Distribution and Determinants of Body Mass Index of Non-smoking Adults in Delhi, India

Data on height and weight of 3,428 non-smoking healthy adult subjects, obtained during an earlier community-based study in Delhi, India, on chronic respiratory morbidity due to ambient air pollution was analyzed to study the distribution of body mass index (BMI) and its determinants among adults in Delhi. The sample was drawn by systematic sampling from rural and urban areas of Delhi. In urban areas, the sampling frame was restricted to areas around air quality-monitoring stations. However, the areas were spread across the city and reflected wide economic spectrum. Subjects were classified as underweight, normal, overweight, and obese as per the criteria of the World Health Organization for BMI. The mean BMI of the entire sample was 22.14 ±4.61. It was higher among females, urban residents, and the higher-income group. Overall, 49.7% of the 3,428 subjects had a normal nutritional status, 24.8% were underweight, 19.4% overweight, and 6.1% obese. The prevalence of underweight was higher in rural areas (38.5%) and among the lower-income group (39.9%), while overweight and obesity were more common in urban residents (22.7% and 7.5% respectively), among females (21.7% and 7.7%), and the higher-income group (31.8% and 11%) (p<0.05). The adjusted odds for underweight were 2.02 for rural subjects and 4.00 for the lower-income group. For overweight or obesity, odds were 5.6 for the higher-income group, 3.62 for urban residents, and 2.5 for females. It was concluded that problems of both underweight and overweight and obesity exist among the adults of Delhi. While females, residents of urban areas, and economically-better-off were more likely to be overweight or obese, residents of rural areas and those from lower-income groups were more likely to be underweight

Distribution and Determinants of Body Mass Index of Non-smoking Adults in Delhi, India

Data on height and weight of 3,428 non-smoking healthy adult subjects, obtained during an earlier community-based study in Delhi, India, on chronic respiratory morbidity due to ambient air pollution was analyzed to study the distribution of body mass index (BMI) and its determinants among adults in Delhi. The sample was drawn by systematic sampling from rural and urban areas of Delhi. In urban areas, the sampling frame was restricted to areas around air quality-monitoring stations. However, the areas were spread across the city and reflected wide economic spectrum. Subjects were classified as underweight, normal, overweight, and obese as per the criteria of the World Health Organization for BMI. The mean BMI of the entire sample was 22.14\ub14.61. It was higher among females, urban residents, and the higher-income group. Overall, 49.7% of the 3,428 subjects had a normal nutritional status, 24.8% were underweight, 19.4% overweight, and 6.1% obese. The prevalence of underweight was higher in rural areas (38.5%) and among the lower-income group (39.9%), while overweight and obesity were more common in urban residents (22.7% and 7.5% respectively), among females (21.7% and 7.7%), and the higher-income group (31.8% and 11%) (p&lt;0.05). The adjusted odds for underweight were 2.02 for rural subjects and 4.00 for the lower-income group. For overweight or obesity, odds were 5.6 for the higher-income group, 3.62 for urban residents, and 2.5 for females. It was concluded that problems of both underweight and overweight and obesity exist among the adults of Delhi. While females, residents of urban areas, and economically-better-off were more likely to be overweight or obese, residents of rural areas and those from lower-income groups were more likely to be underweight

