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   Table of Contents - Current issue
Coverpage
October-December 2019
Volume 4 | Issue 4
Page Nos. 101-136

Online since Tuesday, December 31, 2019

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EDITORIAL  

Essential medicines for noncommunicable diseases: “Quality variable” p. 101
Samir Malhotra
DOI:10.4103/2468-8827.274464  
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REVIEW ARTICLE Top

The relationship between fat mass and obesity-associated gene polymorphism and obesity among children in China: A systematic review and meta-analysis p. 104
Zhiyong Dong, Sheikh Mohammed Shariful Islam, Ashley M Yu, Faraz Razi, Ramit Kumar Gupta, Mohammad Ali Moni, Cunchuan Wang
DOI:10.4103/jncd.jncd_43_19  
The fat mass and obesity-associated (FTO) gene has been shown to be associated with obesity in different populations. However, this association in the Chinese population has been controversial. We evaluated the association of the FTO rs9939609 gene polymorphism with the risk of overweight and obesity in Chinese children and adolescents in a systematic review and meta-analysis. We searched PubMed, Embase, Cochrane Library, and two electronic Chinese databases (CBM, CNKI). Two authors screened abstracts, full-texts, and extracted data according to the prespecified inclusion criteria. A modified STREGA score was used for quality assessment. A random-effects and fixed-effects model was used to conduct the measure the association between FTO gene and obesity. Ten studies including 12,879 participants were included. The FTO rs9939609 gene polymorphism was associated with a statistically significant increased risk of obesity or overweight in Han Chinese children and adolescents (P < 0.05), but absent in the Zhuang and Hazakh Chinese population (P > 0.05). The pooled OR for the codominant genetic model between AA and TT was 1.79 (95% confidence interval: 1.34–2.39, P < 0.0001). Allele A carriers were at greater risk of obesity and overweight compared to noncarriers. Screening for FTO rs9939609 gene polymorphism might help to identify adolescents at risk of developing obesity and consider appropriate prevention strategies.
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ORIGINAL ARTICLES Top

