Indian Journal of Community Medicine最新文献

Background: Previously overweight and obesity are considered to be an issue of high-income countries but now increasingly becoming more prevalent in low-income and middle-income countries. Obesity and overweight are growing health issues in India. It is important to determine the quantum of the risk contribution by individual risk factor siuch as abdominal obesity.

Aims: To find out the association of abdominal obesity and diabetes among the adult tribal population.

Methods and material: A cross-sectional study was conducted using multi-stage random sampling techniques. Using a pretested validated modified Stepwise questionnaire, a detailed interview with the participants aged above 30 years were performed. Random blood sugar and anthropometric parameters were estimated for all the participants. Chi-square test and multivariate regression analysis were used to study association.

Results: Prevalence of abdominal obesity was 49.6% [211] among the study participants. Prevalence of diabetes was 7.8% [33] among the study population and 92.2% [392] of them were nondiabetic. Normal WHR was seen among 27.3% [9] of the diabetic individuals. High WHR was seen among 72.7% [24] of diabetic individuals. Gender, Illiterate, BMI, and waist-hip ratio shows significant association with diabetes.

Conclusions: The prevalence of abdominal obesity was higher in the study population. As this burden among tribal people is on the increasing trend when compared with other general populations, effective strategies to prevent this have to be devised among the tribal population.

Medical research plays a crucial role in advancing our understanding of various aspects related to health, including disease, risk factors, and patient management. However, the interpretation of research data becomes intricate when considering the notions of statistical significance and clinical relevance. It is not uncommon to interpret findings that demonstrate statistical significance as indicative of clinical relevance. To explain it in a more straightforward way, statistical significance, ascertained through statistical tests using the P value, indicates that an observed difference or association is improbable to occur by chance alone. Conversely, clinical relevance focuses on the practical implications of a finding in real-world contexts and determines whether an observed difference or relationship holds practical meaning. Recently, there have been issues and debates surrounding the idea of statistical significance as certain experts argue that its mathematical representation can be misleading when it comes to practical understanding. These experts propose the inclusion of additional measures like effect sizes and confidence intervals. A sound comprehension of both statistical and clinical dimensions is vital in order to ensure precise interpretation of data and facilitate well-informed decision-making in the practice of medicine. By doing so, it positively influences the health of individuals and communities.

Background: Public health action (PHA) in tuberculosis (TB) includes six components: doing screening for HIV/diabetes, carrying out drug susceptibility testing, counseling on tobacco, counseling on nutrition, benefits of Nikshay Poshan Yojana, and contact tracing. All the patients notified by the private practitioners (PPs) and missing any of the above components are intervened by the government staff to cover all the above components.

Objectives: The aim of the article is (1) to assess the timeliness and completeness of PHA and (2) to assess the impact of PHA on the quality of care for TB patients in the private sector.

Methods: A sequential mixed-method (cross-sectional study followed by qualitative study) study was carried out in the Patan district, North Gujarat for a period of one year. Quantitative data were collected through home visits to patients residing in three randomly selected talukas out of nine talukas in the Patan district. Qualitative data were collected purposively from selected clinics of PPs (including a mix of PP notifying and not notifying TB till saturation is achieved) from the above talukas.

Results: Out of a total of 176 patients from the private sector, 48 patients took all six components of PHA. Out of them, 98% were cured compared to 82% who did not receive PHA. None of the PP had heard about PHA or its components.

Conclusion: The Public-private model for TB management needs strengthening. Regular and mandatory training of PPs on the latest TB management guidelines including importance of timely and complete PHA should be carried out.

Background: Being judgmental about self-body image and satisfaction or dissatisfaction with one's own body is a natural phenomenon. If perceived incorrectly can lead to dissatisfaction and negative social, emotional, psychological and physical consequences.

Methods: A cross-sectional study was planned and the data was collected with the help of a semi-structured proforma. Body image perception, image satisfaction, and associated dietary modification were inquired about, and Body Mass Index (BMI) and Body Image Discrepancy Score (BIDS) were calculated. The body image perception of participants was collected with the help of the Figure Rating Scale (FRS).

Results: χ² test, kappa statistics, Mann-Whitney test, multinominal regression, and Z-standardization were applied. Few 10% of participants perceived themselves as underweight, 48% as normal weight and 42% as overweight or obese. About 48%, 19%, and 33% of participants were satisfied, neutral and dissatisfied respectively by their perceived body image, and 43% of the participants had modified their diet. A statistically significant association was found between body image perception, image satisfaction, body image discrepancy and gender.

Conclusion: There was a huge disagreement between perceived and actual body image. Overestimation and underestimation of body image were common in males and females respectively. Misperception of body image might lead to unnecessary dietary modifications resulting in malnutrition and somatoform disorders.

