Mallikharjuna Rao Kodavanti

Bio: Mallikharjuna Rao Kodavanti is an academic researcher from Indian Council of Medical Research. The author has contributed to research in topics: Population & Infant mortality. The author has an hindex of 3, co-authored 3 publications receiving 481 citations.

Abdominal adiposity and metabolic alterations in hypertension -a case control study.

Abstract: Indians are particularly susceptible to chronic diseases like hypertension, diabetes and coronary heart disease. Several Western studies have documented the role of obesity, especially the role of regional adiposity, and associated metabolic aberrations in the aetiopathogenesis of these chronic diseases. However, there is a paucity of information on the Indian sub-continent. This study was therefore undertaken to investigate the role of regional adiposity and metabolic abnormalities in hypertension. Subjects, aged between 30-50 years, attending the out-patient department of Osmania General Hospital {1000 beds), which caters to middle and low income group of people located at Hyderabad City in India, were screened for hypertension. A total of 158 newly diagnosed subjects were selected along with 172 age and gender matched controls. Body mass index (BMI), waist hip ratio (WHR), total body fat and percentage of body fat were calculated from the anthropometric parameters. Biochemical parameters like serum lipids and plasma glucose and insulin (at fasting as well as 2 h post load glucose) were determined in a subsample of 78 hypertensives and 74 controls. Hypertensives had significantly higher body weight, body fat, BMI and WHR as compared to controls in both men and women. No differences were observed in lipid profile. Plasma glucose, fasting as well as 2 h post load, was significantly higher in both hypertensive men and women. Though there were no differences in plasma insulin at fasting, insulin level at 2 h post-load was elevated in hypertensive women. Higher glucose levels, despite elevated insulin levels, suggested insulin resistance. The calculated odds ratios revealed that increased BMI, WHR, plasma triglycerides, and 2 h post load glucose increased the risk for hypertension in both women and men. Insulin was identified as a risk factor only in women. These results suggest a role for regional adiposity and insulin resistance 1000 in the development of hypertension in the Indian sub-continent.

Dietary factors as determinants of hypertension: A case control study in an urban Indian population.

Abstract: Hypertension, an important risk factor for coronary heart disease (CHD), is often associated with certain dietary habits which can either adversely affect or decrease blood pressure. Several Western studies have documented the role of diet, especially excess energy, both quality and quantity of fat and salt, in the aetiopathogenesis of chronic diseases such as hypertension, diabetes and CHD. Indians are particularly susceptible to these chronic diseases. A study was therefore undertaken to investigate the role of dietary factors in relation to hypertension. A total of 158 newly diagnosed cases were selected from the out-patient department of the 1000-bed Osmania General Hospital along with 172 age and gender-matched controls. A detailed diet history was collected and validated. An energy adjustment method was adopted by transforming the data on a log scale as all the nutrients depended upon the intake of energy. A total of 86 hypertensives and 79 controls participated in the study. Among those classified as hypertensives, men reported higher intakes of dietary fat and salt while women reported higher intakes of dietary protein and salt. Risk calculated by Odds ratio revealed that higher intakes of fat, protein and salt increase the risk for hypertension. Multivariate stepwise logistic regression identified salt as the risk factor in men and protein as the risk factor in women. These results suggest a role for dietary fat, protein and salt in hypertension.

Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition

Abstract: Eliminating indigenous and ethnic health inequities requires addressing the determinants of health inequities which includes institutionalised racism, and ensuring a health care system that delivers appropriate and equitable care. There is growing recognition of the importance of cultural competency and cultural safety at both individual health practitioner and organisational levels to achieve equitable health care. Some jurisdictions have included cultural competency in health professional licensing legislation, health professional accreditation standards, and pre-service and in-service training programmes. However, there are mixed definitions and understandings of cultural competency and cultural safety, and how best to achieve them. A literature review of 59 international articles on the definitions of cultural competency and cultural safety was undertaken. Findings were contextualised to the cultural competency legislation, statements and initiatives present within Aotearoa New Zealand, a national Symposium on Cultural Competence and Māori Health, convened by the Medical Council of New Zealand and Te Ohu Rata o Aotearoa – Māori Medical Practitioners Association (Te ORA) and consultation with Māori medical practitioners via Te ORA. Health practitioners, healthcare organisations and health systems need to be engaged in working towards cultural safety and critical consciousness. To do this, they must be prepared to critique the ‘taken for granted’ power structures and be prepared to challenge their own culture and cultural systems rather than prioritise becoming ‘competent’ in the cultures of others. The objective of cultural safety activities also needs to be clearly linked to achieving health equity. Healthcare organisations and authorities need to be held accountable for providing culturally safe care, as defined by patients and their communities, and as measured through progress towards achieving health equity. A move to cultural safety rather than cultural competency is recommended. We propose a definition for cultural safety that we believe to be more fit for purpose in achieving health equity, and clarify the essential principles and practical steps to operationalise this approach in healthcare organisations and workforce development. The unintended consequences of a narrow or limited understanding of cultural competency are discussed, along with recommendations for how a broader conceptualisation of these terms is important.

Aboriginal and Torres Strait Islander health performance framework

Abstract: 'This report gives the latest information on how Aboriginal and Torres Strait Islander people in the Northern Territory are faring according to a range of measures of health status and outcomes, determinants of health and health system performance. Indicators are based on the Aboriginal and Torres Strait Islander Health Performance Framework. The report highlights the main areas of improvement and continuing concern.' - Back cover

Consolidated criteria for strengthening reporting of health research involving indigenous peoples: the CONSIDER statement

Abstract: Research reporting guidelines are increasingly commonplace and shown to improve the quality of published health research and health outcomes. Despite severe health inequities among Indigenous Peoples and the potential for research to address the causes, there is an extended legacy of health research exploiting Indigenous Peoples. This paper describes the development of the CONSolIDated critERtia for strengthening the reporting of health research involving Indigenous Peoples (CONSIDER) statement. A collaborative prioritization process was conducted based on national and international statements and guidelines about Indigenous health research from the following nations (Peoples): Australia (Aboriginal and Torres Strait Islanders), Canada (First Nations Peoples, Metis), Hawaii (Native Hawaiian), New Zealand (Māori), Taiwan (Taiwan Indigenous Tribes), United States of America (First Nations Peoples) and Northern Scandinavian countries (Sami). A review of seven research guidelines was completed, and meta-synthesis was used to construct a reporting guideline checklist for transparent and comprehensive reporting of research involving Indigenous Peoples. A list of 88 possible checklist items was generated, reconciled, and categorized. Eight research domains and 17 criteria for the reporting of research involving Indigenous Peoples were identified. The research reporting domains were: (i) governance; (ii) relationships; (iii) prioritization; (iv) methodologies; (v) participation; (vi) capacity; (vii) analysis and findings; and (viii) dissemination. The CONSIDER statement is a collaborative synthesis and prioritization of national and international research statements and guidelines. The CONSIDER statement provides a checklist for the reporting of health research involving Indigenous peoples to strengthen research praxis and advance Indigenous health outcomes.