Modifiable risk factors of noncommunicable diseases in urban adolescents of Girdhar Nagar, Ahmedabad: A cross-sectional study

Background: Noncommunicable diseases (NCDs) have become a major health burden globally. The four main NCDs (heart disease, stroke, diabetes, and cancers and chronic respiratory diseases) share four modifiable risk factors: Tobacco use, harmful alcohol use, physical inactivity, and unhealthy diet. To minimize the burden of NCD epidemic, main risk behaviors common among young people must be curbed. Measurement of NCD risk factors is necessary to plan out the interventions and would also serve as a stepping stone in achieving primordial prevention of NCDs. Objective: The objective of the study was to measure the modifiable risk factors of NCDs among school-going adolescents of urban Ahmedabad. Materials and Methods: This cross-sectional study was conducted from November 2016 to January 2017 among two schools of Girdhar Nagar ward, Ahmedabad. 581 adolescents of a private and a government-run school, studying in class 8th–10th, of ages 12–16 were interviewed using GSBHS tool after taking informed consent. Appropriate anthropometric and blood pressure (BP) measurements were taken. Statistical analysis: Epi info ver. 7.0 and MS Excel 2007 used for analysis. Chi-square test, t-test, and multiple regression were applied. P < 5% was considered significant. Results: 52% (303) of the subject studied were boys and 48% (278) were girls. Among all, 66% (384) were physically inactive, 88% (511) were not consuming ≥5 servings of fruits and vegetables/day, 65% (376) and 78% (452) regularly consumed soft-drinks and fast food, respectively. 1.5% (9) of the subjects smoked and 3%(15) consumed smokeless form of tobacco. No student admitted consuming alcohol. 11% (65) were overweight and 13% (73) were obese. Raised systolic BP (>140 mmHg) was found in 3% (18) and raised diastolic BP (>90 mmHg) was found in 0.5% (3) of study subjects. Conclusion: One or more risk factors were found to be prevalent in all subjects. The presence of one or more modifiable risk factors in every adolescent point toward the dire need of school-based interventions for the prevention of NCDs in future adults.

Pancreatico-pericardial fistula: a rare complication of chronic pancreatitis.

A 16-year-old boy presented with pericardial effusion, bilateral pleural effusion and mediastinal fluid collection. CT scan of abdomen revealed pancreatic calcification and a fistulous tract from a pseudocyst going along the inferior vena cava wall up to the pericardial cavity. After initial pericardiocentesis and pleurocentesis, lateral pancreatico-jejunostomy with Roux-en-Y loop was performed. The patient is well at 6 months follow up.

Efficacy of non-breath-hold magnetic resonance cholangiography at midfield strength.

The efficacy of non-breath-hold magnetic resonance (MR) cholangiography at mid-field strength (0.5 Tesla) was evaluated for delineating biliary anatomy and the cause and extent of biliary obstruction. We performed 65 MR cholangiograms on a mid-field 0.5 Tesla MR unit and correlated them with contrast cholangiography and/or surgery. MR cholangiography was found to be both sensitive and specific in the detection of biliary obstruction and in the definition of its cause (sensitivity 98%, specificity 100%, positive predictive value 100%, negative predictive value 85.7%, accuracy 98%). MR cholangiography accurately predicted the level of obstruction in 94 per cent of strictures. Normal caliber intra-hepatic biliary radicles were visualised in only 6 per cent of the MR cholangiograms. In contrast, 94 per cent of dilated intrahepatic biliary radicles were demonstrated. The confluence, and right and left hepatic ducts were visualized in 98 per cent; the gall bladder in 65 per cent; the cystic duct in 45 per cent and the cystic duct insertion in 25 per cent. The extrahepatic bile duct was seen in 82.7 per cent. A normal caliber pancreatic duct was seen in 18 per cent while a dilated pancreatic duct was seen in 86 per cent. The pancreatico-biliary junction was visualised in 7 per cent. Non-breath-hold MR cholangiography at midfield strength is a highly accurate method of evaluating the cause and level of biliary obstruction, comparable to high-field MR cholangiography. The spatial resolution however is inadequate for the detection of variations in biliary or pancreatic ductal anatomy when the ducts are of normal caliber.

Culture appropriate indicators for monitoring growth and development of urban and rural children below 6 years.

In this cross sectional study, 2000 apparently normal children aged 0-6 years (1200 urban and 800 rural), were nutritionally and developmentally assessed and their environment scrutinized for possible risk factors. Measurement of mid upper arm circumference (MUAC) using standard techniques revealed malnutrition in 44% of the rural and 24% of the urban children especially in the 2-6 years of age group. Culture appropriate indicators of psycho-social development picked up gross delays in gross motor (GM), vision and fine motor (V&FM) and language skills. Self help, concept hearing (SHCH) skills were recorded as normal while social skills were advanced particularly in the 0-2 years old urban group. By the use of the family protocols, low socio-economic status, malnutrition and 9 other risks factors have been generated for the urban group. No risk factor could be identified for the rural group. Better income emerged as the only real protective factor for the sample showing a direct positive relationship with the 45 skills tested, especially in the 2-6 years age group. Nineteen developmental skills were identified as powerful predictors of development. A prototype home based screening record was constructed for monitoring of growth and development which can be even used by minimally trained primary care worker.