Dorothy Lall

Christian Medical College Vellore | CMCH-Vellore · Chronic Conditions

The COVID-19 pandemic has reflected the weaknesses in the already collapsing health systems of the countries. In India, there has been a mass exodus of migrants during the lockdown, witnessed by the world. We undertook a qualitative data analysis to examine the governance arrangements, decision-making processes and implementation of policies during...

Objectives: Artificial intelligence (AI)-driven clinical decision support systems (CDSSs) can augment antibiotic decision-making capabilities, but physicians' hesitancy in adopting it may undermine their utility. We conducted a cross-country comparison of physician perceptions on the barriers and facilitators in accepting an AI-enabled CDSS for an...

Background Excessive alcohol consumption is the underlying cause of mortality and morbidity. In Tamil Nadu, South India, alcohol is available through government-regulated outlets, and during the lockdown, there was a ban on the sale of alcohol. This study was designed to explore the change in drinking pattern among known alcohol dependants as well...

Health systems with strong comprehensive primary health care (CPHC) are known to result in better health outcomes for people. In India, there is a recent push to strengthen CPHC through Ayushman Bharat. This study aimed to document lessons from successful CPHC initiatives in rural and urban India using a qualitative case study approach. A total of...

Context: As social position rises, health improves. Alma Ata set the stage for community-oriented primary care (COPC), and family medicine is perfectly positioned to integrate Social Determinants of Health. India presents a unique environment for innovations in family medicine. Aims: This study aimed to (1) assess the ability of different primar...

Background Chronic conditions are a leading cause of death and disability worldwide. Low-income and middle-income countries such as India bear a significant proportion of this global burden. Redesigning primary care from an acute-care model to a model that facilitates chronic care is a challenge and requires interventions at multiple levels. Objec...

Chronic non-communicable diseases (NCDs), such as diabetes and cardiovascular diseases, have reached epidemic proportions worldwide. Health systems, especially those in low- and middle-income countries, such as India, struggle to deliver quality chronic care. A reorganization of healthcare service delivery is needed to strengthen care for chronic c...

Background Chronic diseases have emerged as the leading cause of death globally, and 20% of Indians are estimated to suffer from a chronic condition. Care for chronic diseases poses a major public health challenge, especially when health care delivery has been geared traditionally towards acute care. In this study, we aimed to better understand how...

Management of chronic conditions is a challenge for healthcare delivery systems world over and especially for low/middle-income countries (LMIC). Redesigning primary care to deliver quality care for chronic conditions is a need of the hour. However, much of the literature is from the experience of high-income countries. We conducted a synthesis of...

Means of obesity indices and CVD risk factors by quartile of cardiovascular risk factor index. (DOCX)

Associations of deciles of anthropometric indices with cardiovascular risk factors among men. Models compare cardiovascular outcomes in higher compared to the lowest decile of each anthropometric index and were adjusted for age in years, age-squared, city of residence. Deciles were included in the outcome models as a 10-level categorical variable w...

Associations of obesity indices with cardiovascular risk factors and model accuracy measures. All obesity indices were standardized to mean = 0 and SD = 1 to facilitate comparisons across measures. Associations were adjusted for age in years, age-squared, and city of residence. Betas (mean adjusted differences) are shown for the cardiovascular risk...

Associations of standardized BMI and WHtR with diabetes, cholesterol, and hypertension using multiply imputed data: A sensitivity analysis. The table shows results from models using multiply imputed data. Ten completed datasets were created using STATA to impute values for missing variables. Results are averaged across the analysis based on 10 comp...

Baseline questionnaires. (PDF)

Associations of deciles of anthropometric indices with cardiovascular risk factors among women. Models compare cardiovascular outcomes in higher compared to the lowest decile of each anthropometric index and were adjusted for age in years, age-squared, and city of residence. Deciles were included in the outcome models as a 10-level categorical vari...

Background We comparatively assessed the performance of six simple obesity indices to identify adults with cardiovascular disease (CVD) risk factors in a diverse and contemporary South Asian population. Methods 8,892 participants aged 20–60 years in 2010–2011 were analyzed. Six obesity indices were examined: body mass index (BMI), waist circumfere...

Background Effective task-shifting interventions targeted at reducing the global cardiovascular disease (CVD) epidemic in low and middle-income countries (LMICs) are urgently needed. MethodsDISHA is a cluster randomised controlled trial conducted across 10 sites (5 in phase 1 and 5 in phase 2) in India in 120 clusters. At each site, 12 clusters wer...

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death globally. In addition to the mortality associated with it, people with COPD experience significant morbidity, making this set of conditions a major public health concern. Infections caused by influenza virus are a preventable cause of morbidity and vaccination has be...

Chronic non-communicable diseases, predominantly diabetes and cardiovascular disease are a major public health problem globally. The chronicity of these diseases necessitates a restructuring of healthcare to address the multidisciplinary, sustained care including psychosocial support and development of self-management skills. Primary healthcare wit...

Cardiovascular Disease (CVD) has emerged as the leading cause of death in the world. This burden is disproportionately higher in low and middle income countries like India. Obesity is associated not only with increased risk for CVD but is also an independent risk factor for other risk factors of CVD like diabetes and hypertension. Indices like BMI,...