Factors Influencing Life Satisfaction and Discrimination among the Elderly in India

India is moving toward a demographic transition which leads to more elderly population than younger. Maximum life satisfaction (LS) and minimum discrimination are necessary to have healthy aging. The secondary data analysis was conducted to assess the perceived LS and discrimination among the elderly based on Longitudinal Aging Study in India (LASI). Data from the LASI-Wave I were used to analyzing to assess the LS and discrimination and factors associated with them. This study reported that the majority of the elderly were satisfied with their life and does not face any kind of discrimination; however, various factors affect them. LS was positively associated with the level of Monthly per capita consumption expenditure quintile, and education, self-rated good health. Furthermore, refraining from alcohol and tobacco positively influence the LS among the elderly. The factors responsible for more LS among the elderly were education, money, social support, and a healthy lifestyle.

Community based cross sectional study: to assess the prevalence of arthritic symptoms in an army garrison in large city of North India

Background: Arthritis affects almost 350 million people globally and is one of the leading causes of disability in the world. The prevalence in India is like that in developed countries. Symptoms of arthritis have been found to be influenced by alcohol intake, smoking, obesity and type of diet which lead to aggravation in pain, exacerbation in disease activity and deterioration in general health.Methods: Present community-based cross-sectional study was conducted in a large military station in North India over a period of one month. Armed Forces personnel and their family members aged 18 yrs and above residing in military station and consenting to the study were included. A sample of 1475 was studied.Results: The age of participants ranged from 18 to 70 yrs (median 32±7.4 yrs) with 20.54% females and 79.46% males. The prevalence of symptoms suggestive of Gout, RA, OA and Spondyloarthritis was 8.95% (95% CI, 7.54, 10.52), 3.25% (2.41, 4.29), 11.32% (9.75, 13.05) and 14.17% (12.43, 16.05), respectively. Symptoms suggestive of RA were found to be significantly associated with female gender, those of Gout and Spondyloarthritis with male gender, while OA did not have any gender predisposition.Conclusions: The population with symptoms of arthritis needs to be identified early by early symptomatic diagnosis and measures instituted for appropriate management to prevent future complications and associated morbidity.

Outcome of community based planned intervention targeting perceptions, attitudes and health seeking behaviour regarding cancers in New Delhi, India

Background: Cancer prevention and control needs to be based on effective implementation of all approaches. Community as well as individual level interventions to increase knowledge and early reporting have shown effectiveness. A community-based intervention trial was conducted to design, implement and test short-term outcomes of evidence based preventive strategies.Methods: A mixed methods, three phased study was conducted in three districts of Delhi, which were selected by a random process. Two randomly selected districts out of these three were intervention districts while third was the control. A total sample of 500 in each district was studied in quantitative pre and post -intervention phases. Multistage, stratified, cluster sampling was utilized. Pre-tested and validated tools were used.Results: Post intervention, statistically significant higher scores were observed in all domains in intervention districts as compared to control (p<0.01). Though comparison of slum versus non-slum showed significant increment in knowledge and practice scores, with higher scores for non-slum respondents, the attitudes were very similar (p>0.05). The increment score changes between males and females was similar in all classes of society versus control district. Comparison within the intervention and control groups revealed increased scores in intervention districts and decreased scores in control district, in all domains (p<0.05).Conclusions: Our study has helped in understanding the determinants of perceptions, attitude and practices regarding cancer in the community, This, helped in formulating the need-based intervention strategies. Testing the short-term outcome of intervention showed it to be effective.

Body composition parameters as correlates of coronary artery disease.

