{"title":"Is dual bronchodilator therapy the new GOLD standard for initiating treatment for chronic obstructive pulmonary disease?","authors":"A. Aggarwal","doi":"10.4103/jncd.jncd_58_23","DOIUrl":"https://doi.org/10.4103/jncd.jncd_58_23","url":null,"abstract":"","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":"8 1","pages":"63 - 65"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41850865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: End-stage renal disease (ESRD) is a rapidly increasing global health problem where the kidney damage is irreversible. Worldwide, hemodialysis is the most common kidney replacement therapy which increases longevity but is not the ultimate cure, and at the same time, there are multiple complications associated with this treatment modality making life miserable for these patients. Plenty of literature is available on patient education, side effects, and complications of hemodialysis, but very few attempts have been made to understand patients' experiences living on dialysis. Materials and Methods: A phenomenological research design was adopted to explore lived experiences of patients on hemodialysis. Using purposive sampling technique, adult (60 years) posttransplant patients who had hemodialysis at least for 6 months during pretransplantation phase were enrolled. Data were collected through semi-structured interviews, analyzed using descriptive statistics for quantitative and Colaizzi's method for qualitative data. Results: The most common medical diagnosis was unknown chronic glomerulonephritis, and the prevalent comorbid condition was hypertension. Based on participants' verbatim, total 5 themes and 13 subthemes were extracted after data analysis. The main themes emerged were disease- and dialysis-associated problems, emotional turmoil, financial burden, social isolation, and changes in lifestyle. Conclusion: The present study concluded that ESRD patients on haemodialysis experienced physiological disturbances, emotional distress and financial burden. Social isolation, financial constraints, and changes in lifestyle were major challenges faced by patients. Professionals need empathic attitude to deal with patients on hemodialysis to minimize their sufferings.
{"title":"Pretransplant hemodialysis: Lived experiences","authors":"Priya, D. Kenwar, M. Dutta","doi":"10.4103/jncd.jncd_34_23","DOIUrl":"https://doi.org/10.4103/jncd.jncd_34_23","url":null,"abstract":"Introduction: End-stage renal disease (ESRD) is a rapidly increasing global health problem where the kidney damage is irreversible. Worldwide, hemodialysis is the most common kidney replacement therapy which increases longevity but is not the ultimate cure, and at the same time, there are multiple complications associated with this treatment modality making life miserable for these patients. Plenty of literature is available on patient education, side effects, and complications of hemodialysis, but very few attempts have been made to understand patients' experiences living on dialysis. Materials and Methods: A phenomenological research design was adopted to explore lived experiences of patients on hemodialysis. Using purposive sampling technique, adult (60 years) posttransplant patients who had hemodialysis at least for 6 months during pretransplantation phase were enrolled. Data were collected through semi-structured interviews, analyzed using descriptive statistics for quantitative and Colaizzi's method for qualitative data. Results: The most common medical diagnosis was unknown chronic glomerulonephritis, and the prevalent comorbid condition was hypertension. Based on participants' verbatim, total 5 themes and 13 subthemes were extracted after data analysis. The main themes emerged were disease- and dialysis-associated problems, emotional turmoil, financial burden, social isolation, and changes in lifestyle. Conclusion: The present study concluded that ESRD patients on haemodialysis experienced physiological disturbances, emotional distress and financial burden. Social isolation, financial constraints, and changes in lifestyle were major challenges faced by patients. Professionals need empathic attitude to deal with patients on hemodialysis to minimize their sufferings.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":"8 1","pages":"91 - 96"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47941306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sugandha Jauhari, Pratyaksha Pandit, M. Agarwal, P. Bajpai, Abhishek Singh, D. James
