ASSESSMENT OF DENTAL FLUOROSIS IN CHILDREN OF JAIPUR DISTRICT, RAJASTHAN, INDIA

Objective: The objective of the present study was carried out to explore the potential association between fluoride concentration in drinking water and severity of dental fluorosis (DF) in the children.Methods: The study of dental fluorosis (DF) in the children (6-14 years old) was conducted in the two blocks (a) Jamwaramgarh block ;Heerawala, Palera ,Nayabas, Saipur and Birasana, (b) Amber block; Jugalpura, Chitanukalan, Sunder ka bas, Peelwa and Sirsali of Jaipur district, Rajasthan, India of the study villages. Total 150, children were surveyed. The role of fluoride (F) levels in drinking water in the etiology of dental fluorosis (DF) and the cases of dental fluorosis (DF) in both dentitions and teeth were also assessed using DEAN'S classification. The fluoride (F) concentration in source of drinking water was estimated by fluoride (F) ion specific electrode (Thermo Scientific Orion Star A329, USA).Results: The F concentration in (Tube well and Hand pump) water ranges from 0.7 to 15.0 parts per million (ppm) in Jamwaramgarh block and 1.40 to 5. 10 parts per million (ppm) in Amber block. Prevalence of dental fluorosis (DF) 27 (36%) in Jamwaramgar block and 26 (34.66%) in Amber block out of 75 children were examined in each block. Significantly increase in levels of F in drinking water is positively correlated with dental fluorosis.Conclusion: This study finding has shown the relation of dental fluorosis (DF) to high fluoride (F) levels in drinking water sources. A higher fluoride (F) levels in source of drinking water is a major risk factor for dental fluorosis. In view of the severity of the problem the intake of calcium rich foods and defluoridation techniques may help reducing risk of dental fluorosis (DF) in the children.Â

IODINE STATUS OF PREGNANT WOMEN RESIDING IN URBAN SLUMS IN DELHI

Objectives: The present study was carried out to determine the iodine nutrition status among pregnant women in slums of West Delhi.Methods: A community-based cross-sectional study was carried out among the third-trimester pregnant women residing in urban slums of West Delhi. Urinary iodine concentration was estimated using ammonium persulfate method, and salt iodine was estimated using iodometric titration.Results: Of the total 180 pregnant women, 70.6% were consuming adequately iodized salt (iodine levels ≥15 ppm). Median urinary iodine level for the pregnant women was 147.5 μg/L indicating iodine deficiency among this group. A total of 51.1% of women had urinary iodine levels <150 μg/L.Conclusion: Pregnant women belonging to slum community from Delhi have a suboptimal iodine status. Further, the proportion of women consuming iodized salt is less than the national average indicating the need to educate these women about the importance of iodine during pregnancy

ANEMIA AND VITAMIN B12 DEFICIENCY IN ELDERLY.

 Objective: The present study was carried out to assess the prevalence of anemia, vitamin B12 deficiency and hyperhomocysteinemia among elderly in slums of West Delhi.Methods: A cross-sectional study was carried out among 234 elderly aged 60 and above in slums of West Delhi. 5 ml blood was collected from 116 elderly and was analyzed for hemoglobin, Vitamin B12 and homocysteine. Anemia was defined as hemoglobin <130 g/L and <120 g/l for male and female, respectively, Vitamin B12 deficiency as serum Vitamin B12 <203 pg/ml and hyperhomocysteinemia as serum homocysteine >15 μmol/l.Results: The overall prevalence of anemia, Vitamin B12 deficiency, and hyperhomocysteinemia among elderly was 57.76%, 36.36%, and 57.57%, respectively. Among anemic elderly, 33.33% and 64.15% had Vitamin B12 deficiency and hyperhomocysteinemia, respectively.Conclusion: More than half of the elderly population was anemic, while one-third was having Vitamin B12 deficiency

PREVALENCE OF HYPERTENSION AMONG ADULT POPULATION IN SLUMS OF WEST DELHI

Objective: The present study was conducted to assess the prevalence of hypertension in adult population residing in slums of West Delhi.Methods: A cross-sectional study was conducted among adult population of 18-59 years residing in urban slums of West Delhi. Blood pressure was measured using digital machine (OMRON). The data obtained were analyzed for percent prevalence, mean, standard deviation, and median. Joint National Committee (JNC)on prevention, detection, evaluation, and treatment of high blood pressure (JNC)VI and JNC VII criteria were used to classify hypertension.Results: The overall prevalence of hypertension was 25.3%. The prevalence was higher (27.9%)in males than females (22.8%)and also in the age group 46-59 years (43.0%)as compared to 18-45 years (19.8%). The overall prevalence of prehypertension, Stage I and Stage II hypertension, respectively, was 35.2%, 16.1% and 9.2%.Conclusion: A one-fourth of the adult population is hypertensive. Early diagnosis and treatment are advisable, besides awareness about dietary and lifestyle modification

