A cross-sectional study of musculoskeletal disorder and their environmental determinants among cycle rickshaw pullers of Delhi: A geographical information system-based analysis

Introduction: Rickshaw pulling is among the major activities in the informal sector. Cycle rickshaw pulling involves the task of prolonged sitting, fixed posture, and vibrations which could increase the risk of developing many health problems including one of the major problems of musculoskeletal disorder (MSD). Rickshaw pulling remains important for urban transport system, and such activities contribute in terms of employment and transportation services. The injury and illness resulting from work leads to lower productivity and quality employment which force them to increase their daily hours of working. The work environment and various other environmental determinants for MSD were assessed. The spatial variability of these environmental determinants and MSDs of cycle rickshaw pullers was studied in Delhi. Material and Methods: A cross-sectional study was conducted among cycle rickshaw pullers of Delhi. Five districts were randomly selected, and out of 448 study subjects, a total of 425 were included in the study. Consent was obtained before the study. The Nordic Musculoskeletal Questionnaire instrument for MSDs was used. The spatial distribution of MSD and risk factors was studied using QGIS software. Results: MSD was observed in 51.5% of the cycle rickshaw pullers and the prevalence increased with age from 9.6% to 34.7%. A statistically significant association of MSD with duration of work, sleeping hour, and sleeping place was observed. Poor road condition and posture were also having an association with MSD. Conclusion: Every second cycle rickshaw puller was having MSD. Lifestyle, road conditions, harsh environmental condition, strenuous physical exertion, and ergonomics of the cycle rickshaw were important factors contributing for MSD.

Multiplicity of noncommunicable diseases among the elderly in a suburban area of Delhi

Introduction: Continuing advancements in quality of health care has led to increased life expectancy over time. This in turn has resulted in increased prevalence of noncommunicable diseases (NCDs), especially among the elderly. An appropriate portrayal of its epidemiology is essential to adequately understand the health-care needs of the population. The evidence generated from the study will give us an incentive to address the rising burden of polymorbidities. We did the study to assess the prevalence and pattern of NCDs in the elderly above 60 years of age and to determine age- and sex-wise distribution of single and multiple NCDs. Materials and Methods: A community-based cross-sectional study was conducted among 350 elderly participants over 60 years of age in Mehrauli area of Delhi. Data were collected using a semi-structured questionnaire. Detailed general and systemic examination was also done. Results: A total of 87.4% of the study population were suffering from at least one NCD. The number of NCDs per person is 2.41. Overall, 80 out of the total 350 study participants(22.9%) had a single NCD, whereas 226 (64.6%) had two or more NCDs. Hypertension was the most prevalent NCD, followed by cataract, osteoarthritis, diabetes mellitus, and obesity. Conclusion: The prevalence of NCDs was quite high among the elderly. Multimorbidity was more common among the oldest-old age group and elderly women. This calls for increased focus on timely and comprehensive screening for NCDs in adults and asserts the need to approach the screening and management of NCDs in a more holistic way and not as isolated health events.

Shared risk factors of non-communicable diseases: A community based study among adults in an urban resettlement colony of Delhi

As urbanisation is increasing, the problem of communicable as well as non-communicable diseases (NCDs) is also increasing. Hypertension, diabetes, obesity, cardiovascular diseases constitute most of the NCDs whose risk factors are almost similar. They could be modifiable like physical activity, waist circumference, diet, smoking, alcohol intake . Objective: To study the magnitude of shared risk factors for Non-communicable diseases in adults of an urban resettlement colony of Delhi. Material and Methods: A cross sectional survey was conducted on adults >30 years (n=580) in both genders in an urban resettlement colony of Delhi in 2014. A Semi-structured interview schedule consisting of Socio-demographic characteristics, risk factor profile was used. Data was entered and analyzed in SPSS 12 Results: Out of the total 580 subjects (313)53.96% were women and 267(46.03%) were men. Majority 405(69.8%) of the study subjects were taking inadequate fruits and vegetables (<5 times/day) and 212 (36.6%) were taking >5 gm salt per day. About 181(31.2%) of the study subjects were sedentary workers, the proportion was more among women 99(31.6%). 223(83.5%) men had waist circumference within normal limits whereas 178 (56.9%) women had waist circumference more than 88 cm. One in four men were smokers. Nearly 49(18.4 %) of the men were current tobacco chewers as compared to 17(1.6%) of women. Only 33 (12.4%) men were currently consuming alcohol. Results of multiple logistic regression showed increasing age, education and marital status as significant socio demographic factors for increased prevalence of risk factors for NCDs. Conclusion: Promotion of lifestyle change to address these risk factors that can be modified including weight reduction, increased physical activity and healthy eating should be encouraged along with changing of behavioural factors like quitting smoking and alcohol.