Introduction: The rising burden of noncommunicable diseases (NCDs) is a dominating public health crisis, globally causing 38 million of 57 million deaths annually, with 85% of these deaths occurring in low- and middle-income countries (LMICs). However, while addressing NCDs, adolescents have been largely overlooked, who have a notable share in the NCD burden globally. Adolescents are vulnerable for developing high-risk behaviors, which puts them at high risk of NCDs such as ischemic heart diseases, diabetes, and stroke. Objective: The objective of this systematic review will be to identify the effectiveness of educational interventions on the knowledge and behavioral practices of adolescents for the prevention of NCDs in LMICs. Methodology: Five electronic databases such as PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Embase, and Scopus will be utilized for generating pooled evidence. Two reviewers will individually screen the titles and abstracts for eligibility, and in case of any disagreement, the help of a third reviewer will be taken. Recognized studies will be critically appraised for methodological quality using the Cochrane risk-of-bias tool. Data will be extracted from the studies included in the review for author's name, year of study, study setting, study design, study participants and their age, sample size in the intervention group, NCD domain covered by the study intervention, intervention details, measure of outcome, etc. For data synthesis, studies will be pooled using RevMan software and effect sizes will be depicted using forest plots. The Grading of Recommendations, Assessment, Development, and Evaluation approach to grade the certainty of evidence will be followed for assessing the quality of evidence. Publication bias will also be checked using funnel plots and Egger's test. Clinical Relevance: To the best of our knowledge, this will be the first systematic review that will assess the empirical evidence and evaluate the effectiveness of educational interventions for the prevention of NCDs among adolescents of LMICs. This review will assist the public health experts and policymakers in designing effective intervention for preventing NCDs among adolescents. Results and Conclusion: The results of this systematic review will provide an in-depth insight of the existing country-specific educational policies and interventions for the prevention of NCDs among adolescents in various LMICs. This will help in the replication of such cost-effective educational models or interventions in other LMICs followed by advocacy in their school policy reforms and other related programs focusing on NCDs.
非传染性疾病(ncd)负担的不断上升是一项主要的公共卫生危机，每年在全球5700万人死亡中造成3800万人死亡，其中85%发生在低收入和中等收入国家。然而，在应对非传染性疾病的同时，青少年在很大程度上被忽视了，他们在全球非传染性疾病负担中占有显著份额。青少年很容易养成高风险行为，这使他们面临罹患缺血性心脏病、糖尿病和中风等非传染性疾病的高风险。目的:本系统综述的目的是确定教育干预对中低收入国家青少年预防非传染性疾病的知识和行为实践的有效性。方法:5个电子数据库，如PubMed, Cochrane Central Register of Controlled Trials，谷歌Scholar, Embase和Scopus将被用于生成汇总证据。两位审稿人将分别对标题和摘要进行筛选，如有异议，将接受第三位审稿人的帮助。认可的研究将使用Cochrane风险偏倚工具对方法学质量进行严格评价。数据将从纳入综述的研究中提取，包括作者姓名、研究年份、研究设置、研究设计、研究参与者及其年龄、干预组样本量、研究干预所涵盖的非传染性疾病领域、干预细节、结果测量等。在数据合成方面，研究将使用RevMan软件汇总，效应大小将使用森林图来描述。对证据的确定性进行分级的建议、评估、发展和评价方法将被用于评估证据的质量。发表偏倚也将使用漏斗图和Egger检验进行检查。临床相关性:据我们所知，这将是评估经验证据和评估教育干预措施在中低收入国家青少年中预防非传染性疾病有效性的第一个系统综述。本综述将有助于公共卫生专家和决策者设计有效的干预措施，预防青少年非传染性疾病。结果和结论:本系统综述的结果将深入了解不同中低收入国家预防青少年非传染性疾病的现有国家具体教育政策和干预措施。这将有助于在其他中低收入国家复制这种具有成本效益的教育模式或干预措施，然后在其学校政策改革和其他以非传染性疾病为重点的相关方案中进行宣传。
{"title":"Effectiveness of educational interventions on knowledge and behavioral practices of adolescents for prevention of noncommunicable diseases in low- and middle-income countries: A systematic review protocol","authors":"Sugandha Jauhari, Pratyaksha Pandit, M. Agarwal, P. Bajpai, Abhishek Singh, D. James","doi":"10.4103/jncd.jncd_20_23","DOIUrl":"https://doi.org/10.4103/jncd.jncd_20_23","url":null,"abstract":"Introduction: The rising burden of noncommunicable diseases (NCDs) is a dominating public health crisis, globally causing 38 million of 57 million deaths annually, with 85% of these deaths occurring in low- and middle-income countries (LMICs). However, while addressing NCDs, adolescents have been largely overlooked, who have a notable share in the NCD burden globally. Adolescents