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   Table of Contents - Current issue
April-June 2021
Volume 6 | Issue 2
Page Nos. 53-94

Online since Friday, July 16, 2021

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The coronavirus disease-2019 pandemic and noncommunicable diseases-need for primary health care system strengthening p. 53
KR Thankappan, Natasha Dawa, Jai Prakash Narain
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Assessing the characteristics of 110 low- and middle-income countries' noncommunicable disease national action plans Highly accessed article p. 56
Ruitai Shao, Cameron Feil, Cervantée E K Wild, Katharina Morschel, Atousa Bonyani, Robert W Smith, Tamara Kailas, Olivia Leventhal, Yasmin Alsoud, Arian Hatefi, Cherian Varghese, Yuxi Zhang, Natalie Rosseau, Temo Waqanivalu, Hongyi Xu, Bente Mikkelsen, Luke N. Allen
Noncommunicable diseases (NCDs) are a leading contributor to preventable mortality and impoverishment in low- and middle-income countries (LMICs). To support countries in developing holistic and integrated NCD plans, the World Health Organization (WHO) has produced get rid of this a NCD Multisectoral Action Plan (MSAP) guidance. To date, over 160 countries have produced MSAPs and uploaded them to the WHO's NCD document repository. We examined the content and comprehensiveness of the MSAPs uploaded by all 110 LMICs, with reference to the WHO guidance. Overall, the MSAPs included 71% of the elements recommended by the WHO, however, there was a tendency to present situational analyses and recommended actions without providing costings or an overall funding plan. We found no correlation between MSAP comprehensiveness (alignment with the WHO guidance) and policy implementation. There were no significant differences in MSAP alignment by region or income group. Countries with higher universal health coverage indices had lower MSAP alignment score. We concluded that the existence of a comprehensive MSAP is not enough to guarantee policy implementation, and that the WHO should focus its support on helping countries to translate plans and policies into concrete actions to address NCDs.
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Smoking and periodontal disease severity, probing pocket depth and bleeding on probing p. 72
J Suresh Babu, C Swarnalatha, Ritu Mathur, Tayf Naif Radhi Alshammari, Archana Meenakshi, Asma Alavi, Nashwa Alzaki Ali Bushara, Yasser Riaz Malik, Abhishek Singh Nayyar
Background and Objective: The purpose of the present study was to investigate whether severity of disease process differed between smokers and nonsmokers and to study characteristic differences in pattern of periodontal disease in smokers in a group of known chronic periodontitis patients. Materials and Methods: The study included 150 individuals in an age range of 35–60 years wherein periodontal evaluation including probing pocket depth (PPD) and bleeding on probing (BOP) was performed using Williams's periodontal probe. For both the parameters (PPD and BOP), mean scores were calculated from different quadrants of the oral cavity while the results obtained were subjected to statistical analysis. Results: The mean percentage of sites that presented with BOP was higher for nonsmokers compared with smokers. Furthermore, smokers had more number of pockets and pockets with increased PPD. On analysis of buccal and lingual sides, also, it was observed that smokers had more number of sites with PPD of ≥5 mm than nonsmokers. Conclusion: From the results, it could be concluded that smoking is associated with more severe periodontal attachment and bone loss and deeper periodontal pockets.
