Estimates of major non-communicable disease risk factors for India, 2010 & 2015: A summary of evidence

Background & objectives: The National Monitoring Framework for the prevention and control of NCDs in India has set targets for reduction of risk factors relative to the measure recorded in 2010. Estimates for 2010 and 2015 were established using meta-analyses in the absence of a national risk factor survey till 2017. Methods: We searched national survey reports and also articles published in English from India between 2008 and 2017 in PubMed, Google Scholar and Cochrane review databases for specific risk factors among 18-69 yr Indians. Quality of studies was evaluated using Joanna-Briggs tool, but all studies were included in analyses. Estimates for each of the eight strata by age, gender and place of residence, respectively, were generated. MetaXL was used to calculate the pooled estimate for 2010 and 2015 using a random effects model. Strata-specific estimates were combined to arrive at national estimate using population weight of each stratum. The credibility of the estimates was determined using four parameters - average Briggs score; representativeness of the contributing studies and precision and stability of the estimates. Results: The estimates [95% confidence interval (CI)] for 2010 for different risk factors were as follows: current alcohol use, 15.7 per cent (13.2-18.2); current tobacco use, 27 per cent (21.4-32.6); household solid fuel use, 61.5 per cent (50.2-72.5); physical inactivity, 44.2 per cent (37.8-50.6); obesity, seven per cent (3.8-10.2) and raised blood pressure, 20.2 per cent (18.4-22.1). In 2015, compared to 2010, tobacco use showed a relative decline of 18 per cent, household solid fuel use of nine per cent and physical inactivity of 15 per cent. The estimates were stable for alcohol use, raised blood pressure and obesity between 2010 and 2015. All estimates varied between moderate and high degrees of credibility. Interpretation & conclusions: The estimates are consistent with other available estimates and with current national-level initiatives focused on tobacco control and improving access to clean fuel. These estimates can be used to monitor progress on non-communicable disease risk factor targets for India

Characterizing the third wave of COVID-19: An analysis from the National Clinical Registry of COVID-19

Background & objectives: Data from the National Clinical Registry for COVID-19 (NCRC) were analyzed with an aim to describe the clinical characteristics, course and outcomes of patients hospitalized with COVID-19 in the third wave of the pandemic and compare them with patients admitted earlier. Methods: The NCRC, launched in September 2020, is a multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized COVID-19 patients were captured in an electronic data portal from 38 hospitals across India. Patients enrolled during December 16, 2021 to January 17, 2022 were considered representative of the third wave of COVID-19 and compared with those registered during November 15 to December 15, 2021, representative of the tail end of the second wave. Results: Between November 15, 2021 and January 17, 2022, 3230 patients were recruited in NCRC. Patients admitted in the third wave were significantly younger than those admitted earlier (46.7±20.5 vs. 54.6±18 yr). The patients admitted in the third wave had a lower requirement of drugs including steroids, interleukin (IL)-6 inhibitors and remdesivir as well as lower oxygen supplementation and mechanical ventilation. They had improved hospital outcomes with significantly lower in-hospital mortality (11.2 vs. 15.1%). The outcomes were better among the fully vaccinated when compared to the unvaccinated or partially vaccinated.Interpretation & conclusions: The pattern of illness and outcomes were observed to be different in the third wave compared to the last wave. Hospitalized patients were younger with fewer comorbidities, decreased symptoms and improved outcomes, with fully vaccinated patients faring better than the unvaccinated and partially vaccinated ones.

