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Your search keyword '"Chythra R Rao"' showing total 26 results
Start Over Author "Chythra R Rao" Topic 03 medical and health sciences
26 results on '"Chythra R Rao"'

1. SMART STEP – SMARTphone-driven exercise and pedometer-based STEP intervention to promote physical activity among desk-based employees: Study protocol for a three-arm cluster randomized controlled trial

Author

Ashokan Arumugam, Fiddy Davis, Chythra R Rao, and Baskaran Chandrasekaran

Subjects
Adult, medicine.medical_specialty, Sports medicine, Population, Psychological intervention, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Intervention (counseling), Humans, Medicine, 030212 general & internal medicine, Effects of sleep deprivation on cognitive performance, Workplace, education, Exercise, Randomized Controlled Trials as Topic, Desk, education.field_of_study, business.industry, Rehabilitation, Public Health, Environmental and Occupational Health, 030229 sport sciences, Middle Aged, Actigraphy, Pedometer, Physical therapy, Smartphone, Sedentary Behavior, business
Abstract

BACKGROUND: Prolonged sitting in desk-based office workers is found to be associated with increased cardiometabolic risk and poor cognitive performance. Technology-based physical activity (PA) interventions using smartphone applications (SmPh app) to promote PA levels might be effective in reducing cardiometabolic risk among sedentary population but the evidence remains inconclusive. OBJECTIVE: The objective is to investigate the effects of a technology-based PA intervention compared to PA education with a worksite manual or no intervention on PA levels, cardiometabolic risk, cognitive performance, and work productivity among desk-based employees. METHOD: A three-arm clustered randomized trial will be conducted. The study will be conducted among various administrative offices of a multifaceted university in India. Desk-based employees aged between 30 and 50 years (n = 159; 53 in each arm) will be recruited. Employees from various constituent institutions (clusters) of the university will be randomized into one of the three following groups - SMART: SmPh app-driven break reminders (visual exercise prompts) plus pedometer-based step intervention, TRADE: worksite PA education with a manual plus American College of Sports Medicine guided PA prescription, or CONTROL: usual work group. At baseline and after the 1st, 3rd and 6th month of the trial period, accelerometer-measured sitting time and PA levels, cardiometabolic risk (fasting blood glucose, triglycerides, insulin, blood pressure, heart rate variability, functional capacity, and subcutaneous fat), cognitive performance (executive function), sickness absenteeism and work limitations will be assessed by a blinded assessor. Therapist delivering interventions will not be blinded. CONCLUSION: This trial will determine whether a combined SmPh-app and pedometer-based intervention is more effective than education or no intervention in altering PA levels, cardiometabolic risk and cognitive performance among desk-based employees in India. This study has the potential to foster institutional recommendations for using SmPh-based technology and pedometers to promote PA and reduce sedentary behavior at work.

Published
2021

2. Are free workplace health promotion apps adequately mapped with behavior change theories, techniques and desired features? A content analysis

Author

Poornima Panduranga Kundapur, Chythra R Rao, and Baskaran Chandrasekaran

Subjects
020205 medical informatics, Health Behavior, Applied psychology, Behavior change, Behavior change methods, Health Promotion, 02 engineering and technology, Sedentary behavior, Mobile Applications, 03 medical and health sciences, Behavioral Neuroscience, Social support, 0302 clinical medicine, Workplace health promotion, Behavior Therapy, Content analysis, Smartphone app, 0202 electrical engineering, electronic engineering, information engineering, Humans, 030212 general & internal medicine, Workplace, Psychology, Exercise, Goal setting, Applied Psychology
Abstract

Free smartphone applications that aim to promote physical activity or reduce sedentary behavior at workplaces were questioned for its content such as technical features, behavior change techniques (BCT) and security concerns. To evaluate systematically whether smartphone apps are mapped adequately with BCTs and security concerns. Free apps in Google Play store were searched and coded for BCTs systematically in July 2020. Two reviewers independently coded apps that aimed to promote physical activity (n = 18) and reduce sedentary behavior (n = 16) using a taxonomy of 26 BCTs. BCTs, features and security concerns among apps promoting physical activity and reducing sedentary behavior were analyzed. While the features (social support, gamification, or rewards) help increase physical activity and decrease sedentary behavior, the apps do not typically include the above features. Further, the apps were based on an average of 13 (4–21) BCTs. The BCTs coded most frequently were “self-monitoring” (100%), “general encouragement” (97%), and “goal setting” (n = 94%). No significant relation between user rating and BCTs was found in the apps. Majority of the free apps that aimed to increase physical activity or reduce sedentary behavior at workplaces were not adequately based on BCTs and lacked essential features facilitating long term behavior compliance at workplaces. Hence, there is a need to develop newer applications mapped adequately with BCTs, involving the collaborative work of behavioral scientists, app developers and policymakers. Clinical Trial Registry of India CTRI/2020/03/024138.

Published
2021

3. Is hackathon in oncology a plausible way to foster innovation? An experiential narrative account of conducting Hacking Cancer

Author

Arun Shanbhag, Shirley Lewis, Krishnananda Prabhu, Rangan Viveganandan, Chythra R Rao, Chiranjay Mukhopadhyay, Padmaja A. Shenoy, Naveen Salins, and Sharath K Rao

Subjects
Oncology, medicine.medical_specialty, 020205 medical informatics, business.industry, media_common.quotation_subject, Problem statement, Pharmacy, 02 engineering and technology, General Medicine, Creativity, Experiential learning, 03 medical and health sciences, 0302 clinical medicine, Seed money, Internal medicine, 0202 electrical engineering, electronic engineering, information engineering, medicine, Relevance (information retrieval), Narrative, 030212 general & internal medicine, Psychology, business, Hacker, media_common
Abstract

BackgroundHackathons are a popular trend in the technology domain and is considered a powerful tool to spur creativity and innovation. In a health hackathon, an interdisciplinary team of health, technology and management experts work collaboratively to solve a common problem. Health hackathon can be one of the quickest means to derive technology or process-based solutions to the challenges faced by clinicians.MethodsA 2-day hackathon: Hacking Cancer was conducted at a tertiary cancer centre in India to develop quick, cost-effective solutions in cancer care. Twelve oncology-related problem statements were explored. Undergraduate and postgraduate students of health and dental sciences, pharmacy, nursing, engineering and business management were the participants.OutcomesOne hundred and fifty-seven participants expressed interest, and 90 participated in the event. The participants did a time-bound exploration of 12 challenges in oncology elucidated problem statements. The oncology specialists mentored the participants during the hackathon. Seventeen teams presented their solutions. Judges reviewed the solutions and scored the teams based on feasibility, relevance and applicability. The top-scoring three projects were acute lymphoblastic leukaemia (ALL) better-improving adherence to treatment in ALL patients, Donate Life—application for voluntary blood donation and Lumiflex—a novel illuminated flexible abdominal retractor. They received seed funding to develop prototypes and implement their ideas.ConclusionHacking Cancer was an effective way of developing quick, cost-effective solutions to the common problems faced in cancer care. The pool of local participants developed solutions that were relevant and applicable to the practice setting. This one was the first oncology themed hackathon in the country.

Published
2020

4. Risk factors for gestational diabetes mellitus: A prospective case-control study from coastal Karnataka

Author

Chythra R Rao, Avinash Shetty, Asha Kamath, Sathisha Nayak, and Surabhi Mishra

Subjects
Microbiology (medical), medicine.medical_specialty, 030219 obstetrics & reproductive medicine, Epidemiology, Obstetrics, business.industry, Public health, Public Health, Environmental and Occupational Health, Case-control study, Physical activity, medicine.disease, Gestational diabetes, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Diabetes mellitus, medicine, Gestation, University medical, 030212 general & internal medicine, Family history, business
Abstract

Background Identification of gestational diabetes mellitus (GDM) risk factors is pertinent, for it can be an effective intervention for its prevention. As previous information regarding GDM risk factors from India were mostly descriptive and scarce from coastal Karnataka, a current prospective case-control study was designed to identify GDM risk factors among pregnant women seeking antenatal care. Methods A hospital-based prospective matched case–control study was carried among antenatal subjects seeking routine antenatal care at two secondary-level care private hospitals, affiliated to a University Medical College in coastal Karnataka. It comprised of 100 incident GDM cases and 273 frequency-matched controls. Data was collected by personal interviews using a pretested questionnaire. Data was entered and analyzed using Statistical Package for Social Sciences(SPSS), version 15.0. Results Risk factors using Carpenter and Coustan criteria and DIPSI criteria were found similar. Pooled data identified following significant GDM risk factors: marital age (25–29 years)(adjusted OR:18.2; 95% CI:1.9–177.6; p=0.012), delayed menarche (adjusted OR:11.4; 95% CI:1.1–124.6; p=0.045), multiparity (adjusted OR:14.1; 95% CI:1.8–109.8; p=0.011), family history of DM (adjusted OR:66.6; 95% CI:6.9–645.2; p Conclusions Modifiable risk factors identified were low physical activity, high antenatal perceived stress, multiparity, marital age ≥25 years, and low pre-pregnancy intake of GLV, which were also comparable using two criteria in vogue for GDM diagnosis. Pre-conception advice on healthy lifestyle may prove beneficial.

Published
2020

5. Global, regional, and national burden of stroke and its risk factors, 1990–2019 : a systematic analysis for the Global Burden of Disease Study 2019

