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   Table of Contents - Current issue
Coverpage
July-September 2019
Volume 4 | Issue 3
Page Nos. 63-100

Online since Friday, September 27, 2019

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EDITORIAL  

World NCD Federation guidelines for prevention, surveillance and management of noncommunicable diseases at primary and secondary health-care for low resource settings: A key milestone achieved p. 63
JS Thakur
DOI:10.4103/jncd.jncd_37_19  
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REVIEW ARTICLE Top

Systematic review on telephonic Quitline and its effects on smokeless tobacco p. 65
Arpit Singh, Atul Madhukar Budukh, Pankaj Chaturvedi, Rajesh Dikshit
DOI:10.4103/jncd.jncd_26_19  
Tobacco consumption accounts for approximately 80% of total death in low and middle income countries. According to the Global Adult Tobacco Survey (2015) the prevalence of smokeless tobacco (SLT) consumption is being highest in India for about 33% in men and 18% in female. Countries like Bangladesh, Indonesia have highest prevalence of women SLT consumers than males. Quitting of tobacco products is although a difficult process. Evidence suggests two methods that enable a person to quit smokeless tobacco are pharmacotherapy and counselling or advice. The telephonic quit line services is very popular in the US and Europe, however they have predominantly handled smoking cessation. In this study we have done the systematic review on effect of telephone quit line services over smokeless tobacco cessation. We have taken articles from well-known library Pub-Med and Google Scholar with proper inclusion and exclusion criteria. In the systematic review it was noted that use of telephone quit line has reported the quit rate of SLT in the range of 25 to 30% over the population of 1000 despite of many limitations. The smokeless tobacco cessation through telephone quit line is useful and convenient way for tobacco control. The government of India has looked forward into this issue and has recently launched the national telephone quit line services for the tobacco control. This review recommends a policy which has to be made by the Low and Middle income countries to establish the quit line services for the SLT cessation by telephone counselling, which will play important role in tobacco control.
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ORIGINAL ARTICLES Top

