Metabolic Syndrome and Its Correlates Among Female Chronic Obstructive Pulmonary Disease Patients at a Rural Tertiary Health Care Center in Northern India.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a lung disease that is thought to result from chronic inflammation that may affect other organ systems. Similarly, metabolic syndrome includes central obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), hyperglycemia, and hypertension. The prevalence of metabolic syndrome and its associated factors among female COPD patients in northern India needs to be evaluated. AIM AND OBJECTIVES: To find the prevalence of metabolic syndrome and its correlates among female chronic obstructive pulmonary disease patients at a rural tertiary health care center in northern India. MATERIALS AND METHODS: A cross-sectional study was conducted between January 2019 and June 2020 at a rural tertiary health care center in northern India. The female patients who presented with symptoms of COPD and fulfilled the inclusion criteria were included and classified by Global Initiative for Chronic Obstructive Lung Disease (GOLD 2020) guideline while the clinical diagnosis of metabolic syndrome was made according to National Cholesterol Education Program: Adult Treatment Panel III (NCEP: ATP III) criteria. RESULTS: A total of 210 female COPD patients were included, the mean age of patients who had metabolic syndrome was 63.38±10.54 years. Metabolic syndrome was diagnosed in 60.48% of patients. There was a significant difference between female COPD patients with and without metabolic syndrome regarding body weight, BMI (body mass index), waist circumference, systolic blood pressure (SBP) and diastolic blood pressure (DBP), blood sugar, serum triglyceride, serum HDL-C. Whereas no significant difference was found between patients with and without metabolic syndrome group regarding smoking exposure, biomass fuel exposure, duration of biomass fuel exposure, mMRC (modified Medical Research Council) grading of breathlessness, GOLD grading of airflow limitation, route and duration of corticosteroid used. In our study, we also found a significant association between the severity of airflow limitation of COPD with the duration of biomass fuel exposure and BMI. Also, there was a significant association between biomass fuel exposure and the presence of cough in female COPD patients. CONCLUSION: Metabolic syndrome is a prevalent entity in female COPD patients among the northern Indian population. Body weight, BMI, waist circumference, SBP, DBP, fasting blood sugar, serum triglyceride, and serum HDL-C have a significant impact on developing metabolic syndrome in female COPD patients. Duration of biomass fuel exposure and BMI also have a significant impact on the severity of airflow limitation in female COPD patients. So early detection and treatment of parameters of metabolic syndrome are important to reduce complications.

Impact of COVID-19 pandemic on maternal and child health services in Uttar Pradesh, India.

BACKGROUND: In the wake of the Covid-19 Pandemic, parts of the public health system at increased risk of reduced efficiency include healthcare services for women and children. This in turn could reverse all the progress achieved over the years in reducing maternal and child mortality. In this study, an attempt has been made to assess the indirect effect of the pandemic on maternal and child health services in public health facilities. METHODS: Data pertaining to maternal and child health services being provided under specific Government programmes, were collected from public health facilities of District Sant Kabir Nagar in Uttar Pradesh, India. Comparative analysis of the data from the pandemic phase with data from the year 2019 was done to determine the impact on services. RESULTS: Reduced coverage across all maternal and child health interventions was observed in the study. There was an overall decrease of 2.26 % in number of institutional deliveries. Antenatal care services were the worst affected with 22.91% decline. Immunization services were also dramatically decreased by more than 20%. CONCLUSION: The response of the public healthcare delivery system to the Covid-19 Pandemic is negatively affecting both the provision and utilization of maternal and child healthcare services. It is deterrent to the progress achieved in maternal and child health parameters over the years. Better response strategies should be put in place to minimize lag in service deliwvery.

Assessment of the services of ASHA workers on antenatal and postnatal care in a district of western Uttar Pradesh, India.

CONTEXT: India accounts for 17% of the population, contributes to about 19% of maternal deaths, and 21% of childhood deaths of the world. Antenatal and postnatal services were one of the most important works done by ASHA workers. AIMS: The objective of this study was to assess the services provided by ASHA workers in a district of western Utter Pradesh to her beneficiaries regarding antenatal and postnatal care. SETTINGS AND DESIGN: A cross-sectional study was done in four randomly selected blocks of the district with the help of simple random sampling technique. SUBJECTS AND METHODS: A total of 384 study participants (mother having child up to 2 years of age) who availed services from the ASHA of their village. STATISTICAL ANALYSIS: Data were analyzed using SPSS-24.0, IBM Corp., Chicago, USA. Differences between the groups were compared using the Chi-square test and Fisher's exact test. P value <0.05 was considered statistically significant. RESULTS: Out of 384 beneficiaries of ASHA workers regarding antenatal and post-natal services, only 25% educated up to ≥higher secondary. Most of the beneficiaries (>55%) escorted less than four times for ANC, whereas only 0.5% of beneficiaries received the correct number i.e., 180 or > 180 IFA tablet from the ASHA workers. Only 57.2% of beneficiaries replied ≥6 times the post natal care home visit done by ASHA. CONCLUSION: Services provided by ASHA workers regarding ANC and PNC were not adequate.

Japanese encephalitis in Uttar Pradesh, India: A situational analysis.

INTRODUCTION: Japanese encephalitis (JE) is a vector-borne, viral illness caused by the Japanese Encephalitis Virus. Permanent neurologic or psychiatric sequelae can occur in 30%-50% of those with encephalitis; hence, JE is a cause of major public health concern. For the ease of diagnosis and facilitation of surveillance, National Vector Borne Disease Control Programme uses the term Acute Encephalitis Syndrome (AES). In this study, an attempt has been made to ascertain the status and trends of AES and JE in Uttar Pradesh, India. METHODOLOGY: This is a record-based retrospective study. The data were obtained from the Directorate of Medical and Health Services of Uttar Pradesh and analyzed using software SPSS version 24.0. RESULTS: In Uttar Pradesh, there were 47,509 reported cases of AES from 2005 to 2018,. With yearly fluctuations, the average Case Fatality Rate of AES was 17.49% with highest in 2005 (24.76%) and lowest in 2018 (8%). Among the patients with AES, 9.98% were found positive for JE. The most commonly affected age group is 1-5 years for both AES and JE, closely followed by the age group of 5-10 years. Peak occurrence of both AES and JE was recorded in month of September. Among the AES-affected patients 53.8% were males and 46.2% were females. CONCLUSION: The most commonly affected age group was 1-5 years with peak occurrence in the month of September. Though there was a downward trend in CFR, awareness activities like "Dastak" campaign and intersectoral preventive activities, needs to be strengthened.