Mapping of variations in child stunting, wasting and underweight within the states of India: the Global Burden of Disease Study 2000–2017

Background To inform actions at the district level under the National Nutrition Mission (NNM), we assessed the prevalence trends of child growth failure (CGF) indicators for all districts in India and inequality between districts within the states. Methods We assessed the trends of CGF indicators (stunting, wasting and underweight) from 2000 to 2017 across the districts of India, aggregated from 5 × 5 km grid estimates, using all accessible data from various surveys with subnational geographical information. The states were categorised into three groups using their Socio-demographic Index (SDI) levels calculated as part of the Global Burden of Disease Study based on per capita income, mean education and fertility rate in women younger than 25 years. Inequality between districts within the states was assessed using coefficient of variation (CV). We projected the prevalence of CGF indicators for the districts up to 2030 based on the trends from 2000 to 2017 to compare with the NNM 2022 targets for stunting and underweight, and the WHO/UNICEF 2030 targets for stunting and wasting. We assessed Pearson correlation coefficient between two major national surveys for district-level estimates of CGF indicators in the states. Findings The prevalence of stunting ranged 3.8-fold from 16.4% (95% UI 15.2–17.8) to 62.8% (95% UI 61.5–64.0) among the 723 districts of India in 2017, wasting ranged 5.4-fold from 5.5% (95% UI 5.1–6.1) to 30.0% (95% UI 28.2–31.8), and underweight ranged 4.6-fold from 11.0% (95% UI 10.5–11.9) to 51.0% (95% UI 49.9–52.1). 36.1% of the districts in India had stunting prevalence 40% or more, with 67.0% districts in the low SDI states group and only 1.1% districts in the high SDI states with this level of stunting. The prevalence of stunting declined significantly from 2010 to 2017 in 98.5% of the districts with a maximum decline of 41.2% (95% UI 40.3–42.5), wasting in 61.3% with a maximum decline of 44.0% (95% UI 42.3–46.7), and underweight in 95.0% with a maximum decline of 53.9% (95% UI 52.8–55.4). The CV varied 7.4-fold for stunting, 12.2-fold for wasting, and 8.6-fold for underweight between the states in 2017; the CV increased for stunting in 28 out of 31 states, for wasting in 16 states, and for underweight in 20 states from 2000 to 2017. In order to reach the NNM 2022 targets for stunting and underweight individually, 82.6% and 98.5% of the districts in India would need a rate of improvement higher than they had up to 2017, respectively. To achieve the WHO/UNICEF 2030 target for wasting, all districts in India would need a rate of improvement higher than they had up to 2017. The correlation between the two national surveys for district-level estimates was poor, with Pearson correlation coefficient of 0.7 only in Odisha and four small north-eastern states out of the 27 states covered by these surveys. Interpretation CGF indicators have improved in India, but there are substantial variations between the districts in their magnitude and rate of decline, and the inequality between districts has increased in a large proportion of the states. The poor correlation between the national surveys for CGF estimates highlights the need to standardise collection of anthropometric data in India. The district-level trends in this report provide a useful reference for targeting the efforts under NNM to reduce CGF across India and meet the Indian and global targets. Keywords Child growth failureDistrict-levelGeospatial mappingInequalityNational Nutrition MissionPrevalenceStuntingTime trendsUnder-fiveUndernutritionUnderweightWastingWHO/UNICEF target

Prevalence of hypovitaminosis D in India & way forward

Deficiency of vitamin D or hypovitaminosis D is widespread irrespective of age, gender, race and geography and has emerged as an important area of research. Vitamin D deficiency may lead to osteoporosis (osteomalacia in adults and rickets in children) along with calcium deficiency. Its deficiency is linked with low bone mass, weakness of muscles and increased risk of fracture. However, further research is needed to link deficiency of vitamin D with extra-skeletal consequences such as cancer, cardiovascular disease, diabetes, infections and autoimmune disorders. The causes of vitamin D deficiency include length and timing of sun exposure, amount of skin exposed, latitude, season, level of pollution in atmosphere, clothing, skin pigmentation, application of sunscreen, dietary factors and genetic factors. The primary source is sunlight, and the dietary sources include animal products such as fatty fish, food items fortified with vitamin D and supplements. Different cut-offs have been used to define hypovitaminosis D and its severity in different studies. Based on the findings from some Indian studies, a high prevalence of hypovitaminosis D was observed among different age groups. Hypovitaminosis D ranged from 84.9 to 100 per cent among school-going children, 42 to 74 per cent among pregnant women, 44.3 to 66.7 per cent among infants, 70 to 81.1 per cent among lactating mothers and 30 to 91.2 per cent among adults. To tackle the problem of hypovitaminosis D in India, vitamin D fortification in staple foods, supplementation of vitamin D along with calcium, inclusion of local fortified food items in supplementary nutrition programmes launched by the government, cooperation from stakeholders from food industry and creating awareness among physicians and the general population may help in combating the problem to some extent

ASSESSMENT OF RISK FACTORS OF HYPERTENSION AMONG ADULTS RESIDING IN URBAN SLUM OF DELHI.

