Dietary Practices Among Type 2 Diabetes Patients Visiting a Non-communicable Disease (NCD) Clinic in a District of Western India: A Cross-Sectional Study

BACKGROUND AND AIMS: Diabetes is becoming a major public health problem in the country. One of the most important lifestyle modifications necessary for diabetic patients is maintaining healthy dietary choices. These modifications in dietary practices are supposed to be followed lifelong, along with medication, for better glycemic control. Despite understanding the importance of dietary control and physical activity in the management of diabetes, adherence to these practices is poor. This study aimed to assess the dietary practices of type 2 diabetes mellitus (T2DM) patients and various factors that determine adherence to these healthy dietary practices. The secondary objective was to find the perceptions of participants about the role of diet in controlling diabetes and to find the perception-practice gap among study participants. METHODOLOGY: It was a hospital-based cross-sectional study conducted among 450 T2DM patients visiting the non-communicable disease (NCD) clinics of tertiary care hospitals and community health centres (CHCs) of the study district. Dietary practice was assessed using a modified UK Diabetes and Diet Questionnaire (UKDDQ), considering the food patterns in the study area. Statistical tests like chi-square and ordinal logistic regression were applied using Jamovi software for univariate and multivariate analyses. RESULTS: The healthiest food choices were abstinence from alcohol consumption (100%), avoiding processed meat (92.21%), high-fibre breakfast (70.4%), and daily consumption of vegetables (68.2%). Improper dietary practices were regular sugary drinks (38%) and high-glycemic-index food items (22.4%). The mean (SD) of the composite score was 68.02 (8.7) and the median score (interquartile range (IQR)) was 69 (60-76). Tertile analysis of the composite score revealed that with the increase in age, patients were less likely to be in the intermediate or upper tertile score (β = -0.0219, p = 0.016). Being female (odds ratio (OR) =0.603, CI: 0.395-0.917, p = 0.019) and living in a three-generation family made the patients less likely to be in the upper tertile score. CONCLUSION: Nearly half of the participants had an overall healthy score. Dietary practices were healthy among the participants of lower ages, males, and those living in nuclear and joint families. The highest perception-practice gap was seen for fruit and rice consumption

Problems faced by ASHA workers for malarial services under NVBDCP: a cross sectional study

Background: About 95% of the country’s population resides in malaria endemic areas. The NVBDCP is multi-faceted public health programme in the country. The NVBDCP became an integral part of the NRHM launched in 2005. In NRHM, ASHA worker should be placed at grass root level. So role of ASHA is critical at grass root level. Problems faced by ASHA, it will affect the performance. So, ASHA workers positioned at village, Population catered by them, education, work experience, problems related to incentive and any other problems should be considered. The primary objective was to know the problems faced by ASHA workers for malarial services under NVBDCP in Jamnagar district.Methods: A cross-sectional study was conducted in rural areas of the district by using multistage sampling.Results: There was vacant post of ASHA in one village of low performing sub-centre. ASHA having work experience of less than one year was concentrated in poor performing sub-centre villages. More than one third ASHA served > 2000 population and more than half of them belonged to low performing sub centres. Around one sixth ASHA workers had difficulty in getting incentive or any problems. Majority of them belonged to low performing sub centres-villages.Conclusions: Main identified problems were some areas were far to reach by them, getting incentive for work and populations catered by them were too high. Most of them belonged to low performing sub centre-villages. All of above findings had affected the performance of ASHA workers.

An assessment of sociodemographic factors and family planning practices in Jamnagar, Gujarat, India: a cross sectional study

Background: India was the first country in the world to launch a National Family Planning Programme in 1952. It was purely a demographic programme with the sole objective of reducing the birth rate to stabilize the population. As per 2011 census population increased with the growth rate of 17.7%. Thus even after 63 years of programme & many more new advances & updates in programme, India could not reach its target of at least 60% of couple protection rate. So there would be some definite factors prohibiting its use.Methods: A cross section study of 450 reproductive age group women was conducted to find out the factors of unmet need of contraception & socio demographic profile.Results: In present study couple protection rate was 57.11%, majority being permanent sterilization. The selection of contraception was influenced by her husband in 43.24% & by mother-in-law in 62.16%.Conclusions: The study revealed that almost half of the couple population was using the contraception that included temporary as well as permanent methods of contraception