Knowledge and Awareness about the Mode of Transmission of Vector Borne Diseases among General Public

Vector borne diseases account for more than 17% of other contagious diseases and can be caused either by parasites, bacteria or viruses. Malaria is a parasitic infection caused by female Anopheles mosquitoes. It causes millions of cases globally and most deaths occur in children. Dengue is another vector disease caused by Aedes mosquito and also affects millions of people, also causing more deaths. Other vector diseases may include yellow fever, zika fever, west nile fever, chikungunya, elephantiasis etc.  The aim of the study was to assess the knowledge and awareness about the mode of transmission of vector borne disease among the general public and also to analyse the correlation between gender and the level of awareness about vector borne disease among them. A cross sectional questionnaire survey was conducted among people in the region of Chennai. A set of 15 questions including questions on knowledge and awareness on the mode of transmission of vector borne diseases among the general population. It included questions like examples of vector borne diseases, mode of transmission of disease, preventive measures etc. The people of age group between 25-45 years were involved in the survey. There were 100 responses to the survey. The duration of the study was about 7 days. It is clear that the population was aware about the vector borne diseases but not very clear about the preventive measures to be taken to prevent the spread of vector borne diseases.

Knowledge and Awareness about Antibiotic Usage and Emerging Drug Resistance Bacteria among Dental Students

Antibiotics are commonly used in dental practice. It has been estimated that 10% of all antibiotic prescriptions are related with dental infection. Antibiotic treatment is a feature of pharmacotherapy with the particularity of providing both prophylactic and curative action. It was introduced in the mid twentieth century in the form of sulfa drug (1935), penicillin (1941), tetracycline (1948) and erythromycin (1952). Since then, antibiotics have focused much clinical and pharmacological research, in response antibiotics, the consolidation of new disease, and novel clinical situations.to “Penicilin antibiotics are commonly use in dental practice. Amoxicillin, metronidozole and clavulanate are frequently prescribed drugs by dentists.” The aim of this study is to create knowledge and awareness about antibiotic usage and emerging drug resistance bacteria among dental students. The Questionnaires had been prepared and distributed to 100 participants of dental students. The resulting data have been analyzed using SPSS statistical software. Descriptive statistical analysis was carried out and chi square test was used and p value was calculated. Most of the participants in the survey were aware about antibiotic use and emerging drug resistance bacteria. From this present study, it can be concluded that the participants are aware about antibiotic usage and drug resistance bacteria

Isolation, Detection and Molecular Characterization of Staphylococcus aureus from Postoperative Infections

Post operative infections that occur after surgical procedures can cause a lot of complications like sepsis, organ failure or even death. These are the third most commonly reported healthcare associated infection. The most common cause of wound infection regardless of procedure performed remains gram-positive cocci which comprise more than 50% of all infections. Specifically, Staphylococcus aureus and coagulase-negative staphylococci are the most frequent organisms isolated from a wound infection. There has been an increasing incidence of MRSA strains reported in hospitals across the globe. The main aim of our study is isolation, detection and molecular characterization of Staphylococcus aureus from postoperative infections. Samples were collected from post operative patients with infected wounds. The area around the wound was cleaned. Exudates were collected from the wound with a sterile swab stick. The samples were inoculated on different solid culture mediums and the plates were incubated in the presence of oxygen at 37°C overnight. There were many standard procedures done in which tube coagulase was taken as the main criteria. Antibiotic susceptibility testing was done by Kirby Bauer method following Clinical and Laboratory Standards Institute (CLSI) guidelines using commercially available cefoxitin (30 μg) disc (HiMedia) and the results were compared with Staphylococcus aureus ATCC 25923 and MRSA ATCC 43300 control strains. The MRSA strains were identified and detection of Mec A gene that codes for methicillin resistance is done using PCR technique.

A comparative study of the effect of amikacin administered through autoinjector and manual injection on biochemical parameters in rats.