Role of nutrition in pre-eclampsia and eclampsia cases, a case control study

Background: Preeclampsia and eclampsia during pregnancy contribute to maternal and fetal morbidity as well as mortality. The identification of the role of maternal nutrition during pregnancy will help in reducing morbidity and mortality.&nbsp;Aims &amp;&nbsp;Objective:&nbsp;The objective of this study is to find out the role of nutrition, in the form of total calorie, protein, fruits, iron, folic acid and calcium intake in the development of preeclampsia and eclampsia among pregnant women in a tertiary level hospital.&nbsp;Material Methods:&nbsp;After ethical approval and informed consent, 122 women who delivered beyond 22 weeks of gestation and diagnosed as preeclampsia or eclampsia were selected. Simultaneously, 122 controls with no diagnosis of preeclampsia or eclampsia were selected from the post natal ward. Cases and controls were administered the same pre-tested questionnaire containing questions related to food and micronutrient intake by cases and control.&nbsp;Results:&nbsp;Logistic regression was applied in the statistical analysis. The factors that were found to be significant predictors of risk for development of preeclampsia and eclampsia were higher calorie intake (adjusted Odds Ratio (OR) 14.12 [6.41-43.23] P &lt; 0.001), less protein intake (adjusted OR 3.87 [1.97-8.01] P &lt; 0.001) during pregnancy. Fruits intake in both cases and controls were similar. 77.9% of cases and 84.4% of controls had taken iron tablets during their antenatal period. 75.4% of cases and 82.8% of controls had taken calcium tablets during their antenatal period. Iron and calcium intake is not significantly associated with development of preeclampsia and eclampsia.&nbsp;Conclusion:&nbsp;Higher calorie intake and less protein intake during pregnancy were associated with development of preeclampsia and eclampsia. Fruits intake, iron and calcium intake were not associated with development of preeclampsia and eclampsi

To assess the prevalence and factors determining timely initiation of breastfeeding among the mothers in resettlement colony in Delhi

Background: The initiation of breastfeeding within 1 h of birth has various benefits and has been found to reduce neonatal mortality and morbidity. Objective: This study is designed to assess the prevalence and determinants of timely initiation of breastfeeding among mothers in a resettlement colony of Delhi. Materials and Methods: A community-based cross-sectional study was conducted in a resettlement colony of East Delhi among mothers with infants &lt;6 months of age. Mothers were enrolled from Anganwadi Centers using systematic random sampling, and a questionnaire was used to record information on feeding practices. Chi-square test and multiple logistic regression analysis were performed. Results: The prevalence of the initiation of breastfeeding within 1 h of birth was 51.7%. Using multiple logistic regression analysis, the factors which were found to be significantly associated were type of delivery (p&lt;0.005), place of delivery (p&lt;0.005), and advice on the initiation of breastfeeding at the time of delivery or postnatal period (p&lt;0.005). Conclusions: In this study, the prevalence of the initiation of breastfeeding is better than the national average. It was higher in children born in government health institutions. This study suggests that the importance of the early initiation of breastfeeding should be emphasized during antenatal care visits through trained skilled health professionals in public and private health sector

Maternal near miss: An indicator for maternal health and maternal care

Maternal mortality is one of the important indicators used for the measurement of maternal health. Although maternal mortality ratio remains high, maternal deaths in absolute numbers are rare in a community. To overcome this challenge, maternal near miss has been suggested as a compliment to maternal death. It is defined as pregnant or recently delivered woman who survived a complication during pregnancy, childbirth or 42 days after termination of pregnancy. So far various nomenclature and criteria have been used to identify maternal near-miss cases and there is lack of uniform criteria for identification of near miss. The World Health Organization recently published criteria based on markers of management and organ dysfunction, which would enable systematic data collection on near miss and development of summary estimates. The prevalence of near miss is higher in developing countries and causes are similar to those of maternal mortality namely hemorrhage, hypertensive disorders, sepsis and obstructed labor. Reviewing near miss cases provide significant information about the three delays in health seeking so that appropriate action is taken. It is useful in identifying health system failures and assessment of quality of maternal health-care. Certain maternal near miss indicators have been suggested to evaluate the quality of care. The near miss approach will be an important tool in evaluation and assessment of the newer strategies for improving maternal health

Prevalence of respiratory disease and associated factors in an urban area of Delhi

Objectives: To study the prevalence of respiratory morbidity and its associated factors in urban Delhi. Study Design and Setting: A cross-sectional, house-to-house survey was conducted in an urban upper middle class locality. Materials and Methods: All the residents aged 18 years or more were administered a questionnaire to identify the major symptoms of chronic respiratory tract disease - chronic cough, chronic phlegm, dyspnea and wheezing. The prevalence of all these symptoms in different groups was calculated. Chi square test and logistic regression were applied to determine the significant factors. Results: A total of 3465 individuals were interviewed of which 1756 (50.68&#x0025;) were males and 1709 (49.3&#x0025;) were females. Only 9.05&#x0025; of the men smoked. The overall prevalence of chronic cough, chronic phlegm and dyspnea was 2.0&#x0025;, 1.2&#x0025; and 3.4&#x0025;, respectively. The prevalence of wheezing was 3.2&#x0025;. All the symptoms increased with age ( P &lt; 0.05). No significant difference was observed in these symptoms between males and females. Less educated and retired individuals were more likely to have respiratory symptoms. The prevalence of chronic cough, chronic phlegm, dyspnea and wheezing was 5.8&#x0025;, 2.9&#x0025;, 9.9&#x0025; and 8.7&#x0025;, respectively, among smokers, which was significantly higher than that observed in nonsmokers. Logistic regression analysis revealed that age and smoking remained significant factors for occurrence of all the respiratory symptoms

