The triad of physiological challenges: investigating the intersection of sarcopenia, malnutrition, and malnutrition-sarcopenia syndrome in patients with COPD - a cross-sectional study.

BACKGROUND: One of the most prevalent respiratory disorders in modern society is chronic obstructive pulmonary disease (COPD). Frequent comorbidities in patients with COPD are abnormal nutritional status and body composition variations. Malnutrition-sarcopenia syndrome, which occurs when the 2 conditions - malnutrition and sarcopenia - coexist, raises the risk of death more than either condition alone. The current study sought to determine the prevalence of malnutrition, sarcopenia, and malnutrition-sarcopenia syndrome in patients with COPD as well as the association between these diseases and the severity of COPD. METHODS: The study was an analytical cross-sectional study conducted on hospitalized patients with COPD. The sample size of the study was calculated to be 160. A self-structured questionnaire was used to collect the data, containing sociodemographic characteristics, clinical profiles, anthropometric assessment, and bioimpedance indices. Sarcopenia was diagnosed with low muscle strength and muscle mass by the EWGSOP2 recommendations. Muscle mass is measured by BIA and muscle strength (Handgrip) was measured by a Hand Dynamometer. Assessment of the risk of malnutrition was performed using the Mini Nutritional Assessment-Short Form questionnaire and was confirmed by GLIM criteria. The COPD assessment test (CAT) tool determined the severity of the condition. For the data analysis, comparisons were made using Student's t test and Mann-Whitney test in bivariate analysis. Multivariate logistic regression analyses were performed considering the outcomes of patients with COPD by CAT scores, prolonged length of stay, and hospital readmission 6 months after discharge. RESULTS: The mean age of the participants was 48 ± 5 years. Approximately 61.9% were found to be sarcopenic. Approximately 45.6% of participants had malnutrition. Malnutrition sarcopenia syndrome was diagnosed in 32.5% of patients. The study analysis revealed that patients with COPD with malnutrition-sarcopenia syndrome had more than twice the odds of prolonged hospital stay, re-admission within 6 months, and higher CAT scores. CONCLUSION: The study revealed a high prevalence of sarcopenia, malnutrition, and malnutrition sarcopenia syndrome in patients with COPD. These conditions were found to be statistically significant with prolonged length of stay, re-admission within 6 months, and CAT scores. The findings highlight the importance of addressing these conditions as part of the management of the patients.

Multimorbidity, health Literacy, and quality of life among older adults in an urban slum in India: a community-based cross-sectional study.

BACKGROUND: India is experiencing a rising burden of chronic disease multimorbidity due to an aging population and epidemiological transition. Older adults residing in urban slums are especially vulnerable due to challenges in managing multimorbidity amid deprived living conditions. This study aimed to assess the prevalence of multimorbidity, associated health literacy, and quality of life impact in this population. METHODS: A community-based cross-sectional study was conducted among 800 adults aged ≥ 65 years in an urban slum in Gujarat, India. Data on sociodemographics, physical and mental health conditions, health literacy (HLS-SF-47), quality of life (Short Form-12 scale), and social determinants of health were collected. Multimorbidity is ≥ 2 physical or mental health conditions in one person. RESULTS: The prevalence of multimorbidity was 62.5% (500/800). Multimorbidity was significantly associated with lower physical component summary (PCS) and mental component summary (MCS) scores on the SF-12 (p < 0.001). After adjusting for sociodemographic variables, the odds ratio of 0.81 indicates that for every 1 unit increase in the health literacy score, the odds of having multimorbidity decrease by 19%. Older age within the older adult cohort (per year increase) was associated with greater odds of multimorbidity (AOR 1.05, 95% CI 1.02-1.09). Physical inactivity (AOR 1.68, 95% CI 1.027-2.77) and lack of social support (AOR 1.57, 95% CI 1.01-2.45) also increased the likelihood of multimorbidity. CONCLUSION: There is a substantial burden of multimorbidity among urban slum dwellers aged ≥ 65 years in India, strongly linked to modifiable risk factors like poor health literacy and social determinants of health. Targeted interventions are essential to alleviate this disproportionate burden among urban slum older adults.