Non-alcoholic fatty liver disease (NAFLD), a major cause of chronic liver disease, is known to affect a quarter of the global adults. Natural history of NAFLD shows interindividual variation, traditionally it progresses from simple steatosis to steatohepatitis to fibrosis/cirrhosis and finally yet rarely to hepatocellular carcinoma. It is largely a lifestyle-related disease and is often labeled as the hepatic manifestation of metabolic syndrome. Both prevention and control of NAFLD include controlling risk factors (obesity, diabetes mellitus, hypertension and dyslipidemia), through lifestyle modification and medications. Drug therapy for NAFLD per se is still evolving and till date, no drugs are approved. It is clinically silent, especially in the early stages, and is a diagnosis of exclusion. Certain easily calculated indices can stratify cases into high or low risk for advanced fibrosis, thereby dictating appropriate monitoring and treatment measures. In addition to complications specific to liver disease in those who do progress to advanced fibrosis or cirrhosis, an increased risk of nonliver disease-related morbidity and mortality is also present. Challenges are manifold and include rising burden due to ever-growing epidemic of diabetes and obesity, low public awareness, fragmented healthcare, no approved drugs, and dearth of data on magnitude and epidemiology of the disease. The recent integration of NAFLD into the National Program for Prevention and Control of Non-Communicable Diseases (NPCDCS) by the Ministry of Health and Family Welfare of India is a welcome step in this direction as the contributory factors are mostly the same for all diseases and controlling any one or all of them will have a desired impact on the prevalence of all the diseases under this program.

Introduction: Physical inactivity (PI) is the fourth leading risk factor for global mortality and is potentially modifiable. Understanding its sociodemographic correlates can contribute in planning preventive measures to reduce the same.

Aims and objectives: 1) To estimate the prevalence of PI among adults aged 20-60 years and 2) to identify the sociodemographic determinants of PI among adults.

Material and methods: A community-based cross-sectional study was done in district Aligarh, Uttar Pradesh. 304 adults aged 20-60 years, giving informed consent were selected by simple random sampling. Pregnant women and those with febrile disease and physical defect were excluded. Predesigned structured proforma and Global Physical Activity Questionnaire were used. Chi-square test and logistic regression analysis were applied using IBM SPSS 23.0.

Results: Prevalence of PI was 47.7% (95% CI: 42.0-52.6). It was significantly higher in urban (55.3% vs 41.1%) than in rural area and among females than in males (68.7% vs 34.9%). PI during work was 74.3%, during travel 78.9%, and during recreation 88.5%. Being female increased odds of PI by almost ten times (adjusted odds atio (AOR) =9.7, 95% CI: 1.6-58.5). Unskilled workers/laborers and farmers (those involved in active occupational work) were found to have lesser odds of PI (AOR = 0.2, 95% CI: 0.1-0.5 and AOR = 0.2, 95% CI: 0.01-0.6, respectively).

Conclusion: PI is highly prevalent among adults. Targeted interventions to increase physical activity in recreational domain are recommended, specially in urban areas and among women. Further studies to explore barriers to physical activity are needed to address this problem.

Public-private partnerships (PPPs) are integral to the National Health Mission (NHM). Kasturba Medical College (KMC), Mangalore, was the first private institution in India to embrace the PPP model way back in 1953. The then Government of Madras permitted KMC Mangalore to partner with the 2 district hospitals - the Government Wenlock and the Lady Goschen Hospitals. For almost seven decades, KMC Mangalore has been using the clinical facilities at District Wenlock and Lady Goschen hospitals to provide quality health care and also train the Undergraduate and Postgraduate students of KMC. The Manipal experiment is a shining example of public-private collaboration to provide quality accessible health care to everyone, which is in line with the Sustainable Development Goal (SDG) 3 and its targets.

Background: Chronic obstructive pulmonary disease (COPD) is a serious lung condition that imposes a significant financial burden on individuals and society, straining the medical system. According to the World Health Organization, it was the third leading cause of death worldwide in 2020. In India, it ranks as the second leading cause of death, and in Tamil Nadu, it is the tenth. The Global Burden of Disease study in 2018 found that COPD accounted for 50% of all cases and 69% of disability. Outdoor air pollution plays a major role in India's burden of chronic respiratory diseases. Early diagnosis and intervention can help to alleviate symptoms, prevent complications, and reduce morbidity and mortality, ultimately improving quality of life.

Objectives: (1) To estimate the prevalence of COPD among the study population (2) To assess the risk factors associated with COPD among the study population.

Methodology: A community-based cross-sectional study was conducted among adults along the roadside dwelling of a National Highway. Using a multi-stage random sampling technique 403 elderly was selected. Participants were interviewed by a pre-tested structured questionnaire followed by spirometry (pulmonary function test) evaluation. Data entry was performed in an Excel sheet and analyzed using SPSS. The odds ratio and Chi-square test were performed to determine the association between qualitative variables.

Results: Among 403 study population 58% were male and 42% were female. The prevalence of COPD was found to be 22%, it was 11.1% among males and 10.9% among females. It is evident that individuals, who had exposure to risk factors such as cigarette smoking 78%, overcrowding 35.8%, lack of cross ventilation 10.9%, and living near a highway within 50 m of distance 36.2% are at more risk for developing COPD.

Conclusion: Study revealed that people living in closer proximity with roadways increases the risk of COPD.