Sitanshu Sekhar Kar

• MD (Community Medicine) MBA (Hospital Management) Fulbright Fellowship 2016-17
• Professor at Jawaharlal Institute of Post Graduate Medical Education and Research

[This corrects the article DOI: 10.1371/journal.pone.0272042.].

Introduction Primary healthcare is broadly acknowledged as the cornerstone of any strategy aimed at achieving Universal Health Coverage (UHC). This study aims to evaluate the costs, work patterns and efficiency of comprehensive primary healthcare (CPHC) in India. Methods and analysis We will use a top-down microcosting approach to estimate the econ...

Background Access to antenatal care (ANC) services has improved. However, it is also noted that some antenatal women seek multiple healthcare services. Exploring this practice will identify gaps in service provision and pave the path toward improving the quality of services. Objective This study aimed to measure the concurrent use of public and pr...

The current study aimed to determine the trend in the incidence of various communicable diseases reported under the Integrated Disease Surveillance Program (IDSP) in Puducherry. This record-based study obtained disease details in terms of the number of suspected cases reported, tested, and positive for the selected diseases reported under IDSP from...

Background: India faces over 220 000 lakh new kidney failure cases annually, requiring approximately 34 million dialysis sessions, creating a significant economic burden on the healthcare system. This study estimates the costs of providing hemodialysis (HD) and Continuous Ambulatory Peritoneal Dialysis (CAPD) under a Public-Private Partnership (PP...

Objective: To describe the change in mean and shape of the distributions of blood pressure (BP) and random blood glucose (RBG) of adults aged 15–49 between two consecutive rounds of the National Family Health Survey in India. Study design and methods: We analyzed the data of adults aged 15–49 from the household datasets of NFHS 4 (2015–16) and 5 (...

Background Faculty development programs (FDPs) in health professions education (HPE) are instrumental in supporting, promoting, and improving HPE curricula and activities that target individual- and system-level capacity strengthening. FAIMER, a division of Intealth, has been offering FDPs for global health professions educators in HPE and leadersh...

Background: The cardiovascular disease (CVD) risk prediction charts, updated by the World Health Organization for 21 regions in 2019. These charts—lab and non-lab versions—estimate a person’s overall CVD risk; the non-lab version is intended for low-resource environments. Objectives: Using the “non-lab” and “lab” versions of the WHO CVD risk predi...

Background Existing creatinine-based equations to estimate glomerular filtration rate (GFR), developed primarily in populations of European and African American ancestry, do not accurately reflect the GFR in the Indian population due to differences in body composition, diet, and other factors. This manuscript describes the rationale and methodology...

Background Adequate sleep is essential for human beings to maintain optimal health. Medical professionals, including nurses, work in stressful environments that could affect their sleep quality. The objective of this study was to determine the prevalence and the factors associated with poor sleep quality among nurses in a tertiary care public hospi...

Both diabetes mellitus (DM) and hypertension (HTN) have been on the rise in recent decades all over the world more remarkably in developing countries like India. We intend to measure the prevalence of DM and HTN in the Indian population and to compare the trends and various correlates of these diseases in NFHS (National Family Health Survey)-4 and...

Context: Diabetes self‑management education (DSME) improves patients’ clinical outcomes and quality of life by encouraging self‑care behavior. Aims: This study aimed to find out the effectiveness of a DSME by comparing changes in stages of self‑care behavior and to explore perceived barriers in diet, exercise, and foot care among patients with type...

Objective To assess the potential associations between social determinants of health (SDH) and severe maternal outcomes (SMO), to better understand the social structural framework and the contributory, non-clinical mechanisms associated with SMO. Study design Prospective observational study. Study setting Tertiary referral centre in south-eastern...

Objective To assess the cost-effectiveness of emicizumab prophylaxis for patients having haemophilia A with inhibitors in the Indian context using an adaptive health technology assessment (aHTA) methodology. Design Economic evaluation using multiple approaches aimed at adjusting previously generated cost-effectiveness results based on (1) price di...

Background Cardiovascular diseases (CVDs) account for over three-quarters of all deaths taking place in developing nations. Objective The present study aims to stratify noncommunicable disease (NCD) patients using the Globorisk chart for predicting their 10-year risk of a major (fatal or nonfatal) CVD event and to estimate the level of agreement b...

