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1.
Indian J Public Health ; 67(2): 247-253, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37459020

RESUMO

Background: High HIV prevalence among injecting drug users (IDUs) remains a cause of concern and are considered key drivers of concentrated epidemic in India. The present paper aims to assess the effectiveness of the targeted intervention (TI) program on the risk behaviors among IDUs across regions of India. Materials and Methods: This paper used the data from the integrated biological and behavioral surveillance 2014-2015 among the IDUs in India. Descriptive statistics and propensity score matching analysis was carried out to understand the effectiveness of the TI program on the new needle/syringe used and needle/syringe shared in the last injecting episode by accounting for the covariates. Results: The matched samples estimate, i.e., average treatment effect on treated of new needles/syringe used and shared in the last injecting episode by those who received needles/syringes from peer educator or outreach workers (PE/ORWs) and those who did not receive was 2.8% (confidence interval [CI]: 0.05-5.6) increase in the use of new needles/syringes and 6.5% (CI: -9.7--3.3) decrease in the needles/syringes shared in last injecting episode indicating that IDUs who received new needles/syringes from PE/ORWs are more likely to use new needle/syringe and less likely to share needle/syringes to those who did not receive needles/syringes. The results vary across the different regions of India. Conclusion: TI program proves to be an effective initiative in the behavior change among IDUs as substantiated by use of new needles/syringes and decreased sharing of needles/syringes. TI program coverage varies from region to region and may further be expanded to accelerate the program services to prevent HIV/AIDS.


Assuntos
Síndrome da Imunodeficiência Adquirida , Usuários de Drogas , Infecções por HIV , Abuso de Substâncias por Via Intravenosa , Humanos , Uso Comum de Agulhas e Seringas , Abuso de Substâncias por Via Intravenosa/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Índia/epidemiologia , Assunção de Riscos
2.
Indian J Med Res ; 156(6): 742-749, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-37056073

RESUMO

Background & objectives: HIV sentinel surveillance (HSS) among antenatal women in India has been used to track the epidemic for many years. However, reliable tracking at the local level is not possible as ANC sentinel sites are limited in number and cover a smaller sample size at each site. Prevention of parent-to-child-transmission (PPTCT) programme data has a potential advantage due to better geographical coverage, which could provide more precise HIV case estimates; therefore, we compared HSS ANC data with PPTCT programme data for HIV tracking. Methods: Out of the 499 surveillance sites, where HSS and PPTCT programme was being conducted in 2015, 210 sites (140 urban and 70 rural) were selected using a stratified random sampling method. HSS (n=72,981) and PPTCT (n=112,832) data records were linked confidentially. The sociodemographic characteristics of HSS and PPTCT attendees were compared. HIV prevalence from HSS ANC was compared with the PPTCT programme data using Chi-square test. State- and site-level correlation of HIV prevalence was also done. Concordance between HSS and PPTCT HIV positivity was estimated using kappa statistics. Results: The age distribution of HSS and PPTCT attendees was similar (range: 23 to 27 yr); however, HSS ANC participants were better educated, whereas PPTCT recorded a higher proportion of homemakers. The correlation of HIV prevalence between HSS and PPTCT was high (r=0.9) at the State level and moderate at the site level (r=0.7). The HIV positivity agreement between HSS ANC and PPTCT was good (kappa=0.633). A similar prevalence was reported across 26 States, whereas PPTCT had a significantly lower prevalence than HSS in three States where PPTCT coverage was low. Overall HIV prevalence was 0.31 per cent in HSS and 0.22 per cent in PPTCT (P<0.001). Interpretation & conclusions: High-quality PPTCT programme data can provide reliable HIV trends in India. An operational framework for PPTCT-based surveillance should be pilot-tested in a phased manner before replacing HSS with PPTCT.