Readiness of primary health centers and community health centers for providing noncommunicable diseases-related services in Bengaluru, South India p. 73
Karthika Parameswaran, Twinkle Agrawal
DOI:10.4103/jncd.jncd_45_18  
Context: India is experiencing a rapid health transition with a rising burden of noncommunicable diseases (NCDs). Primary health centers (PHCs) and community health centers (CHCs) are the key health-care delivery institutions providing majority of health-care services to the Indian population. Aim: We assessed the service readiness of PHCs and CHCs to bear the responsibility of providing NCD-related services. Settings and Design: This design was a facility-based quantitative cross-sectional study. Subjects and Methods: The study was conducted on randomly selected 36 PHCs and six CHCs from five taluks of Bengaluru Urban District. Data were collected using an interviewer-administered questionnaire and observation of key items. Descriptive statistics were calculated using SPSS software (SPSS Inc., IBM corp., Chicago, Illinois, United States). Ethical approval was obtained before the data collection. Results: Medical professionals were available only in 47.2% PHCs and 16.6% CHCs. About 94.4% PHCs and all CHCs were reported to have medical equipment. The percentage availability of necessary laboratory services was reported by 44.4% PHCs and 58.3% CHCs. Essential medicines were available only in 55.5% PHCs and 50% CHCs. Guideline materials and training for NCD prevention were given by 8.3% PHCs and 26.6% CHCs. Conclusion: This study found that readiness of PHCs and CHCs for providing NCD-related services was suboptimal. Therefore, primary health-care system strengthening in the form of human resources, functional laboratories, and equipment and supply of medicines is essential at PHCs and CHCs.
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Contribution of single-nucleotide polymorphism in transcription factor 7-like 2 gene to cardiometabolic risk in adult Nigerians p. 80
Ifeoma Christiana Udenze, Idowu A Taiwo, Oyesola O Ojewunmi
DOI:10.4103/jncd.jncd_1_19  
Background: Single-nucleotide polymorphism in the gene, transcription factor 7-like 2 (TCF7L2), shows the strongest and most consistent association with risk of developing type 2 diabetes (T2D). TCF7L2 has been associated with both impaired beta-cell function and insulin resistance. Gene variants of TCF7L2 may, therefore, contribute to cardiometabolic risk (CMR) and metabolic syndrome (MS). Aims and Objectives: The study aims to examine the relationship between gene variants in TCF7L2 with MS and CMR. Methods: Three hundred and fifty-six adult Nigerians aged between 40 and 100 years participated in a cross-sectional, analytical study. The association between TCF7L2 genotypes and MS and its components was determined. The data were analyzed, and statistical significance was set at P< 0.05. Results: Three hundred and fifty-six individuals participated in the study (35.6% of males and 64.2% of females). About 64.9% of participants had T2D. The prevalence of MS was 26.4%. Among the individuals with the wild-type homozygote genotype CC, heterozygote genotype CT, and homozygote mutant TT, 24.9%, 27.2%, and 30.6% had MS, respectively. The risk T allele was associated with higher mean values of waist circumference and triglyceride than the C allele (P = 0.006 and 0.022, respectively). The T allele had a significant correlation with MS components (P < 0.05). In multivariate regression analysis, quantitative index of insulin resistance (Quantitative Insulin-Sensitivity Check Index) remained independently associated with the T risk allele (P = 0.033). Conclusion: Variants in the TCF7L2 gene are associated with components of MS and correlate with CMR through insulin resistance.
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Productivity losses among individuals with common mental illness and comorbid cardiovascular disease in rural Karnataka, India p. 86
Farah Naaz Fathima, James G Kahn, Srinivasan Krishnamachari, Maria Ekstrand
DOI:10.4103/jncd.jncd_17_19  
Context: Common mental disorders (CMD) and cardiovascular diseases (CVDs) frequently co-occur. Productivity losses due to these diseases are substantial in high-income countries. Similar data from the developing world are lacking. Aims: This study aims to quantify productivity losses among individuals with comorbid CMD and CVD in rural Karnataka, India. Settings and Design: A cross-sectional study was done among patients with a dual diagnosis of a comorbid CMD and CVD in a district in Karnataka, India. Subjects and Methods: Three hundred and three patients were administered the iMTA Productivity Cost Questionnaire to measure losses of productivity at paid work (absenteeism and presenteeism) and unpaid work. Statistical Analysis Used: Valuation of productivity losses was done by multiplying the number of days of lost productivity by the standard value of productivity based on the minimum wage for agricultural work. Results: Among individuals with dual CMD and CVD, 76% had productivity losses. These losses were higher at unpaid (62%) than at paid work (32%). At paid work, losses due to presenteeism were greater than those due to absenteeism. The total days of productivity loss were 1204, amounting to 14.2% of the available person-days. The total productivity loss among 303 individuals with mental illness and comorbid CVD over a 4-week period amounted to 30.3 INR (0.47 USD) per person per day, representing 9.9% of total potential productivity. Conclusions: Productivity losses due to common mental illnesses and CVDs are high. There is a need to conduct more studies in this field.
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Assessment of knowledge regarding self-management of bronchial asthma among patients attending the outpatient department of a North Zone tertiary care center p. 93
Ankita Sukhpal Kaur, Neena Vir Singh, Ashutosh Aggarwal
DOI:10.4103/jncd.jncd_30_19  
Background: Bronchial asthma is a well-known chronic illness with a significant burden. The chronic nature of the disease demands time to time management. Knowledge about the disease condition is essential to understand the dynamic nature of the symptoms. Therefore, it is important to assess the knowledge of the patients related to disease, so that further teaching can be planned to educate them about their disease condition and self-management measures. Objective: The objective of this study was to assess the knowledge of patients regarding self-management of bronchial asthma. Materials and Methods: One hundred and thirty-five participants with varying asthma severity were enrolled in the study group. Each participant was interviewed using a prevalidated questionnaire consisting of 19 items. The items were divided into three subcategory questions related to disease condition, triggering factors and symptoms, and correct inhalation device use and acute management. The scores were categorized into three categories, namely poor (0–6), moderate (7–12), and good (13–19) knowledge score. Results: Poor knowledge has been seen in 10.37%. The mean knowledge score of the participants was 10.24 ± 3.11 and ranged from 4 to 17. There was a negative linear correlation between duration of diagnosis and knowledge score (r = −0.16, P > 0.05). A slight positive linear correlation was seen in age and knowledge score (r = 0.2, P < 0.05), and a negative linear correlation was spotted in educational status and knowledge score (r = −0.24, P < 0.05). Conclusion: Written educational material should be routinely provided to patients to enhance their understanding and knowledge about disease condition and its proper management.
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Expanding role of radiation in pancreatic tumors – A rare case report and a new horizon p. 98
Rakesh Kapoor, Chinna Babu Dracham, GY Srinivasa, Ankita Gupta
DOI:10.4103/jncd.jncd_4_19  
Solid pseudopapillary tumors (SPTs) of the pancreas are neoplasms with low malignant potential. Surgical resection offers excellent survival. Adjuvant therapy can have an increased role. A 45-year-old female presented with pain abdomen. Contrast-enhanced computed tomography of the abdomen revealed a 6 cm × 6 cm × 6 cm lesion in the pancreas. Fine-needle aspiration from the mass revealed a neuroendocrine tumor, and she underwent distal pancreatectomy and splenectomy. The diagnosis of SPT was made on histopathology report. Subsequently, the patient received adjuvant radiotherapy. Adjuvant radiotherapy can be considered to decrease the risk of local recurrences in the presence of poor-risk features.
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