Introduction: The objective of this study was to estimate the level of compliance and the factors associated with high adherence to the Tobacco-Free Educational Institutions (ToFEI) guidelines of the Government of India among schools in the district of Puducherry, India. Methods: This cross-sectional study was conducted among schools (N=50) in the...

Background Faculty development programs (FDPs) in health professions education (HPE) are instrumental in supporting, promoting, and improving HPE curricula and activities that target individual- and system-level capacity strengthening. FAIMER, a division of Intealth, has been offering FDPs for global health professions educators in HPE and leadersh...

Background & objectives The Cigarette and Other Tobacco Products Act (COTPA) limits the sale of tobacco products, promotion and advertising and packaging of tobacco products in India. Periodic monitoring of the level of compliance with all sections of COTPA is obligatory to assess the effectiveness of the act. Methods This pre-post study aimed to...

Background To compare the morbidity and treatment-seeking pattern of low birth weight (LBW) and normal birth weight (NBW) infants during the first six months. Material and Methods A prospective cohort study was conducted in the service areas of eight urban primary health centers of Puducherry from October 2019 to July 2021. Details of LBW and sex-...

Background Microalbuminuria is an early indicator for renal and cardiovascular diseases, especially among patients with diabetes mellitus (DM) and hypertension (HTN). We determined the prevalence and the factors associated with microalbuminuria among patients with type 2 DM and/or HTN in the urban areas of the Puducherry district in India. Methods...

Background Cancers represent a challenging public health threat in Asia. This study examines the temporal patterns of incidence, mortality, disability and risk factors of 29 cancers in Asia in the last three decades. Methods The age, sex and year-wise estimates of incidence, mortality, and disability-adjusted life years (DALYs) of 29 cancers for 4...

Background: To trigger quit intention and practice of preventive measures for COVID-19 among tobacco users; it is imperative for them to be well aware of the fact that they are at higher risk of COVID-19 infection and should be at higher efficacy to practice preventive measures for the disease as compared to nonusers of tobacco. Objectives: This...

During the initial phases of the COVID-19 pandemic contact tracing was used to control spread of the disease. It played a key role in health care institute which continued to work even during lockdown. In this piece of work, we share the lessons learnt from the contact tracing activity done in the health care institution during April to July 2020....

https://pubmed.ncbi.nlm.nih.gov/38092509/#full-view-affiliation-41

Predictors of hypertension (HTN) control status have not been well understood in India. This information is crucial for policymakers and program managers to devise newer HTN control strategies and implement relevant policies and programs. Therefore, we undertook this meta-analysis to estimate the effect of various factors on the control status of H...

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is a multinational collaborative research study with >10,000 collaborators around the world. GBD generates a time series of summary measures of health, including prevalence, cause-specific mortality (CSMR), years of life lost (YLLs), years lived with disability (YLDs), and disabi...

Repeated serological testing tells about the change in the overall infection in a community. This study aimed to evaluate changes in antibody prevalence and kinetics in a closed cohort over six months in different sub-populations in India. The study included 10,000 participants from rural and urban areas in five states and measured SARS-CoV-2 antib...

Objectives Patients with diabetes have a higher risk of developing chronic kidney disease (CKD). Early detection of CKD through microalbuminuria screening, followed by treatment, delays the progression of CKD. We evaluated the cost-effectiveness of population-based screening of microalbuminuria among normotensive type 2 diabetes mellitus patients a...

In an individual, the development and severity of Non-Communicable Diseases (NCDs) are determined by the presence or absence of clustering of NCD risk factors in them. We aimed to determine the prevalence and the factors associated with clustering of risk factors of NCDs in the district of Puducherry in India. We conducted a community-based cross-s...

Background: Cardiovascular disease (CVD) risk stratification is recommended by the World Health Organization (WHO) for effective CVD management in primary healthcare settings. Using the 2019 updated WHO CVD risk charts, we estimated the 10-year risk for developing fatal and non-fatal CVD among participants of the Longitudinal Aging Study in India (...

Background: Social capital denotes the relationships, networks, norms and values in the community. A high level of social capital positively improves health through a supportive social system. Illnesses affect health and social relationships. One such disease is tuberculosis (TB), known for its social stigma. India has the highest burden of morbidi...