Author

Mosiur Rahman, Rehab Salah, Mario F P Peres, Licia Iacoviello, Benjamin A Stark, Mahalaqua Nazli Khatib, Amir Radfar, Kamarul Imran Musa, Yannick Béjot, Deanna Anderlini, Carlos Cantú-Brito, Feng Sha, V. E. Nwatah, Pradip Gyanwali, Boris Bikbov, Bartosz Miazgowski, Sindhura Lakshmi Koulmane Laxminarayana, Ali Bijani, Imteyaz A Khan, Yaser Mokhayeri, Bogdan Oancea, Tarang Parekh, Martin Dichgans, Linh Gia Vu, Naohiro Yonemoto, Ahmad Ghashghaee, Marcos Roberto Tovani-Palone, Gebiyaw Wudie Tsegaye, Mona Pathak, Maciej Banach, Marissa B Reitsma, Derrick A Bennett, Treska S Hassan, Allen Seylani, Gdiom Gebreheat Abady, Islam Y. Elgendy, Hassan Mehmood Lak, Ismael R. Campos-Nonato, Sorin Hostiuc, Sheikh Mohammed Shariful Islam, Alessandra C. Goulart, Silvia Schiavolin, Simona Sacco, Atif Amin Baig, Azeem Majeed, Sahar Eftekharzadeh, Badr Hasan Sobaih, Archith Boloor, Aimé Bonny, Graeme J. Hankey, Jiregna Darega Gela, Mohamed I Hegazy, Pedram Keshavarz, Segun Emmanuel Ibitoye, Maseer Khan, Hatem Abdelaziz Mohamed Wafa, Hualiang Lin, Enayet Karim Chowdhury, Simon I. Hay, Vanessa De la Cruz-Góngora, Xuefeng Liu, Arokiasamy Perianayagam, Maryam Zamanian, Sezer Kisa, Preetam Bhalchandra Mahajan, Junmei Miao Jonasson, Alberto Raggi, Shubha Jayaram, Tahira Ashraf, Ejaz Ahmad Khan, Matthias Endres, Masoumeh Sadeghi, Dominique Vervoort, Hanadi Al Hamad, Mowafa Househ, Elena V. Gnedovskaya, Johan Ärnlöv, Andrea Sylvia Winkler, Yousef Khader, Mikhail Sergeevich Zastrozhin, Yuming Guo, Yunquan Zhang, Sami Almustanyir, Lalit Dandona, Amir Masoud Rahmani, Chythra R Rao, Giancarlo Lucchetti, Irena Ilic, Suzanne Barker-Collo, Priya Rathi, Emerito Jose A. Faraon, Mohamad-Hani Temsah, Reza Ghanei Gheshlagh, Gyu Ri Kim, Carlos A Castañeda-Orjuela, Alaa Makki, Yun Jin Kim, Vida Abedi, Shanshan Li, Kewal Krishan, David Flood, Abdollah Mohammadian-Hafshejani, Michele Romoli, Gregory A. Roth, Jagdish Khubchandani, Isabela M. Benseñor, Rupak Desai, Mohammed Shannawaz, Aziz Sheikh, Claudiu Herteliu, Xiaoyue Xu, Santi Martini, Kenji Shibuya, Jasvinder A. Singh, Ravi Prakash Jha, Kairat Davletov, Mahya Beheshti, Rahmatollah Moradzadeh, Ismaeel Yunusa, Maria Inês Schmidt, Koustuv Dalal, Sohail Ahmad, Patrick D. M. C. Katoto, Oladimeji Adebayo, Nima Hafezi-Nejad, Ranil Jayawardena, Giampiero Mazzaglia, Mitra Abbasifard, Usman Iqbal, Hamid Yimam Hassen, Alireza Rafiei, Catherine O. Johnson, Mark Thomaz Ugliara Barone, Simona Giampaoli, Gaetano Isola, Ricardo Lutzky Saute, Mandira Lamichhane Dhimal, Vishnu Renjith, Farshad Farzadfar, Irina Filip, Daniel Diaz, André Karch, Samer Hamidi, Diego Augusto Santos Silva, David Colozza, Gbenga A. Kayode, Dinh-Toi Chu, Truong-Minh Pham, Arielle Wilder Bell, Aziz Rezapour, David Laith Rawaf, Anasthasia Zastrozhina, Yves Miel H Zuniga, Ivo Iavicoli, Adrian Pana, Salman Rawaf, Pankaj Bhardwaj, Omid Dadras, Anayat Ullah, Gina Agarwal, Shafiu Mohammed, Bing-Fang Hwang, Eyayou Girma Tadesse, Charles D.A. Wolfe, Sanjay Basu, Michael Brauer, Tanuj Kanchan, Ahmad Azam Malik, Brigid Unim, Min Seo Kim, Kia Vosoughi, Tomasz Miazgowski, Warren D. Lo, Vivek Podder, Dana Bryazka, Chuanhua Yu, Hassan Magdy Abd El Razek, Rufus Akinyemi, Zhi-Jiang Zhang, Ettore Beghi, Xiaochen Dai, Meghnath Dhimal, Mehrnoosh Samaei, Sathish Kumar Jayapal, Bay Vo, Amanual Getnet Mersha, Rajaa Al-Raddadi, Savita Lasrado, Jalal Arabloo, Pablo M. Lavados, Samaneh Akbarpour, Khezar Hayat, Ritesh G. Menezes, Vahid Alipour, Sowmya J. Rao, Mariam Molokhia, Trang Huyen Nguyen, Aletta E. Schutte, Zahra Kamiab, Lidia Morawska, Mohammad Ali Moni, Bo Norrving, Tommi Vasankari, Bruno Ramos Nascimento, Ai Koyanagi, Tissa Wijeratne, Rizwan Kalani, Chenwen Zhong, Bright Opoku Ahinkorah, Sepideh Ahmadi, Bruce Bartholow Duncan, Andrzej Rynkiewicz, Pradyumna Agasthi, Saeed Shahabi, Adnan Kisa, Fares Alahdab, Vafa Rahimi-Movaghar, Adnan Ansar, Matilde Leonardi, Ali Koolivand, Jefferson Antonio Buendia Rodriguez, Leonardo Roever, Daniel Asfaw Erku, Alok Atreya, Jean Jacques Noubiap, Dhaval Kolte, Shajedur Rahman Shawon, Michael Ekholuenetale, Navid Manafi, Narayanaswamy Venketasubramanian, Syed Amir Gilani, Mohamed M. Gad, Christopher J L Murray, Louis Jacob, Robert Ancuceanu, Simona Costanzo, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Nazanin Rajai, Muhammed Elhadi, Abdelrahman Ibrahim Abushouk, Alireza Zandifar, Walter Muruet, Jagadish Rao Padubidri, Promit Ananyo Chakraborty, Hans Orru, Mikk Jürisson, Rajeev Gupta, Kurnia Dwi Artanti, Till Bärnighausen, Mark Woodward, Masao Iwagami, Brijesh Sathian, Bingyu Li, Vijay Krishnamoorthy, Ahamarshan Jayaraman Nagarajan, Sherief Ghozy, Amanda G. Thrift, Michael A. Piradov, Florian Fischer, Mayowa O. Owolabi, Lorenzo G. Mantovani, Aman Yesuf Endries, Sara Sheikhbahaei, Stefan Lorkowski, Muhammed Shahriar Zaman, Ali Yadollahpour, Abdiwahab Hashi, Sreenivas Narasimha Swamy, Krittika Bhattacharyya, Hiroshi Yatsuya, Mika Kivimäki, Olayinka Stephen Ilesanmi, Irmina Maria Michalek, Ruxandra Irina Negoi, Alberico L. Catapano, Gholamreza Bazmandegan, Ahmed Al Montasir, Fakher Rahim, Amirhossein Sahebkar, Syed Mohamed Aljunid, Giang Thu Vu, G Anil Kumar, Juan Jesus Carrero, Hiroyasu Iso, Abdallah M. Samy, Stefan Stortecky, Reza Malekzadeh, Ashwin Kamath, Nevine El Nahas, Ayesha Humayun, Miguel A Barboza, Sheng-Chia Chung, Carlo La Vecchia, Oluwakemi Ololade Odukoya, Rita Krishnamurthi, Masood Ali Shaikh, Milena Ilic, Lalit Yadav, Nahlah Elkudssiah Ismail, Abdel Douiri, Yousef Mohammad, Jason H Y Wu, Sahar Saeedi Moghaddam, Ramesh Holla, Sadaf G. Sepanlou, Itamar S. Santos, Jost B. Jonas, Dian Kusuma, Atte Meretoja, Yasir Waheed, Ben Lacey, Zahra Aryan, Mulugeta Molla Birhanu, Moien Ab Khan, K. M. Saif-Ur-Rahman, Ramin Zand, Anna Aleksandrovna Skryabina, Sung In Jang, Rakhi Dandona, Emanuele D'Amico, Priyanga Ranasinghe, Jaykaran Charan, Bhaskaran Unnikrishnan, Davide Sattin, Akram Pourshams, Markus P. Schlaich, Arief Hargono, Samaneh Asgari, Ovidiu Baltatu, Ippazio Cosimo Antonazzo, Sandhya Neupane Kandel, Nizal Sarrafzadegan, Jakub Morze, Man Mohan Mehndiratta, Manjari Tripathi, Panniyammakal Jeemon, Rohollah Kalhor, Yogeshwar Kalkonde, Soraya Siabani, Sojib Bin Zaman, Seyed Sina Naghibi Irvani, Shilpa Gaidhane, Sahel Valadan Tahbaz, Yihienew Mequanint Bezabih, Samath D Dharmaratne, Ingan Ukur Tarigan, Vivek Gupta, Klara Dokova, Alireza Vakilian, Vardhmaan Jain, Akshaya Srikanth Bhagavathula, Sarah Wulf Hanson, Umar Farooque, Mohammad Ali Mansournia, Vera Marisa Costa, Alessandro Gialluisi, Valery L. Feigin, Himal Kandel, Suzanne Polinder, Nermin Ghith, Deepak Dhamnetiya, Michael H. Criqui, Asif Hanif, Ahmed Abualhasan, Veer Bala Gupta, Mahaveer Golechha, Bach Xuan Tran, Jason A. Anderson, Catherine Bisignano, Kazumasa Yamagishi, Zahid A Butt, Budi Aji, Baye Dagnew, Rasmus Havmoeller, Victor Volovici, Jitendra Singh, Paramjit Gill, Saverio Stranges, Eun Cheol Park, Andrew T Olagunju, Milena Santric-Milicevic, Woldesellassie M. Bezabhe, Sheikh M. Alif, Junjie Huang, Foad Abd-Allah, Yvonne Teuschl, Rajkumar Doshi, Nelson Alvis-Guzman, Marcel Ausloos, Mohsen Naghavi, Yusra Ahmed Salih, Mohsen Abbasi-Kangevari, Maarten J. Postma, Ghozali Ghozali, Yanzhong Wang, Ali H. Mokdad, Valentin Yurievich Skryabin, Nitin Joseph, Andre M. N. Renzaho, Muhammad Aziz Rahman, Mohammad Athar, Rustam Al-Shahi Salman, Albertino Damasceno, Fatemeh Pashazadeh Kan, Marcello Tonelli, Florentino Luciano Caetano dos Santos, Sonali G. Choudhari, Abdullah Hamid Feroze, Walter D. Johnson, Ro-Ting Lin, Francesca Giulia Magnani, Hermann Brenner, Shaimaa I. El-Jaafary, Tea Lallukka, Niveen M E Abu-Rmeileh, Jacek Jerzy Jozwiak, GBD 2019 Stroke Collaborators, Feigin, V. L., Stark, B. A., Johnson, C. O., Roth, G. A., Bisignano, C., Abady, G. G., Abbasifard, M., Abbasi-Kangevari, M., Abd-Allah, F., Abedi, V., Abualhasan, A., Abu-Rmeileh, N. M. E., Abushouk, A. I., Adebayo, O. M., Agarwal, G., Agasthi, P., Ahinkorah, B. O., Ahmad, S., Ahmadi, S., Salih, Y. A., Aji, B., Akbarpour, S., Akinyemi, R. O., Al Hamad, H., Alahdab, F., Alif, S. M., Alipour, V., Aljunid, S. M., Almustanyir, S., Al-Raddadi, R. M., Salman, R. A. -S., Alvis-Guzman, N., Ancuceanu, R., Anderlini, D., Anderson, J. A., Ansar, A., Antonazzo, I. C., Arabloo, J., Arnlov, J., Artanti, K. D., Aryan, Z., Asgari, S., Ashraf, T., Athar, M., Atreya, A., Ausloos, M., Baig, A. A., Baltatu, O. C., Banach, M., Barboza, M. A., Barker-Collo, S. L., Barnighausen, T. W., Barone, M. T. U., Basu, S., Bazmandegan, G., Beghi, E., Beheshti, M., Bejot, Y., Bell, A. W., Bennett, D. A., Bensenor, I. M., Bezabhe, W. M., Bezabih, Y. M., Bhagavathula, A. S., Bhardwaj, P., Bhattacharyya, K., Bijani, A., Bikbov, B., Birhanu, M. M., Boloor, A., Bonny, A., Brauer, M., Brenner, H., Bryazka, D., Butt, Z. A., Dos Santos, F. L. C., Campos-Nonato, I. R., Cantu-Brito, C., Carrero, J. J., Castaneda-Orjuela, C. A., Catapano, A. L., Chakraborty, P. A., Charan, J., Choudhari, S. G., Chowdhury, E. K., Chu, D. -T., Chung, S. -C., Colozza, D., Costa, V. M., Costanzo, S., Criqui, M. H., Dadras, O., Dagnew, B., Dai, X., Dalal, K., Damasceno, A. A. M., D'Amico, E., Dandona, L., Dandona, R., Gela, J. D., Davletov, K., De La Cruz-Gongora, V., Desai, R., Dhamnetiya, D., Dharmaratne, S. D., Dhimal, M. L., Dhimal, M., Diaz, D., Dichgans, M., Dokova, K., Doshi, R., Douiri, A., Duncan, B. B., Eftekharzadeh, S., Ekholuenetale, M., El Nahas, N., Elgendy, I. Y., Elhadi, M., El-Jaafary, S. I., Endres, M., Endries, A. Y., Erku, D. A., Faraon, E. J. A., Farooque, U., Farzadfar, F., Feroze, A. H., Filip, I., Fischer, F., Flood, D., Gad, M. M., Gaidhane, S., Gheshlagh, R. G., Ghashghaee, A., Ghith, N., Ghozali, G., Ghozy, S., Gialluisi, A., Giampaoli, S., Gilani, S. A., Gill, P. S., Gnedovskaya, E. V., Golechha, M., Goulart, A. C., Guo, Y., Gupta, R., Gupta, V. B., Gupta, V. K., Gyanwali, P., Hafezi-Nejad, N., Hamidi, S., Hanif, A., Hankey, G. J., Hargono, A., Hashi, A., Hassan, T. S., Hassen, H. Y., Havmoeller, R. J., Hay, S. I., Hayat, K., Hegazy, M. I., Herteliu, C., Holla, R., Hostiuc, S., Househ, M., Huang, J., Humayun, A., Hwang, B. -F., Iacoviello, L., Iavicoli, I., Ibitoye, S. E., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Iqbal, U., Irvani, S. S. N., Islam, S. M. S., Ismail, N. E., Iso, H., Isola, G., Iwagami, M., Jacob, L., Jain, V., Jang, S. -I., Jayapal, S. K., Jayaram, S., Jayawardena, R., Jeemon, P., Jha, R. P., Johnson, W. D., Jonas, J. B., Joseph, N., Jozwiak, J. J., Jurisson, M., Kalani, R., Kalhor, R., Kalkonde, Y., Kamath, A., Kamiab, Z., Kanchan, T., Kandel, H., Karch, A., Katoto, P. D. M. C., Kayode, G. A., Keshavarz, P., Khader, Y. S., Khan, E. A., Khan, I. A., Khan, M., Khan, M. A. B., Khatib, M. N., Khubchandani, J., Kim, G. R., Kim, M. S., Kim, Y. J., Kisa, A., Kisa, S., Kivimaki, M., Kolte, D., Koolivand, A., Laxminarayana, S. L. K., Koyanagi, A., Krishan, K., Krishnamoorthy, V., Krishnamurthi, R. V., Kumar, G. A., Kusuma, D., Vecchia, C. L., Lacey, B., Lak, H. M., Lallukka, T., Lasrado, S., Lavados, P. M., Leonardi, M., Li, B., Li, S., Lin, H., Lin, R. -T., Liu, X., Lo, W. D., Lorkowski, S., Lucchetti, G., Saute, R. L., Abd El Razek, H. M., Magnani, F. G., Mahajan, P. B., Majeed, A., Makki, A., Malekzadeh, R., Malik, A. A., Manafi, N., Mansournia, M. A., Mantovani, L. G., Martini, S., Mazzaglia, G., Mehndiratta, M. M., Menezes, R. G., Meretoja, A., Mersha, A. G., Jonasson, J. M., Miazgowski, B., Miazgowski, T., Michalek, I. M., Mirrakhimov, E. M., Mohammad, Y., Mohammadian-Hafshejani, A., Mohammed, S., Mokdad, A. H., Mokhayeri, Y., Molokhia, M., Moni, M. A., Al Montasir, A., Moradzadeh, R., Morawska, L., Morze, J., Muruet, W., Musa, K. I., Nagarajan, A. J., Naghavi, M., Swamy, S. N., Nascimento, B. R., Negoi, R. I., Kandel, S. N., Nguyen, T. H., Norrving, B., Noubiap, J. J., Nwatah, V. E., Oancea, B., Odukoya, O. O., Olagunju, A. T., Orru, H., Owolabi, M. O., Padubidri, J. R., Pana, A., Parekh, T., Park, E. -C., Kan, F. P., Pathak, M., Peres, M. F. P., Perianayagam, A., Pham, T. -M., Piradov, M. A., Podder, V., Polinder, S., Postma, M. J., Pourshams, A., Radfar, A., Rafiei, A., Raggi, A., Rahim, F., Rahimi-Movaghar, V., Rahman, M., Rahman, M. A., Rahmani, A. M., Rajai, N., Ranasinghe, P., Rao, C. R., Rao, S. J., Rathi, P., Rawaf, D. L., Rawaf, S., Reitsma, M. B., Renjith, V., Renzaho, A. M. N., Rezapour, A., Rodriguez, J. A. B., Roever, L., Romoli, M., Rynkiewicz, A., Sacco, S., Sadeghi, M., Moghaddam, S. S., Sahebkar, A., Saif-Ur-Rahman, K. M., Salah, R., Samaei, M., Samy, A. M., Santos, I. S., Santric-Milicevic, M. M., Sarrafzadegan, N., Sathian, B., Sattin, D., Schiavolin, S., Schlaich, M. P., Schmidt, M. I., Schutte, A. E., Sepanlou, S. G., Seylani, A., Sha, F., Shahabi, S., Shaikh, M. A., Shannawaz, M., Shawon, Md. S. R., Sheikh, A., Sheikhbahaei, S., Shibuya, K., Siabani, S., Silva, D. A. S., Singh, J. A., Singh, J. K., Skryabin, V. Y., Skryabina, A. A., Sobaih, B. H., Stortecky, S., Stranges, S., Tadesse, E. G., Tarigan, I. U., Temsah, M. -H., Teuschl, Y., Thrift, A. G., Tonelli, M., Tovani-Palone, M. R., Tran, B. X., Tripathi, M., Tsegaye, G. W., Ullah, A., Unim, B., Unnikrishnan, B., Vakilian, A., Tahbaz, S. V., Vasankari, T. J., Venketasubramanian, N., Vervoort, D., Vo, B., Volovici, V., Vosoughi, K., Vu, G. T., Vu, L. G., Wafa, H. A., Waheed, Y., Wang, Y., Wijeratne, T., Winkler, A. S., Wolfe, C. D. A., Woodward, M., Wu, J. H., Hanson, S. W., Xu, X., Yadav, L., Yadollahpour, A., Jabbari, S. H. Y., Yamagishi, K., Yatsuya, H., Yonemoto, N., Yu, C., Yunusa, I., Zaman, M. S., Zaman, S. B., Zamanian, M., Zand, R., Zandifar, A., Zastrozhin, M. S., Zastrozhina, A., Zhang, Y., Zhang, Z. -J., Zhong, C., Zuniga, Y. M. H., Murray, C. J. 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Yonemoto, N, Yu, C, Yunusa, I, Zaman, M, Zaman, S, Zamanian, M, Zand, R, Zandifar, A, Zastrozhin, M, Zastrozhina, A, Zhang, Y, Zhang, Z, Zhong, C, Zuniga, Y, Murray, C, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Microbes in Health and Disease (MHD)