are vulnerable for developing high-risk behaviors, which puts them at high risk of NCDs such as ischemic heart diseases, diabetes, and stroke. Objective: The objective of this systematic review will be to identify the effectiveness of educational interventions on the knowledge and behavioral practices of adolescents for the prevention of NCDs in LMICs. Methodology: Five electronic databases such as PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Embase, and Scopus will be utilized for generating pooled evidence. Two reviewers will individually screen the titles and abstracts for eligibility, and in case of any disagreement, the help of a third reviewer will be taken. Recognized studies will be critically appraised for methodological quality using the Cochrane risk-of-bias tool. Data will be extracted from the studies included in the review for author's name, year of study, study setting, study design, study participants and their age, sample size in the intervention group, NCD domain covered by the study intervention, intervention details, measure of outcome, etc. For data synthesis, studies will be pooled using RevMan software and effect sizes will be depicted using forest plots. The Grading of Recommendations, Assessment, Development, and Evaluation approach to grade the certainty of evidence will be followed for assessing the quality of evidence. Publication bias will also be checked using funnel plots and Egger's test. Clinical Relevance: To the best of our knowledge, this will be the first systematic review that will assess the empirical evidence and evaluate the effectiveness of educational interventions for the prevention of NCDs among adolescents of LMICs. This review will assist the public health experts and policymakers in designing effective intervention for preventing NCDs among adolescents. Results and Conclusion: The results of this systematic review will provide an in-depth insight of the existing country-specific educational policies and interventions for the prevention of NCDs among adolescents in various LMICs. This will help in the replication of such cost-effective educational models or interventions in other LMICs followed by advocacy in their school policy reforms and other related programs focusing on NCDs.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":"8 1","pages":"110 - 114"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46954413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Luc, Kara Herrera, R. Allam, Sabitha Gandhamalla, Ramkishan Dharmakari, M. Dinaker, V. Yeldandi
Background: Dietary patterns are paramount in the prevention and management of metabolic syndrome (MetS) yet the definition and criteria for MetS diagnosis varies. This analysis aims to estimate the prevalence of MetS among the adult Chenchu tribal population comparing International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) definitions of MetS and assess the relationship between dietary patterns and MetS. Materials and Methods: Demographics, medical history, nutrition, and physical activity were collected among 337 South Indian Chenchu tribal adults. The prevalence ratios and 95% confidence intervals of MetS using ATP and IDF definitions were estimated and associations between individual components of the MetS definitions, demographics, and dietary patterns were assessed. Pearson correlation coefficients (r) were calculated between the Modified Finnish Diabetic Risk Score (FINDRISC)-Bahasa Indonesia instrument and MetS definitions. Results: The prevalence of MetS was low by IDF (25, 7.4%) and ATP (22, 6.5%) definitions, while reporting vigorous physical activity (202, 59.9%) and a “vegetarian” dietary pattern (173, 51.3%) were high. Increasing age, high mutton consumption, and “empty-calorie” dietary pattern were associated with an increased prevalence of MetS, while vigorous physical activity and “vegetarian” dietary pattern were protective of MetS. The modified FINDRISC was not highly correlated with IDF MetS (r = 0.47; P < 0.0001) or ATP MetS (r = 0.11; P = 0.0683). Conclusions: Healthy behaviors, such as vigorous physical activity and high vegetable consumption, may contribute to the low prevalence of MetS in Chenchu tribal adults. Future efforts should continue to monitor dietary patterns and the prevalence of MetS in the understudied South Indian Chenchu tribal population.