 Objective: The objective of this study is to assess the risk factors of hypertension among adults residing in urban slums of West Delhi.Methods: A cross-sectional study was carried out among adult population of 18–59 years residing in urban slums of West Delhi. Blood pressure was measured twice using digital machine (OMRON). Height, waist circumference, and hip circumference were measured, weight was taken, and body mass index (BMI) was calculated. The Joint National Committee VII criteria were used to define hypertension, and the National Cholesterol Education Program and Adult Treatment Panel-III guidelines were used to define different categories of dyslipidemia. The World Health Organization (2014) criteria were used to classify the BMI.Results: The overall prevalence of hypertension among adults (n=423) was 25.3%. Among hypertensive adults, the prevalence of obesity was 22.7%, while among non-hypertensives, it was 10.9%. Similarly, overweight prevalence was higher (27.3%) in hypertensive adults compared to non-hypertensive adults (20.6%). The overall prevalence of hypercholesterolemia, hypertriglyceridemia, high-density lipoprotein-cholesterol <40/<50 mg/dl, and low-density lipoprotein-cholesterol (LDL-C) ≥130 was 19.7%, 33.7%, 75.7%, and 21.8%, respectively. The prevalence of hypercholesterolemia, hypertriglyceridemia, and serum LDL-C ≥130 mg/dl was 38%, 50%, and 32% among hypertensive adults, while among non-hypertensive adults, it was 15%, 29%, and 19%, respectively.Conclusion: Hypertensive adults had higher BMI, serum cholesterol, triglycerides, and LDL-C compared to non-hypertensives

PREVALENCE OF HYPERTENSION AMONG ELDERLY RESIDING IN SLUMS OF WEST

 Objective: The present study was carried out to assess the prevalence of hypertension among elderly in slums of West Delhi.Methods: A cross-sectional study was carried out among 202 elderly residing in urban slums of West Delhi. Hypertension was classified as per JNC VII criteria. Blood pressure was measured twice using digital machine (OMRON) after an interval of 5 min. The data obtained were analyzed for percent prevalence, mean, standard deviation, and median.Results: The overall prevalence of hypertension was 49.1%; higher among male (56.0%) than female (41.9%). The prevalence of Stage I, Stage II, and isolated systolic hypertension was 30.7%, 18.8%, and 47%, respectively.Conclusion: Almost half of the elderly population in slums was hypertensive. Periodical health checkup and management through treatment and dietary and lifestyle modification is needed.Â

PREVALENCE OF HYPERTENSION AMONG ELDERLY RESIDING IN SLUMS OF WEST

 Objective: The present study was carried out to assess the prevalence of hypertension among elderly in slums of West Delhi.Methods: A cross-sectional study was carried out among 202 elderly residing in urban slums of West Delhi. Hypertension was classified as per JNC VII criteria. Blood pressure was measured twice using digital machine (OMRON) after an interval of 5 min. The data obtained were analyzed for percent prevalence, mean, standard deviation, and median.Results: The overall prevalence of hypertension was 49.1%; higher among male (56.0%) than female (41.9%). The prevalence of Stage I, Stage II, and isolated systolic hypertension was 30.7%, 18.8%, and 47%, respectively.Conclusion: Almost half of the elderly population in slums was hypertensive. Periodical health checkup and management through treatment and dietary and lifestyle modification is needed.Â

HOMOCYSTEINE STATUS OF ELDERLY SLUM WOMEN IN DELHI

Objective: The study was undertaken to assess homocysteine levels among economically deprived elderly women in Delhi.Methods: The study was carried out among elderly women aged 60–70 years residing in Kirti Nagar slums of West Delhi. Blood samples were collected, and serum homocysteine was analyzed using chemiluminescent immunometric assay. Hyperhomocysteinemia was defined as serum homocysteine >15 μmol/l. Dietary information was also collected using 24 h dietary recall method and food frequency questionnaire.Results: The prevalence of hyperhomocysteinemia was 16.9%. The mean serum homocysteine was 12.35±6.43 μmol/l. Serum homocysteine levels ranged from 3.84 to 35.20 μmol/l. It was observed that hyperhomocysteinemia was higher in vegetarians (31.2%) compared to non-vegetarians (6.7%).Conclusion: The prevalence of hyperhomocysteinemia is higher among vegetarians than non-vegetarians. Further, research is necessary to see the effect of elevated homocysteine in multiple age-related diseases