Assuntos
Infecções por HIV , Complicações Infecciosas na Gravidez , Gravidez , Feminino , Humanos , Vigilância de Evento Sentinela , Infecções por HIV/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologia , Índia/epidemiologia , Prevalência , Pais
3.
Indian J Public Health ; 64(3): 236-241, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32985423

RESUMO

BACKGROUND: Nutritional anemia due to iron deficiency is the most common cause of anemia in India. The average diet in India is low in iron and mostly of vegetable origin. This can be improved by increasing awareness of foodstuffs that are rich in iron and ensuring their availability. OBJECTIVE: The objective of the study was to assess the quality of information available on iron-rich foods and to assess their production and consumption in India. METHODS: This was a review of common textbooks for medical, nursing, and home science students; related policy and program documents; and government publications on production and consumption of various foodstuffs in India. RESULTS: Details of specific foods that are rich in iron have not been provided. Instead, food groups such as pulses, cereals, nuts, and green leafy vegetables (GLVs) have been mentioned that are good sources of non-heme iron. This is in spite of the fact that all the foodstuffs in these groups are not uniformly iron rich. Among cereals and pulses, rice and red gram dal (arhar) are the most commonly produced and consumed, though they have the lowest iron content. Spinach and mustard leaves believed to be iron rich and commonly consumed are among those GLVs having lowest iron content. CONCLUSION: Details of 5-10 foodstuffs which have the highest iron content within each food group should be available in relevant books and documents meant for education, production, and consumption data.


Assuntos
Anemia Ferropriva/prevenção & controle , Dieta , Promoção da Saúde , Ferro/administração & dosagem , Feminino , Análise de Alimentos , Humanos , Estado Nutricional
4.
Int J Equity Health ; 17(1): 171, 2018 11 20.
Artigo em Inglês | MEDLINE | ID: mdl-30458803

RESUMO

BACKGROUND: Socio-economic inequity leads to health inequity. Inequity is closely intertwined with internal migration. This study was planned with the objective of documenting the maternal health care utilization among women labourers working in brick kilns situated in an area of Haryana, north India. METHODS: A community based mixed method study was done in select brick kilns of Faridabad district in north India. A mixed method study was done to assess maternal health care utilization in a sample of 500 women in the reproductive age group. Focus group discussions were also carried out. Descriptive analysis was done. Qualitative data was analysed using the thematic framework approach. RESULTS: The mean age of the women was 30 (SD 0.3) years. Mean number of pregnancies per woman was 3.1 (SD 1.7). Only 22.9% ever had institutional delivery. About one third of women had ever received cash benefit under Janani SurakshaYojana (JSY) or had ever used free ambulance services. Seven major themes emerged from the qualitative analysis. Important themes include-Gaps in knowledge regarding local health system; Sub-standard private health care delivered at brick kilns prevent migrants from accessing the basic public health services; Misconceptions and mistrust about public health system influenced maternal health care utilization; Barriers to avail universal health coverage: location of brick kilns, time, apathy of public health system, partial health insurance cover. CONCLUSIONS: A typical migrant woman labourer in the brick kiln was an illiterate, had migrated from poor states, belonged to a socially disadvantaged community and worked long hours, and had been doing so for many years. This study has identified migrant women working in brick kilns as a vulnerable population subgroup in terms of maternal health utilization. To achieve universal health care it is important to understand the needs of all population subgroups and make concerted efforts at the health system level.


Assuntos
Instalações de Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Serviços de Saúde Materna/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adulto , Feminino , Programas Governamentais , Acessibilidade aos Serviços de Saúde/economia , Disparidades em Assistência à Saúde/economia , Humanos , Índia/epidemiologia , Serviços de Saúde Materna/economia , Gravidez , Qualidade da Assistência à Saúde/normas , Serviços Urbanos de Saúde/estatística & dados numéricos , Adulto Jovem
5.
Natl Med J India ; 31(5): 268-273, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-31267990

RESUMO

Background: Globally, around 1 billion persons are disabled as per the WHO report on disability in 2011. The bio-psycho-social model of disability was developed by the WHO as the International Classification of Functioning, Disability and Health. We studied the prevalence of disability and its association with sociodemographic factors and quality of life among adults in a rural area. Methods: We did a community-based, cross-sectional study among 418 randomly selected adult participants aged 18 years and above in a rural area of Ballabgarh, Haryana. Participants were interviewed by administering WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) for assessing disability and WHO Quality of Life-BREF (WHOQOL-BREF) scale for assessing quality of life. Multivariate analyses were done for the predictors of disability. Correlation was applied to find the association between disability and quality of life. Results: The prevalence of disability was 7.7% (95% confidence interval [CI]: 5.3%-10.6%) based on the cut-off > 40 summary score. More women (10.9%) than men (4.1 %) were disabled (p = 0.009). Being ≥60 years of age was independently associated with disability (adjusted odds ratio 12.3; 95% CI 4.45-33.97). The mean (SD) of the WHOQOL-BREF health-related quality of life (HRQOL) summary score was 67.6 (11.6) and the median was 66.43. HRQOL summary scores decreased as age increased. There was a negative correlation between summary scores of WHODAS 2.0 and WHOQOL-BREF (r -0.57, p<0.001). Conclusion: Prevalence of disability was higher than the estimate given by Census 2011. The elderly and women experience more disability. As age increases, quality of life decreases. Increase in the level of disability decreases the quality of life.


