ABSTRACT
Non-alcoholic fatty liver disease (NAFLD) is an emerging public health problem globally. NAFLD is one of the most common liver diseases worldwide and is the most common cause of abnormal liver enzymes in many developed countries. NAFLD is estimated to afflict approximately 1 billion individuals worldwide. An estimated 20-30 % of general population is afflicted from it globally. In India NAFLD could be a silent epidemic with its prevalence ranging from 9-32%. Studies have shown, strong association of NAFLD with major Non Communicable diseases (NCD) like Diabetes, Obesity, CVD, Chronic Kidney diseases, Cancers, etc. Perceiving the threat of NAFLD and the central role of hepatic accumulation of fat in the pathogenesis of other NCD, the Government of India (GoI) has taken steps to include NAFLD in the public health agenda. It has included it in the national NCD programme, i.e., National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 2021. India has become the first country in the world to start a national programme for preventive efforts for NAFLD. The present review describes public health relevance of NAFLD and the process of integration of Non Alcoholic Fatty Liver Diseases (NAFLD) into NPCDCS programme in India.
ABSTRACT
Background: Malnutrition is associated with increased risk of morbidity and mortality amongst elderly population. Lack of scientific evidence exists on the status of malnutrition amongst elderly population residing at high altitude regions of Uttarakhand, India. Materials and methods: A community based cross-sectional study was conducted in high altitude regions of District Nainital. A total of 980 elderly subjects were selected from 30 clusters identified using population proportionate to size sampling method. Nutritional status of the elderly population was assessed using Mini Nutritional Assessment (MNA) tool. Data was entered in MS Excel 2007 and analyzed using SPSS version 20.0. Results: The results of MNA revealed that 14.3% of the elderly subjects were malnourished. High prevalence of malnutrition was found among subjects who were illiterate (74.5%), financially dependent (75.2%), belonged to low monthly income (43.3%) had poor appetite (71.6%) and chewing problems (63.1%); (p<0.0001). Conclusions: High prevalence of malnutrition was present amongst the elderly population in India. There is a need for timely assessment of malnutrition for maintenance of nutritional status and prevention of chronic diseases.
ABSTRACT
Non-Alcoholic fatty liver disease (NAFLD) is a broad term covering a spectrum of conditions ranging from hepatic steatosis, steatohepatitis and cirrhosis. NAFLD is highly prevalent across all regions of the world with its global prevalence of 25.2%(95%CI:22.1-28.7). It is commonly referred as the ‘hepatic manifestation’ of metabolic syndrome (MetS). Moreover, it is strongly associated with the individual components as well as MetS as a whole. NAFLD has been independently associated with other non-communicable diseases (NCDs) like chronic kidney disease (CKD), Polycystic ovary Syndrome (PCOS), Stroke and Cancers. This strong association of NCDs with NAFLD not only affects the prevalence but also the progression and management of the disease. Thus, this review aims at highlighting the association of NAFLD with other NCDs. A literature search was undertaken in the MEDLINE database using the necessary MeSH terms. The review concludes NAFLD is a systemic disease, not just confined to liver-specific morbidity and mortality, but also associated with numerous extra-hepatic manifestations, such as metabolic syndrome, cardiovascular diseases, chronic renal diseases, and malignancy. With coexistence of NAFLD with various NCDs it is expected to become the most overwhelming liver disease in the world in coming years. Hence, to reduce medical and economic impact associated with these comorbidities, it is recommended that all countries should estimate and predict the burden on comorbidities associated with NAFLD and galvanize its health resources in providing integrated therapeutic approaches for management of NAFLD and related comorbidities at an early stage.
ABSTRACT
Anaemia is a severe public health problem amongst all vulnerable age groups in India. The National Nutritional Anaemia Prophylaxis Programme initiated in 1970, was revised and expanded to include beneficiaries from all age groups namely children aged 6-59 months, 5-10 yr, adolescents aged 10-19 yr, pregnant and lactating women and women in reproductive age group under the National Iron Plus Initiative (NIPI) programme in 2011. The dose of iron, frequency and duration of iron supplementation and roles and responsibilities of the functionaries were described. At present, the coverage of beneficiaries with iron and folic acid has been poor at the national level. The prevalence of anaemia has continued to remain high during the last 60 years, and there has been no significant change in the scenario due to various reasons. The constraints in implementation and measures to improve the NIPI programme are discussed in the current article.
ABSTRACT
Recent scientific evidence suggests there is high prevalence of Vitamin D deficiency in India. There is paucity of scientific data on Vitamin D status in population residing at high altitude regions in India. Hence, the present study was undertaken to determine Vitamin D status of adult population residing at altitude of 4000 meter and above in Himachal Pradesh, India.