Subjects
Male, Aging, 030204 cardiovascular system & hematology, Stroke data, GUIDELINES, 3124 Neurology and psychiatry, Body Mass Index, Global Burden of Disease, 0302 clinical medicine, RA0421, Risk Factors, Epidemiology, Strokes, YOUNG-ADULTS, Prevalence, 80 and over, Aetiology, 610 Medicine & health, Stroke, POPULATION, 1103 Clinical Sciences, 1109 Neurosciences, Cause of death, Aged, 80 and over, education.field_of_study, Mortality rate, Incidence (epidemiology), Incidence, 1. No poverty, Articles, Hälsovetenskaper, Middle Aged, Stroke types, ddc, 3. Good health, ISCHEMIC-STROKE, Income, Female, Quality-Adjusted Life Years, Life Sciences & Biomedicine, Adult, medicine.medical_specialty, GBD, Population, Clinical Sciences, Clinical Neurology, 03 medical and health sciences, Clinical Research, MIDDLE-INCOME COUNTRIES, Health Sciences, medicine, Humans, Risk factor, education, GBD 2019 Stroke Collaborators, Cerebral Hemorrhage, Aged, Ischemic Stroke, Global burden, Science & Technology, Neurology & Neurosurgery, HYPERTENSION, business.industry, MORTALITY, Prevention, 3112 Neurosciences, Neurosciences, 1103 Clinical Sciences, SERVICES, Subarachnoid Hemorrhage, medicine.disease, PREVENTION, Brain Disorders, Good Health and Well Being, Attributable risk, Human medicine, Neurology (clinical), Neurosciences & Neurology, business, 1109 Neurosciences, 030217 neurology & neurosurgery, Demography, 2.4 Surveillance and distribution, RC
Abstract

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. Funding Bill & Melinda Gates Foundation.

Published
2021

6. Life-cycle approach for prevention of gestational diabetes mellitus

Author

Ajeet Singh Bhadoria, Surabhi Mishra, Chythra R Rao, Aparna Sen Chaudhary, Surekha Kishore, and Soumya S. Mohanty

Subjects
Microbiology (medical), American diabetes association, Pediatrics, medicine.medical_specialty, Pregnancy, 030219 obstetrics & reproductive medicine, endocrine system diseases, Referral, Epidemiology, business.industry, Incidence (epidemiology), Public Health, Environmental and Occupational Health, Psychological intervention, nutritional and metabolic diseases, Postpartum diabetes, medicine.disease, Gestational diabetes, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Diabetes mellitus, medicine, 030212 general & internal medicine, business
Abstract

Problem considered Despite enough evidence available supporting temporal relation between gestational diabetes mellitus (GDM) and overt DM, former has earned less attention while managing current diabetes epidemic. This calls for a community-based ‘Life-cycle approach' that could employ mutually-linked interventions specific to GDM prevention at various stages of life cycle by utilizing involving already existing Indian health system. Methods Freely accessible, full-text articles published between 1990 and 2018, available in PubMed and Google Scholar in English language, pertaining to GDM risk factors and its preventive strategies were reviewed using combination of medical subject headings (MeSH) and keywords. Results GDM prevention begins right from pre-pregnancy phase. Adoption of a healthy lifestyle, mass awareness of risk factors, early identification and prompt referral are key to avert pre-GDM development. During pregnancy, government of India (GoI) mandates universal GDM screening for all Indian pregnant women, avoiding any undiagnosed/untreated GDM woman, thus preventing occurrence of complications including overt DM. Those screened GDM positive are more likely to develop overt DM throughout postpartum. During postpartum, American Diabetes Association (ADA) recommends postpartum diabetes screening for all women with GDM, by employing two h 75 g oral glucose tolerance test (OGTT) and HbA1C prior to and beyond three months postpartum, respectively. Conclusions Promotion and practice of life-cycle approach would be key to curb overall diabetes incidence.