Assuntos
Avaliação da Deficiência , Pessoas com Deficiência/estatística & dados numéricos , Qualidade de Vida , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Adulto , Fatores Etários , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
6.
J Trop Pediatr ; 63(5): 365-373, 2017 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-28122945

RESUMO

Background: Planning a comprehensive program addressing neonatal mortality will require a detailed situational analysis of available neonatal-specific health infrastructure. Methods: We identified facilities providing essential and sick neonatal care (ENC, SNC) by a snowballing technique in Ballabgarh Block. These were assessed for infrastructure, human resource and equipment along with self-rated competency of the staff and compared with facility-based or population-based norms. Results: A total of 35 facilities providing ENC and 10 facilities for SNC were identified. ENC services were largely in the public-sector domain (68.5% of births) and were well distributed in the block. SNC burden was largely being borne by the private sector (66% of admissions), which was urban-based. The private sector and nurses reported lower competency especially for SNC. Only 53.9% of government facilities and 17.5% of private facilities had a fully equipped newborn care corner. Conclusions: Serious efforts to reduce neonatal mortality would require major capacity strengthening of the health system, including that of the private sector.


Assuntos
Competência Clínica , Atenção à Saúde/organização & administração , Planejamento de Instituições de Saúde/organização & administração , Pessoal de Saúde , Acessibilidade aos Serviços de Saúde , Mortalidade Infantil , Serviços de Saúde Materno-Infantil , Morte Perinatal/prevenção & controle , Atenção à Saúde/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Saúde Pública
7.
Natl Med J India ; 30(4): 198-200, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29162751

RESUMO

BACKGROUND: Stones in the urinary tract are a common condition but there is paucity of data on their population-based estimates in India. We describe our findings of the burden of urinary stones during a cross-sectional study with another primary goal. METHODS: We conducted the study at Ballabgarh Health and Demographic Surveillance System, Haryana, among residents aged 18 years or above. We used simple random sampling to enrol participants. Self-reported history of urinary stones was elicited through an interview schedule. Results of the descriptive analysis were described as proportions with 95% confidence intervals (CI) or as mean wherever applicable. Bivariate analysis was done using t-test and chi-square test as applicable. RESULTS: The response rate for our study was 86.6%; lifetime prevalence (95% CI) of urinary stones was 7.9% (5.7, 10.8). In a majority of participants, urinary stones were diagnosed at an age of 20-40 years (55.9%), mostly by an ultrasonography examination (94.1%). CONCLUSIONS: A high burden of urinary stones is indicated in the working-age population in northern India at the community level. Untreated urinary stones can lead to an acute emergency (colic) or may have long-term adverse consequences, e.g. hydronephrosis, which have implications for the healthcare delivery system.


Assuntos
Cálculos Urinários/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência
8.
Indian J Public Health ; 64(Suppl 2): S83, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32496228
10.
Paediatr Perinat Epidemiol ; 28(2): 127-37, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24354747