ABSTRACT
Micronutrient malnutrition (MNM) can affect all age groups, but young children and women of reproductive age tend to be among those most at risk of developing micronutrient deficiencies. In India, Iodine Deficiency Disorders and Iron Deficiency Anaemia are important Public Health problems.No state in India is free from iodine deficiency. Out of 343 districts surveyed, 286 are reported have Iodine Deficiency Disorders. Iron Deficiency Anaemia is reported in about 60% population across all age groups. The magnitude of vitamin B12 Deficiency is reported to be about 47% in urban population of Delhi while Zinc Deficiency is reported in about 44% amongst Indian children. In addition, there are other micronutrients and minerals like folic acid which are of public health concern.
ABSTRACT
Background: Dyslipidemia is a major contributing determinant in the development of ischemic heart diseases, stroke, and other vascular diseases. It increases the risk of mortality amongst the geriatric population.
ABSTRACT
Although functional impairment begins with iron deficiency in the absence of anaemia, the development of anaemia heralds a homeostatic dysfunction that impairs daily activity. Iron deficiency anaemia is often the reason for poor physical performance, maternal and child morbidity and referral to a healthcare professional. (1) Women in their reproductive years, pregnant women and children are most vulnerable to develop iron deficiency anaemia (IDA) and will be the focus of this review.
ABSTRACT
Recent National Family Health Survey-4 data shows that anaemia continues to be a major public health problem in India. In India much of the anaemia is due to iron deficiency, and women and children are at the greatest risk of anaemia. TheMinistry of Health and Family Welfare took a policy decision, in 2013, to develop the National Iron+ Initiative (NIPI) to address the prevailing iron deficiency anaemia. This initiative covered pregnant and lactating women, children and adolescents. However, the guidelines do not match the current World Health Organization (WHO) guidelines for prevention of iron deficiency anaemia in these population groups. The background evidence for the WHO and NIPI is thus reviewed to come to a common consensus on the optimum recommendation of iron supplementation for the population, while taking into consideration the feasibility of the program, without burdening the groups with iron over-dose. However, from the present review, there is a need for increased number of trials in India that could qualify for a high grade of evidence to support the guidelines of NIPI.
ABSTRACT
Anemia is a major public health problem globally. Due to loss of 42.2 million disability-adjusted life years (DALYs) in 2011, Iron-deficiency anemia (IDA) was ranked among the top three major causes of disability in the world (1,2). IDA is responsible for at least 50% of anemia and is highly prevalent in India especially among women, children below 5 years, and adolescent girls (3) perhaps due to increased needs, insufficient dietary supplies, poor intervention coverage etc (4). Anemic girls will grow up to anemic mothers and in turn give birth to anemic children. Childhood anemia can have long term consequences. IDA has been associated with developmental deficits, impaired memory and neurodevelopment, diminished physical function, depression, fatigue, loss of vitality, preterm delivery, and lower infant birth weight (5–10). These, effects attributable to anemia remain invisible but are substantial (11), as it has serious health and economic costs and may hinder nation’s development. Therefore, effective and safe interventions are urgently needed across the lifecycle. The issue has attracted global attention and for the first time targets have been suggested like reducing the proportion of anemia among women of reproductive age (WRA) by 50% by 2025 in comparison to the baseline year 2011 (12). This is likely to add impetus to global efforts in reducing anemia and monitor the progress towards it.
ABSTRACT
Anaemia, as defined by low haemoglobin concentration, is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs. It is a major public health problem that affects low, middle and high-income countries. The global prevalence of anaemia is 42.6% in children, 38% in pregnant women and 29.4% in all women of reproductive age. The prevalence of severe anaemia amongst women and children is in the range of 0.9% to 1.5% and is associated with substantially worse health outcomes (1).
ABSTRACT
Anemia is highly prevalent disease of global concern. Childhood anemia can result in irreversible damage to brain and affect cognitive, intellectual, and pyscho-motor development. In pregnant women, it is a significant contributor to adverse maternal outcome (1–4). In 2011, alone it was responsible for loss of 42 million Disability adjusted life years and among the top three causes of disability worldwide (5). In an attempt to address this huge public health problem, guidelines have been issued by various leading international organizations and targets have been set to monitor progress towards its control. One such indicator is 50% reduction of anemia in women in reproductive age group (WRA) between 2011 and 2025 (6). This makes it necessary to carry out huge population-based anemia prevalence surveys repeatedly, to measure the progress and guide policy makers in carrying out specific interventions needed to reduce its prevalence.