{"title":"The prevalence of metabolic syndrome and its components among South Indian Chenchu tribal adults","authors":"C. Luc, Kara Herrera, R. Allam, Sabitha Gandhamalla, Ramkishan Dharmakari, M. Dinaker, V. Yeldandi","doi":"10.4103/jncd.jncd_38_23","DOIUrl":"https://doi.org/10.4103/jncd.jncd_38_23","url":null,"abstract":"Background: Dietary patterns are paramount in the prevention and management of metabolic syndrome (MetS) yet the definition and criteria for MetS diagnosis varies. This analysis aims to estimate the prevalence of MetS among the adult Chenchu tribal population comparing International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) definitions of MetS and assess the relationship between dietary patterns and MetS. Materials and Methods: Demographics, medical history, nutrition, and physical activity were collected among 337 South Indian Chenchu tribal adults. The prevalence ratios and 95% confidence intervals of MetS using ATP and IDF definitions were estimated and associations between individual components of the MetS definitions, demographics, and dietary patterns were assessed. Pearson correlation coefficients (r) were calculated between the Modified Finnish Diabetic Risk Score (FINDRISC)-Bahasa Indonesia instrument and MetS definitions. Results: The prevalence of MetS was low by IDF (25, 7.4%) and ATP (22, 6.5%) definitions, while reporting vigorous physical activity (202, 59.9%) and a “vegetarian” dietary pattern (173, 51.3%) were high. Increasing age, high mutton consumption, and “empty-calorie” dietary pattern were associated with an increased prevalence of MetS, while vigorous physical activity and “vegetarian” dietary pattern were protective of MetS. The modified FINDRISC was not highly correlated with IDF MetS (r = 0.47; P < 0.0001) or ATP MetS (r = 0.11; P = 0.0683). Conclusions: Healthy behaviors, such as vigorous physical activity and high vegetable consumption, may contribute to the low prevalence of MetS in Chenchu tribal adults. Future efforts should continue to monitor dietary patterns and the prevalence of MetS in the understudied South Indian Chenchu tribal population.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":"8 1","pages":"97 - 103"},"PeriodicalIF":0.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49055152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Noncommunicable diseases among tribal populations in India: A case of double jeopardy","authors":"Natasha Dawa, J. Narain","doi":"10.4103/jncd.jncd_24_23","DOIUrl":"https://doi.org/10.4103/jncd.jncd_24_23","url":null,"abstract":"","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":"8 1","pages":"1 - 3"},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44676185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Kumar, F. Fathima, Twinkle Agrawal, D. Misquith, G. Gururaj
Background: Road traffic injuries (RTIs) are the major causes of mortality, morbidity, and disability among young adults and pose a significant economic burden to individuals, families, and communities. Objective: To estimate the cost of care at discharge, 3 months and 6 months among patients with RTIs admitted to a private tertiary hospital in Bengaluru, India. Methods: A cost-of-illness study from patient's perspective was done among 150 hospitalized injured subjects with RTIs admitted to a tertiary care hospital in Bengaluru city. A face validated, structured interview schedule was administered in local language at baseline (hospital discharge time), 1 month and at 6 months to capture data on direct medical costs, direct nonmedical costs, and indirect costs incurred by the RTI victims and their family members. Hospital bills were reviewed for all the patients included in the study. Results: Among the 150 study participants, majority were men (94.67%), with a mean age of 35.36 years ± 14.62 years and majority were two-wheeler riders/pillions and pedestrians. Our results show the median cost incurred for care of RTI to be INR 106,374 (inter quartile range [IQR] 57,402–163,250) (USD 1418 [IQR 765–2176]). Direct medical costs contributed to 66% of the costs, whereas direct nonmedical and indirect costs contributed to 21% and 13% of the total costs, respectively. Conclusion: RTIs contribute to significant economic burden to patients. While prevention should be our primary goal, health financing and risk protection mechanisms should be strengthened by streamlining insurance coverage mechanisms to reduce out-of-pocket expenditure.