Background & objectives: Obesity is a major risk factor for cardiovascular disease (CAD). This study was aimed to assess the risk for CAD determined by certain new and conventional body composition parameters such as visceral fat area (VFA), body mass index (BMI), waist to hip ratio (WHR), etc. Methods: We did an age and sex matched case-control study of acute myocardial infarction with 100 participants in a tertiary care hospital (50 cases and 50 controls) representing the serving army personnel. The relation between VFA, per cent body fat (PBF), BMI, waist and hip circumferences, and WHR to CAD was assessed. Results: The study showed that there was a significantly increased risk for CAD associated with VFA (OR: 5.67; 95% CI: 1.96, 16.95), WHR (7.07; 2.19, 24.27), waist circumference (WC) (2.63; 1.05, 6.66) and BMI (2.53; 1.03, 6.26). Interpretation & conclusions: In conclusion, increased VFA, BMI, WHR and WC showed an association with CAD. VFA is a good index for assessing not only visceral fat accumulation but also cardiovascular risk factors.

Innovations in Teaching/Learning Methods for Medical Students: Research with Mentoring.

In this era of evidence-based medicine, innovative teaching learning methods coupled with appropriate mentoring are required to make the undergraduate medical students interested in the speciality of Community Medicine. Teaching research methodology to medical students by a hands-on approach along with mentoring by involving them in small, feasible, sustainable, and replicable studies on a topic of interest clearly showed renewed interest among students toward the subject.

Role of homocysteine & MTHFR C677T gene polymorphism as risk factors for coronary artery disease in young Indians.

Background & objectives: Hyperhomocysteinaemia (HCA) either due to mutation of MTHFR gene or deficiency of vitamin B12 and folic acid, has been reported as a risk factor for coronary artery disease (CAD). The present study was aimed to determine plasma homocysteine (Hcy) levels and to evaluate MTHFR C677T gene polymorphism as risk factors for CAD, and to study the role of Hcy in conjunction with a few other risk factors of CAD in young Indians. The effect of vitamin B12 and folic acid supplements on the raised plasma Hcy levels in patients of CAD was also assessed. Methods: The present study included 199 consecutive angiography confirmed CAD patients, <45 yr of age, without any other known pro- coagulant state and 200 age- and sex-matched healthy controls. Fasting blood samples were collected in EDTA and plasma Hcy was estimated by ELISA test and the MTHFR C677T polymorphism detection was carried out by PCR-RFLP method. Results: Significant difference (P<0.001) was found between mean fasting levels of plasma Hcy in cases (22.14 ± 10.62 μmol/l) and controls (17.38 ± 8.46 μmol/l) with an Odds ratio as 1.93 (95% CI, 1.27-2.94). Levels of cholesterol, LDL, and triglycerides were significantly (P<0.001) higher in cases compared with controls. Interpretation & conclusions: Our study showed significant correlation between hyperhomocysteinaemia and coronary artery disease. Multivariate analysis by logistic regression of the various risk factors of CAD, found high levels of Hcy, cholesterol, LDL and low levels of HDL and smoking as independent predictors of CAD when all other factors were controlled. Significant post-treatment decrease found in HCA was easily modifiable by vitamin intervention irrespective to their CT or TT genotype of C677T MTHFR gene. Further studies to look at the plasma levels of folate and cobalamines and their association with Hcy are required to be done.

Geriatric health: Need to make it an essential element of primary health care.

Within the next few decades, we will see an extraordinary increase in the number of older people worldwide. The public health benefit of preventive medicine in old age comes from the compression of the time spent in dependency to a minimum. A community-based, cross-sectional study was conducted to assess the morbidity profile of the geriatric population in a rural area of Maharashtra. A total of 214 subjects, of age 60 years and above, were examined. Data were collected by structured interviews and clinical and laboratory examinations. Out of the total of 214 subjects, 190 were suffering from some or the other diseases and the major morbidities were visual (56%), musculoskeletal (38.3%), respiratory (32.7%), and hypertension (28%). Anemia was present in 62.6%, 5.61% had Diabetes Mellitus and 22.5% were found to be overweight. The average morbidity load was 2.61. The rising morbidities clearly showed that a regular, complete health checkup of the elderly should be embedded in the essential elements of the Primary Health Care. This would reduce the morbidity, improve the quality of life, and facilitate 'Active Aging'.