Prevalence of type 2 diabetes mellitus in rural population of India- a study from Western Uttar Pradesh

Background: Diabetes is a major challenge for a resource-limited country like India. Majority of the patients are diagnosed late in the course of illness with presence of complications. There is limited data on diabetes from rural India. Present study is an attempt to provide data on diabetes in rural India. The overall objective of present study was to estimate the prevalence of Type 2 diabetes mellitus in rural population above 25 years age in district Etawah and neighbouring areas of Uttar Pradesh, India.Methods: The study was planned to determine the prevalence of diabetes mellitus in rural community by health camp and door to door approach. Fasting capillary blood glucose was first determined using a glucose meter (SD check code free, SD biosensor Inc. Korea). All the adults were given 75gm of glucose dissolved in 200ml water which was drunk over a period of up to 5 minutes and the 2-hour post load capillary blood glucose was estimated. Diabetic status was confirmed by taking blood samples for fasting and postprandial blood sugar levels in a fluoride vacutainer. Fasting plasma glucose ≥126mg/dl and or 2-hour postprandial glucose ≥200mg/dl were taken as the diagnostic criteria for diagnosis.Results: Prevalence of type 2 diabetes in the rural population was found to be 8.03%. Prevalence was higher in female population (9.91%) as compared to males (6.79%). 19.74 % of participants over 70 yrs of age were diabetics while diabetes was present only in 2.95% of participants in the age group of 25-39 year. The maximum number of diabetes were in the age group of 50-59 years. 10.04 % of participants were diagnosed to be Prediabetics. 35.77% of the diabetics were newly diagnosed.Conclusions:Present study shows there is high prevalence of type 2 diabetes in rural area of western Uttar Pradesh, India.

Prevalence of metabolic syndrome in a rural population- a cross sectional study from Western Uttar Pradesh, India

Background: Prevalence of non-communicable diseases like hypertension, diabetes mellitus and coronary artery disease is on the rise due to the change in lifestyle, unfavourable dietary habits and obesity. Metabolic syndrome is a simple tool by which we can predict the future risk of diabetes mellitus and cardiovascular disease. Studies showed that prevalence of metabolic syndrome is rising in Indian population, but majority of them were done in urban population. This study was conducted to look into the current status of the metabolic syndrome in rural population.Methods: The study was conducted among a population of 2982. Each participant was subjected to clinical examination, anthropometric measurements and necessary laboratory investigations. Metabolic syndrome was diagnosed based on modified NCEP: ATP III criteria.Results: The prevalence of metabolic syndrome was found to be 11.7% and was higher among female population (13.8%) as compared to males (9.6%). The prevalence of metabolic syndrome increased with increasing age. 28.3% of the participants over the age of 50 years had metabolic syndrome whereas it was only 0.4% below the age of 20 years. Nearly half (47.1%) of the obese individuals were suffering from metabolic syndrome implicating obesity as one of the most important risk factors in the etiopathogenesis of metabolic syndrome. The prevalence was only 1.1% among the underweight group.Conclusions: Present study has shown moderate prevalence of metabolic syndrome among the rural population of Western Uttar Pradesh, India with a more female predisposition

Prevalence of non-alcoholic fatty liver disease in patients of metabolic syndrome in a rural population attending tertiary care centre

Background: Non-alcoholic fatty liver disease and steatohepatitis now constitute the major etiology of chronic liver disease. Prevalence of non-alcoholic fatty liver disease is rising due to the change in lifestyle habits, diet and obesity. Metabolic syndrome is closely related with the pathogenesis of non-alcoholic fatty liver disease. Studies showed that prevalence of metabolic syndrome is rising in Indian population. This study was conducted to look into the current status of the metabolic syndrome in rural population.Methods: The study was conducted among patients attending General Medicine OPD. Each participant was subjected to clinical examination, anthropometric measurements, laboratory investigations and abdominal ultrasound. NAFLD was diagnosed by ultrasound and metabolic syndrome was diagnosed based on modified NCEP:ATP III criteria.Results: The prevalence of NAFLD was found to be 18.78% and was higher among male population (20.05%) as compared to females (17.32%). The prevalence of metabolic syndrome among NAFLD and control groups were 42.74% and 17.91% respectively.Conclusions: Present study has shown moderate prevalence of NAFLD and metabolic syndrome among the rural population of western Uttar Pradesh with a more male predisposition.

