Prevalence and pattern of risk factors for non-communicable diseases in urban population of Jaipur, Rajasthan

Background: Majority of the risk factors for NCDs are measurable and modifiable thus continuous surveillance of the levels and pattern of these risk factors is of fundamental importance. Taking cognizance of Jaipur city rapidly adopting to metropolitan culture; this study may mark an important milestone in surveillance activities and setting preventive priorities for NCDs in the state of Rajasthan. Aim of the study is to measure prevalence and associated variables of major risk factors for NCDs in the age group of 25-64 years.Methods: It is a cross sectional, descriptive study, conducted on 1454 person aged 25 to 64 years, residing in Jaipur city, from 1st June 2012 to 31st December 2013, using two steps of ‘standard WHO STEPS structured instrument’. Categorical data were expressed in form of percentage. Chi-square test was used to analyse difference in proportions. Continuous data were summarized in form of mean and SD. The differences in means were analysed by student’s t test.Results: At least one risk factor was present in all persons moreover 35% had multiple risk factors. Multiple risk factors were present even in 20% of relatively young adults (25-34 years). Tobacco and alcohol consumption was seen in 28% and 29% respectively. Standard of living index was associated with obesity, hypertension and low physical activity but not with alcohol use, smoking and daily consumption of fruit & vegetable. Male consumed more alcohol, indulged in less physical activity and smoked more than twelve times than females.Conclusions: Educating younger population for healthy lifestyle adoption and focused educational intervention with strict enforcement of existing laws will be helpful in controlling this epidemic of NCD.

Non-compliance to Antiretroviral Therapy:Road Blocks and Possible Solutions.

A hospital based interventional study was done at Anti Retroviral Therapy centre (ART) of SMS Medical College during August 2010 to January 2011 with the objectives of finding out the proportion of patients who did not adhere to ART, its associated factors, reasons for non-compliance and determine the effect of reinforced counselling through interpersonal communication addressing patient specific reasons and solution for increasing compliance. There were 2841 HIV patients on ART during study period and on an average 381 (13%) of them did not adhere to ART. Age, literacy, unemployment, presence of co-infections were significantly associated with non-compliance while marital status, sex of patient, area of living, family size, distance from ART centre and type of ART regime were not associated with non-compliance. Reasons stated for not coming to collect drugs or not consuming them were mainly patients were travelling, forget to take the pills, no one was there to accompany them, no money for fare, busy in agriculture or other day to day activities. 100 randomly selected non-compliant patients were offered reinforced counselling with focus on patient specific reasons for non compliance and with an intention to encourage the patients to come up with solutions in prevailing circumstances. 74 patients started taking drugs regularly at the end of study. One patient out of these hundred died during study period.

H1N1 Deaths Reported at SMS Hospital.

Background: The influenza virus has unique ability to cause recurrent epidemics and global pandemics. Very few information is available regarding death pattern and associated factors till now so this study was conducted with the objective to evaluate the profile of H1N1 deaths reported at SMS hospital, Jaipur and it’s associated factors. Methods: The present study was conducted at SMS hospital, Jaipur during 22nd August 2009 to 13th January 2010. The secondary data related to case reports of death due to H1N1 2009 was collected. Data on following variables were collected age, sex, urban / rural, presenting clinical symptoms, associated illness if any, investigation done, time lag between admission and death, time lag of sample taken and reporting. The data so collected were analyzed with appropriate statistical procedures. Observation: There were total 34 deaths reported due to H1N1 related cause. Almost one fourth (8 /34) of deaths occurred in the age group of 21 to 25 years. Majority of the patients reported with high grade fever (88.2%), cough and breathlessness (79.4%) each, sore throat was present in 23.5%, 11.7% had some associating complications when admitted to the hospital. In 71.8% deaths were due to problems related to respiratory system. There were five H1N1 positive pregnant women who were admitted at SMS hospital and all five died.