Published
2019

7. Cognitive Dysfunction Among Adults With Type 2 Diabetes Mellitus in Karnataka, India

Author

Chythra R Rao, Henry Seow Ern Lee, Devesh Bhaskar Yerrapragada, and Kavinya Karunakaran

Subjects
medicine.medical_specialty, Cross-sectional study, business.industry, Type 2 Diabetes Mellitus, Montreal Cognitive Assessment, General Medicine, Type 2 diabetes, Anthropometry, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Blood pressure, Diabetes mellitus, Internal medicine, medicine, Dementia, 030212 general & internal medicine, business, 030217 neurology & neurosurgery, Original Research
Abstract

Background: Type 2 diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia that affects various body systems. Elevated blood glucose levels cause brain malfunction, sorbitol-induced blood vessel damage, and degeneration of the nerves that can lead to dementia or cognitive impairment. Cognitive impairment can result in nonadherence of patients to diabetes treatment, such as diet, medication, and exercise. Methods: We used a cross-sectional design to individually interview 194 patients with type 2 diabetes in a rural field practice area in India. A questionnaire was used to collect sociodemographic and diabetes disease characteristics; anthropometric measurements were also collected. Cognitive dysfunction was assessed with the Kannada version (local language) of the Montreal Cognitive Assessment (MoCA) tool. Blood pressure was measured for all subjects using a standardized sphygmomanometer on the right arm with the patient in a sitting position. Results: Among the 194 diabetic subjects interviewed, 98 (50.5%) were cognitively impaired. More than half of the subjects (56.2%) were ≥65 years, and female participants (53.6%) outnumbered males (46.4%). The majority of patients (62.4%) had had diabetes for

Published
2019

8. Does breaking up prolonged sitting improve cognitive functions in sedentary adults? A mapping review and hypothesis formulation on the potential physiological mechanisms

Author

Chythra R Rao, Ashokan Arumugam, Arto J. Pesola, and Baskaran Chandrasekaran

Subjects
Adult, lcsh:Diseases of the musculoskeletal system, Physiology, medicine.medical_treatment, Review, Sitting, Executive functions, 03 medical and health sciences, 0302 clinical medicine, Cognition, Rheumatology, Neurotrophic factors, Neuroplasticity, Medicine, Humans, Orthopedics and Sports Medicine, Effects of sleep deprivation on cognitive performance, Workplace, Exercise, Brain-derived neurotrophic factor, Rehabilitation, business.industry, 030229 sport sciences, Brain health, Standing Position, Cognitive function, lcsh:RC925-935, Sedentary Behavior, business, Neuroscience, 030217 neurology & neurosurgery
Abstract

Background Prolonged (excessive) sitting is detrimentally associated with cardiovascular, metabolic and mental health. Moreover, prolonged sitting has been associated with poor executive function, memory, attention and visuospatial skills, which are important cognitive aspects of work performance. Breaking up prolonged sitting with standing or light-intensity exercises at the workplace is recognized as a potential measure in improving cognition. However, preliminary evidence, primarily from acute laboratory experiments, has enabled formulating hypothesis on the possible mechanistic pathways. Hence, the aim of this mapping review is to gather preliminary evidence and substantiate possible physiological mechanisms underpinning the putative effects of breaking prolonged sitting on improving cognitive function among sedentary office workers. Mapping method We searched four databases to identify relevant studies that explored the effects of uninterrupted sitting on cognitive function. First, we introduce how prolonged sitting increases the risks of hyperglycemia, autonomic stability, inflammation, adverse hormonal changes and restrictions in cerebral blood flow (CBF) and alters cognitive function. Second, we elucidate the direct and indirect effects of breaking up prolonged sitting time that may prevent a decline in cognitive performance by influencing glycaemic variability, autonomic stability, hormones (brain derived neurotrophic factor, dopamine, serotonin), vascular functions, and CBF. We highlight the importance of breaking up prolonged sitting on metabolic, vascular and endocrine functions, which in turn may improve cognitive functions and eventually foster work productivity. Improved synaptic transmission or neuroplasticity due to increased brain glucose and mitochondrial metabolism, increased endothelial shear and CBF, increased brain neurotrophic factors (dopamine) and accelerated anti-inflammatory functions are some of the hypothetical mechanisms underpinning improved cognitive functions. Conclusion We postulate that improving cognitive function by breaking up prolonged sitting periods is biologically plausible with the myriad of (suggested) physiological mechanisms. Future experimental studies to ascertain the aforementioned hypothetical mechanisms and clinical trials to break sedentary behavior and improve cognitive functions in sedentary office workers are warranted.

Published
2021

9. Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990–2050

Author

Junaid Khan, Blake Angell, Marcel Ausloos, Catherine M. Antony, Elham Ehsani-Chimeh, Edgar Denova-Gutiérrez, Kewal Krishan, Mohamed Kamal Mesregah, Arrigo Francesco Giuseppe Cicero, Simona Cătălina Ştefan, Tanuj Kanchan, Maysaa El Sayed Zaki, Mohamed I Hegazy, Richard James Maude, Salman Rawaf, Viktória Szerencsés, Milena Santric-Milicevic, Martin McKee, Reza Rawassizadeh, Anton C Harle, Neda Milevska Kostova, Hamidreza Pazoki Toroudi, Saravanan Muthupandian, Mohammad Hifz Ur Rahman, Hassan Abolhassani, Christine Mpundu-Kaambwa, Atta Abbas Naqvi, John Dube, Habib Benzian, Cristiano Piccinelli, Kedir Hussein Abegaz, Mohammad Khammarnia, Carlo Eduardo Medina-Solís, Tanvir M. Huda, Fakher Rahim, Modhurima Moitra, Valentin Yurievich Skryabin, Emily Joy Callander, David Laith Rawaf, Saeed Shahabi, Mohsen Bayati, Raffaele Palladino, Shahin Soltani, Mohammad Ali Mansournia, Rafael Lozano, Himal Kandel, João Vasco Santos, MA Garcia-Gordillo, Savita Lasrado, Alexey V Breusov, Nicola Luigi Bragazzi, Deepak Dhamnetiya, Mohammad Amin Bahrami, Teroj Abdulrahman Mohamed, Reinhard Busse, Veer Bala Gupta, Ionut Negoi, Xiaochen Dai, Eun-Cheol Park, Trang Huyen Nguyen, Gulrez Shah Azhar, Annie Haakenstad, Asadollah Gholamian, Vafa Rahimi-Movaghar, Subramanian Senthilkumaran, Ismaeel Yunusa, Hubert Amu, G. K. Mini, Francesco Saverio Violante, Michael Abdelmasseh, Yun Jin Kim, Yousef Moradi, Nataliya Foigt, Afshin Maleki, Pavanchand H Shetty, Mesfin Agachew Woldekidan, Ramesh Holla, Mina Anjomshoa, Seyyed Meysam Mousavi, Azeem Majeed, Bright Opoku Ahinkorah, Hassan Magdy Abd El Razek, Avirup Guha, Telma Zahirian Moghadam, Olayinka Stephen Ilesanmi, Alessandro Arrigo, Neda Kianipour, Marcos Roberto Tovani-Palone, Mosiur Rahman, Tomas Y Ferede, Catalina Liliana Andrei, Alaa Makki, Joseph L Dieleman, Shuhei Nomura, Kanwar Hamza Shuja, Ileana Heredia-Pi, Mukhammad David Naimzada, Ali Kazemi Karyani, Chisom Joyqueenet Akunna, Souranshu Chatterjee, Yonas Akalu, Hanadi Al Hamad, Abdollah Mohammadian-Hafshejani, Hayley N Stutzman, Getinet Ayano, Atte Meretoja, Fahad Alanezi, Aravind Thavamani, Sonu Bhaskar, Claudiu Herteliu, Andreea Mirica, Masood Ali Shaikh, Soewarta Kosen, Nelson J. Alvis-Zakzuk, Emma Elizabeth Spurlock, Ferrán Catalá-López, Samath D Dharmaratne, Stany W. Lobo, Alemayehu Hailu, Sebastian Vollmer, Tarik Ahmed Rashid, Sheikh Mohammed Shariful Islam, Lalit Dandona, Farahnaz Joukar, Jacob Olusegun Olusanya, Befikadu Legesse Wubishet, Sezer Kisa, Songhomitra Panda-Jonas, Nasir Umar, Adrian Otoiu, Yonas Getaye Tefera, Harapan Harapan, Ivo Iavicoli, Jakub Morze, Mihajlo Jakovljevic, Nicholas J K Breitborde, Ian E Cogswell, Mehdi Hosseinzadeh, Sadia Bibi, Stefan Kohler, Florian Fischer, Jagdish Khubchandani, Justice Nonvignon, Salah Eddin Karimi, Yousef Khader, Jan-Walter De Neve, Stanislav S. Otstavnov, Ruoyan Tobe-Gai, Tommi Vasankari, Carlos A Castañeda-Orjuela, Nahlah Elkudssiah Ismail, Khezar Hayat, Chythra R Rao, Priya Rathi, Asma Tahir Awan, Jean Jacques Noubiap, Salime Goharinezhad, Ai Koyanagi, Rafael Tabarés-Seisdedos, Angela E Micah, Rakhi Dandona, Jaykaran Charan, Lorainne Tudor Car, Michael R.M. Abrigo, Kenji Shibuya, Aziz Sheikh, B Reshmi, Rovshan Khalilov, Haroon Ahmed, Andrea Werdecker, Alberto Freitas, Tara Ballav Adhikari, Vasily Vlassov, Risky Kusuma Hartono, Leila Keikavoosi-Arani, Gyu Ri Kim, Ana Laura Manda, Carlos Alberto Marrugo Arnedo, Obinna Onwujekwe, Van C. Lansingh, Miklós Szócska, Gelin Xu, Ted R. Miller, Saad M.A. Dahlawi, Till Bärnighausen, Jagadish Rao Padubidri, Bernhard T. Baune, Fatemeh Pashazadeh Kan, Juan Sanabria, Bruno Ramos Nascimento, Stefano Olgiati, Navid Rabiee, Mark G. Shrime, Mayowa O. Owolabi, V. E. Nwatah, Tesleem Kayode Babalola, Ranil Jayawardena, Robert Kaba Alhassan, Takeshi Fukumoto, Lucero Cahuana-Hurtado, Aparna Ichalangod Narayana, Mohammad Ali Sahraian, Atif Amin Baig, Carl Abelardo T. Antonio, Jost B. Jonas, Dian Kusuma, Priyanga Ranasinghe, Mikhail Sergeevich Zastrozhin, Ali Bijani, Arash Ziapour, Seyed Behzad Jazayeri, Francesco Sanmarchi, Seyed Sina Naghibi Irvani, Allen Seylani, Theo Vos, Tuomo J. Meretoja, Delia Hendrie, Mostafa Amini-Rarani, Manthan D Janodia, Sathish Kumar Jayapal, Sorin Hostiuc, Marjan Ajami, Ali Gholamrezanezhad, Muhammad Aqeel, Muhammed Magdy Abd El Razek, Shaun Wen Huey Lee, Rawlance Ndejjo, Maarten J. Postma, Luis Camera, Chhabi Lal Ranabhat, Sadaf G. Sepanlou, Adnan Kisa, Tahira Ashraf, Tudorel Andrei, Mohammad Ali Jahani, Virginia Bodolica, Chuanhua Yu, Moses K. Muriithi, Pascual R. Valdez, Paul S. F. Yip, Demetris Lamnisos, Amir Masoud Rahmani, Hamed Zandian, Anna Aleksandrovna Skryabina, Yeong Yeh Lee, Sana Salehi, Syed Mohamed Aljunid, Kyle E. Simpson, Sami Almustanyir Almustanyir, Bogdan Oancea, Biswa Prakash Nayak, Omid Dadras, Fariborz Mansour-Ghanaei, Turki Alanzi, Mahaveer Golechha, Bach Xuan Tran, Lal B. Rawal, Shoaib Hassan, Rahul R. Zende, Sandhya Neupane Kandel, Martin Amogre Ayanore, Adam E. 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Subjects
Economic growth, Financing, Government, International Cooperation, HN, HM, Global Health, Gross domestic product, International Agencies/economics, 0302 clinical medicine, RA0421, Per capita, Global health, Healthcare Financing, 11 Medical and Health Sciences, 2. Zero hunger, COVID 19, develompment assistance, health financing, projection 1995-250, INCOME, COVID-19, Development assistance, Health financing, COVID-19/economics, 1. No poverty, Public Health, Global Health, Social Medicine and Epidemiology, Articles, General Medicine, 3. Good health, Government Programs, Health Expenditures/statistics & numerical data, 030220 oncology & carcinogenesis, Transparency (graphic), QR180, Economic Development, International development, Life Sciences & Biomedicine, medicine.medical_specialty, Government Programs/economics, Gross Domestic Product, Context (language use), 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, medicine, Humans, Developing Countries/economics, Developing Countries, Government, Science & Technology, Public health, COVID-19, development assistance, global health, Global Burden of Disease 2020 Health Financing Collaborator Network, International Agencies, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Business, Global Health/economics, Health Expenditures, 030217 neurology & neurosurgery, RC, Financing, Government/economics
Abstract