RESUMO

BACKGROUND: Reducing the global total of 3.3 million neonatal deaths is crucial to meeting the fourth Millennium Development Goal. Until recently, attention has been on the medical causes of the neonatal deaths, while the social factors contextualising these deaths have largely remained unaddressed. The current review aimed to quantify the role of these factors in neonatal deaths. METHODS: A systematic search was performed through PubMed, Google scholar, Cochrane library, Medline, IndMed, Embase, World Health Organization and Biomed central databases. Studies published from 1995 to 2011 were included. Random effects meta-analysis was performed to derive at an estimate of the burden of delays, as defined by the 'three delays model' by Thadeus and Maine. RESULTS: A total of 17 studies were reviewed. The majority of them (n = 10) were from the African continent. Level 3 delay, i.e. delay in receiving appropriate treatment upon reaching a health facility (38.7%, 95% CI, 21.7%-57.3%) and delay in deciding to seek care for the illness (Level 1 delay) (28%, 95% CI, 16%-43%) were the major contributors to neonatal deaths. Level 2 delay, i.e. delay in reaching a health facility (18.3%, 95% CI, 2.6-43.8%) contributed least to the neonatal deaths. CONCLUSION: Creating awareness among caregivers regarding early recognition and treatment seeking for neonatal illness along with improving the quality of neonatal care provided at the health facilities is essential to reduce neonatal mortality.


Assuntos
Atitude Frente a Saúde , Cuidadores/psicologia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Causas de Morte , Feminino , Humanos , Mortalidade Infantil , Recém-Nascido , Vigilância da População , Fatores de Risco , Fatores de Tempo
11.
BMC Health Serv Res ; 14: 278, 2014 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-24965875

RESUMO

BACKGROUND: Rabies is the most severe and neglected public health problem in India. Management of animal bite with post exposure prophylaxis is the only existent strategy to prevent rabies related deaths. Cost-effective and sustainable programme for provision of post exposure prophylaxis (PEP) is needed in India. METHODS: In this study, we have documented the experience of implementation of intra-dermal anti rabies vaccination in Animal Bite Management (ABM) clinic at Primary Health Centre (PHC). This study facility belonged to Comprehensive Rural Health Services Project, Ballabgarh in Faridabad district of Haryana. Hospital service record of ABM clinic was analyzed and various feasibility issues such as costing of services, vaccine wastage and other operational issues in providing PEP services at PHC level were documented. RESULTS: A total of 619 patients were treated in the ABM clinic. Service utilization of ABM clinic was increased by 38% in the second year of implementation. Mean age of the patients was 23.9 years (SD: 18.8) and majority (70.4%) were males. Majority (86%) of the patients received the first dose of anti-rabies vaccine within the recommended 48 hours. A total 446 vaccine vials (1 ml) were consumed of which 20.8% was contributed in vaccine wastage. User-fee (350 Indian Rupees) collected from the patients. User-fee was re-used to purchase vaccines, intradermal (ID) syringes and other consumables required to ensure regular availability of ARV services at the PHC. CONCLUSIONS: This study demonstrated the cost-effective and sustainable model of provision of PEP against rabies at primary care level. ID PEP provision at primary care level not only address the unmet need of animal bite management in the community also reduces the out of pocket expenditure of the patients.


Assuntos
Profilaxia Pós-Exposição , Atenção Primária à Saúde , Raiva/prevenção & controle , Serviços de Saúde Rural , Adolescente , Adulto , Criança , Pré-Escolar , Análise Custo-Benefício , Estudos de Viabilidade , Feminino , Humanos , Índia , Injeções Intradérmicas , Masculino , Auditoria Médica , Adulto Jovem
12.
Rural Remote Health ; 14(4): 2784, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25416920

RESUMO

INTRODUCTION: Early diagnosis and supervised treatment remains the mainstay for tuberculosis (TB) control in India. METHODS: A facility-based cross-sectional study was conducted to assess diagnostic and treatment practices of tuberculosis management as per the Revised National Tuberculosis Control Programme at a secondary level health facility in north India. This hospital mostly caters to rural and peri-urban populations in the Ballabgarh block of Faridabad district, Haryana. A sample size of 244 was calculated. Consecutive chest symptomatic patients were recruited in the study. Information about socio-demographic characteristics and treatment was obtained from a routine history-taking process in the outpatient clinic. Results were expressed as mean, standard deviation (SD) and odds ratio (OR) with 95% confidence interval (CI). RESULTS: A total of 250 pulmonary TB suspects were recruited, out of which 55.4% were males and mean age of study participants was 35.4 years (SD 14.6). Almost half (47.1%) of the participants had sought treatment from government hospitals, followed by 46.7% from private hospitals. Those who had visited a private facility were significantly more likely not to receive sputum acid-fast bacillus (AFB) diagnostic testing (OR=7.26, 95% CI 4.04-13.08), likely to be taking a second-line anti-TB drug as an antibiotic trial (OR=3.65, 95% CI 1.17-11.30), be empirically taking anti-TB drugs (OR=5.28, 95% CI 1.50-118.64) and getting a serological test done (OR=9.58, 95% CI 1.20-76.0) than those who went to a government health facility. Those who made at least three visits to a private facility were significantly more likely to have taken a second-line anti-TB drug as an antibiotic trial (OR=3.56, 95% CI 1.36- 9.28) and be empirically taking anti-TB drugs (OR=5.75, 95% CI 2.18-15.20) than those that made fewer than three visits. CONCLUSIONS: This study documented inappropriate diagnostic and treatment practices in TB management and highlights the need to generate awareness about it among health practitioners in north India.