Screening of Hospitalized Elderly Patients for Frailty and Associated Co-morbid Conditions in Western Gujarat in India.

Background: Older patients admitted to hospitals have a greater impact on the healthcare system as the population ages. The relationship between the recovery of functional impairments and frailty status in geriatric care units is still not clear. Simple screening technologies are required in order to operationalize frailty management in this susceptible population due to these restrictions. Aim: The study aims to screen hospitalized older adults for frailty and associated co-morbid conditions in western Gujarat, India. Materials and Methods: This is an institutionally based cross-sectional study conducted on the elderly patients (aged 60 years or more) admitted at the tertiary-level government hospital of Jamnagar District of Gujarat State during the period of October 22 to December 22. The assessment was done with a structured questionnaire for FRAIL screen, the Rapid Cognitive Screen (RCS), Charles Co-morbidity Index, Geriatric Depression Scale-5 (GDS-5), and Short Form-12 (SF-12) Health Survey. Results: The overall findings of this study reveal that of 124 participants 34 (27%) were frail, 52 (42%) were found to be a likelihood of depression by the GDS, and 29 (23%) were having dementia by RCS, respectively. In our study, we also found a statistically significant association between frailty and dementia (P value < 0.001). Conclusion: The present study implies the prevalence of frailty among old age elderly patients and its association with various socio-demographic and co-morbid conditions of the participants. Early identification of frailty and co-morbid conditions can help to prevent adverse health outcomes.

The Hidden Battle Within: Shedding Light on the Co-existence of Sarcopenia and Sarcopenic Obesity among Participants with Type 2 Diabetes in a Tertiary Care Hospital, Gujarat.

Introduction: Type 2 diabetes (T2DM) is characterised by chronic hyperglycaemia due to abnormal insulin secretion and/or utilisation. Currently, sarcopenia has emerged as a new complication of T2DM, which increases the risk of physical disability, and even death. The study aims to estimate the prevalence of sarcopenia and sarcopenic obesity (SO) as well as their association with various other factors related to T2DM. Methods: The study was an observational hospital-based cross-sectional study conducted among diabetic patients who came to the non-communicable diseases (NCD) clinic of a tertiary care hospital in Gujarat, India, from April 2023 to June 2023. Adult patients with T2DM attending follow-ups were included, with a diagnosis of T2DM for at least 1 year from the date of their electronic medical records, regardless of their mode of therapeutic treatment. They were on regular medical reviews with two or more visits to the study site in the past 1 year. Then a self-structured standard questionnaire was used to collect the data, containing socio-demographic characteristics, clinical profiles, anthropometric assessment (comprising weight, height and body mass index [BMI]), bio-impedance indices like body fat%, skeletal muscle% and handgrip by hand dynamometer. Results: In the study, a total of 404 participants participated. Their mean age was 55 ± 13.5 years and their mean body fat (BF) % was 30 ± 7.4%. BF%-defined obesity was found in 260 (64.4%) participants. A total of 362 (89.6%) had possible sarcopenia, 183 (45.3%) had sarcopenia and 124 (30.7%) had SO. Age (OR: 2.6, CI: 1.7-3.9), duration of diabetes for more than 7 years (OR: 7.5, CI: 3.65-15.4) and BF%-defined obesity (OR: 2.2, CI: 3.6-15) were statistically associated with Sarcopenia, in similar pattern age (OR: 2.4, CI: 1.5-3.7), and duration of diabetes more than 7 years (OR: 18.9, CI: 5.7-62) were associated with SO (P < 0.05). Conclusion: Older age, longer diabetes duration and BF%-defined obesity are associated with an increased likelihood of developing sarcopenia and sarcopenic obesity. Healthcare providers should prioritise regular screening for sarcopenia and SO in elderly individuals with diabetes to facilitate early detection and intervention.