Awareness and willingness to pledge for eye donation among adult population of an urban re-settlement colony of Delhi

Blindness is one of the major public health problems in India. Visual rehabilitation by corneal transplantation remains a major treatment option in those who are already blind due to corneal diseases. To combat with shortage of corneal donation in India, spreading awareness among masses regarding eye donation becomes important. Objectives: (1) To determine the awareness regarding eye donation amongst adults (>20 years) in an urban re-settlement colony of Delhi. (2) To assess their willingness to pledge for eye donation. (3) To determine the factors influencing their decision for eye donation. Material and Methods: This was a cross sectional study, conducted in the urban health centre attached to a medical college of Delhi between October to December 2013. Systematic random sampling was used and every alternate adult patient >20 yrs attending the UHC was recruited. Data entry and analysis was done using SPSS by a single investigator. Results: Majority (84.4%) had heard of eye donation. Only 21.2% were aware about contraindications for donating eyes. A little over quarter (27.6%) had heard of eye bank facility. When asked whether the retrieved eye can be stored before transplantation, majority (59.2%) didn’t know. More than half (54%) didn’t know which part of eye is removed. Mass media was major source of information in three forth respondents (74.9%). 45.5% were willing to pledge their eyes, a similar proportion was not willing (44.1%), five (2.4%) had already pledged and 17 (8.1%) were yet undecided to pledge. Conclusion: While majority of participants had heard of eye donation, but their knowledge regarding certain aspects of eye donation was found to be poor.

Do patients with tuberculosis referred from a tertiary care referral centre reach their peripheral health institution.

Background. Tuberculosis (TB) is a major public health problem in India. The Revised National Tuberculosis Control Programme (RNTCP), started in 1997, involved medical colleges in the control of TB on a high priority. We assessed whether patients with TB referred from a tertiary care hospital in Delhi reached the desired peripheral health institution and had their treatment initiated. Methods. This descriptive, retrospective study was done at a tertiary care hospital and included all patients with a diagnosis of TB (pulmonary or extrapulmonary) who were seen at the referral centre during the year 2011. Data were collected from various records of the referral centre and analysed for availability of feedback of the referred patients. Information regarding their registration and initiation of treatment was also collected. Postcards were used for the first time to trace referrals in patients with TB. Results. The majority (94%) of patients with TB seen in the referral centre at a tertiary care facility were referred to a peripheral health institution nearest to their place of residence. Feedback on referral was received from these institutions for 79.4% of patients from the National Capital Region (NCR) of Delhi and for 47.4% of patients from outside the NCR of Delhi. Conclusion. We found that a majority of patients with TB were referred and the registration and initiation of treatment could be traced in >75% of patients.

Profile of biochemical risk factors for non communicable diseases in urban, rural and periurban Haryana, India.

BACKGROUND: Globalisation and increasing urbanisation in most developing countries including India raises concerns of possibility of a major increase in NCDs in these countries. WHO has recommended a STEPwise approach for NCD risk factor surveillance since risk factors of today are diseases of tomorrow. This paper presents the estimation of biochemical risk factors for NCDs undertaken as a part of the ICMR six centre study. OBJECTIVE: To estimate the prevalence and levels of bio-chemical risk factors (fasting blood glucose, total cholesterol, HDL and triglyceride levels) in urban, rural and periurban locations in Ballabgarh, Haryana. METHODOLOGY: A community based cross-sectional study was carried out in urban, rural and periurban areas. A total of 1513 subjects were enrolled (501 in urban, 504 in periurban and 508 in rural areas) with equal distribution by area of residence, sex and age group. Fasting blood glucose and lipids were estimated using enzymatic kits. RESULTS: The mean levels of fasting blood glucose, cholesterol, TGL and low HDL were the highest in the urban area, though there was not much difference in the rural and periurban areas. There was also an increasing trend of all the parameters as age increased in both men and women. 11.4% of men in urban areas had fasting blood glucose above the cut off levels and 44.3% of urban men and women had high cholesterol levels. CONCLUSION: This study documents a high burden of biochemical risk factorsnot only in urban areas but also in the periurban and rural population. It has also brought out some technical and operational issues for carrying out biochemical risk factors surveillance in the community. There is a need to scale up from surveys to surveillance mode using appropriate tools and application of this information for policy planning and programme implementation.