Assuntos
Antituberculosos/uso terapêutico , Pessoal de Saúde , Qualidade da Assistência à Saúde , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Adulto , Estudos Transversais , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Serviços de Saúde Rural , Escarro/microbiologia , Teste Tuberculínico/estatística & dados numéricos , Adulto Jovem
13.
Artigo em Inglês | MEDLINE | ID: mdl-38973017

RESUMO

Metal Organic Frameworks (MOFs) are an evolving category of crystalline microporous materials that have grabbed the research interest for quite some time due to their admirable physio-chemical properties and easy fabrication methods. Their enormous surface area can be a working ground for innumerable molecular adhesions and site for potential sensor matrices. They have been explored in the last decade for incorporation in electrochemical sensor matrices as diagnostic solutions for a plethora of diseases. This review emphasizes on some of the recent advancements in the area of MOF-based electrochemical biosensors with focus on various important diseases and their significance in upgrading the sensor performance. It summarizes MOF-based biosensors for monitoring biomarkers relevant to diabetes, viral and bacterial sepsis infections, neurological disorders, cardiovascular diseases, and cancer in a wide range of real matrices. The discussion has been supplemented with extensive tables elaborating recent trends in the field of MOF-composite probe fabrication strategies with their respective sensing parameters. The article sums up the future scope of these materials in the field of biosensors and enlightens the reader with recent trends for future research scope. This article is categorized under: Diagnostic Tools > Biosensing Diagnostic Tools > Diagnostic Nanodevices.


Assuntos
Técnicas Biossensoriais , Técnicas Eletroquímicas , Estruturas Metalorgânicas , Estruturas Metalorgânicas/química , Humanos , Animais
14.
Indian J Community Med ; 49(1): 152-156, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38425976

RESUMO

Introduction: Alcohol use disorder (AUD) is a significant risk factor for tuberculosis (TB) treatment loss-to-follow-up (LTFU). This field-based study was undertaken to understand the role of AUD and TB treatment LTFU and the reasons behind this association in a rural area of Ballabgarh, Haryana. Material and Methods: TB patients who had completed their treatment and who had been LTFU were included in the study, along with the National TB Elimination Program (NTEP) staff, healthcare providers, family, and community members from Ballabgarh block of the north Indian state of Haryana. In-depth interviews (IDIs) and focused group discussions (FGDs) were conducted to gauge the perceptions of stakeholders regarding reasons for LTFU, especially in the context of alcohol use. Inductive analysis of the transcripts was done in keeping with the grounded theory, and themes with their sub-themes were identified. A conceptual framework of TB-AUD was constructed, and potential areas for intervention were determined. Results: Fifty-eight IDIs and four FGDs were conducted in mid-2018. Almost all key informants and many patient participants believed that alcohol use makes TB patients highly susceptible to treatment LTFU. Key themes identified were shared personality traits and attitudes, combined side effects of anti-tubercular drugs and alcohol use, lack of family support, and an adverse financial situation. Conclusion: These findings call for a change in NTEP's approach to AUD-TB. Interventions may include collecting alcohol use information at patient enrolment and closure, integrating brief interventions for alcohol cessation in NTEP, and linking patients to deaddiction centers with the provision of appropriate dietary and financial support.