Association of serum ferritin trends with liver enzyme patterns in ß-thalassemia major: A longitudinal correlational study.

Background: ß-Thalassemia major patients require lifelong blood transfusions, leading to iron overload and liver injury. This study examines the longitudinal association between serum ferritin and liver function over 5 years in pediatric patients. Methods: This retrospective study included 582 transfusion-dependent thalassemia patients aged 1-18 years. Serum ferritin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and albumin were measured annually. Correlation and linear regression analyses assessed associations between ferritin trajectories and liver enzymes. Results: Mean ferritin rose from 1820 ± 960 ng/mL at baseline to 4500 ± 1900 ng/mL at year 5, indicating worsening iron overload. AST and ALT levels also steadily climbed over follow-up, whereas albumin declined slightly. Ferritin correlated positively with AST (r = 0.675, P < 0.01) and ALT (r = 0.607, P < 0.01), but not with albumin (r = -0.143, P = 0.153) annually. The regression interaction term showed within-patient ferritin increases over time were independently associated with escalating AST and ALT (P < 0.05), after adjusting for confounders. Conclusion: Rising ferritin levels predict progressive liver injury in regularly transfused pediatric thalassemia patients. Tighter control of iron overload may help preserve hepatic function.

Prevalence and predictors of loneliness and its association with health-seeking behaviors among the elderly population, Gujarat, A community-based cross-sectional study.

Objectives: To determine the prevalence and predictors of loneliness and its associations with health behaviors among elderly adults in Gujarat, India. Methodology: This community-based cross-sectional study included 250 participants aged ≥60 years. Loneliness was measured using the UCLA Loneliness Scale. Associations with socio-demographic, health, and social factors were explored through regression models. Health behaviors were compared between lonely and non-lonely groups. Results: The prevalence of moderate and severe loneliness was 24% (n = 60) and 16% (n = 40), respectively. 40% (n = 100) were found to be lonely. Widowhood (55/125, OR 3.67), living alone (75/125, OR 1.85), social isolation (90/125, OR 2.38), recent bereavement (68/125, OR 1.69), depression (85/125, OR 6.52), and disability (70/125, OR 6.35) were significant predictors of loneliness (P < 0.05). Lonely elders had poorer diet, exercise, sleep, increased smoking, screen time, reduced medical checkups, and social engagements versus non-lonely peers (P < 0.05). Conclusion: Loneliness was highly prevalent among 40% of elderly Indians and strongly linked to adverse health behaviors. Interventions promoting social connectedness, counseling, and peer support are recommended.

Unravelling the obesity maze in diabetic patients: A comparative analysis of classification methods.

Background: Obesity is a significant health concern among individuals with type 2 diabetes mellitus (T2DM). Emerging evidence suggests that alternative measures, such as abdominal girth (AG) and body fat percentage (BF%), can provide a more accurate reflection of obesity-related metabolic risks in diabetic populations. This study aimed to compare the accuracy of different obesity classification methods, including BMI, AG, and BF%, among individuals with T2DM. Methodology: This was an observational cross-sectional study conducted among T2DM patients who came to the non-communicable diseases clinic of GG Govt Hospital, Jamnagar, Gujarat during the period of March-April 2023. Demographic and anthropometric information was collected. Body fat analysis was done using a validated Omron fat analyzer. Results: The study found the sensitivity of BMI in males and females as 41.6% and 45% against BF%, respectively. It also showed that the sensitivity of BMI in males and females was 38% and 40.7%, respectively, against AG. The present study also found a moderate positive correlation (r = 0.575) between AG and BF% in individuals with T2DM. Conclusion: The findings indicate that BF% and AG provide valuable insights into adiposity, surpassing the limitations of BMI as a measure of body composition. BF% is an indicator of body fat content, whereas AG serves as a proxy for central adiposity. The correlations between BF% and AG suggest that excess abdominal fat accumulation signifies increased body fat. By incorporating measures such as BF% and AG alongside BMI, clinicians can obtain a more comprehensive understanding of body composition and its relationship with metabolic abnormalities.