Prevalence of hypertension in rural population of Central India

Background: Hypertension is an important public health problem in both rural and urban areas of economically developed as well as developing nations. It is a chronic medical condition and is one of the most common life threatening non-communicable disease. It is an asymptomatic condition, symptoms do not arise unless the complications develop which result in delayed diagnosis and treatment especially among the uneducated and unexplained social groups such as rural population. Present study was an attempt to provide data on hypertension in rural area of central India. The objective of present study was to estimate the prevalence of hypertension in rural population above 18 years of age in Etawah and neighbouring districts of Uttar Pradesh, India.Methods: The study was planned to determine the prevalence of hypertension in rural community by health camp and door to door approach. BP measurements were made after the subject had rested for at least 5 minutes in a seated position using mercury sphygmomanometer. The first blood pressure measurement was taken after obtaining socio-demographic information from the study subject, while the second was recorded after 5 minutes.Results: The prevalence of hypertension was found to be 17%, which was observed to be higher among female i.e. 170 (18.3%) individuals than males 153 (15.8%) individuals. The prevalence of hypertension was observed to be higher among the older individuals. It was found to be 5.26 times higher in older (>50 years) than the younger (<30 years) age group. We found prehypertension in 65.74%, Stage I hypertension in 11.33% and stage II hypertension in 5.69% individuals.Conclusions: Present study showed that high prevalence of hypertension in rural area of Western Uttar Pradesh, Central India

Clinico-radiological profile of abdominal tuberculosis in HIV/AIDS patients-a study from rural central India

Background: One of the major challenge of present era is dual epidemic of HIV/AIDS and tuberculosis. With immunosuppression, risk of opportunistic diseases increases in these patients and tuberculosis is most common opportunistic infection. The prevalence of abdominal tuberculosis seems to be rising, particularly due to increasing prevalence of HIV infection. The diagnosis of abdominal tuberculosis can often be difficult and it remains underdiagnosed, in view of its nonspecific manifestations. The investigations involved in its diagnosis are expensive and time consuming, however, ultrasonography (USG) is an affordable, non-invasive and widely available modality which can be of help in the diagnosis of abdominal tuberculosis. Therefore, this study was undertaken to evaluate clinical and USG finding among Abdominal Tuberculosis patients with HIV/AIDS.Methods: After informed consent, patients underwent thorough history taking and clinical examination followed by high quality USG abdomen and other biochemical and haematological tests including CD4 count. Follow up USG abdomen was done at time of completion of course of ATT and data was analysed.Results: 45 were found to have abdominal tuberculosis. Of these patients, 31(68.9%) were male and 14 (31.1%) were female. Mean age of HIV-abdominal TB was 34.27±9.66 years. most common symptoms were weight loss 41(91.1%), loss of appetite 38(84.4%), fever       32(71.1%), generalized weakness 30(66.7%) and abdominal pain 27(60.0%). On USG abdomen, intraabdominal lymphadenopathy was most common finding found in 44(97.8%). Average size of enlarged lymph node was 3.1+-1.0 cm. Mesenteric lymphnodes were enlarge in 40(88.89%), paraaortic 8(17.78%), retroperitoneal 4(8.89%) while peripancreatic and porta hepatic in 3(6.67%). splenomegaly was noted in 14(31.1%) cases. Hepatomegaly was found in 6 cases, who all were male. Ascites was evident in 5(11.1%) patients. Extensive involvement, defined as involvement of two or more intraabdominal sites, was found 24(53.3%) cases. There was no statistically significant difference found among these USG findings and CD4 count.Conclusions: The findings of lymphadenopathy (size&gt;15mm) and hypoechoic/necrotic echotexture, hepatosplenomegaly with hypoechoic lesions in ultrasonography are suggestive of abdominal tuberculosis in HIV infected patients with unexplained nonspecific symptoms and low CD4 count.  However, above findings are not standardized and inability to confirm the diagnosis of tuberculosis by direct microscopy and culture is the limitation of this study. Ultrasonography is an affordable, widely available, non-invasive imaging modality which may be optimally utilized for the diagnosis of abdominal tuberculosis in HIV infected patients, especially in the rural setup where microbiological and other sophisticated radiological investigations have limited availability