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached $8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this, $13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and $1.4 billion was repurposed from existing health projects. $3.1 billion (22.4%) of the funds focused on country-level coordination and $2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34.3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. For complete list of authors see http://dx.doi.org/10.1016/S0140-6736(21)01258-7

Published
2021

10. Hearing loss prevalence and years lived with disability, 1990-2019: findings from the Global Burden of Disease Study 2019

Author

Rezaul Karim Ripon, Lydia M. Haile, Richard C. Franklin, Virginia Núñez-Samudio, Sonali G. Choudhari, Chythra R Rao, Maria Inês Schmidt, Jeff T. Zhao, Hanadi Al Hamad, Bing-Fang Hwang, Christopher R. Cederroth, Howard J. Hoffman, Naohiro Yonemoto, Rajaa Al-Raddadi, Avina Vongpradith, David Laith Rawaf, Valentin Yurievich Skryabin, Maja Pasovic, Ismail Tareque, Alessandra Lugo, Theo Vos, Rabia Hussain, Golnaz Heidari, Tarik A. Rashid, Ghozali Ghozali, Stephen S Lim, Bay Vo, Emma Elizabeth Spurlock, Himal Kandel, Jitendra Singh, Adrian Davis, Pankaj Bhardwaj, Houman Sotoudeh, Arif Mohammed, Rekha Thapar, Mohammad Rabiee, Florian Fischer, Deepika Singhal, Haroon Ahmed, Irina Filip, Michael Ekholuenetale, Amirhossein Sahebkar, Abdallah M. Samy, Fatemeh Pashazadeh Kan, Sathish Kumar Jayapal, Ionela-Roxana Glavan, Mikhail Sergeevich Zastrozhin, Bruce Bartholow Duncan, Aziz Rezapour, Jalal Arabloo, Sahel Valadan Tahbaz, Chuanhua Yu, Huong Lan Thi Nguyen, Vahid Rashedi, Shrikant Pawar, Shelly Chadha, Mahaveer Golechha, Bach Xuan Tran, Jaimie D Steinmetz, Deepak Dhamnetiya, Olayinka Stephen Ilesanmi, Masood Ali Shaikh, Charlie Ashbaugh, Stany W. Lobo, Akshaya Srikanth Bhagavathula, Biruk Wogayehu Taddele, Baye Dagnew, Walter Mendoza, Morteza Arab-Zozani, Turki Alanzi, Sandhya Neupane Kandel, Kebadnew Mulatu Mihretie, Zaheer-Ud-Din Babar, Jasvinder A. Singh, Veer Bala Gupta, Maheswar Satpathy, Ali H. Mokdad, Simon I. Hay, Sadia Bibi, Louis Jacob, Christopher J L Murray, Liaqat Ali, Keyvan Pakshir, Allen Seylani, Andre M. N. Renzaho, Eman Abu-Gharbieh, Till Bärnighausen, Segun Emmanuel Ibitoye, Voilet Rodrigues, Vahit Yigit, Mohammed Shannawaz, Mohammad Ali Moni, Ali Yadollahpour, Rose G Bender, Victor M. Oguoma, Rohollah Kalhor, Saif Ullah, Mohammad Zamani, Anna Aleksandrovna Skryabina, Mowafa Househ, Milena Santric-Milicevic, Juwel Rana, Fakher Rahim, Soraya Siabani, Mokhtar Mohammadi, Bolajoko O. Olusanya, Khezar Hayat, Teroj Abdulrahman Mohamed, Palash Chandra Banik, Nikha Bhardwaj, Brijesh Sathian, Fahad Alanezi, Jean Jacques Noubiap, Jagadish Rao Padubidri, Hans Orru, Nawzad K. Al-Salihi, Navid Rabiee, Xuefeng Liu, Iván Landires, Paul S Briant, Jost B. Jonas, Mayowa O. Owolabi, Zhi Jiang Zhang, Farhad Ghamari, Vahid Alipour, Sowmya J. Rao, Mehdi Hosseinzadeh, Desta Debalkie Atnafu, Lalit Dandona, Molly R Nixon, Rovshan Khalilov, Ai Koyanagi, Silvano Gallus, Saad M.A. Dahlawi, Salman Rawaf, Mohammad Abdollahi, Ted R. Miller, Masao Iwagami, Amanual Getnet Mersha, Savita Lasrado, Marcos Roberto Tovani-Palone, Umar Saeed, Fares Alahdab, Vafa Rahimi-Movaghar, Ivo Iavicoli, Yonas Akalu, Amir Masoud Rahmani, Kathleen Pillsbury Hopf, Assefa Desalew, Sheikh Mohammed Shariful Islam, Amare Belachew Dagnew, Ravi Prakash Jha, Jacob Olusegun Olusanya, Jingkai Wei, Mandira Lamichhane Dhimal, Kaloyan Kamenov, Anasthasia Zastrozhina, Samer Hamidi, Gbenga A. Kayode, Katrin Burkart, Anjali Singal, Shahina Pardhan, Rakhi Dandona, Jaykaran Charan, Akram Pourshams, Xiaochen Dai, Meghnath Dhimal, Kerrie E. Doyle, Seyed Sina Naghibi Irvani, Shilpa Gaidhane, Francesco Saverio Violante, Monika Sawhney, Animut Tagele Tamiru, Hai Quang Pham, Atif Amin Baig, Hubert Amu, Judie Arulappan, Ayele Semachew Kasa, Alaa Makki, Syed Amir Gilani, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Abhay Gaidhane, Birhanu Wubale Yirdaw, Ismaeel Yunusa, Ali Bijani, Billy Randall Hammond, Neeti Rustagi, Bogdan Oancea, Ahmad Ghashghaee, Amadou Barrow, Mosiur Rahman, Ashkan Afshin, Yigizie Yeshaw, Mahalaqua Nazli Khatib, Amir Radfar, Winfried Schlee, Andrew T Olagunju, Dinh-Toi Chu, Vasily Vlassov, Ejaz Ahmad Khan, Sanjeev Misra, Rosa A. S. Couto, Marina Pinheiro, Mohammad Hifz Ur Rahman, Amir Abdoli, Bárbara Niegia Garcia de Goulart, Wondimeneh Shibabaw Shiferaw, Seyed Hossein Yahyazadeh Jabbari, Aislyn U. Orji, Vivek Gupta, Giang Thu Vu, G Anil Kumar, Haile L.M., Kamenov K., Briant P.S., Orji A.U., Steinmetz J.D., Abdoli A., Abdollahi M., Abu-Gharbieh E., Afshin A., Ahmed H., Rashid T.A., Akalu Y., Alahdab F., Alanezi F.M., Alanzi T.M., Al Hamad H., Ali L., Alipour V., Al-Raddadi R.M., Amu H., Arabloo J., Arab-Zozani M., Arulappan J., Ashbaugh C., Atnafu D.D., Babar Z.-U.-D., Baig A.A., Banik P.C., Barnighausen T.W., Barrow A., Bender R.G., Bhagavathula A.S., Bhardwaj N., Bhardwaj P., Bibi S., Bijani A., Burkart K., Cederroth C.R., Charan J., Choudhari S.G., Chu D.-T., Couto R.A.S., Dagnew A.B., Dagnew B., Dahlawi S.M.A., Dai X., Dandona L., Dandona R., Desalew A., Dhamnetiya D., Dhimal M.L., Dhimal M., Doyle K.E., Duncan B.B., Ekholuenetale M., Filip I., Fischer F., Franklin R.C., Gaidhane A.M., Gaidhane S., Gallus S., Ghamari F., Ghashghaee A., Ghozali G., Gilani S.A., Glavan I.-R., Golechha M., Goulart B.N.G., Gupta V.B., Gupta V.K., Hamidi S., Hammond B.R., Hay S.I., Hayat K., Heidari G., Hoffman H.J., Hopf K.P., Hosseinzadeh M., Househ M., Hussain R., Hwang B.-F., Iavicoli I., Ibitoye S.E., Ilesanmi O.S., Irvani S.S.N., Islam S.M.S., Iwagami M., Jacob L., Jayapal S.K., Jha R.P., Jonas J.B., Kalhor R., Al-Salihi N.K., Kandel H., Kasa A.S., Kayode G.A., Khalilov R., Khan E.A., Khatib M.N., Kosen S., Koyanagi A., Kumar G.A., Landires I., Lasrado S., Lim S.S., Liu X., Lobo S.W., Lugo A., Makki A., Mendoza W., Mersha A.G., Mihretie K.M., Miller T.R., Misra S., Mohamed T.A., Mohammadi M., Mohammadian-Hafshejani A., Mohammed A., Mokdad A.H., Moni M.A., Kandel S.N., Nguyen H.L.T., Nixon M.R., Noubiap J.J., Nunez-Samudio V., Oancea B., Oguoma V.M., Olagunju A.T., Olusanya B.O., Olusanya J.O., Orru H., Owolabi M.O., Padubidri J.R., Pakshir K., Pardhan S., Kan F.P., Pasovic M., Pawar S., Pham H.Q., Pinheiro M., Pourshams A., Rabiee N., Rabiee M., Radfar A., Rahim F., Rahimi-Movaghar V., Ur Rahman M.H., Rahman M., Rahmani A.M., Rana J., Rao C.R., Rao S.J., Rashedi V., Rawaf D.L., Rawaf S., Renzaho A.M.N., Rezapour A., Ripon R.K., Rodrigues V., Rustagi N., Saeed U., Sahebkar A., Samy A.M., Santric-Milicevic M.M., Sathian B., Satpathy M., Sawhney M., Schlee W., Schmidt M.I., Seylani A., Shaikh M.A., Shannawaz M., Shiferaw W.S., Siabani S., Singal A., Singh J.A., Singh J.K., Singhal D., Skryabin V.Y., Skryabina A.A., Sotoudeh H., Spurlock E.E., Taddele B.W., Tamiru A.T., Tareque M.I., Thapar R., Tovani-Palone M.R., Tran B.X., Ullah S., Tahbaz S.V., Violante F.S., Vlassov V., Vo B., Vongpradith A., Vu G.T., Wei J., Yadollahpour A., Jabbari S.H.Y., Yeshaw Y., Yigit V., Yirdaw B.W., Yonemoto N., Yu C., Yunusa I., Zamani M., Zastrozhin M.S., Zastrozhina A., Zhang Z.-J., Zhao J.T., Murray C.J.L., Davis A.C., Vos T., Chadha S., Haile, Lydia M, Kamenov, Kaloyan, Briant, Paul Svitil, Orji, Aislyn U, Steinmetz, Jaimie D, Abdoli, Amir, Abdollahi, Mohammad, Abu-Gharbieh, Eman, Afshin, Ashkan, Ahmed, Haroon, Ahmed Rashid, Tarik, Akalu, Yona, Alahdab, Fare, Alanezi, Fahad Mashhour, Alanzi, Turki M, Al Hamad, Hanadi, Ali, Liaqat, Alipour, Vahid, Al-Raddadi, Rajaa M, Amu, Hubert, Arabloo, Jalal, Arab-Zozani, Morteza, Arulappan, Judie, Ashbaugh, Charlie, Atnafu, Desta Debalkie, Babar, Zaheer-Ud-Din, Baig, Atif Amin, Banik, Palash Chandra, Bärnighausen, Till Winfried, Barrow, Amadou, Bender, Rose G, Bhagavathula, Akshaya Srikanth, Bhardwaj, Nikha, Bhardwaj, Pankaj, Bibi, Sadia, Bijani, Ali, Burkart, Katrin, Cederroth, Christopher R, Charan, Jaykaran, Choudhari, Sonali Gajanan, Chu, Dinh-Toi, Couto, Rosa A S, Dagnew, Amare Belachew, Dagnew, Baye, Dahlawi, Saad M A, Dai, Xiaochen, Dandona, Lalit, Dandona, Rakhi, Desalew, Assefa, Dhamnetiya, Deepak, Dhimal, Mandira Lamichhane, Dhimal, Meghnath, Doyle, Kerrie E, Duncan, Bruce B, Ekholuenetale, Michael, Filip, Irina, Fischer, Florian, Franklin, Richard Charle, Gaidhane, Abhay Motiramji, Gaidhane, Shilpa, Gallus, Silvano, Ghamari, Farhad, Ghashghaee, Ahmad, Ghozali, Ghozali, Gilani, Syed Amir, Glavan, Ionela-Roxana, Golechha, Mahaveer, Goulart, Bárbara Niegia Garcia, Gupta, Veer Bala, Gupta, Vivek Kumar, Hamidi, Samer, Hammond, Billy Randall, Hay, Simon I, Hayat, Khezar, Heidari, Golnaz, Hoffman, Howard J, Hopf, Kathleen Pillsbury, Hosseinzadeh, Mehdi, Househ, Mowafa, Hussain, Rabia, Hwang, Bing-Fang, Iavicoli, Ivo, Ibitoye, Segun Emmanuel, Ilesanmi, Olayinka Stephen, Irvani, Seyed Sina Naghibi, Islam, Sheikh Mohammed Shariful, Iwagami, Masao, Jacob, Loui, Jayapal, Sathish Kumar, Jha, Ravi Prakash, Jonas, Jost B, Kalhor, Rohollah, Kameran Al-Salihi, Nawzad, Kandel, Himal, Kasa, Ayele Semachew, Kayode, Gbenga A, Khalilov, Rovshan, Khan, Ejaz Ahmad, Khatib, Mahalaqua Nazli, Kosen, Soewarta, Koyanagi, Ai, Kumar, G Anil, Landires, Iván, Lasrado, Savita, Lim, Stephen S, Liu, Xuefeng, Lobo, Stany W, Lugo, Alessandra, Makki, Alaa, Mendoza, Walter, Mersha, Amanual Getnet, Mihretie, Kebadnew Mulatu, Miller, Ted R, Misra, Sanjeev, Mohamed, Teroj Abdulrahman, Mohammadi, Mokhtar, Mohammadian-Hafshejani, Abdollah, Mohammed, Arif, Mokdad, Ali H, Moni, Mohammad Ali, Neupane Kandel, Sandhya, Nguyen, Huong Lan Thi, Nixon, Molly R, Noubiap, Jean Jacque, Nuñez-Samudio, Virginia, Oancea, Bogdan, Oguoma, Victor Maduabuchi, Olagunju, Andrew T, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Orru, Han, Owolabi, Mayowa O, Padubidri, Jagadish Rao, Pakshir, Keyvan, Pardhan, Shahina, Pashazadeh Kan, Fatemeh, Pasovic, Maja, Pawar, Shrikant, Pham, Hai Quang, Pinheiro, Marina, Pourshams, Akram, Rabiee, Navid, Rabiee, Mohammad, Radfar, Amir, Rahim, Fakher, Rahimi-Movaghar, Vafa, Rahman, Mohammad Hifz Ur, Rahman, Mosiur, Rahmani, Amir Masoud, Rana, Juwel, Rao, Chythra R, Rao, Sowmya J, Rashedi, Vahid, Rawaf, David Laith, Rawaf, Salman, Renzaho, Andre M N, Rezapour, Aziz, Ripon, Rezaul Karim, Rodrigues, Voilet, Rustagi, Neeti, Saeed, Umar, Sahebkar, Amirhossein, Samy, Abdallah M, Santric-Milicevic, Milena M, Sathian, Brijesh, Satpathy, Maheswar, Sawhney, Monika, Schlee, Winfried, Schmidt, Maria Inê, Seylani, Allen, Shaikh, Masood Ali, Shannawaz, Mohammed, Shiferaw, Wondimeneh Shibabaw, Siabani, Soraya, Singal, Anjali, Singh, Jasvinder A, Singh, Jitendra Kumar, Singhal, Deepika, Skryabin, Valentin Yurievich, Skryabina, Anna Aleksandrovna, Sotoudeh, Houman, Spurlock, Emma Elizabeth, Taddele, Biruk Wogayehu, Tamiru, Animut Tagele, Tareque, Md Ismail, Thapar, Rekha, Tovani-Palone, Marcos Roberto, Tran, Bach Xuan, Ullah, Saif, Valadan Tahbaz, Sahel, Violante, Francesco S, Vlassov, Vasily, Vo, Bay, Vongpradith, Avina, Vu, Giang Thu, Wei, Jingkai, Yadollahpour, Ali, Yahyazadeh Jabbari, Seyed Hossein, Yeshaw, Yigizie, Yigit, Vahit, Yirdaw, Birhanu Wubale, Yonemoto, Naohiro, Yu, Chuanhua, Yunusa, Ismaeel, Zamani, Mohammad, Zastrozhin, Mikhail Sergeevich, Zastrozhina, Anasthasia, Zhang, Zhi-Jiang, Zhao, Jeff T, Murray, Christopher J L, Davis, Adrian C, Vos, Theo, and Chadha, Shelly