Background: High blood pressure (hypertension) is a major risk factor contributing to 60% of premature deaths caused by non-communicable diseases. In India, a mere 15% of the hypertensive population achieves optimal blood pressure control. Effective monitoring of hypertension is crucial for mitigating the morbidity and mortality associated with car...

Cost effectiveness analysis of interim positron emission tomography (PET-2, done after 2 cycles of chemotherapy) based response adaptive therapy (RAT) approaches in advanced Hodgkin lymphoma (aHL) are not available from an Indian perspective. We used a five-year decision analytics model to assess the cost-effectiveness of the two RAT approaches [(e...

Background Haemoglobin disorders are unique and important health challenges for tribal populations. Hence, this study was undertaken with the aim to screen for haematological disorders, particularly anaemia and haemoglobinopathies, and to assess the sociodemographic profile in indigenous communities residing in and around Puducherry. Methods This...

Introduction The World Health Organization (WHO) has released the updated cardiovascular disease (CVD) risk prediction charts in 2019 for each of the 21 Global Burden of Disease regions. The WHO advocates countries to implement population-based CVD risk assessment and management using these updated charts for preventing and controlling CVDs. Objec...

Introduction: Continued tobacco use in cancer patients leads to decreased treatment efficacy and safety, decreased survival, decreased quality of life, and an increased risk of cancer recurrence and primary tumours at other sites. Objective: To determine the prevalence of continued tobacco usage during the first 6 months of diagnosis among tobac...

Background: Studies estimating treatment cost associated with hypertension care in the Indian context are limited and show considerable variations. Objective: To estimate the extent of out-of-pocket expenditure (OOPE) for hypertension care at the population level and its financial impact on households in India. Methods: We analysed the data of the...

Objective To assess the impact of maternal near‐miss on late maternal death and the prevalence of hypertension or chronic kidney disease (CKD) and mental health problems at 12 months of follow up. Methods This prospective cohort study was conducted in a tertiary hospital in the southeastern region of India from May 2018 to August 2019, enrolling t...

Introduction India accounts for one-fourth of the global tuberculosis (TB) burden and also faces a rising burden of non-communicable diseases. Only a few have studied the association between the infective pathogenesis of TB and cardiovascular diseases (CVD). Methods A cross-sectional exploratory analytical design was used to compare CVD risk factor...

Background Common childhood illnesses such as diarrhea, fever, and acute respiratory infection impose substantial health burdens among under-five children, and Low Birth Weight (LBW) has been associated with an increased prevalence of these illnesses. However, the impact of LBW on healthcare utilization and the economic burden of these illnesses re...

Purpose The objectives were to study the effect of a single dose of intravenous (IV) zoledronic acid (ZA) on changes in bone mineral density (BMD) (lumbar spine (LS), hip, & distal forearm), trabecular bone score (TBS) and bone turnover markers (BTMs) in postmenopausal osteoporotic women with and without diabetes over 12 months. Methods Patients w...

Objectives To determine the proportion of depression and anxiety disorders; their association with sociodemographic, NCD-related factors and Quality of Life among persons with type II Diabetes Mellitus or Hypertension at a rural health center in Puducherry. Materials and Methods This facility-based cross-sectional analytical study recruited 692 pa...

Neighbourhood environment plays a pivotal role in determining the individual’s nutrition through availability and accessibility of healthy food options. This community-based cross-sectional descriptive study examined neighbourhood spatial attributes using Geographical Information System (GIS) and describe perceived nutrition environment among adult...

Repeated serological testing tells about the change in the overall infection in a community. This study aimed to evaluate changes in antibody prevalence and kinetics in a closed cohort over six months in different sub-populations in India. The study included 10,000 participants from rural and urban areas in five states and measured SARS-CoV-2 antib...

Background: In India, women with GDM are at an increased risk of developing type 2 diabetes mellitus (T2DM). Despite this, the rate of postnatal blood glucose monitoring is low, and the reasons are not well known. Hence, our study explored the barriers and facilitating factors associated with T2DM postnatal screening six weeks after delivery. Mat...

Background and aims: Uncontrolled hypertension is a major risk factor for cardiovascular diseases (CVDs). The present study aimed to conduct a systematic review and meta-analysis to estimate the pooled prevalence of control status of hypertension in India. Methods and results: We carried out systematic search (PROSPERO No.: CRD42021239800) in Pu...

