Exploring Behavioral Risk Factors for Non-communicable Diseases Among Undergraduate Medical Students in Western Gujarat: A Cross-Sectional Study.

Background The burden of morbidity and death caused by non-communicable diseases (NCDs) such as cancer, diabetes, and cardiovascular disease is a significant global health concern influenced by modifiable behavioral risk factors. In India, the burden of NCDs is particularly high, with medical college students being a vulnerable population. This study aims to bridge the knowledge gap by investigating the prevalence and patterns of behavioral risk factors for NCDs among medical college students. Methodology A cross-sectional study was conducted on medical students in Gujarat. Risk factors for NCDs were assessed using various tools, including the General Health Questionnaire-12 (GHQ-12) for stress, the International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the body mass index (BMI) for obesity, and dietary factors. The chi-square test was employed as a statistical tool to determine the association between socio-demographic variables and various risk factors. A p-value of <0.05 was considered statistically significant. Results Among the 400 students surveyed, the prevalence of single behavioral NCD risk factors was as follows: 248 (62%) reported stress (GHQ-12), 215 (54%) experienced poor sleep quality (PSQI), 251 (63%) had low levels of physical activity (IPAQ), 339 (85%) had inadequate fruit and vegetable intake, 97 (24%) consumed extra salt during meals, 163 (41%) were overweight or obese, and 189 (47%) had three or more risk factors for NCDs. In bivariate logistic regression analysis, factors such as age, male gender, urban residence, hostel stay, and lower socioeconomic status were found to be statistically significant (p < 0.05). Conclusion This study reveals an alarming failure of medical colleges to positively influence students' health behaviors, despite their medical knowledge. The high rates of inactivity, stress, poor diet, and obesity among students demonstrate the curriculum's inability to instill preventative lifestyle practices. This omission in training compromises students' own health and their ability to counsel patients on NCD prevention. Urgent reform is needed to integrate health promotion into the curriculum, providing a supportive campus culture focused on wellness. By overlooking students' behaviors, medical colleges gravely disserve these future providers. This evidence compels curriculum reform to develop exemplary physician role models for NCD prevention.

Thyroid Fine Needle Aspiration: Successful Prospective Implementation of Strategies to Eliminate Unnecessary Biopsy in the Veteran Population.

OBJECTIVE: Thyroid nodules are prevalent in over half the general population. Several multidisciplinary societies have management recommendations. However, the majority of data to support these guidelines are derived from studies of predominantly younger and female populations. This study's aim was to evaluate characteristics of thyroid nodules in a largely older and male Veteran population and apply these findings prospectively to reduce unnecessary thyroid fine needle aspiration (FNA). MATERIALS AND METHODS: Over a 4-year period, all ultrasound-guided FNA of thyroid nodules performed in our department were reviewed. Sonographic features, patterns, and histopathology were evaluated. A prospective strategy of avoiding FNA in all lesions matching imaging patterns of benignity was implemented and positive predictive value (PPV) of malignancy was calculated and compared to the retrospective data. RESULTS: Retrospectively, FNA was performed on 351 successive thyroid nodules, 9 of which were malignant. Statistically significant malignant features include presence of microcalcifications, irregular or amorphous morphology, taller-than-wide shape, spiculated margins, vascularity, and lymphadenopathy. PPV of thyroid FNA was 2.6% in this period. Four sonographic patterns were 100% specific for benignity, including: "spongiform," "cyst with a colloid clot," "giraffe," and "white knight" patterns. Over 23 months, prospective avoidance of FNA of lesions characterized as a benign pattern (159 nodules) was implemented and PPV was calculated as 7.2% resulting in a cost savings of $477,000. CONCLUSION: Four sonographic patterns were 100% specific for benignity in the older and predominantly male Veteran population. Strict prospective application of avoiding biopsy in these benign patterns resulted in a decrease of unnecessary biopsies, decrease in patient morbidity, and improved allocation of health care resources.

Chitotriosidase, a marker of innate immunity, is elevated in patients with primary breast cancer.

BACKGROUND: Cancer progression has been associated with altered immune cell function and activation. Neopterin, which is secreted by interferon-γ stimulated macrophages, exhibits an association with multiple cancer types and metastatic disease. Chitotriosidase, which is secreted by chronically activated macrophages and granulocyte-macrophage colony-stimulating factor stimulated neutrophils has not been studied in the setting of cancer. OBJECTIVE: The goal of this discovery study was to screen chitotriosidase for diagnostic capacity in detecting cancer and compare its operating characteristics with those of neopterin. METHODS: Serum from subjects with breast (n= 66) or prostate (n= 70) cancer, and from 204 subjects free of malignant disease were studied. Chitotriosidase was measured by enzyme activity assay, while neopterin was measured by a competitive enzyme immunoassay. Statistical analyses included group comparisons by Mann Whitney U test, diagnostic capacity by receiver operating characteristics (ROC) curve analysis and biomarker associations with physiologic and clinical measures by Spearman correlation. RESULTS: Chitotriosidase activity was significantly higher in both cancer types compared with gender matched controls, though only in breast cancer was the diagnostic capacity significant (area under the ROC curve of 0.97 ± 0.01). In contrast, neopterin was significantly elevated in prostate cancer and exhibited discriminatory capacity (area under the ROC curve of 0.76 ± 0.05). Age, BMI, % body fat and metastasis were variables that correlated with neopterin, but not chitotriosidase levels. CONCLUSIONS: The operating characteristics of serum chitotriosidase were different from neopterin and further analysis of chitotriosidase as a biomarker for breast cancer is warranted.

Behavioral risk factors of coronary artery disease: A paired matched case control study.

BACKGROUND: Cardiovascular diseases are becoming the major cause of morbidity and mortality in most of the developing countries including India. Various behavioral risk factors are the major risk factors for coronary artery disease. Present study was carried out to study the role of various behavioral risk factors in the occurrence of coronary artery disease. MATERIALS AND METHODS: Present study was a hospital-based paired-matched case-control study, carried out at civil hospital, Ahmedabad. A total of 135 newly-diagnosed cases of coronary artery disease and 135 controls were studied after taking an informed written consent. Data was analyzed by using Epi-info version 3.5.1 computer package, Chi -square test, Z test and Odds ratio was calculated. RESULTS: Among the total 135 cases, 70.4% were male and 29.6% were female, most of the cases (40%) belong to the age group of 51-60 years. Smokers, smokeless tobacco users, and alcoholic were significantly higher among the cases as compared to controls. Significant association was also observed between current smokers, smokeless tobacco users, and coronary artery disease. Dose-response relationship was observed between the frequency of smoking per day and coronary artery disease (OR = 3.72). Significant association was also observed between obesity, physical inactivity, and coronary artery disease. Salt and oil intake per day were significantly higher among the cases as compared to controls. CONCLUSION: Modifiable and preventable behavioral risk factors are major etiology behind the occurrence of coronary artery disease, which highlights the need of appropriate control strategies and measures.