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   Table of Contents - Current issue
Coverpage
January-March 2021
Volume 6 | Issue 1
Page Nos. 1-52

Online since Wednesday, April 21, 2021

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EDITORIAL  

Global Health and Wellness Initiative of World Noncommunicable Disease Federation – Play, Laugh, and Grow (Indian version: Khelo, Hasso Aur Hasao, Badho Aur Badhao, India) p. 1
JS Thakur
DOI:10.4103/jncd.jncd_14_21  
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REVIEW ARTICLE Top

Integrated digital approach for prevention and control of noncommunicable diseases: Review of the progress of “mukhyamantri nirog yojna” in the state of Himachal Pradesh, India p. 4
Gopal Chauhan, Jarnail Singh Thakur
DOI:10.4103/jncd.jncd_70_20  
Noncommunicable diseases (NCDs) are on the rise globally. The proportional mortality by NCDs in India is 72% (including 12% due to injuries). Most of the NCDs share common risk factors. The approach of delivery for NCD related programs in India is vertical and fragmented. In order to address the rising burden of NCDs, the state of Himachal Pradesh in India has adopted a comprehensive approach known as Mukhyamantri Nirog Yojna by integrating all existing NCD-related vertical programs for the purpose of implementation, surveillance, and to ensure continuum of care from November 2018. The digital surveillance of all NCDs risk factors, cancers, diabetes, cardiovascular diseases, stroke, chronic obstructive pulmonary disease, chronic kidney disease, blindness, deafness, mental illness, and stroke is ensured through E-Health card software. Till March 31, 2020, a total of 1.78 million (41.43% of the entire +18 population) individuals have been enrolled under the surveillance. More than 67% are at risk of developing NCDs. About 38% of all on risk have been screened for NCDs by the auxiliary nurse midwife, out of which 12.3% have high blood pressure, 6.2% have increased waist circumference, and 5.4% have increased blood sugar. About 73% of the screened positive has been diagnosed by the doctors for further management. The basic health services such as risk assessment, screening, diagnoses drugs, and follow-ups are available free to all through the public health system under this strategy. This approach is an efficient, cost-effective, and reliable strategy to address the common NCDs collectively and can be considered for upscaling in other states and low- and middle-income countries.
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SYSTEMATIC REVIEW ARTICLE Top

Impact of chronic obstructive pulmonary disease on severity and outcomes in COVID-19 patients: A systematic review p. 10
Ashutosh Nath Aggarwal, Ritesh Agarwal, Sahajal Dhooria, Kuruswamy Thurai Prasad, Inderpaul Singh Sehgal, Valliappan Muthu
DOI:10.4103/jncd.jncd_7_21  
We conducted this systematic review to evaluate whether comorbid chronic obstructive pulmonary disease (COPD) increases the risk of severe disease and adverse outcomes among patients with coronavirus disease (COVID-19). We queried the PubMed and Embase databases for studies indexed till December 2020. We included studies that provided data on severe disease, hospitalization, intensive care unit (ICU) care, need for mechanical ventilation, or mortality among COVID-19 patients with and without COPD. We calculated the relative risk (RR) for each reported outcome of interest from each study and used a random-effects model to summarize our data. We retrieved 997 citations and included 110 studies published in 2020, in our review. Most publications reported the data retrieved from electronic records of retrospective patient cohorts. Only 27 studies were judged to be of high quality. COPD patients with COVID-19 had a significantly higher risk of severe disease (summary RR 2.44, 95% confidence interval [CI] 1.93–3.09), hospitalization (summary RR 1.91, 95% CI 1.70–2.14), ICU admission (summary RR 1.81, 95% CI 1.35–2.43), mechanical ventilation (summary RR 1.75, 95% CI 1.35–2.28), and mortality (summary RR 2.40, 95% CI 1.93–2.51), as compared to COVID-19 patients without COPD. All analyses showed significant between-study heterogeneity. We conclude that comorbid COPD significantly increases the risk of severe disease and adverse outcomes among COVID-19 patients.
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ORIGINAL ARTICLES Top