Subjects
Hearing aid, Male, Hearing loss, medicine.medical_treatment, Psychological intervention, 030204 cardiovascular system & hematology, Affect (psychology), Health Services Accessibility, Global Burden of Disease, 03 medical and health sciences, Tinnitus, Medicine, General & Internal, 0302 clinical medicine, Neonatal Screening, Hearing Aids, Acquired immunodeficiency syndrome (AIDS), Hearing, General & Internal Medicine, Health care, otorhinolaryngologic diseases, Prevalence, Medicine, Humans, Age Factor, Disabled Persons, 030212 general & internal medicine, Hearing Loss, Hearing Lo, 11 Medical and Health Sciences, Science & Technology, business.industry, Infant, Newborn, Age Factors, Infant, GBD 2019 Hearing Loss Collaborators, General Medicine, Articles, medicine.disease, Otitis, Hearing Aid, Cytomegalovirus Infections, Disabled Person, Female, medicine.symptom, business, Life Sciences & Biomedicine, Human, Demography
Abstract

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods: We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings: An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation: As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings. Funding: Bill & Melinda Gates Foundation and WHO.

Published
2020

11. Annual cost incurred for the management of type 2 diabetes mellitus—a community-based study from coastal Karnataka

Author

Asha Kamath, Chythra R Rao, Veena G Kamath, and Eshwari K

Subjects
business.industry, Total cost, Endocrinology, Diabetes and Metabolism, Type 2 Diabetes Mellitus, 030209 endocrinology & metabolism, Family income, Health administration, Stratified sampling, 03 medical and health sciences, Indirect costs, 0302 clinical medicine, Environmental health, Health care, Internal Medicine, population characteristics, Medicine, 030212 general & internal medicine, Disease management (health), business, health care economics and organizations
Abstract

Diabetes is projected to become one of the world’s main disabler and killer within the next 25 years. Type 2 diabetes mellitus (T2DM) due to its chronicity and incident complications is not only consuming patient’s household budget but also the overall healthcare budget. To estimate the annual cost incurred and proportion of family income spent for management of T2DM in the community, a community-based cross-sectional study was conducted among T2DM patients aged ≥ 40 years residing in the field practice area of a Medical College in Karnataka. A total of 809 subjects were included using stratified random sampling with proportionate sample technique. A pretested questionnaire was used to assess direct and indirect costs incurred for disease management in the last 1 year. Data was entered and analyzed using SPSS version 15.0. The annual median (IQR) total cost incurred for the management of diabetes mellitus was estimated to be USD 73.2 which included direct cost of USD 62.2 (27.9–138.2) and indirect cost of USD 6.7 (2.2–22.6). The direct medical cost included USD 5.2 (

Published
2018

12. Goiter Prevalence and Interrelated Components from Coastal Karnataka

Author

Sravan Kumar Reddy T, Chythra R Rao, Avinash Shetty, Vibha Sp, and Asha Kamath

Subjects
Male, medicine.medical_specialty, Goiter, United Nations, Prevalence, India, Nutritional Status, chemistry.chemical_element, 030209 endocrinology & metabolism, Urine, Sodium Chloride, World Health Organization, Iodine, 03 medical and health sciences, Iodine value, 0302 clinical medicine, Environmental health, medicine, Humans, 030212 general & internal medicine, Sodium Chloride, Dietary, Child, Schools, business.industry, Incidence (epidemiology), Public health, medicine.disease, Iodine deficiency, Cross-Sectional Studies, chemistry, Pediatrics, Perinatology and Child Health, Female, business
Abstract

To assess prevalence of goiter and associated factors among school going children in Udupi district. A school based cross-sectional survey was conducted among 6–12 year old children. A sample of 30 villages was selected from the entire district by probability proportionate to size. One school was then randomly selected from each of the 30 villages. Goiter was assessed clinically and was graded as per the recommended criteria of World Health Organization (WHO)/ United Nations Children’s Fund (UNICEF)/ International Council for the Control of Iodine Deficiency Disorders (ICCIDD). Salt and urine samples were collected from a subsample for iodine estimation. A total of 2703 children were examined. The mean (±SD) age of the participants was 9.6 y (±1.9). The overall prevalence of goiter in Udupi district was found to be 9.3% with 7.0% and 2.3% having grade 1 and grade 2 goiter respectively. Prevalence of goiter was significantly higher among females [153(11.1%)] as compared to males [98(7.4%)] (p = 0.001). Of the 543 salt samples analyzed, 379 (69.8%) salt samples had adequate salt iodine content (> 15 ppm); while among the children with goiter 32 (8.4%) had inadequate salt iodine. Median iodine value was 202.12 mcg/l among the 270 urine samples tested for iodine levels. Goiter prevalence at 9.3% in the coastal district contributes to the endemicity of the public health problem. The district had adequate iodine nutrition based on median urinary iodine levels. Hence, other contributing factors for the persistence of endemic goiter need to be explored.