Assessment of ophthalmic morbidities in school children (6-14 years) in rural community

Background: School children are affected by various eye disorders like refractive errors, squint, Vitamin A deficiency and eye infections. Most of the ophthalmic morbidities originate in childhood and if they are not diagnosed early they may result in severe disabilities and affects children’s performance in the school. Objectives: To find out prevalence of various ophthalmic morbidities in the school children (6 – 14 years) and to study the socio demographic profile of school children (6 – 14 years) related to ophthalmic morbidities. Materials and Methods: A cross-sectional study was carried out on 500 school children in schools of Aliabada village, Jamnagar district. A Pretested semi-structured proforma was used to collect the information related to study and students were screened for eye disorders by visual acuity testing using snellen’s chart and colour blindness was checked by using Ishihara’s chart and torch light examination. Visual acuity was assessed. Data entry and analysis was done using Microsoft excel 2007 and Epi info. Results: The prevalence of ophthalmic morbidity was found to be 33%. Among the various ophthalmic morbidities, major were refractive errors i.e. 25.6% followed by Vit A deficiency in 8.6% cases and followed by squint 2.4% and various others. The study also found that social class and age were associated with ophthalmic morbidity. It is found statistically significant. Conclusions: Refractive error was the most common ophthalmic morbidity in the school children followed by Vit A deficiency, squint and various others. In the study we found that social class and age were significantly associated with ophthalmic morbidity

Knowledge, Attitude and Practice for Pruritus Management in Physicians and Patients with Diabetes

Pruritus is a common dermatological condition observed in patients with diabetes, making it a dermatometabolic condition. Being multiaethiological, pruritis is caused by autoimmune, genetic, infectious and various systemic diseases. The present survey aimed to understand the knowledge, attitude and practice toward pruritus among Indian physicians and patients with diabetes presenting with pruritus. A telephonic, cross-sectional, qualitative survey was conducted among physicians and patients across five cities in India from July–August 2020. An open-ended discussion guide was used for the interview; the data were analyzed to check for common themes and trends. A majority of the consulting physicians (CPs) believed that uncontrolled diabetes is the main causal factor for pruritus in patients with diabetes and reported that currently there are no standard tests or treatment guidelines for its management. CPs emphasized proper monitoring and counseling to overcome current challenges. Patients reported a negative impact of pruritus on their daily activities and quality of life. The survey concluded that poor management of diabetes is one of the main causal factors for patients with diabetes presenting with pruritus in India. CPs emphasized controlling diabetes along with symptomatic treatment. For patients, pruritus has multifaceted effects on their health, overall well-being, and quality of life

An assessment of maternal morbidity pattern among reproductive age group women in a district of West Gujarat: A community based cross sectional study

Introduction: For each maternal mortality, there are number of various morbidities, which directly or indirectly affects health of women. For every woman who dies of pregnancy-related causes, an estimated 20 women experience acute or chronic morbidity, often with tragic consequences. Objectives: To assess maternal morbidity pattern, prevalence of maternal morbidity & its associated factors. Material and Methods: A community based cross- sectional study was conducted among 450 women of reproductive age group women of Jamnagar district. Study subjects were selected by multistage sampling. Data collected in proforma consist of sociodemographic profile, past obstetric profile & any antenatal, Intranatal, & postnatal morbidities. Results: Prevalence of maternal morbidity was about 80% with, highest morbidity found during antenatal period in 36% subjects, followed by 26% in postnatal period. There were also associated medical problems during pregnancy. Conclusion: There is 80% prevalence of morbidity related to pregnancy which adds on to ill health of women. It was also observed that statistical significance between few of the important variables like educational status, parity & place of delivery, which could be independent risk factors & occurrence of maternal morbidity

Hemangioma of rib : a different perspective

Background: Hemangiomas are one of the common primary benign tumors of the intraosseous and soft tissue compartments in humans. Vertebral hemangiomas being the most common of all are seen in daily radiological practice. Hemangioma of the rib is rarely seen. Case Report: We reported on a case of a rib lesion which had a classic imaging pattern of hemangioma. We highlighted the use of pre-operative embolization of such a vascular rib lesion before surgically removing the lesion by thoracotomy to reduce the risk of bleeding. Conclusions: We also emphasized overt complications of overzealous needling of such a vascular lesion for histopathological diagnosis as in our case