Evaluation of quality of multivariable logistic regression in Indian medical journals using multilevel modeling approach

Background: Availability of user-friendly statistical software has increased the application of multivariable logistic regression (MLR) in the medical journal many fold. The reporting quality in terms of checking assumptions, model building strategies, proper coding, and report format need proper care and attention to communicate correct and reliable model results. Objective: The objective of this article is to evaluate the quality of MLR article based on 10-point well establish criteria and to study the factors that may influence the quality. Methods: Study included PubMed indexed Indian medical journals as on March 2010 and published at least ten original articles that applied MLR during 10 years was included in the study. Multilevel modeling was applied to assess the role of journal and article attributes on MLR quality. Results: Twelve out of 39 Indian PubMed indexed journals fulfilled the inclusion criterion. Of a total 5599 original articles in these journals, 262 (4.68%) applied MLR in their study. Conformity of linear gradient assumption for continuous covariate was the least fulfilled criterion. One-third of the MLR articles involved statistician or epidemiologist as co-author, and almost same number of MLR articles′ first author was from outside India. The trend of 10-point criteria remained consistent although the number of MLR articles increased over the period. The average quality score was 3.78 (95% confidence interval: 2.97-4.60) out of a possible 10. Larger sample size, involvement of statistician as co-author, non-Indian as the first author, and use of SAS/STATA software increased the quality of MLR articles. Conclusions: The quality of MLR articles in Indian medical journals is lagging behind as compared to the quality of MLR articles published from the United States and Europe medical journals. Joint effort of editors, reviewers, and authors are required to improve the quality of MLR in Indian journals so that the reader gets the correct results

Prevalence and predictors of risk factors for noncommunicable diseases among women in an Urbanized Village of India

Background: The burden of noncommunicable diseases (NCDs) and their risk factors among the underprivileged women of the urban areas are expected to increase. The objective of the study was to estimate the prevalence and sociodemographic predictors of these risk factors. Materials and Methods: A cross-sectional study was conducted among 370 women between 25 and 64 years in an urbanized village of India. Risk factors for NCDs were assessed using the WHO STEPS instrument. To determine the sociodemographic predictors of these risk factors binary logistic regression was used. Results: The prevalence of tobacco consumption, physical inactivity, and insufficient fruit and vegetable intake, overweight, and obesity was found to be 18.3%, 61.6%, 96.5%, 27.6%, and 5.9%, respectively. Raised blood pressure, blood glucose, and cholesterol were found to be present in 23%, 22%, and 42%, respectively. Older age was found to be a significant predictor of tobacco consumption, physical inactivity, raised blood pressure, and raised blood glucose. Conclusion: The current study reported a high prevalence of physical inactivity and insufficient fruit and vegetable intake, with age being a significant predictor of the majority of risk factors. Thus, arises the need for programs and policies tailored toward addressing the local needs, targeted toward older women

Antenatal care, care at birth, and breastfeeding during the Coronavirus (COVID-19) pandemic

Coronavirus (COVID-19) pandemic has been declared by the World Health Organization after it has gripped many countries of the world. The exponential increase in the number of cases has resulted in panic and confusion among healthcare workers and the vulnerable population. Pregnant and lactating mothers are a vulnerable group and need evidence-based advice to protect the health of the mother and the child. Healthcare workers can play an important role in dispelling the myths and misconceptions among pregnant and lactating mothers regarding COVID-19, if they are equipped with scientific information on antenatal care, care at birth, and breastfeeding. This review attempts to summarize the published evidence related to antenatal care, care at birth and breastfeeding during the COVID-19 pandemic