Published
2018

13. Cross-sectional analysis of obesity and high blood pressure among undergraduate students of a university medical college in South India

Author

Sravan Kumar Chenji, Veena G Kamath, Chythra R Rao, Asha Kamath, and Saranya Sivanesan

Subjects
obesity, Cross-sectional study, body mass index, medical students, Overweight, 030226 pharmacology & pharmacy, Prehypertension, 03 medical and health sciences, 0302 clinical medicine, High blood pressure, Diabetes mellitus, Medicine, overweight, 030212 general & internal medicine, Medical education, lcsh:R5-920, business.industry, Public Health, Environmental and Occupational Health, medicine.disease, Obesity, Blood pressure, Underweight, medicine.symptom, Family Practice, business, lcsh:Medicine (General), Body mass index, Demography
Abstract

Objective To estimate the prevalence of obesity and high blood pressure among undergraduate students of a university medical college. Methods A cross-sectional study was conducted at a medical college among 434 medical students. A questionnaire was used to collect basic demographic details, followed by anthropometric measurements. Body mass index (BMI) was classified according to the World Health Organization classification. Blood pressure was measured with a standard mercury sphygmomanometer and classified according to the seventh report of the Joint National Committee (JNC VII) on prevention, detection, evaluation, and treatment of high blood pressure. Data were entered into and analyzed with SPSS version 15.0. Results Nearly 65.0% of students had normal BMI, 9.9% were underweight, 17.9% were overweight, and 7.6% were obese. Obesity was more prevalent among males than among females on the basis of anthropometric variables such as BMI, waist-hip ratio, and waist-stature ratio, and this difference was found to be statistically significant. Blood pressure was in the normal range among 55.0% of the students, 36.6% had blood pressure in the prehypertensive range, 7.6% had blood pressure in the stage 1 category of the JNC VII criteria, and 0.5% had blood pressure in the stage 2 category of the JNC VII criteria. Among the students who had blood pressure greater than 140/90 mm Hg, 63.0% were males and 37.0% were females, and this difference was statistically significant. Conclusion The prevalence of obesity was 7.6% and that of high blood pressure was 8.1% among the medical students, which were higher than those reported in the literature for the same age group and warrant further evaluation. Statement of Significance Non-communicable diseases have been described as the modern epidemic of the current era. A retrograde age shift is being noted in the prevalence of diseases such as diabetes mellitus, hypertension, and obesity, which is alarming. Young adults are at an increased risk of developing these diseases because of indulgence in faulty lifestyle practices. The present study attempted to quantify the risk among medical students. The prevalence of obesity was 7.6% and that of high blood pressure was 8.1% among the medical students, which were higher than those reported in the literature for the same age group. Future medical professionals need to be aware of their own risk factors and take proactive steps before advising and encouraging their patients to adopt healthy lifestyles.

Published
2018

14. Assessment of risk factors and predictors for spontaneous pre-term birth in a South Indian antenatal cohort

Author

Chythra R Rao, Dinesh M Nayak, Veena G Kamath, Shashikala Bhat, Revathi P Shenoy, KE Vandana, Parvati Bhat, and Asha Kamath

Subjects
Microbiology (medical), Pregnancy, medicine.medical_specialty, Pediatrics, 030219 obstetrics & reproductive medicine, Epidemiology, Obstetrics, business.industry, Incidence (epidemiology), Public Health, Environmental and Occupational Health, Oligohydramnios, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Cohort, medicine, Term Birth, Gestation, 030212 general & internal medicine, Prospective cohort study, business, Cohort study
Abstract

Objective To assess incidence of spontaneous preterm births and determine biochemical and obstetric risk factors for spontaneous pre-term births in a cohort of antenatal women visiting a secondary care hospital. Methods A prospective cohort study was designed to include 1420 pregnant women coming for antenatal care at a secondary care hospital. The cohort was followed throughout pregnancy and relevant history, obstetric and ultrasonographic examination and biochemical investigations was carried out in 2nd (20-24 weeks period of gestation) and 3rd trimester (28-32 weeks period of gestation). Outcome of delivery was noted for all the subjects. Results A total of 1133 women were recruited. Among the 1071 respondents, 11 had abortions, 93.1% delivered at term while 5.9% had preterm deliveries. Preterm deliveries were noted among 6.5% women with short stature, 13.3% with cervical length Conclusions The incidence of preterm births (5.9%) was low in the present cohort. Oligohydramnios and Intrauterine Growth Retardation (IUGR) were identified as significant risk factors for preterm births. Conventional risk factors like short cervix, short stature and biochemical inflammatory markers were not identified as predictors of prematurity. Lower levels of salivary estriol identified among women at risk of preterm births demonstrates the utility of the test as a non-invasive investigation for early identification of preterm births.

Published
2018

15. Effect of maternal perceived stress during pregnancy on gestational diabetes mellitus risk: A prospective case-control study

Author

Avinash Shetty, Surabhi Mishra, Chythra R Rao, Asha Kamath, and Sathisha Nayak

Subjects
Adult, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Perceived Stress Scale, India, 030209 endocrinology & metabolism, Odds, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Risk Factors, Diabetes mellitus, Stress (linguistics), Internal Medicine, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Obstetrics, business.industry, Public health, Case-control study, Prenatal Care, General Medicine, medicine.disease, Prognosis, Gestational diabetes, Diabetes, Gestational, Case-Control Studies, Female, Pregnant Women, business, Stress, Psychological, Follow-Up Studies
Abstract

A variety of risk factors have been reported for the development of gestational diabetes mellitus (GDM). But limited review on the role of antenatal perceived stress necessitated the design of the present study to evaluate the association between GDM and perceived stress during pregnancy.A prospective case-control study was carried out among 100 GDM cases and 273 matched controls, attending regular antenatal clinic at two private hospitals of Karnataka. Data was collected by personal interviews using a standard questionnaire. Perceived stress was assessed using the Cohen 10-item Perceived Stress Scale. Score of ≥20 was identified as high stress. Statistical Package for the Social Sciences version 15 was used for analysis.Exposure rates for high maternal perceived stress among cases during pregnancy were noted. The odds of GDM were 13 folds higher among those with high antenatal stress (≥20) compared to those with low (20) (p 0.001) perceived stress. No correlation between maternal antenatal stress and blood glucose following OGTT was noted.The study identified high perceived stress during pregnancy as a potential risk factor for GDM.

Published
2019

16. Risk Factors for Preterm Birth and Low Birth Weight Among Pregnant Indian Women: A Hospital-based Prospective Study

Author

Asha Kamath, Sathisha Nayak, Chythra R Rao, Chaitanya Tellapragada, Shashidhar Acharya, Shashikala Bhat, Parvati Bhat, Chiranjay Mukhopadhyay, and Vandana Kalwaje Eshwara

Subjects
Adult, Gestational hypertension, medicine.medical_specialty, Bacteriuria, India, lcsh:Medicine, Oligohydramnios, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Asian People, Pregnancy, Risk Factors, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Periodontitis, Premature birth, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics, lcsh:Public aspects of medicine, lcsh:R, Infant, Newborn, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Hypertension, Pregnancy-Induced, Infant, Low Birth Weight, Bacterial vaginosis, medicine.disease, Intermediate vaginal flora, Body Height, Hospitals, Confidence interval, Gestational diabetes, Diabetes, Gestational, Low birth weight, Relative risk, Population study, Original Article, Female, medicine.symptom, business
Abstract

Objectives: The present study was undertaken to study the maternal risk factors for preterm birth (PTB) and low birth weight (LBW) with a special emphasis on assessing the proportions of maternal genitourinary and periodontal infections among Indian women and their association with adverse pregnancy outcomes. Methods: A hospital-based prospective study comprising 790 pregnant women visiting the obstetrics clinic for a routine antenatal check-up was undertaken. Once recruited, all study participants underwent clinical and microbiological investigations for genitourinary infections followed by a dental check-up for the presence of periodontitis. The study participants were followed up until their delivery to record the pregnancy outcomes. Infectious and non-infectious risk factors for PTB and LBW were assessed using univariate and multivariate Cox regression analysis. Independent risk factors for PTB and LBW were reported in terms of adjusted relative risk (ARR) with the 95% confidence interval (CI). Results: Rates of PTB and LBW in the study population were 7.6% and 11.4%, respectively. Previous preterm delivery (ARR, 5.37; 95% CI, 1.5 to 19.1), periodontitis (ARR, 2.39; 95% CI, 1.1 to 4.9), Oligohydramnios (ARR, 5.23; 95% CI, 2.4 to 11.5), presence of Nugent’s intermediate vaginal flora (ARR, 2.75; 95% CI, 1.4 to 5.1), gestational diabetes mellitus (ARR, 2.91; 95% CI, 1.0 to 8.3), and maternal height

Published
2016

17. Reproductive Health Issues—Who to Discuss With? A Qualitative Study to Address Unmet Needs of Adolescent Boys

Author

Asha Hegde, Lena Ashok, Chythra R Rao, K Roy, Asha Kamath, and Veena G Kamath

Subjects
medicine.medical_specialty, Sociology and Political Science, Social work, business.industry, Public health, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), medicine, Premarital sex, Pornography, 030212 general & internal medicine, business, Social policy, Clinical psychology, Qualitative research, Reproductive health
Abstract

In India, less research has been dedicated to reproductive health needs of boys as compared to girls. Various sociocultural aspects hinder the caregiving process towards adolescent boys. Our aim was to assess the views and perceptions of adolescent boys and their caregivers about reproductive health (RH) for adolescent boys. This qualitative study was conducted in rural urban settings of an entire Taluk (sub-district). It examined the perception and expectations of RH and the services that would cater their unmet needs. The perceptions of parents, teachers and clinicians who interacted with adolescent boys were also taken in to account. RH issues of boys were considered to be completely neglected by all caregivers. The boys felt ‘only girls have all sort of facilities and help’. Masturbation and wet dreams were considered as ‘problems’. Pornography and Internet influenced young minds negatively. Awareness about HIV/AIDS and premarital sex were good among the boys. Boys stressed on ‘counselling’ and ‘online services’ that would help them to discuss their RH issues with experts. Parents and teachers highlighted the importance of ‘sex education’. Doctors mentioned the problems they face to address the boys in community settings. It could be concluded that RH aspects of adolescent boys need further research.

Published
2016

18. A comparative study of Michel's medium versus honey as a transport medium for skin specimens prior to direct immunofluorescence microscopy and antigen mapping

Author

Chythra R Rao, Subraminiam Kumudhini, Sathish Pai, and Raghavendra Rao

Subjects
Pathology, medicine.medical_specialty, Histology, Biopsy, Group ii, Dermatology, Pathology and Forensic Medicine, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Basement membrane zone, Antigen, Transport medium, Microscopy, Pemphigoid, Bullous, medicine, Humans, Direct fluorescent antibody, Skin, medicine.diagnostic_test, business.industry, Biological Transport, Honey, Microscopy, Fluorescence, 030220 oncology & carcinogenesis, Skin biopsy, business
Abstract

Background: Michel's medium (MM) is currently the recommended transport medium for skin biopsy specimens prior to direct immunofluorescence (DIF) microscopy. Objective: To compare the utility of honey with that of MM as a transport medium for skin biopsy specimens used for DIF and antigen mapping. Methods: Group I consisted of 45 freshly-taken skin specimens earmarked for DIF testing. It was divided into three groups (A, B and C), each containing 15 specimens. Biopsy specimens were sliced into two, one each for MM and honey. Samples in group A were processed at the end of week 1 while those in group B and C were processed at the end of weeks 2 and 4, respectively. Group II consisted of five specimens of epidermolysis bullosa (EB) which was further divided into three groups; two specimens were processed for antigen mapping at the end of week 1, while others were processed at the end of week 2 (two specimens) and 4 (one specimen). Results: Sensitivity of honey as a transport medium for skin biopsy specimens was 100%, 92.6% and 53.8% at weeks 1, 2 and 4, respectively. The antigen mapping was positive in all specimens. Conclusion: Utility of honey was comparable to MM for DIF samples tested at weeks 1 and 2 but was lower at week 4.

