Compliance to iron and folic acid tablets among pregnant women attending antenatal clinic in Agartala Government Medical College.

Introduction: Anemia is a public health problem worldwide, and in pregnancy, the main cause of anemia is nutritional. Non-compliance to iron and folic acid supplement plays a role in the high prevalence of anemia in pregnant women. Objectives: The objectives were to find out the proportion of compliance to iron and folic acid tablets (IFA) among pregnant women and to determine factors associated with it. Methods: A cross-sectional study was conducted among 240 pregnant women attending antenatal clinic in Agartala Govt. Medical College, from 15th June to 14th September 2019. Subjects were recruited through consecutive sampling. A pretested, predesigned, semi-structured interview schedule was used to collect information. Data were analyzed using SPSS 15.0. Chi-square and Fisher's exact tests were used to find out the association of compliance with independent variables. P value of < 0.05 was considered as significant. Results: Majority (56.3%) of the participants were in the age group of 20-29 years and were housewives (92.1%), Hindu (93.8%), and completed secondary education (34.6%). The proportion of compliance to IFA among pregnant women was 52.5% (n = 126), and the reason for non-compliance (n = 114) in the majority was side effects of IFA (35.09%), followed by forgetfulness (28.07%). Factors like age, religion, education, socio-economic status, birth order, number of antenatal visits, or number of IFA consumed daily have not shown any significant association with this compliance. Conclusion: This study highlighted that only around half of the pregnant women are compliant with IFA, and this situation demands for information education and communication activities to generate awareness.

Effect of internal migration on diabetes and metabolic abnormalities in India - The ICMR-INDIAB study.

AIMS: To assess the effect of migration (rural-to-urban and vice versa) on prevalence of diabetes and metabolic disorders in Asian Indians participating in the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. MATERIALS AND METHODS: The ICMR-INDIAB study is a national study on diabetes and associated cardiometabolic disorders in individuals aged ≥20 years from 28 states and 2 union territories of India. Individuals who moved to a different place from their place of birth and had resided in the new location for at least one year were considered as migrants. Anthropometric measurements, blood pressure estimation and a capillary oral glucose tolerance test were performed. RESULTS: Of the 113,043 participants, 66.4% were non-migrant rural dwellers, 19.4% non-migrant urban dwellers, 8.4% rural-urban migrants, 3.8% multiple migrants and 2.0% urban-rural migrants. Weighted prevalence of diabetes was highest in rural-urban migrants followed by urban dwellers, urban-rural migrants and rural dwellers [14.7%, 13.2%, 12.7% and 7.7% respectively (p < 0.001)]. Rural-urban migrants had highest prevalence of abdominal obesity (50.5%) compared to the other three groups. The risk for diabetes was 1.9 times higher in rural-urban migrants than among rural dwellers. Five risk factors [hypertension, abdominal and generalized obesity, physical inactivity and low fruit and vegetable intake] together explained 69.8% (partial population attributable risk) of diabetes among rural-urban migrants and 66.4% among non-migrant urban dwellers. CONCLUSIONS: Rural-to-urban migration is associated with increased risk of developing diabetes and other cardiometabolic abnormalities. Adoption of healthier lifestyle patterns among migrants could help prevent/delay onset of these abnormalities in this population.

Role of body visceral fat in hypertension and dyslipidemia among the diabetic and nondiabetic ethnic population of Tripura-A comparative study.

BACKGROUND: Excess fat in the upper part of human body correlates with increased mortality and risk for diabetes, dyslipidemia, and hypertension. In India, there are very limited data available on the association of excess body visceral fat with hypertension and dyslipidemia independent of obesity and diabetes. OBJECTIVE: The objective of this study is to assess the role of body visceral fat percentage in hypertension and dyslipidemia among diabetic and nondiabetic indigenous ethnic population of Tripura. METHODS: Random blood sugar test was done for each of the study subjects with the help of a standard and validated glucometer. Then, blood samples were obtained after an 8-12-h overnight fast using vacutainer. Later on, all the blood samples were transported to the MRU laboratory at Agartala Government Medical College maintaining cold chain for following investigations: (1) FBS, PP by GOD-POD method; (2) HbA1c by immunoturbidimetric method; (3) cholesterol estimation by CHOD-PAP method; and (4) triglyceride estimation by glycerol phosphate oxidase method. RESULTS: In this study, it has been found that 62.5% diabetic subjects having high body visceral fat are suffering from Dyslipidemia, whereas only 42.9% nondiabetic subjects with high body visceral fat percentage are having dyslipidemia. Fisher's exact test showed association between diabetes status and body visceral fat (P = 0.048). It has been also observed that there was significant (P < 0.05) association between hypertension and body visceral fat among local indigenous ethnic population of Tripura. CONCLUSION: Body visceral fat percentage is significantly associated with hypertension, dyslipidemia, and type-2 diabetes among indigenous ethnic population of Tripura.

Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR-INDIAB population-based cross-sectional study.

BACKGROUND: Previous studies have not adequately captured the heterogeneous nature of the diabetes epidemic in India. The aim of the ongoing national Indian Council of Medical Research-INdia DIABetes study is to estimate the national prevalence of diabetes and prediabetes in India by estimating the prevalence by state. METHODS: We used a stratified multistage design to obtain a community-based sample of 57 117 individuals aged 20 years or older. The sample population represented 14 of India's 28 states (eight from the mainland and six from the northeast of the country) and one union territory. States were sampled in a phased manner: phase I included Tamil Nadu, Chandigarh, Jharkhand, and Maharashtra, sampled between Nov 17, 2008, and April 16, 2010; phase II included Andhra Pradesh, Bihar, Gujarat, Karnataka, and Punjab, sampled between Sept 24, 2012, and July 26, 2013; and the northeastern phase included Assam, Mizoram, Arunachal Pradesh, Tripura, Manipur, and Meghalaya, with sampling done between Jan 5, 2012, and July 3, 2015. Capillary oral glucose tolerance tests were used to diagnose diabetes and prediabetes in accordance with WHO criteria. Our methods did not allow us to differentiate between type 1 and type 2 diabetes. The prevalence of diabetes in different states was assessed in relation to socioeconomic status (SES) of individuals and the per-capita gross domestic product (GDP) of each state. We used multiple logistic regression analysis to examine the association of various factors with the prevalence of diabetes and prediabetes. FINDINGS: The overall prevalence of diabetes in all 15 states of India was 7·3% (95% CI 7·0-7·5). The prevalence of diabetes varied from 4·3% in Bihar (95% CI 3·7-5·0) to 10·0% (8·7-11·2) in Punjab and was higher in urban areas (11·2%, 10·6-11·8) than in rural areas (5·2%, 4·9-5·4; p<0·0001) and higher in mainland states (8·3%, 7·9-8·7) than in the northeast (5·9%, 5·5-6·2; p<0·0001). Overall, 1862 (47·3%) of 3938 individuals identified as having diabetes had not been diagnosed previously. States with higher per-capita GDP seemed to have a higher prevalence of diabetes (eg, Chandigarh, which had the highest GDP of US$ 3433, had the highest prevalence of 13·6%, 12.8-15·2). In rural areas of all states, diabetes was more prevalent in individuals of higher SES. However, in urban areas of some of the more affluent states (Chandigarh, Maharashtra, and Tamil Nadu), diabetes prevalence was higher in people with lower SES. The overall prevalence of prediabetes in all 15 states was 10·3% (10·0-10·6). The prevalence of prediabetes varied from 6·0% (5·1-6·8) in Mizoram to 14·7% (13·6-15·9) in Tripura, and the prevalence of impaired fasting glucose was generally higher than the prevalence of impaired glucose tolerance. Age, male sex, obesity, hypertension, and family history of diabetes were independent risk factors for diabetes in both urban and rural areas. INTERPRETATION: There are large differences in diabetes prevalence between states in India. Our results show evidence of an epidemiological transition, with a higher prevalence of diabetes in low SES groups in the urban areas of the more economically developed states. The spread of diabetes to economically disadvantaged sections of society is a matter of great concern, warranting urgent preventive measures. FUNDING: Indian Council of Medical Research and Department of Health Research, Ministry of Health and Family Welfare, Government of India.

A study to assess the emotional disorders with special reference to stress of medical students of agartala government medical college and govinda ballabh pant hospital.

BACKGROUND: Stress is very common psychological phenomena where medical students faced in day to day activities. Epidemiological studies have asserted that about 70-80% of the diseases may be related to stress. Research related to this stress especially among medical students is essential, considering their learning, role and responsibilities as a future physician and health intervention programs. OBJECTIVES: To estimate the prevalence of stress and identify stressors among medical students. MATERIALS AND METHODS: A Cross-sectional study was carried out among undergraduate medical students and self administered GHQ-12 and stressor questionnaire were used to collect information regarding stress. Binary logistic regression analysis was performed to calculate odds ratio (OR). RESULTS: Prevalence of stress was 94.52% and more common among females. 33.56% students felt constantly under strain and 25.34% had loss of sleep over worry. Majority of the students of all semesters had stress (P > 0.05) and stressors viz. 'competition for marks' (P = 0.005), 'frequent examination' (P = 0.001), 'difficulty in finding time for recreation' (P = 0.014) and 'being away from home' (P = 0.027) were predominantly experienced by the 1(st) year medical students. Multiple logistic regression analysis revealed the causal effect of main parameter on the GHQ caseness and students who found difficulties in following teaching language among the caseness had 81.59% higher chance of developing stress (OR = 8.159, CI = 1.228-54.213). CONCLUSION: The stress experience was more common due to academics and seen among all year of medical students. Strategy development for eliminating stressors is necessary for promoting healthy life.