ABSTRACT
A “National Expert Group Technical Consultation on Prevention and Treatment of Iron Deficiency Anemia” was held from 23rd to 24th April 2018 at All India Institute of Medical Sciences, New Delhi. The Consultation was conducted under the aegis of Ministry of Health and Family Welfare, Government of India. The following were the Co-organizers i) Departments of Human Nutrition and Hematology, All India Institute of Medical Sciences, New Delhi; ii) Sitaram Bhartia Institute of Science and Research (SBISR), New Delhi; iii) Public Health Foundation of India (PHFI), iv) Nutrition Society of India (NSI), v) Indian Association of Preventive and Social Medicine (IAPSM), vi) Indian Academy of Pediatrics (IAP) Nutrition Sub-specialty Chapter , vii) Federation of Obstetric and Gynecological Societies of India (FOGSI), viii) Indian Public Health Association (IPHA), ix) Indian Society of Haematology and Blood Transfusion (ISHBT), x) International Epidemiological Association - South East Asia Region (IEA-SEA), xi) Alive and Thrive India, xii) Knowledge Integration and Translational Platform (KnIT – BIRAC-DBT), and xiii) World Health Organization (WHO).
ABSTRACT
There has been an increase in the consumption of junk food (JF) among school-aged children (SAC) possibly leading to obesity and diet-related diseases among them. We do not have evidence on consumption of JF in rural areas; hence, we conducted a study to assess the consumption of JF by SAC in rural, Himachal Pradesh. A total of 425 children in the age group of 12� years studying in 30 government schools (clusters) were included. The clusters were selected using population proportionate to size sampling methodology. We found high prevalence (36%) of consumption of JF among SAC during the last 24 h. Efforts should be taken to reduce the consumption of JF by promotion of healthy dietary habits and educating children about the ill effects of JF.
ABSTRACT
Breast cancer is one of the most common incident cancer and cause of death from cancer in women. It is known that several factors that influence hormonal status (e.g., age at first child birth) or are markers of change in hormonal status (e.g., age at menarche and age at menopause) are associated with the risk of breast cancer. Reproductive factors are known risk factors for breast cancer that probably act early in life. They point toward endogenous estrogens as likely player in the initiation, progression, and promotion of breast cancer. An attempt has been made in this article to review the scientific data published in Indexed journals on the role of reproductive factors in breast cancer.
ABSTRACT
Background: Clinical, animal, and epidemiological studies have clearly demonstrated that cancer is a hormonally mediated disease and several factors that influence hormonal status or are markers of change in hormonal status have been shown to be associated with the risk of breast cancer. Aims: To identify the association of various reproductive factors with breast cancer. Settings and Design: A hospital-based, matched, case-control study. Materials and Methods: Three hundred and twenty newly diagnosed breast cancer cases and three hundred and twenty normal healthy individuals constituted the study population. The subjects in the control group were matched individually with the cases for their age ± 2 years and socioeconomic status. A pre-tested, semi-structured questionnaire was administered to each individual to collect information on identification data, socio-demographic profile, and reproductive factors. Statistical Analysis Used: The Chi-square test and unpaired t-test were used. The conditional univariate logistic regression analysis (unadjusted odds ratio and confidence intervals) was used to calculate the significance level of each variable followed by multivariate regression analysis. Results and Conclusions: The cases had a lower mean age at menarche, higher age at marriage, higher mean age at last child birth, lower mean duration of breastfeeding, higher number of abortions, late age at menopause, history of oral contraceptive pills, and a family history of breast cancer as compared to the controls. The results of the present study revealed a strong association of reproductive factors with breast cancer in the Indian population.
Subject(s)
Adult , Breast Neoplasms/epidemiology , Breast Neoplasms/etiology , Case-Control Studies , Chi-Square Distribution , Female , Humans , India , Menarche , Middle Aged , Reproductive History , Risk Factors , Tertiary Care CentersABSTRACT
Objective. A school survey was conducted to estimate the prevalence of goitre among schoolchildren in Belgaum district. Methods. A cross-sectional study was conducted in primary, middle and high schools of villages selected. All the children of the selected schools were examined for the presence of goitre and the salt samples obtained from their homes were tested for iodine content. Results. Overall prevalence of goitre was 16.7%. Prevalence of palpable goitre was 16.4 % and visible goitre was very low (0.3%). Higher prevalence was found among females (21.1%) when compared to that of male children (12.8 %). Prevalence of goitre increased significantly with advancement of age until 16-yr. 72.1 % children were consuming rock salt and only 27.9 % were consuming powdered salt at their homes. Estimation of Iodine content in the salt samples showed that 68.7 % of the sample had inadequate iodine content. Prevalence of goitre was significantly high among children who consumed rock salt (16.2%) as compared to those who used powdered salt (11%). Conclusion. Strict implementation of salt codization and marketing in rural area is desired. Also health education programme be showed.