Prevalence and predictors of multimorbidity in older adults, a community-based cross-sectional study.

Background: Multimorbidity is a condition that refers to the coexistence of two or more chronic diseases or long-term medical conditions in an individual. It has become one of the key issues in the public health sector, particularly among older adults. So, this study aimed to estimate the prevalence of multimorbidity and its associated factors among older adults. Methodology: The present study was a community-based cross-sectional study carried out on the elderly population (≥60 years) in a rural area of the study district, Gujarat. The estimated sample size was 384, and the final sample size was taken as 420, considering the multistage sampling procedure for fair distribution. The eligibility criteria included elderly people ≥60 years old, who were permanent residents (living for ≥6 months) of the study district and willing to participate in the study. Elderly people who were not willing to participate in the study for their reasons were excluded. A multistage sampling procedure was used to choose the study participants. The data collection tools included a pretested, predesigned, semi-structured questionnaire. The questionnaire consisted of two parts: sociodemographic details and morbidity details. Categorical variables were described by frequency and percentage, and numerical variables were described by mean ± SD. Logistic regression analyses were applied to test the relationship of categorized independent and dependent variables, and all tests were two-tailed with statistical significance set at the probability value (P < 0.05). Results: Out of the 420 study participants, 52.1% were male and 47.9% were female, with a mean age of 70.70 years (SD ± 8.18 years). The prevalence of multimorbidity was 50%, with males having a mean number of morbidities of 1.38 ± 1.06 and females having a mean number of morbidities of 1.44 ± 0.99. As the age increased, the strength of association of multimorbidity also increased. Literacy level, marital status, occupation (business, farmer, housewife), and family history were statistically associated with multimorbidity in the study participants in both bivariate and multivariate analyses (P < 0.05). Conclusion: The study provides valuable insights into the health status of the elderly population in the rural area and can be used to inform healthcare policies and interventions aimed at improving the health outcomes of this population.

Prevalence of normal weight obesity and its cardiometabolic implications among government doctors in Gujarat, India: a cross-sectional study.

BACKGROUND: Obesity is rising globally. Normal weight obesity (NWO) and normal weight central obesity (NWCO) despite normal BMI pose added metabolic risks. Limited data on these phenotypes among Indian doctors merits investigation. The present study aimed to assess the prevalence of overall obesity, NWO, NWCO, and their associations with cardiometabolic risks among doctors in Gujarat, India. METHODS: It's a Cross-sectional study among 490 doctors aged 20-60 years at a tertiary hospital. Anthropometry, blood pressure, fasting glucose, and lipids were assessed. NWO was defined as a BMI of 18.5-24.9 kg/m2 with a high body fat percentage. NWCO as normal BMI and increased waist circumference. Body composition was assessed using an Omron body composition analyzer. RESULTS: The prevalence of overall obesity was 101 (20%), NWO 239 (48.7%), and NWCO 210 (42.8%). Mean BMI, blood pressure, glucose, and LDL increased from normal weight to NWO/NWCO groups (p < 0.05). NWO and NWCO had significantly higher odds of hypertension, dyslipidemia, and high fasting blood sugar compared to non-obese after adjusting for confounders. CONCLUSION: The high burden of overall obesity, NWO, and NWCO among doctors highlights the need for lifestyle interventions to mitigate long-term cardiometabolic disease risk.

Converging Pathways: Exploring the Interplay of Malnutrition, Sarcopenia, and Frailty in Nursing Home Residents: A Cross-sectional Study.