15.
J Trop Pediatr ; 59(2): 100-5, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23174990

RESUMO

OBJECTIVE: To investigate causes of and contributors to newborn deaths in rural Haryana using a three delays audit approach. METHODS: The study was conducted in 28 villages under the rural field practice area of the Comprehensive Rural Health Services Project, All India Institute of Medical Sciences situated in Ballabgarh, Haryana. Data were collected through house visits and analysed using the three delays model. RESULTS: Of the 50 newborn deaths investigated, 44% occurred within the first 24 h after birth. The leading causes of death were pre-term/low birthweight (32%), birth asphyxia (28%) and neonatal sepsis (14%). Major contributing delays to neonatal death were caretaker's delay in deciding to seek care (44%, 22/50) and delay in reaching a health care facility, i.e. the transport delay (34%, 17/50). CONCLUSIONS: Household and transport-related delays were the major contributors to newborn deaths, and efforts to improve newborn survival need to address both concurrently.


Assuntos
Atitude Frente a Saúde , Cuidadores/psicologia , Acessibilidade aos Serviços de Saúde , Mortalidade Infantil , Causas de Morte , Estudos Transversais , Humanos , Índia/epidemiologia , Recém-Nascido , Modelos Teóricos , Vigilância da População , Serviços de Saúde Rural , População Rural , Fatores Socioeconômicos , Fatores de Tempo
16.
Indian J Public Health ; 57(2): 78-83, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23873194

RESUMO

BACKGROUND: With the on-going epidemiological transition, information on the pattern of mortality is important for health planning. Verbal autopsy (VA) is an established tool to ascertain the cause of death in areas where routine registration systems are incomplete or inaccurate. We estimated cause-specific mortality rates in rural adult population of 28 villages of Ballabgarh in North India using VA. MATERIALS AND METHODS: During 2002-2007, trained multi-purpose health workers conducted 2294 VA interviews and underlying cause of death was coded by physicians. Proportional mortality (%) was calculated by dividing the number of deaths attributed to a specific cause by the total number of deaths for which a VA was carried out. FINDINGS: 61% of deaths occurred among males and 59% occurred among those aged ≥60 years. The leading causes of death were diseases of the respiratory system (18.7%) and the circulatory system (18.1%). Infectious causes and injuries and other external causes, each accounted for around 15% of total deaths followed by neoplasms (6.8%) and diseases of the digestive system (4%). Among those 45 years of age or more than half of deaths were attributed to non-communicable diseases (NCDs) alone. Accidents and injuries were responsible for one-fourth of deaths in 15-30 years age group. CONCLUSION: NCDs and injuries are emerging as major causes of death in this region thereby posing newer challenges to public health system.


Assuntos
Autopsia/métodos , Causas de Morte , População Rural/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Vigilância de Evento Sentinela , Distribuição por Sexo , Adulto Jovem
17.
J Orthop Case Rep ; 13(11): 167-170, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38025362

RESUMO

Introduction: Heel pain is one of the most common painful conditions of the foot. There are many causes of heel pain, which are usually associated with calcaneal spurs. Hence, it becomes imperative to diagnose and treat them effectively. The development of calcaneal spur is somewhat not well known but is often said to be developed from inflamed plantar fascia. Heel being weight-bearing part of the body, it is very painful something and adversely affects the activity of daily living. Calcaneal spurs are fibrocartilaginous triangular projections from an insertional area of the plantar fascia. Calcaneal spurs are usually single in number but can vary in size. Paired or double calcaneal spurs are not yet reported in the literature and further, the occurrence of bilateral paired calcaneal spurs is extremely rare too. The aim of this case report is to report the occurrence of bilateral paired or double calcaneal spurs. Case Report: A 56-year-old man presented himself at the orthopedics outpatient department with spontaneous onset bilateral heel pain for the past few months. The pain was more in the morning as soon as he gets up from bed and persisted throughout the day with variable intensity. Conclusion: The presence of calcaneal spur is usually symptomatic and may be asymptomatic sometimes. The presence of symptomatic bilateral paired calcaneal spur is rare and the present case report may be helpful for further study.