{"title":"Economic burden of road traffic injuries among hospitalized subjects in a tertiary care center in Bengaluru, India: A cost of illness study","authors":"R. Kumar, F. Fathima, Twinkle Agrawal, D. Misquith, G. Gururaj","doi":"10.4103/jncd.jncd_61_22","DOIUrl":"https://doi.org/10.4103/jncd.jncd_61_22","url":null,"abstract":"Background: Road traffic injuries (RTIs) are the major causes of mortality, morbidity, and disability among young adults and pose a significant economic burden to individuals, families, and communities. Objective: To estimate the cost of care at discharge, 3 months and 6 months among patients with RTIs admitted to a private tertiary hospital in Bengaluru, India. Methods: A cost-of-illness study from patient's perspective was done among 150 hospitalized injured subjects with RTIs admitted to a tertiary care hospital in Bengaluru city. A face validated, structured interview schedule was administered in local language at baseline (hospital discharge time), 1 month and at 6 months to capture data on direct medical costs, direct nonmedical costs, and indirect costs incurred by the RTI victims and their family members. Hospital bills were reviewed for all the patients included in the study. Results: Among the 150 study participants, majority were men (94.67%), with a mean age of 35.36 years ± 14.62 years and majority were two-wheeler riders/pillions and pedestrians. Our results show the median cost incurred for care of RTI to be INR 106,374 (inter quartile range [IQR] 57,402–163,250) (USD 1418 [IQR 765–2176]). Direct medical costs contributed to 66% of the costs, whereas direct nonmedical and indirect costs contributed to 21% and 13% of the total costs, respectively. Conclusion: RTIs contribute to significant economic burden to patients. While prevention should be our primary goal, health financing and risk protection mechanisms should be strengthened by streamlining insurance coverage mechanisms to reduce out-of-pocket expenditure.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":"8 1","pages":"21 - 30"},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47870625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Cervical cancer (CC) is the fourth main cause of death among women. Poor uptake of CC screening has indirect effects on increased mortality among women. Therefore, we employed the care cascade to understand the CC outcomes in sub-Saharan Africa (SSA) using the PEPFAR Panorama CC data collected between 2019 and 2021. Methods: A retrospective study using the PEPFAR Panorama CC data, from 13 countries from SSA, was performed. We calculated the proportions of women who were screened, those who were found to have positive results after screening for CC, and those who were linked to CC treatment. Results: A total of 2,312,541 were eligible for screening and of these, 1,429,925 (62%) were screened for CC. Of these, 162,758 (11%) were diagnosed with CC. Of these, 115,890 (71%) were provided with treatment. CC screening increased from 41% in 2019 to 90% in 2021. The CC diagnosis ranged from 8% in 2019 to 13% in 2021. CC treatment coverage increased from 64% in 2019 to 75% in 2021. Screening uptake, CC diagnosis, and CC treatment coverage varied by country and age of the women. Conclusion: There were variations in CC screening and treatment uptake for CC by country and age. With these inequalities in screening and coverage of treatment for CC, eliminating CC as stipulated in the sustainable development goals will remain a farfetched dream.
{"title":"Cervical cancer care cascade among women living with human immunodeficiency virus in 13 sub-Saharan Africa countries between 2019 and 2021: An ecological analysis of PEPFAR Panorama cervical cancer program data","authors":"W. Ng'ambi, Cosmas Zyambo","doi":"10.4103/jncd.jncd_14_23","DOIUrl":"https://doi.org/10.4103/jncd.jncd_14_23","url":null,"abstract":"Introduction: Cervical cancer (CC) is the fourth main cause of death among women. Poor uptake of CC screening has indirect effects on increased mortality among women. Therefore, we employed the care cascade to understand the CC outcomes in sub-Saharan Africa (SSA) using the PEPFAR Panorama CC data collected between 2019 and 2021. Methods: A retrospective study using the PEPFAR Panorama CC data, from 13 countries from SSA, was performed. We calculated the proportions of women who were screened, those who were found to have positive results after screening for CC, and those who were linked to CC treatment. Results: A total of 2,312,541 were eligible for screening and of these, 1,429,925 (62%) were screened for CC. Of these, 162,758 (11%) were diagnosed with CC. Of these, 115,890 (71%) were provided with treatment. CC screening increased from 41% in 2019 to 90% in 2021. The CC diagnosis ranged from 8% in 2019 to 13% in 2021. CC treatment coverage increased from 64% in 2019 to 75% in 2021. Screening uptake, CC diagnosis, and CC treatment coverage varied by country and age of the women. Conclusion: There were variations in CC screening and treatment uptake for CC by country and age. With these inequalities in screening and coverage of treatment for CC, eliminating CC as stipulated in the sustainable development goals will remain a farfetched dream.