Background: Within the context of nursing home care, malnutrition, sarcopenia, and frailty stand as notable conditions, each exerting distinct yet interconnected impacts on residents' well-being. The objective of this cross-sectional study is to elucidate the intricate interplay among malnutrition, sarcopenia, and frailty among nursing home residents. Methodology: It is a community-based, cross-sectional, descriptive study among nursing home residents of Vatsalyadham Vrudhsharam, which is an institution for aged old-age people in Jamnagar from April 2023 to July 2023. The estimated minimum sample size was 345. A self-structured questionnaire was used to collect the data containing sociodemographic characteristics, anthropometric assessment, and bio-impedance indices. The handgrip was measured by a hand dynamometer. Assessment of the risk of malnutrition was performed using the Mini Nutritional Assessment-Short Form questionnaire and was confirmed by the Global Leadership Initiative for Malnutrition (GLIM) criteria. Sarcopenia was assessed by a bio-impedance analyzer using the Asian Working Group of Sarcopenia 2019. Frailty was assessed using the fatigue, resistance, ambulation, illness, and loss (FRAIL) screener. Descriptive statistics were used for the representation of percentages and frequencies. Both Chi-square and logistic regression analyses were used for the association. P < 0.05 was considered statistically significant, respectively. Results: About 345 participants were included, and mean age of the participants was 85 ± 5.6 years, about 159 (49%) participants belonged to the age group of more than 80 years, 220 (63.7%) were males, then malnutrition was diagnosed by GLIM criteria, about 154 (44.6%) were found to have malnutrition. Sarcopenia was found in 184 (53%) participants. The FRAIL screening was used to identify frailty, according to that prefrail was around 170 (49%) and frail was about 122 (35%), respectively. Age, gender, and history of falls were associated with frailty and sarcopenia (P < 0.001). Only, age and gender were associated with malnutrition but not a history of falls. Conclusion: The findings of this study suggest that frailty, sarcopenia, and malnutrition are prevalent among nursing home residents. Health-care providers should identify and manage these conditions in older adults to improve their quality of life.

A Study on the Pattern of Self-reported Tobacco Addiction in Hypertensive Patients in Gujarat, India.

BACKGROUND: Both hypertension (HTN) and tobacco addiction pose a threat to the health, environment, and socioeconomic status (SES) of the people. When tobacco use disorder exists in people with HTN, it hastens the disease progress and causes early complications. The present study aimed to study the knowledge and practice of tobacco addiction in patients with HTN and find out the correlates of knowledge and practice of tobacco addiction. METHODS: A cross-sectional study was conducted for a period of one year in the Jamnagar District of Western Gujarat, India. Out of total 400 samples, 50% were collected from the five selected Community Health Centers (CHCs) by random sampling and the rest from non-communicable disease (NCD) clinics at the tertiary care hospital of the district. FINDINGS: Most of the patients were in their fifties or above (67.0%), women (57.0%), and married (86.5%). Only 12.0% had awareness about the hazards of tobacco addiction and the prevalence of tobacco addiction was 11%. It was found that use of smokeless tobacco (SLT) among samples was the highest (72.7%) followed by dual consumption, i.e., SLT and smoking (20.5%). The frequency of consumption was ≥ 5 times/day in 54.5%, 70.4% were addicted for > 10 years, and only 15.9% had ever tried to quit tobacco while only 11.4% had successfully quit it. It was seen that those who were aged < 50 years, men, literates, employed, and those belonging to higher SES and urban residence had better knowledge of the health hazards. This was found to have significant statistical association. CONCLUSION: The results provide valuable insight into the tobacco addiction in patients with HTN on which non-pharmacological treatment of HTN can be based.

A lay epidemiological study on coexistent stress in hypertension: Its prevalence, risk factors, and implications in patients' lives.