18.
J Family Med Prim Care ; 12(9): 1885-1892, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38024890

RESUMO

Background: Living with hypertension (HTN) has been found to cause distress, which adversely affects one's self-care and may lead to elevated blood pressure. There is a paucity of data regarding the prevalence of HTN-related distress. This study was conducted to estimate the prevalence of HTN-related distress among adults with HTN attending an outpatient department in an urban primary health centre and to determine the factors associated with distress. Methods: This was a cross-sectional study conducted at the outpatient department of an urban primary health centre in Delhi, India. The enrolled participants were administered a questionnaire, which included a Distress Scale for patients with diabetes mellitus and/or hypertension (DSDH17 M) (to assess for HTN-related distress) and Health-Related Quality of Life, Healthy Days Measure. A descriptive analysis was performed. Factors associated with HTN-related distress were tested using logistic regression. Results: One hundred forty-one participants were enrolled in this study. Most were women (73.76%) with a mean age of 60.15 years (standard deviation [SD]: 0.78). The prevalence of HTN-related distress (average DSDH17 M score ≥3) was 14% (95% confidence interval [CI]: 9.30-21.03). Patients with HTN-related distress had significantly poor health and reported a greater number of days where they were physically or mentally unhealthy. Patients with uncontrolled blood pressure had six times the odds (95% CI: 1.69-21.77, P value = 0.006) of HTN-related distress compared to those with controlled blood pressure. Conclusions: Hypertension-related distress was present in 14% of adults with HTN. Patients with uncontrolled blood pressure had six times the odds of HTN-related distress.

19.
J Family Med Prim Care ; 12(9): 1843-1848, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38024892

RESUMO

Objective: Fracture around the hip is amongst the most common and serious fractures in the elderly, which leads to significant morbidity and mortality. In literature, many authors noted that even mild hyponatremia adversely affects bone, leading to an increased incidence of fractures. We aim to determine whether chronic hyponatremia (>90-day duration) increases the risk of hip fracture in the elderly and whether primary care physicians can help to prevent it. Materials and Methods: During the period from January 2020 to March 2022, we identified 145 patients aged between 65 and 90 years who were admitted to the hospital with hip fractures following a fall and compared them with 140 healthy controls. We recorded sodium (Na) serum levels in all included patients at the time of arrival and consequently for 3 days and compared them with those of controls. Logistic regression was used to calculate odds ratios (ORs). We measured serum Na levels for 3 days and took the average to ascertain hyponatremia. Result: In the study, the odds of hyponatremia were 70.3% with a confidence interval of 95% versus 3.6% in controls (P = 0.05). Age and hyponatremia were strongly associated with hip fractures following a fall. With a 5-year increase in age, the univariate OR for hip fracture increased by 5.67 (P < 0.0001). After adjusting for age, cases were nearly six times more likely to be hyponatremic than controls (OR = 4.90, P = 0.04). Conclusion: In our study, we noted that even mild chronic hyponatremia in old age increased the chance of falls. Addressing hyponatremia in the elderly may reduce the risk of falls and minimize hip fractures.

20.
Sci Rep ; 13(1): 2315, 2023 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-36759634

RESUMO

The ultra-thin heterostructure of Pr0.6Sr0.4MnO3(15 nm)/Pr0.5Ca0.5MnO3(15 nm)/SrTiO3 fabricated using pulsed laser deposition technique exhibits the phase-segregated nature wherein the ferromagnetism of Pr0.6Sr0.4MnO3, and the antiferromagnetic state of Pr0.5Ca0.5MnO3 coexist in proximity. The observation of two exciting phenomena in the grown ultra-thin heterostructure, namely, the kinetic arrest and training effect, confirms its phase-segregated nature. The melting of the antiferromagnetic state in Pr0.5Ca0.5MnO3 into a ferromagnetic state due to the interfacial interaction arising from the magnetic proximity of the ferromagnetic clusters of Pr0.6Sr0.4MnO3 have been observed. A metal-insulator transition (TMIT) found at 215 K, close to its Curie temperature (TCurie) observed at 230 K, reveals a strong correlation between the electrical transport and the magnetization of the ultra-thin heterostructure. The electrical conduction in the high-temperature regime is explained in terms of the adiabatic small polaron hopping model. While the resistance in the metallic regime for temperatures above 100 K is contributed by the inelastic scattering due to the two-magnons, in the metallic regime below 100 K, the one-magnon inelastic scattering contribution is prevalent. An enhanced colossal magnetoresistance property near room temperature is obtained in the ultra-thin heterostructure arising from the proximity-driven interfacial interaction, making it a suitable candidate for technological applications near room temperature.

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