040 and an insignificant p-value of 0.081. Conclusion More than 90% patients presented in later stages of the disease and there was no survival benefit in patients who were treated with palliative care.

Health care is a fundamental right of every human being. About half of the world’s population (An estimated 3.4 billion of the world’s 7.6 billion in 2018) lived in rural areas. Individuals in rural areas often have poor access to healthcare because of poor accessibility and availability of standard healthcare systems and socio-cultural factors affecting their perception of health compared to the urban population. Though there is a projected decrease in the absolute percentage of the world’s population dwelling in rural areas by 2050, there is also a projected increase projected increase needing of prioritizing rural health. This chapter shall discusses the critical factors that disadvantage the rural population. It also considers the methods used to work out rural healthcare delivery strategies to decrease this disparity in rural areas’ health care facilities.

Background: Children with disabilities are expected to have poor nutritional status in comparison to children without disabilities. However, limited data on nutritional status of children with and without disabilities in rural settings in India. Objective: To assess and compare the nutritional status of children with and without disability. Methods: A cross-sectional study among children aged 5–15 years was conducted in the rural practise area of a medical college in Karnataka. 290 children (145 with and 145 children without disability) of similar age and sex were studied. Age and sex-specific World Health Organization (WHO) BMI centiles, 24 h dietary calorie and protein intakes were assessed and compared. Median and interquartile ranges were calculated for quantitative variables. Mann–Whitney U test was used to assess the differences in quantitative variables among the two groups. Results: As per WHO BMI centiles, 33.1% with and 37.20% without disabilities were undernourished. The median calorie consumed by children with disabilities was 1169.0 (946.5–1586.0) significantly lower compared to that of children without disability, that is, 1362.0 (1167.0–1641.0). The median protein consumed by children with disabilities was 28.0 (22.5–38.0) significantly lower compared to that of children without disability, that is, 32.0 (28.0–40.0). Conclusions: Children with disabilities had similar rates of undernutrition as that of their non-disabled peers and their lesser dietary intake in terms of calories and proteins.

Background: Endosulphan was extensively sprayed in the cashew plantations in over 90 villages in Dakshina Kannada district for almost two decades before a ban was imposed. Areas where Endosulfan spraying was carried out, disability screening camps were conducted. The study aimed at describing the distribution of attendees of the disability screening camps among the population residing in the Endosulfan exposed area of Dakshina Kannada district of Karnataka, India.Methods: A cross sectional descriptive was undertaken with the permission of district health authorities by specialists in the villages of five taluks, on the patients attending the disability screening camps conducted in the year 2014-15. The patients were consecutively listed and classified based on the Persons with Disabilities Act, 1995 and analysed using SPSS version 20.0.Results: Of the 4214 patients who attended the screening camps for disability held in the taluks mentioned above, 2190 (52.0%) were males. The most common affected age groups were between 5-19 years of 1606 (38.1%). The most common disability was intellectual disability (including cerebral palsy) in 2474 (58.7%) followed by physical disability seen in 384 (15.5%). Infertility was seen among 297 (7.09%) of the attendees of the screening camps. The total number of cancers patients attending the screening camps was 71 (1.6%), and 21 (0.5%) were cancers related to the reproductive tract, and 6 (0.1%) had breast cancer.Conclusions: The most common age groups reporting with disabilities to the screening camps conducted by the district health authorities in Endosulfan sprayed villages of Dakshina Kannada district belonged to 5-19 years, and the most common disability was intellectual disability.

Background: Food insecurity exists when people are undernourished due to the physical unavailability of food, lack of social or economic access to adequate food, and inadequate food utilization. As per FAO, India is home to 25% of world’s hungry population and 194.6 million undernourished people for the period of 2014-2016. The objectives were to assess the food insecurity and determine its correlates in a rural community of Karnataka.Methods: A cross sectional study was undertaken to assess food insecurity and its correlates in households of a rural community of Karnataka using the “Household Food Insecurity Access Scale (HFIAS) for measurement of food access: Version 3” questionnaire during December 2014. The data collected was analyzed using SPSS version 20.0 and mean, proportion and chi-square were calculated as appropriate.Results: The average HFIAS score was as low as 4.15. 80.8% of the 52 households were food insecure, of which 17.3% were mildly insecure, 48.1% were moderately insecure and 15.4% were severely food insecure.Conclusions: With 80.8% food insecurity in the rural agriculture-based community, there is a need for improvements in stability, accessibility and utilization of available food through use of fair price shops and garden kitchen promotion.