INTRODUCTION: Hypertension poses a global challenge in terms of morbidity and mortality. Worldwide prevalence of hypertension is over 40%. Management of hypertension targets blood pressure control to prevent disease complications. Though stress and hypertension are closely related, stress management is often overlooked in the treatment of hypertension. AIMS: (1) To estimate the prevalence of stress in hypertensive patients and (2) to study the associated risk factors of stress and its implications in disease management. MATERIALS AND METHODS: It was a hospital-based, cross-sectional study done in Western India for 1 year. Data were collected from 400 hypertensive patients attending the selected health institutions using a pretested questionnaire. Chi-square tests were done using Medcalc 10.4.8.0. RESULTS: The prevalence of stress in hypertensive patients was found to be 84.3%. Only 2.4% of these patients sought help from any health professional for stress. The most common stressors found in the patients were financial dependence on others, living in rented house, having a daughter of marriageable age because of associated dowry, death of a loved one, sleep-related problem, and owing a debt among others. Significant statistical association (P < 0.05) of stress was observed with the type of family and socioeconomic status. A highly significant association (P < 0.001) of stress with religion and residential area (whether urban non-slum, slum, or rural) was observed. Stress in individuals leads to poorer compliance with treatment and blood pressure control. CONCLUSION: Coexistent stress should be diagnosed and managed in patients of hypertension for proper disease management and control.

Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews.

OBJECTIVES: This umbrella review aimed to determine the effectiveness of exercise interventions, alone or in combination with other interventions, in improving physical function in community-dwelling older people identified as pre-frail or frail. INTRODUCTION: Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty. Several systematic reviews discuss the effects of exercise interventions on physical function parameters, such as strength, mobility, gait, balance and physical performance, and indicate that multi-component exercise, including resistance, aerobic, balance and flexibility training, appears to be the best way in which to improve physical function parameters in frail older people. However, there is still uncertainty as to which exercise characteristics (type, frequency, intensity, duration and combinations) are the most effective and sustainable over the long-term. INCLUSION CRITERIA: Participants were adults, 60 years or over, living in the community and identified as pre-frail or frail. Quantitative systematic reviews, with or without meta-analysis that examined the effectiveness of exercise interventions of any form, duration, frequency and intensity, alone or in combination with other interventions designed to alter physical function parameters in frail older people, were considered. The quantitative outcome measures were physical function, including muscular strength, gait, balance, mobility and physical performance. METHODS: An iterative search strategy for ten bibliometric databases and gray literature was developed. Critical appraisal of seven systematic reviews was conducted independently by two reviewers using a standard Joanna Briggs Institute tool. Data was extracted independently by two reviewers using a standard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach. RESULTS: Seven systematic reviews were included in this umbrella review, with a total of 58 relevant randomized controlled trials and 6927 participants. Five systematic reviews examined the effects of exercise only, while two systematic reviews reported on exercise in combination with a nutritional approach, including protein supplementations, as well as fruit and dairy products. The average exercise frequency was 2-3 times per week (mean 3.0 ±â€Š1.5 times per week; range 1-7 weekly) for 10-90 minutes per session (mean of 52.0 ±â€Š16.5 mins) and a total duration of 5-72 weeks with the majority lasting a minimum of 2.5 months (mean 22.7 ±â€Š17.7 weeks). Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength, gait speed, balance and physical performance, including resistance, aerobic, balance and flexibility tasks. Resistance training alone also appeared to be beneficial, in particular for improving muscular strength, gait speed and physical performance. Other types of exercise were not sufficiently studied and their effectiveness is yet to be established. CONCLUSIONS: Interventions for pre-frail and frail older adults should include multi-component exercises, including in particular resistance training, as well as aerobic, balance and flexibility tasks. Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made.

The EXPRESS Study: Exercise and Protein Effectiveness Supplementation Study supporting autonomy in community dwelling frail older people-study protocol for a randomized controlled pilot and feasibility study.