Objective: The objective was to compare the biochemical changes of amikacin by autoinjector delivery and manual injection in rats. Materials and Methods: Amikacin drug cartridge (500 mg/2 mL) for autoinjectors was diluted to 63 mg/mL and rats were administered 1.2 mL, i.p. One group was given 3 and a second group 7 injection on consecutive days. 3 and 7 days manual injection of same dose of amikacin (about 500 mg/kg, i.p.) and a control group (saline) were also included (total 5 groups). On day 4 or 8 biochemical parameters were studied. Results: Significant increase in urea, creatinine and aspartate aminotransferase were observed in 7 days administration in both autoinjector and manual injection groups compared to control group. All other parameters viz., glucose, cholesterol, total triglycerides, bilirubin, uric acid, total protein, albumin, alanine aminotransferase and alkaline phosphatase did not show any significant change. No significant change was observed in 3 days administration groups. Conclusion: High dose of amikacin for longer duration is known for its nephrotoxicity which is evidenced by the increase in urea and creatinine in both autoinjector and manual injection groups. This study shows that autoinjector device for amikacin which is new can be considered for further research work.

Risk factors for non-communicable disease in urban Haryana: a study using the STEPS approach.

BACKGROUND: India is in the midst of an epidemiological transition with non-communicable diseases increasing in importance. Targeting the risk factors for non-communicable diseases is recognized as an essential preventive strategy. There is lack of good quality data on prevalence of risk factors. The present study addresses this challenge in urban population of Ballabgarh town in Faridabad district of Haryana. METHODS: A total of 1263 male and 1326 female respondents were selected using multistage systematic random sampling, in 5 age groups of 10 years (15-24, 25-34, 35-44, 45-54 and 55-64). The World Health Organization's STEPS approach entails stepwise collection of the risk factor data based on standardized questionnaires (step 1), basic physical measures in step 2 and finally in 3rd step, basic biochemical investigations such as blood sugar and cholesterol. The prevalence was adjusted to the age and sex strata of urban Faridabad as per census 2001. RESULTS: The prevalence of current daily use of smoked tobacco was 22.2% (95% CI7colon; 20.0-24.6) for males and 1.4% (95% CI: 0.9-2.2) for females. In males the prevalence of current alcohol consumption was 28.9% (95% CI: 26.4-31.5). Physical inactivity was reported by 23.2% (95% CI: 20.9-25.6) of males and 52.4% (95% CI: 49.7-55.1) of female respondents. Only 8.6% of males and 4.4% of females were consuming adequate portions of the fruits and vegetables. 23.1% (95% CI: 20.8-25.5) males and 15.7% (95% CI: 13.87ndash;17.8) females were either in Stage 1 and 2 hypertension (JNC VII) or were taking anti-hypertensives. Among males, 25.4% (95% CI: 23.0-27.9) and, among females 34.9% (95% CI: 32.3-37.6) were overweight. CONCLUSION: The prevalence of tobacco and alcohol use among males and physical inactivity among females was high. Low consumption of fruits and vegetables, hypertension and overweight was equally common among both the sexes in the population studied. Thus there is an urgent need for initiating measures at the risk factor level to counter this modern day epidemic of non-communicable disorders, within this urban community.

Early diagnosis of CKD and its prevention.

Chronic kidney disease is associated with increased mortality and morbidity especially due to cardiovascular disease and imposes a huge economic burden to the family and health care delivery system. In both developing and developed countries, diabetes mellitus and hypertension are the leading causes of CKD. While dialysis and transplantation are excellent options for end stage kidney disease, they are costly. Renal transplant is again limited by organ shortage. The better strategy to tackle CKD will be early identification of the disease and adopt measures to slow its progression to ESRD. A comprehensive approach to the prevention of CKD and retarding its progression is outlined.

Introduction of red palm oil into the 'ready to eat' used supplementary feeding programme through ICDS.

Children attending the anganwadi centres were fed with Ready to eat (RTE) food containing 2g of Red Palm Oil (RPO). Daily children's attendance, their participation in the feeding programme, quantity of food supplement consumed were recorded. Heights, weights, clinical signs of vitamin A deficiency and morbidity pattern of the beneficiary children were assessed. There was increase in attendance of the children in the feeding programme after introduction of RPO. Quantity of the food supplement consumed by the children also increased. An improvement in the nutritional grades of children was observed. Signs of vitamin A deficiency were absent. Anganwadi teachers, helpers and parents accepted the inclusion of RPO in the supplementary feeding programme.