Introduction To ensure that the evidence generated by health technology assessment (HTA) is translated to policy, it is important to generate a threshold value against which the outcomes of HTA studies can be compared. In this context, the present study delineates the methods that will be deployed to estimate such a value for India. Methods and an...

Objectives To perform an external validation to assess the usefulness of the Maternal Severity Index (MSI) in predicting maternal death among women with potentially life-threatening complications during pregnancy or childbirth. Design Prospective observational study. Setting A tertiary referral centre in southeastern India. Participants 1833 wom...

Background: Formative assessments methods such as objective structured clinical examination (OSCE) are reliable and valid assessment tools employed under the competency-based medical education (CBME) curriculum. However, there was no uniform scale to assess the attributes of OSCE for any of the medical subjects. Hence, this study was done to devel...

Introduction: Nurses are constantly exposed to physical and mental stress due to the nature of their job. Estimating the prevalence and the factors associated with psychological distress among nurses is crucial to devise health promotion strategies. We conducted this study to determine the prevalence of psychological distress and its associated fa...

Background COVID-19 vaccination of the healthcare workers (HCWs) is a key priority in the fight against the SARS-CoV-2 pandemic. India launched its COVID-19 vaccination program in January 2021. We aimed to understand the trends in willingness to receive COVID-19 vaccines and its associated factors among HCWs in India. Methods Using a repeated cros...

Background: In India, around 10% of mothers with gestational diabetes mellitus (GDM) develop diabetes within months after delivery. But only 29% of them undergo blood glucose testing in the postnatal period. Our study aimed to compare the proportion of mothers with GDM who got postnatal blood glucose checked at 8 weeks among mothers who received h...

Cesarean section (CS) is generally performed either to ensure maternal and child safety when vaginal delivery is not possible. The WHO has indicated that CS rates of more than 10% are considered overutilization. Increased CS rates can cause an increase in postpartum antibiotic treatment and longer hospital stay. In this research, we conducted a mat...

Objectives Dabigatran has a better safety profile and requires less monitoring, but is costlier than warfarin. This study evaluated the cost-utility of dabigatran relative to warfarin for preventing stroke in nonvalvular atrial fibrillation (NVAF) in India. Methods A Markov decision analysis model was developed to compare dabigatran (110 or 150 mg...

Objectives: This study aimed to determine the proportion of tobacco-related head and neck cancer patients in need of nicotine de-addiction services at the time of diagnosis and factors associated with it. Methods: Facility-based cross-sectional study was conducted in a tertiary care center. Tobacco-related head and neck cancer patients with a pa...

Background & objectives: The World Health Organization (WHO) document released on the World No Tobacco Day, 2020, mentions that tobacco kills over 22,000 people worldwide every day either from its use or second-hand smoke exposure, which is one person every 4 sec. In 2003, the Cigarettes and Other Tobacco Products Act (COTPA) was enacted by the In...

Objective: This study was undertaken to assess the change in social contact and transmission dynamics among adults in the Puducherry district during the different phases of country‑wide lockdown. Methods: Adults aged 18–69 years in Puducherry were assessed for frequency and duration of contacts in the following time points: prior to lockdown (March...

Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods:...

Background In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unma...

The Framework Convention on Tobacco Control (FCTC), negotiated under the auspices of WHO is one of the most quickly ratified treaties in United Nations history that seeks "to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke" by en...

Background Abdominal obesities are better markers for predicting cardiovascular abnormalities than risk stratification based only on body mass index (BMI). We aimed to estimate the prevalence of abdominal adiposities using predictive equations for Asian Indian adults and to determine the prevalence of metabolically healthy subjects among those over...

Purpose The work nature of nurses and the associated lifestyle changes put them at high risk of developing non-communicable diseases (NCDs). This study was conducted to estimate the prevalence of NCD risk factors among nurses working in a tertiary care hospital in Puducherry and to determine the associated factors among nurses. Methods We conducte...

Objectives: India introduced BBV152/Covaxin and AZD1222/Covishield vaccines in January 2021. We estimated the effectiveness of these vaccines against severe COVID-19 among individuals aged ≥45 years. Methods: We did a multi-centric, hospital-based, case-control study between May and July 2021. Cases were severe COVID-19 patients, and controls were...