BACKGROUND: Research has repeatedly demonstrated that exercise has a positive impact on physical function and is beneficial in the treatment of physical frailty. However, an even more effective strategy for managing physical frailty might be the combination of multicomponent exercise with the intake of high-quality protein supplements, but the efficacy remains unclear for older adults who are already pre-frail and frail. The aim is to examine the feasibility of recruiting frail older adults to participate in a trial designed to determine the potential effects of a 6-month exercise and nutrition intervention on physical function. The feasibility objectives will include frail older peoples' compliance, the safety and tolerability of the trial, the estimation of estimates to aid sample size calculation, and the potential efficacy. Primary outcomes for the main trial will include gait speed, grip strength and physical performance. Secondary outcomes will include frailty status, muscle mass, nutritional intake, physical activity levels, cognitive performance and quality of life. METHODS/DESIGN: A randomised, parallel, control pilot and feasibility study will be conducted. All participants will be randomly assigned to either (a) an exercise program + high-quality protein supplement or (b) an exercise program + low-quality protein supplement. Both protein supplements will be matched closely in colour, flavour and packaging so that both the participants and the research staff are blinded. The exercise program will be the same in both groups. Assessments will be conducted at baseline and at 3 and 6 months and include gait speed, grip strength, the Short Physical Performance Battery, Timed Up and Go Test, FRAIL Screen, bioelectrical impedance analyses, 24-h dietary recall, Katz Activities of Daily Living, Lawton Instrumental Activities of Daily Living, the Trail Making Test, Short Form Health Survey-36, and 1 week accelerometer quantification. The data will be analysed using an ANCOVA model. DISCUSSION: This study is expected to provide much needed insight into the feasibility of recruiting and retaining frail older adults into community-based intervention programs, while providing knowledge relating to the safety, tolerability and benefits of a combined exercise and protein supplement program designed to halt or reverse the transition of physical frailty in the community. If shown to be effective, this strategy could be included in the best practice clinical guidelines for community-dwelling older adults who are pre-frail or frail. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12616000521426.

Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review protocol.

REVIEW QUESTION/OBJECTIVE: The objectives of this umbrella review are to determine the effectiveness of exercise interventions, alone or in combination with other interventions, for improving physical function in community-dwelling older people who are identified as frail or at risk of frailty, and to identify if any particular intervention type or characteristic is the most effective.Specifically, the review question is: What is the effectiveness of exercise interventions, alone or in combination with other interventions, for improving physical function in community-dwelling older people identified as frail or at risk of frailty?

Profile of dengue infection in Jamnagar city and district, west India.

Background and Methods India is one of the countries in the World Health Organization South-East Asia Region that regularly reports outbreaks of dengue fever (DF)/dengue hemorrhagic fever (DHF). As effective control and preventive programmes depend upon improved surveillance data, this study was carried out to report the seroprevalence of dengue virus infection in an area around Jamnagar city, Western India. [1] Methods The laboratory records of clinically suspected dengue patients from July 2008 to June 2011 were analysed retrospectively for the results of immunoglobulin M (IgM) anti-dengue antibodies, tested by dengue monoclonal antibody (IgM) capture enzyme-linked immunosorbent assay (MAC ELISA). Variations in disease incidence by sex, age group and season were assessed. Results A total of 903 serum samples were tested, of which 253 were positive. The majority were males (72%) and in the age group of 16-30 years. The incidence of dengue peaked in October and slowly tapered by December. Conclusion Dengue cases were higher during September to December, in the post-monsoon season. This observation is useful for planning special preventive strategies. The study draws attention to the susceptibility of the male, young adult age group.

The prevalence of fungi in fingernail onychomycosis.