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Interrelationship between noncommunicable diseases, COVID-19 and sociodemographic index in the economic community of West African States p. 77
Olayinka Stephen Ilesanmi, Aanuoluwapo Adeyimika Afolabi
Background: Noncommunicable diseases (NCD) increase COVID-19 morbidity and mortality. Objective: This study aimed to describe the interrelationship between NCD, COVID-19, and sociodemographic index (SDI) in the Economic Community of West African States (ECOWAS). Methods: We extracted data from the global burden of disease (GBD) estimates. The GBD was used to estimate variations in epidemiologic data sources, model predictions, and 95% corresponding uncertainty intervals (UIs) for disability-adjusted life years (DALY). COVID-19 data were extracted and collated from web-based repositories as of December 18, 2020. We assessed the strength of association between the number of COVID-19 cases per thousand population, COVID-19 deaths, case-fatality rate, SDI, and DALY due to NCD using Pearson's correlation test. The level of statistical significance was P < 0.01. Results: Ghana's SDI of 0.56 and DALY% (95% UI) due to NCD of 40.66 (36.05–44.98) was the highest. Ghana had 177 COVID-19 cases/100,000 population while Niger has 11 cases/100,000 population as of December 18, 2020. Niger's SDI of 0.16 and DALY% (95% UI) due to NCD of 21.22 (16.72–25.6) were the minimum. We found a strong positive correlation between COVID-19 cases per thousand population and DALY due to NCD (r = 0.870, P<0.001, n = 15) and a strong positive correlation between SDI and DALY due to NCD (r = 0.647, P = 0.009, n = 15). Conclusion: Countries with higher SDI and DALY due to NCD experienced higher COVID-19 cases. NCD prevention and control should be promoted to reduce COVID-19–related mortality and morbidity in the ECOWAS.
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Prevention of vertebral fractures in primary osteoporosis with once-weekly teriparatide: A systematic review and meta-analysis of randomized controlled trials p. 84
Rimesh Pal, Sanjay Kumar Bhadada, Vandana Dhiman
Aims: The present meta-analysis was undertaken to summarize the data from hitherto available randomized controlled trials (RCTs) on the prevention of incident fractures in patients with primary osteoporosis following the use of once-weekly teriparatide. Methods: PubMed/MEDLINE, Web of Science, and Google Scholar databases were systematically searched till May 21, 2021, to identify RCTs with duration ≥72 weeks, evaluating the efficacy of once-weekly teriparatide (at a dose of 56.5 &#s956;g/week or 28.2 μg/week) in the prevention of incident fractures as compared to placebo or active comparator. Results: We identified 3 eligible RCTs, pooling data retrieved from 1643 participants with primary osteoporosis. Pooled data showed that the risk of incident morphometric vertebral fractures was significantly lower with once-weekly teriparatide compared to placebo/active comparator (RR 0.33, 95% confidence intervals [CI]: 0.12,0.90, P = 0.03; I2 = 86%). Sensitivity analysis after exclusion of the study where an active comparator had been used instead of placebo also showed a similar result (RR 0.20, 95% CI: 0.11,0.37, P < 0.00001; I2 = 0%). Data on clinical vertebral fractures or nonvertebral fractures were inadequately reported across the RCTs and hence could not be pooled together. Nevertheless, all the RCTs did not find any significant difference in the risk of incident nonvertebral fractures. Conclusions: The present systematic review and meta-analysis show that once-weekly teriparatide leads to a 67% reduction in the risk of incident morphometric vertebral fractures. Considering the reasonable efficacy, once-weekly dose, and reduced cost, the formulation can be an important antiosteoporotic drug, especially in resource-constraint settings, like India.
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Use of mHealth technology for modification of behavioural risk factors of noncommunicable diseases in primary health care settings: Effectiveness and Feasibility in South East Asian Region Countries p. 91
Bratati Banerjee
Noncommunicable diseases (NCDs) kill 41 million people each year, of which more than three-quarters occur in low- and middle-income countries. Four groups of diseases, namely cardiovascular diseases, cancers, respiratory diseases, and diabetes, account for over 80% of all premature NCD deaths, and four common modifiable behaviors, namely tobacco use, physical inactivity, unhealthy diet, and the harmful use of alcohol, increase the risk of NCDs. The use of mHealth interventions for Behavior Change Communication has been shown to be effective in modifying the behavioral risk factors, through various studies. The present study proposes to conduct a systematic review and meta-analysis to assess the effectiveness and feasibility of the use of mHealth in improving diet and increasing physical activity, which are two of the major behavioral risk factors of NCDs. Research reported on this, from countries in the South-East Asian Region, during the past 20 years, will be included in this review.
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