Traditional healers in Senegal: Characteristics and beliefs about treatment of diabetes p. 115
Nicole Hammond, Rhonda Belue, Bilikisu Elewonibi, Rhoda Moise, Laura Leuenberger, Gail Hughes
DOI:10.4103/jncd.jncd_3_19  
Background: It is known that patients with noncommunicable diseases utilize traditional healers (THs) regardless of their ability to access biomedical treatment facilities. However, information regarding the practices of THs and how they treat in Sub-Saharan African (SSA) is limited. This study examines the sociodemographic characteristics of Senegalese THs, how they treat diabetes, and how they interact with both patients and the larger health-care system. Materials and Methods: THs were identified in M'bour, Senegal, who practice alongside a government hospital and several health outposts. Twenty THs agreed to participate in recorded interviews. A standardized questionnaire was used to investigate general practices and management of diabetes. Results: Eighteen of the THs were male, ages 22–70 years. Thirteen were trained through family members, while five never received training, citing that they were born with or received their gift in a dream. All THs treated physical illnesses, including diabetes. Plants were used by all THs and were usually dispensed in the form of powder. Nine THs stated that they could lower blood sugar levels, while five said they were able to cure diabetes completely. Many THs cited referring patients to biomedical treatment centers if unable to manage their conditions either initially or after treatments were unsuccessful. Conclusions: This study provides insight into the practice of THs in rural Senegal. Findings suggest the need for collaboration among THs, health professionals, and patients, given the increasing burden of diabetes in SSA.
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Emergency nurses' knowledge about tissue plasminogen activator therapy and their perception about barriers for thrombolysis in acute stroke care p. 121
Priya Baby, PR Srijithesh, Jesna Ashraf, Deiva Kannan
DOI:10.4103/jncd.jncd_16_19  
Introduction: Thrombolytic therapy using tissue plasminogen activator (t-PA) has been proven to be a cost-effective means of treating acute stroke. However, several factors lead to the underutilization of this treatment. This study was undertaken to assess the knowledge of emergency nurses regarding t-PA therapy and to identify the barriers perceived by them in the utilization of thrombolysis in acute stroke. Materials and Methods: A cross-sectional survey was conducted among 30 nurses working in the emergency department of a tertiary level public hospital in India. A self-administered questionnaire was used to assess their knowledge and perceived barriers. Results: Against a total score of 26, the score of the sample ranged from 13 to 22 with a mean score of 17.9 ± 2.4. The mean accuracy rate of the questions was 68.6 ± 25.3. Three major categories of barriers were identified in the efficient utilization of thrombolytic therapy. These were patient-related barriers, organizational barriers, and behavioral barriers. “Unaffordability of t-PA therapy due to financial constraints” and “patients not reaching the facility in the window period” were the two topmost barriers for thrombolysis identified by the nurses. Conclusion: Ongoing continuing nursing education is essential to fill the knowledge gap of nurses regarding thrombolysis. Sufficient measures need to be taken at prehospital, institutional, and personnel levels to mitigate the barriers for thrombolysis so that no eligible patients are left without the benefits of the treatment.
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Effect of atorvastatin nanoparticles compared to free atrovastatin on plaque properties in rabbit model of atherosclerosis p. 127
Anjuman Arora, Ritika Kondel Bhandari, Avaneesh Kumar Pandey, Imran Ibni Gani Rather, Samir Malhotra, Alka Bhatia, Nusrat Shafiq
DOI:10.4103/jncd.jncd_27_19  
Background: Atherosclerosis is a systemic disease affecting the entire arterial tree involving the accumulation of inflammatory cells in the atherosclerotic plaques with larger macrophage-rich areas. Utilizing this property, we aimed to study the effect of atorvastatin nanoparticles given once in a week compared to free atorvastatin given daily on the plaque properties in a rabbit model of atherosclerosis. Materials and Methods: Rabbits were fed with high-cholesterol diet over a period of 2 months. Thereafter, aortic wall tissues were taken for histological changes, and morphometric analysis and plasma samples were taken for the measurement of lipid profile. Results: Our nanoformulation has been effective in improving lipid profile and decreasing plaque content in the aortic wall and showed comparable effect with that of a free drug. Conclusion: Thus, our novelty is the development of sustained-release nanoformulation of atorvastatin having similar pharmacodynamic activity when compared to free atorvastatin.
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Process of care indicators among patients treated for hypertension at a tertiary care hospital in Puducherry, South India p. 132
Jeby Jose Olickal, Chanaveerappa Bammigatti, Vinayagamoorthy Venugopal, Kalaiselvi Selvaraj, Karthickeyan Duraisamy, Kalpita Shringarpure, Vanitha Priya Deenathayalan, Kedar Gautambhai Mehta, Priya Rathi, Manisha Chetan Khemani, Sadhana Subramanian, Revathi Ulaganeethi, Palanivel Chinnakali
DOI:10.4103/jncd.jncd_34_19  
Background: Routine follow-ups, laboratory tests, and fundus examination are necessary in controlling blood pressure (BP) and thus control the complications of hypertension (HTN). Hence, in this study, we aimed to determine the process of care indicators among patients with HTN who have obtained care at a tertiary care center, South India. Methods: A hospital-based cross-sectional descriptive study was conducted among patients with HTN who were registered on or before September 2017 and were on treatment for a minimum of 1 year. Patient case records were retrospectively reviewed to identify the process indicators. Results: A total of 385 patients with HTN were included in this study. The mean (standard deviation) age was 57.9 (9.8) years and more than half were females (51.7%). Of total, 274 (71.2% [95% confidence interval (CI) 66.5–75.5]) patients have consulted their physicians on the last two scheduled visits and 62% (95% CI 56.9–66.5) have got their BPs measured. Only one-fifth underwent retinal examination and lipid profiling. Only 77 (20% [95% CI 15.8–23.7]) of the patients achieve at least three processes of care indicators we studied. Outcome indicators showed that around one-third (36.9%) of the participants had unsatisfactory outcome indicators with respect to BP control. Care-availing outpatients have 1.2 (95% CI 1–1.4) times higher poor care indicators (not underwent last three processes of care indicators) as compared to those availing care from HTN clinic (P = 0.01). Conclusions: We found suboptimal adherence to process of care indicators among patients with HTN availing care at a tertiary care hospital.
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