Knowledge about cardio-vascular disease and its risk factors among college-going students in peri-urban Bengaluru, South India Highly accessed article p. 29
Joseph Thomas, Avita Rose Johnson, Savan Sara Mathew, Chitra Tomy, Farah Naaz Fathima
DOI:10.4103/jncd.jncd_47_20  
Background: Knowledge on cardiovascular disease (CVD), its risk factors and preventive measures including lifestyle and behavior changes among youth is an important primary prevention measure to control CVDs. Objective: To assess the knowledge about CVD and its risk factors among college-going youth near Bengaluru city, Karnataka Methods: A cross-sectional study was conducted among college-going youth pursuing various undergraduate degree courses in a peri-urban area near Bangalore, South India. A face-validated, pre-tested, and self-administered questionnaire which captured sociodemographic details along with fifty questions to assess knowledge of CVD and its risk factors was administered. Results: A total of 693 college students participated in the study, of whom 342 (49.4%) were male. The mean age of the participants was 19.06 ± 1.62 years. Overall mean knowledge score regarding CVD and its risk factors was 20.69 ± 6.75 (out of 50). Knowledge scores were significantly higher among those residing in a hostel (P = 0.043) and among those in the 2nd and 3rd year of the course (P < 0.001). Conclusions: College-going youth were found to have poor knowledge about CVD and its risk factors. We were able to identify erroneous beliefs and myths regarding CVD and its risk factors. It is necessary to create awareness among the youth by including CVD and its risk factors as a part of the regular college curriculum.
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A study of serum magnesium level in type 2 diabetes mellitus and its association with glycemic control and its complications p. 34
Kalpesh Moradiya, Arti Muley
DOI:10.4103/jncd.jncd_53_20  
Context: Diabetes is a major public health problem with increasing morbidity due to complications. There have been reports regarding the association of serum magnesium (S. Mg) with diabetic complications but they are few and inconclusive. Aims: The aim was to find the status of S. Mg in patients of type 2 diabetes mellitus (type 2 DM) and study association of S. Mg with glycemic control and diabetic complications. Settings and Design: This was a cross-sectional observational study carried out in a tertiary care hospital in rural area. Subjects and Methods: All patients of type 2 DM were included. Detailed history was taken and all were subjected to routine investigations and S. Mg level. Patients were also screened for complications of diabetes. Statistical Analysis Used: Data were analyzed for any association between S. Mg levels and diabetic control (hemoglobin A1c [HbA1c]) and also for the correlation with diabetic retinopathy and nephropathy. Results: Mean S. Mg was significantly less in patients having uncontrolled diabetes (HbA1c ≥7%) as compared to those with HbA1c <7% (78.8% vs. 21.2%; P = 0.001). There was a negative correlation between S. Mg and HbA1c (r = −0.499; P = 0.001). We also found a statistically significant association of hypomagnesemia with retinopathy (odds ratio [OR] = 4.871; P = 0.001) and nephropathy (OR = 5.4; P = 0.001). Conclusions: Hypomagnesemia is associated with uncontrolled HbA1c and diabetic complications. Routine monitoring and correction of S. Mg levels in type 2 diabetes patients may help in better control of HbA1c and delaying progression to retinopathy and nephropathy.
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Compliance assessment with tobacco control regulations at wheelchair-based tobacco Point of sale in Delhi, India p. 38
Shammi Kumar, Shivam Kapoor, Renu Sharma, Ashish K Pandey, Rana J Singh
DOI:10.4103/jncd.jncd_76_20  
Background: In India, tobacco products are sold at the outlets/shops following the provisions regulating the point-of-sale (PoS) environment under the Cigarettes and Other Tobacco Products Act (COTPA, 2003). Objectives: Given the lack of evidence regarding wheelchair-based tobacco PoSs (WC-PoSs), compliance assessment for Sections 5 and 6 of COTPA was conducted within Delhi. Materials and Methods: Using multistage random sampling in the 11 districts of Delhi, 200 WC-PoSs were identified in May–June 2017. Areas 1 km around each selected landmark were mapped using a map tool, and WC-PoSs were screened using a self-designed study tool (background information and compliance checklist). Descriptive statistics were used to characterize the data using EpiData. Results: Of the 11 districts, 4 were constituted majority of the WC-PoSs: South West (21.5%), West Delhi (20%), North West (17.5%), and North East (11%). The outlet characteristics were government sponsored (36.5%) and mobile outlets (95.5%). Majority of them (94.5%) showed noncompliance toward Section 5 of COTPA. While none of them complied with the display of Section 6(a) signage, only 6% of the outlets were found selling tobacco products within the 100 yards of educational institutes. Conclusions: The sale of tobacco in Delhi at these unique PoSs continues with a lack of compliance with the rules of COTPA. The implications of this noncompliance in the national capital are of major significance for the rest of the country.
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Noncommunicable disease risk profile of urban women in Indore city, India p. 46
Damodar Bachani, Amanda Pomeroy Stevens, Krishnan Anand, Ritvik Amarchand
DOI:10.4103/jncd.jncd_91_20  
Background: Lifestyle changes are affecting the health risk profile of women in developing countries. This study assesses risk factors for noncommunicable diseases (NCDs) and access to NCD screening services among women in Indore city, India. Materials and Methods: A NCD risk factor survey was undertaken in Indore city through the United States Agency for International Development-funded Building Healthy Cities project. The survey used the World Health Organization STEPwise methodology and tools. A total of 1987 women and 1083 men aged 18–69 years were randomly selected from 90 settlements across 30 wards of the city. Weighted analysis based on sampling strategy and response rate was conducted. Results: A total of 22% of women (95% confidence interval [CI]: 21, 24) had raised blood pressure and 13% (95% CI: 11, 14) had raised fasting blood sugar or had already been diagnosed with hypertension or diabetes. While only 6% of women were current tobacco users and <1% consumed alcohol in the last 30 days, 60% of women were overweight or obese. Central obesity was observed in 70% of women; 89% of women were not consuming adequate fruits and vegetables, and 20% were physically inactive. Only 41% and 20% of women had their blood pressure and blood sugar measured, respectively, in the last 12 months; <1% were screened for oral and cervical cancers. Conclusion: Women living in Indore have higher levels of metabolic risk factors, and current NCD screening programs have poor uptake. Gender-sensitive solutions targeting awareness, access, and community environment need further exploration.
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