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":"8 1","pages":"51 - 57"},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47354767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Noncommunicable diseases (NCDs) have become a major global problem, accounting for approximately three-fifths of morbidity and mortality. Due to the epidemiological shift, the disease pattern in many developing nations is shifting from infectious to chronic NCDs.[1] NCDs cause 41 million deaths every year, accounting for 80.2% of all deaths worldwide. There are over 15 million (38%) premature NCD mortality that is avoidable and preventable. Around 77% of all NCD deaths occur in low-middle-income countries (LMICs).[2] Primary health care (PHC) is essential for achieving universal health coverage and reducing the prevalence of NCDs. However, there is a huge capacity gap, and the majority of primary care physicians are not competent to diagnose and treat NCDs, especially in LMICs.[3] A well-functioning primary care system, including ambulatory primary care administered through primary health centers, is cost-effective and can meet up to 90% of health-care demand in poor and middle-income countries, including NCDs.[4] Primary care is more than just a first point of contact; it is the base of a health-care system. It is available to all patients and can manage NCDs in their early stages by providing first contact, continuity, and integration of care. According to the World NCD Federation guidelines for NCDs in PHC settings and the WHO package of essential noncommunicable Package, high-impact important NCD interventions can be offered through PHC to improve early detection and treatment. Approximately 80% of disease conditions, according to estimates, can be handled at the primary care level with a primary care physician and a community health worker.[5] Almost 52% of all conditions, especially NCDs, can be managed at the primary care level.[6] The phrase “gatekeeping” refers to the role of primary care physicians or general practitioners in improving access, which has a significant impact on service utilization, health outcomes, health-care expenditures, and patient satisfaction. There is a lack of effective implementation of NCD services at the PHC level, due to a lack of trained health workforce and essential supplies for implementing comprehensive NCD care programs (standards of treatment protocols, referral, and follow-up for NCDs).[7] To address this huge capacity gap of PHC professionals, the World NCD Federation has initiated an International Course as “Certification of PHC physician in NCDs” which focuses on meeting the requirements of the Global NCD Agenda under the Global strategy for prevention and control of NCDs.[8] The World NCD Federation aimed to develop this e-learning course to provide simple and comprehensive guidance on the prevention, surveillance, and management of common NCDs to health-care professionals, including frontline workers, community health workers, and PHC doctors. The objective of the course includes the development and implementation of a certification course for primary health physicians in NCDs at the global level
{"title":"The world noncommunicable disease federation's international certification course of primary health-care physician in noncommunicable diseases: Key to strengthen primary health-care interventions in noncommunicable diseases","authors":"JS Thakur, Ronika Paika","doi":"10.4103/jncd.jncd_90_23","DOIUrl":"https://doi.org/10.4103/jncd.jncd_90_23","url":null,"abstract":"Noncommunicable diseases (NCDs) have become a major global problem, accounting for approximately three-fifths of morbidity and mortality. Due to the epidemiological shift, the disease pattern in many developing nations is shifting from infectious to chronic NCDs.[1] NCDs cause 41 million deaths every year, accounting for 80.2% of all deaths worldwide. There are over 15 million (38%) premature NCD mortality that is avoidable and preventable. Around 77% of all NCD deaths occur in low-middle-income countries (LMICs).[2] Primary health care (PHC) is essential for achieving universal health coverage and reducing the prevalence of NCDs. However, there is a huge capacity gap, and the majority of primary care physicians are not competent to diagnose and treat NCDs, especially in LMICs.[3] A well-functioning primary care system, including ambulatory primary care administered through primary health centers, is cost-effective and can meet up to 90% of health-care demand in poor and middle-income countries, including NCDs.[4] Primary care is more than just a first point of contact; it is the base of a health-care system. It is available to all patients and can manage NCDs in their early stages by providing first contact, continuity, and integration of care. According to the World NCD Federation guidelines for NCDs in PHC settings and the WHO package of essential noncommunicable Package, high-impact important NCD interventions can be offered through PHC to improve early detection and treatment. Approximately 80% of disease conditions, according to estimates, can be handled at the primary care level with a primary care physician and a community health worker.