Background India introduced BBV152/Covaxin and AZD1222/Covishield vaccines from January 2021. We estimated effectiveness of these vaccines against severe Coronavirus disease 2019 (COVID-19) among individuals aged ≥45 years. Methods We did a multi-centric, hospital-based, case–control study between May and July 2021. Cases were severe COVID-19 pati...

The share of expenditure on medicines as part of the total out-of-pocket (OOP) expenditure on healthcare services has been reported to be much higher in India than in other countries. This study was conducted to ascertain the extent of this share of medicines expenditure using a novel methodology. OOP expenditure data were collected through exit-in...

Objective To compare the incidence of maternal near miss using the World Health Organization (WHO) near-miss tool and six other criteria sets, including criteria designed for low-resource settings or specifically for India. Methods In a cohort study we used WHO severity indicators to identify women with potentially life-threatening conditions durin...

Background Vaccine hesitancy is of considerable concern as it threatens the great potential of a vaccine against COVID-19. This study aims to determine factors associated with community health workers’ willingness to participate in clinical trials of COVID-19 vaccine, and their vaccination intention, in India. Methods A cross-sectional study was c...

Background Responding to the fast transmission rates and increasing fatality rates, countries across the world expedited the development and deployment of the vaccine for coronavirus disease 2019 (COVID-19). Evaluation of individuals' willingness to pay (WTP) would provide pertinent information regarding future demand and financing preferences, whi...

Background: Diabetic foot ulcer (DFU) is a common complication of diabetes. Hyperbaric oxygen therapy (HBOT) is an adjunct treatment that expedites the healing of DFU. Aim: To evaluate the cost-utility of using standard wound care (SWC) plus HBOT as compared to SWC alone for the treatment of DFU from a societal perspective in the Indian context....

Background and aim The World Health Organization has revised the cardiovascular disease (CVD) risk prediction charts in 2019 for each of the 21 Global Burden of Disease regions. These charts (non-lab and lab versions) estimate the total CVD risk in an individual, of which the non-lab is for low-resource settings. We aimed to estimate the burden of...

Background: Despite the success of adult vaccination against COVID-19, providing vaccines to children remains a challenge for policymakers globally. As parents are primary decision-makers for their children, we aimed to assess parents' perceptions and intentions regarding COVID-19 vaccination in India. Methods: A cross-sectional web-based study...

Background: Despite the success of adult vaccination against COVID-19, providing vaccines to children remains a challenge for policymakers globally. As parents are primary decision-makers for their children, we aimed to assess parents’ perceptions and intentions regarding COVID-19 vaccination in India. Methods: A cross-sectional web-based study was...

Introduction: Several studies have explored the effect of anthropometric risk factors on metabolic syndrome. However, no systematic effort has explored the effect of overweight and obesity on the prevalence of metabolic syndrome in India. Thus, we undertook a meta-analysis to estimate the effect of anthropometric risk factors on the prevalence of...

Background: Settings-based approach has received lot of attention under WHO renewed strategy of health promotion. It advocates regular screening/health check-ups of employees to maintain a healthy workplace. This study aimed to assess prevalence of metabolic syndrome (MetS) among faculty members and its association with selected sociodemographic, b...

Background: Various literature have dealt with the physical aspect of amputation and the functional outcome after amputation. There are a few studies that give focused attention to the quality of life (QOL) of amputees. These studies are mostly from the developed countries. This study analyzed amputation as a whole and how it affects an individual...

Background and Aims: A significant number of postmenopausal women have both diabetes and osteoporosis in our country. The objectives of the study were to study the effect of intravenous (IV) zolendronic acid (ZA) on change in bone mineral density (BMD) at lumbar spine (LS), total hip (TH), femoral neck (FN) and distal forearm (FA) and the changes i...

Concerns have been raised in the media that 'the third wave' will severely affect children. Here, an experience of SARS-CoV-2 infection in children is reported. Of the 8,626 SARS-CoV-2 RT-PCR tests performed in children (0-17 y) from March 2020 to July 2021 at the authors' institute, 1470 (17%) were positive, [711/4821 (14.7%) during the first wave...