BACKGROUND: Fingernail onychomycosis is a fungal infection of the finger nails. It is mainly produced by yeasts, dermatophytes and molds and sometimes it shows a mixed infection. It is a cosmetic issue rather than a medical problem. AIMS: This study was conducted with the aim of exposing the fungal concept in nail diseases, to introduce nail testing which was underutilized as a diagnostic tool despite being involved in many dermatological conditions, as well as to introduce microbiological techniques in the diagnosis of nail diseases, based on the clinical parameters only. MATERIALS AND METHODS: A total of 45 samples were tested in our laboratory by using 20% KOH and culture plates of Sabouraud's Dextrose Agar (SDA) which were mixed with chloramphenicol and cycloheximide. RESULTS: A total of 37.78% samples were identified as positive by culture, among which 17.78% were KOH positive and 20.00% were KOH negative. 62.22% were culture negative. The predominant pathogen was yeast (64.71%), followed by dermatophytes (17.65%). A mixed infection was identified in 11.76%. Scytalidium hyalinum was identified in 5.88% of the cases. Fungi commonly presented in the middle age, between 31-40 years of age, due to trauma at the work site and in women, due to their wet work. CONCLUSION: This study highlighted the yeast, genus Candida as the main pathogen which caused fingernail onychomycosis in our region. So, it is imperative to diagnose it properly by using microbiological techniques and to treat it properly.

A Study on High-risk Premarital Sexual Behavior of College Going Male Students in Jamnagar City of Gujarat, India.

BACKGROUND: The pre-marital sex and live-in relationship among young people are increasing at an alarming rate. Remote consequences of such high risk behaviors are increase in the incidence of STDs (including HIV), unsafe and illegal abortion, adolescent pregnancy and motherhood, single mother child/abandoned child, juvenile delinquency and many more. OBJECTIVES: The aim of this study was to investigate the high-risk sexual behaviors in depth, influenced by various factors including age at sexual debut, type of partners, consistent condom usage, hostel stay, socioeconomic class, etc. among college-going male youth. MATERIALS AND METHODS: The study was conducted in Jamnagar among undergraduate (18-24 years) male college students. A total of 450 students were randomly selected from three colleges of Jamnagar. RESULTS: Out of all 450 participants, 49.11% were in the age group of 18-20 years. Among study subjects, 13.78% had one or more pre-marital sexual exposures. In students with positive pre-marital sexual history, the various sex partners were girlfriends (95.16%), commercial sex workers (14.5%), homosexuals (6.45%), and multiple sex partners (33.88%). Among students, 62.9% were using condom consistently. Three-fifth of the ones indulged in premarital sex, were in the age group of 16-20 at the time of sexual debut. CONCLUSIONS: Most of the students were quite young (16-18 years) at the time of first pre-marital sexual exposure. Consistent condom usage was not uniform. The students staying at hostels, indulged in premarital sex, were found to have multiple sex partners.

Awareness of HIV/AIDS among rural youth in India: a community based cross-sectional study.

INTRODUCTION: More than one third of reported cases of HIV/AIDS in India are among youth and 60 percent of these reside in rural areas. Assessment of the awareness of HIV/AIDS in the youth is important for determining the impact of previous and current awareness programs as well as the need for interventions. This study aimed to assess the knowledge of rural youth regarding HIV/AIDS and to explore the epidemiological determinants of awareness among them. METHODOLOGY: A community-based cross-sectional study was conducted among youths aged 15-24 years in rural areas of the Saurashtra region of Gujarat, India. A cluster sampling design was used, surveying 50 subjects from each of 30 clusters. Data was collected through house-to-house visits using a semi-structured questionnaire. Proportions and logistic regression were used for analysis. RESULTS: Out of a total of 1,237 subjects who participated in survey, 60% knew something about HIV. Of those who had heard of HIV, more than 90% subjects knew the modes of transmission and more than 80% were aware of modes of prevention of HIV/AIDS. One fifth of the subjects had misconceptions in relation to HIV/AIDS. On applying multiple logistic regression, age, education, occupation, and mass media exposure were found to be the major determinants of their knowledge with regard to HIV/AIDS. CONCLUSIONS: Basic knowledge of HIV/AIDS is still lacking in two fifths of the rural youth. Literacy and media exposure are factors that determine awareness of HIV among them and can be helpful to raise their knowledge regarding this scourge.