[5] Almost 52% of all conditions, especially NCDs, can be managed at the primary care level.[6] The phrase “gatekeeping” refers to the role of primary care physicians or general practitioners in improving access, which has a significant impact on service utilization, health outcomes, health-care expenditures, and patient satisfaction. There is a lack of effective implementation of NCD services at the PHC level, due to a lack of trained health workforce and essential supplies for implementing comprehensive NCD care programs (standards of treatment protocols, referral, and follow-up for NCDs).[7] To address this huge capacity gap of PHC professionals, the World NCD Federation has initiated an International Course as “Certification of PHC physician in NCDs” which focuses on meeting the requirements of the Global NCD Agenda under the Global strategy for prevention and control of NCDs.[8] The World NCD Federation aimed to develop this e-learning course to provide simple and comprehensive guidance on the prevention, surveillance, and management of common NCDs to health-care professionals, including frontline workers, community health workers, and PHC doctors. The objective of the course includes the development and implementation of a certification course for primary health physicians in NCDs at the global level","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136004705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sriharsha Boppana, Nikhil Ravula, L. S. Simhachalam Kutikuppala, Nagarjuna Sivaraj, C. Raja Hamsa, Sidharth Mahajan, P. Chaitanya
Background: A major modifiable risk factor for cardiovascular disease is hypertension. Resistant hypertension is observed to be associated with an increased likelihood of deleterious effects such as cardiovascular events, cerebrovascular accident, and renal dysfunction. The raised levels of inflammatory cytokines in the plasma like the C-reactive protein (CRP) have previously been observed to be significantly raised in hypertensive patients, but the overlying mechanisms corresponding to these processes remain unknown. Materials and Methods: In essence, this was an observational study with data collected from a population at a specific moment in the time to assess the relationships between the variables analyzed. A total of 200 individuals with arterial hypertension took part in the study. Fasting venous blood was obtained to evaluate plasma lipoprotein-related phospholipase A2 (Lp-PLA2) activity, and baseline data were collected. To diagnose RH, a 24-h ambulatory blood pressure management was done. Results: RH was observed among 100 patients and found to be predominant among males and older individuals, who were smokers and having hypertension for a longer period of time with higher Lp-PLA2 activity. More RH patients used calcium channel blockers and diuretics, while a fewer used angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and statins (P 0.05 for all comparisons). Conclusion: The plasma Lp-PLA2 activity beyond a certain threshold suggests a raised risk of RH, and the statins can help in reducing the RH incidence among persons with high Lp-PLA2 levels.
{"title":"Prevalence of resistant hypertension and its relation with plasma lipoprotein-associated phospholipase A2","authors":"Sriharsha Boppana, Nikhil Ravula, L. S. Simhachalam Kutikuppala, Nagarjuna Sivaraj, C. Raja Hamsa, Sidharth Mahajan, P. Chaitanya","doi":"10.4103/jncd.jncd_80_22","DOIUrl":"https://doi.org/10.4103/jncd.jncd_80_22","url":null,"abstract":"Background: A major modifiable risk factor for cardiovascular disease is hypertension. Resistant hypertension is observed to be associated with an increased likelihood of deleterious effects such as cardiovascular events, cerebrovascular accident, and renal dysfunction. The raised levels of inflammatory cytokines in the plasma like the C-reactive protein (CRP) have previously been observed to be significantly raised in hypertensive patients, but the overlying mechanisms corresponding to these processes remain unknown. Materials and Methods: In essence, this was an observational study with data collected from a population at a specific moment in the time to assess the relationships between the variables analyzed. A total of 200 individuals with arterial hypertension took part in the study. Fasting venous blood was obtained to evaluate plasma lipoprotein-related phospholipase A2 (Lp-PLA2) activity, and baseline data were collected. To diagnose RH, a 24-h ambulatory blood pressure management was done. Results: RH was observed among 100 patients and found to be predominant among males and older individuals, who were smokers and having hypertension for a longer period of time with higher Lp-PLA2 activity. More RH patients used calcium channel blockers and diuretics, while a fewer used angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and statins (P 0.05 for all comparisons). Conclusion: The plasma Lp-PLA2 activity beyond a certain threshold suggests a raised risk of RH, and the statins can help in reducing the RH incidence among persons with high Lp-PLA2 levels.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":"8 1","pages":"46 - 50"},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43523606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：