Published
2018

19. Utility of three dimensional (3-D) ultrasound and power Doppler in identification of high risk endometrial cancer at a tertiary care hospital in southern India: A preliminary study

Author

Rajagopal Kadavigere, Chythra R Rao, Harshitha Pandey, and Shyamala Guruvare

Subjects
medicine.medical_specialty, India, Logistic regression, Endometrium, lcsh:Gynecology and obstetrics, Sensitivity and Specificity, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Imaging, Three-Dimensional, Risk Factors, Carcinoma, medicine, Humans, Stage (cooking), lcsh:RG1-991, Neoplasm Staging, Ultrasonography, 030219 obstetrics & reproductive medicine, Receiver operating characteristic, Neovascularization, Pathologic, business.industry, Endometrial cancer, Ultrasound, Obstetrics and Gynecology, Ultrasonography, Doppler, Odds ratio, medicine.disease, Endometrial Neoplasms, medicine.anatomical_structure, ROC Curve, 030220 oncology & carcinogenesis, Female, Radiology, business
Abstract

Objective: The study was conducted to find the utility of three dimensional (3-D) ultrasound and Doppler sonography in differentiating benign and malignant endometrial lesions and to ascertain the association of sonology parameters with type, grade and stage of endometrial cancer. Materials and methods: Women attending the gynaecology department of a tertiary care hospital, with a provisional diagnosis of carcinoma endometrium were subjected to three dimensional power Doppler ultrasound evaluation and assessment of vascular patterns. VOCAL (Virtual Organ Computer-aided Analysis) software was used to assess volume, Vascularisation Index (VI), Flow Index (FI) and Vascularisation Flow Index (VFI). Ultrasound parameters were compared with histologic diagnosis to evaluate the diagnostic performance using Receiver Operating Characteristic (ROC) Curve. Results: Sixty-four women were included in the study, 33 with benign and 31 with malignant endometrial lesions. Larger endometrial volume and higher Doppler indices correlated with malignant lesions. The variables with good discriminatory potential between benign and malignant status were VI and VFI, having a sensitivity of 90.3% and specificity of around 80%. VFI (adjusted odds ratio of 40.4; (95% CI – 8.46–192.88), p value

Published
2018

20. Knowledge, attitude and practices regarding generic medicines and its usage: a community-based study

Author

Aparna Sen Chaudhary, Kirthinath Ballala, Akhilesh Pandey, Chythra R Rao, and Ashwini Shivakumar Bidnurmath

Subjects
Government, education.field_of_study, medicine.medical_specialty, 030503 health policy & services, Population, Computer-assisted web interviewing, humanities, Essential medicines, Outreach, 03 medical and health sciences, 0302 clinical medicine, Informed consent, Family medicine, medicine, Residence, 030212 general & internal medicine, 0305 other medical science, Psychology, education, Socioeconomic status
Abstract

Background: India is the largest provider of generic medications globally. Despite this, several essential medicines remain inaccessible to majority of the general population, due to poor awareness, unavailability of drugs, distrust about the quality of the medicines, poor policy implementation and inadequate recommendation by doctors.Methods: A community-based cross-sectional study was carried out among 1151 adults in rural and urban areas attached to the community outreach area of a University Medical College. Written informed consent was taken from the participants. Data was collected using a pre-tested semi-structured online questionnaire and analysed using SPSS 15.0.Results: Knowledge regarding generic medicines was found to be low among the surveyed population (666, 57.9%), irrespective of their socio-economic status, education, occupation, place of residence or presence of chronic illnesses. As the knowledge was poor, participants were briefed about the generic medicines and their benefits. Thereafter, the attitude was assessed and found to be favourable among more than half (633, 55.0%) of the surveyed population. The usage of Generic medicines was found to be poor among the respondents. Only 53 (4.6%) of the total study population had switched from branded to generic medicines in the past six months as generic medicines were less expensive compared to their branded counterparts.Conclusions: The awareness about generic drugs and its usage was poor in the surveyed population. A favourable attitude towards generic drugs was achieved by educating the people about their similarity to branded medications. Therefore, there is a need to educate people not only about the quality, safety and efficacy of the generic medicines but also about the government initiatives like the Jan Aushadhi scheme.

Published
2019

21. Prevalence of Anaemia among Postnatal Mothers in Coastal Karnataka

Author

Ashwini Kumar, Chythra R Rao, Asha Kamath, and Darshan Bhagwan

Subjects
0301 basic medicine, Pediatrics, medicine.medical_specialty, cross-sectional, Clinical Biochemistry, cyanomethaemoglobin method, Developing country, lcsh:Medicine, Reproductive cycle, 03 medical and health sciences, 0302 clinical medicine, Field practice, hemic and lymphatic diseases, Medicine, Community Medicine Section, 030212 general & internal medicine, Functional illiteracy, manipal, Community based, 030109 nutrition & dietetics, business.industry, Rural health, lcsh:R, General Medicine, haemoglobin, Stratified sampling, business, Severe anaemia, Demography
Abstract

Introduction: Postpartum is the most neglected period in reproductive cycle of woman. Prevalence of anaemia in developing countries ranges from 50-95%. Aim: To estimate the prevalence of anaemia among postnatal mothers. Setting and design: A community based cross-sectional study among recently delivered mothers residing in field practice area of Department of Community Medicine, Kasturba Medical College, Manipal, India. Materials and Methods: The study sample included 401 respondents who were selected using stratified random sampling with proportionate allocation from all rural health centres. Data was collected by personal interviews followed by haemoglobin estimation by indirect cyanomethaemoglobin method. Results: The prevalence of postnatal anaemia was 26.5% (Anaemia = Hb

Published
2016

22. A qualitative study on how adolescent males in South India view reproductive health

Author

Lena Ashok, Chythra R Rao, Asha Kamath, Kallol Roy, Asha Hegde, and Veena G Kamath

Subjects
medicine.medical_specialty, education.field_of_study, business.industry, media_common.quotation_subject, Public health, Taboo, Population, Public Health, Environmental and Occupational Health, Focus group, Developmental psychology, 03 medical and health sciences, 0302 clinical medicine, Pediatrics, Perinatology and Child Health, medicine, Pornography, 030212 general & internal medicine, Peer pressure, Psychiatry, education, business, 030217 neurology & neurosurgery, media_common, Reproductive health, Qualitative research
Abstract

In India it is taboo to discuss sexual and reproductive health (RH) issues, especially with adolescent boys. Minimal research has been done in India to address the adolescent mindset of boys. Our aim was to study the unaddressed issues among boys and to highlight their perspectives regarding RH. Methods: A qualitative study design-using focus group discussions (FGD) in a rural-urban setting in South India was conducted. A convenient sample of 60 boys aged 16–19 years participated in six FGD and 10 boys had participated in in-depth interviews. Results: The study revealed that a cordial environment both at home and school were primary needs. Peer pressure and media instigated adolescents to get involved in risky behaviour and substance use. “Pornography”, “wrong myths about RH”, “substance use”, and “sexual attractions” were the primary unaddressed issues of boys. Participants had poor awareness about RH services. Conclusion: RH services are inadequate and proper infrastructure is required for providing these services to adolescent boys.

Published
2015

23. Erratum: Effect of physical activity during pregnancy on gestational diabetes mellitus

Author

Asha Kamath, Sathisha Nayak, Surabhi Mishra, Chythra R Rao, Avinash K. Shetty, and Surekha Kishore

Subjects
Pregnancy, 030219 obstetrics & reproductive medicine, business.industry, Endocrinology, Diabetes and Metabolism, Physical activity, Physiology, Metabolism, medicine.disease, Gestational diabetes, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Medicine, 030212 general & internal medicine, business
Published
2018

24. Prevalence of visual impairment in adults aged 18 years and above in a rural area of coastal Karnataka

Author

Chythra R Rao, Ranjitha S Shetty, Veena G Kamath, S Sathiya Narayanan, Sanjay Kini, and Asha Kamath

Subjects
medicine.medical_specialty, Refractive error, Pediatrics, education.field_of_study, genetic structures, business.industry, Public health, Arcus senilis, Visual impairment, Population, medicine.disease, eye diseases, Low vision, 03 medical and health sciences, 0302 clinical medicine, Chart, 030221 ophthalmology & optometry, Medicine, medicine.symptom, Rural area, business, education, 030217 neurology & neurosurgery
Abstract

BACKGROUND: Vision loss and age-related eye diseases are major global public health problems. The burden of visual impairment worldwide varies depending on the methods of assessment. The need for local data on the prevalence of visual impairment in adults coupled with limited resources necessitated the conduct of the study in a limited geographical area. METHODS: A cross-sectional study was conducted in the field practice area of Department of Community Medicine of a Medical College. Study patients included adults aged ≥18 years, identified through purposive sampling. A semi-structured questionnaire was used to collect sociodemographic data. Snellen's chart for distant vision; reduced Snellen's chart for near vision and Ishihara chart for color vision was used. Data were analyzed using SPSS software version 15. RESULTS: The study included 411 patients. Nearly 40% of the patients were ≥50 years. Among the patients, 195 (47.4%) had H/o refractive error, 78 (19%) had H/o hypertension, 56 (13.6%) had H/o diabetes, and 43 (10.5%) had H/o cataract. The most common ocular morbidity was arcus senilis 113 (27.5%) and cataract 28 (6.8%). Using Snellen's distant vision chart low vision ( CONCLUSIONS: Farsightedness was detected among a quarter of the population, while impaired near vision was detected among two.fifths of the study group. Nearly 7% of patients had cataract and were referred for further evaluation. Advancing age and the presence of comorbidities were significant determinants of visual impairment.

Published
2018

25. Prevalence and risk factors for peripheral neuropathy among type 2 diabetes mellitus patients at a tertiary care hospital in coastal Karnataka

Author

Chythra R Rao and Sonalika Gogia

Subjects
medicine.medical_specialty, peripheral neuropathy, Diabetic neuropathy, type 2 diabetes mellitus, Endocrinology, Diabetes and Metabolism, prevalence, 030209 endocrinology & metabolism, Context (language use), Disease, lcsh:Diseases of the endocrine glands. Clinical endocrinology, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Internal medicine, medicine, risk factors, lcsh:RC799-869, Diabetic Neuropathy Examination, Diabetic Neuropathy Symptom, lcsh:RC648-665, business.industry, Type 2 Diabetes Mellitus, Tertiary care hospital, medicine.disease, Blood pressure, Peripheral neuropathy, Physical therapy, Original Article, lcsh:Diseases of the digestive system. Gastroenterology, Health education, business, 030217 neurology & neurosurgery
Abstract

Context and Objective: In view of the growing burden of type 2 diabetes mellitus (T2DM) globally and associated microvascular and macrovascular complications, the study was done to assess the prevalence and risk factors for diabetic neuropathy among T2DM patients attending a tertiary care hospital. Subjects and Methods: T2DM patients’ ≥30 years of both gender, presenting to the Medicine Department at a tertiary care hospital were included in the study. Diabetic Neuropathy Symptom (DNS) questionnaire to assess symptoms and Diabetic Neuropathy Examination (DNE) scoring to assess clinical signs were used. Results: A total of 273 patients were included. The mean age was 57.8 ± 11.5 years. The male to female distribution was 75% (202) and 25% (71), respectively. According to DNS instrument, 41.4% patients scored positive for the presence of neuropathy while only 24.5% had neuropathy according to DNE score. The proportion of males affected by neuropathy was more than females. 43.1% males had a positive DNS score while only 27.2% of them had a positive DNE score. Duration of the disease was positively correlated with neuropathy. Neuropathy was more prevalent among people who had higher systolic and diastolic blood pressure as per DNS and DNE instruments. Conclusions: The present study identified a higher proportion of males to be affected by neuropathy. Hence, more detailed evaluation must be accorded to elderly male diabetic patients with longer duration of the disease. Lifestyle modifications and watchful screening need to be incorporated as part of routine patient health education during follow-up clinic visits.

Published
2017

26. Dietary habits and physical activity among medical students of a teaching hospital in South India: A descriptive analysis

Author

Veena G Kamath, Sravan C Kumar, Chythra R Rao, Asha Kamath, and SV Saranya

Subjects
Gerontology, education.field_of_study, medicine.medical_specialty, Univariate analysis, Descriptive statistics, business.industry, education, Population, Alternative medicine, Context (language use), Overweight, medicine.disease, Obesity, Test (assessment), 03 medical and health sciences, 0302 clinical medicine, Environmental health, Medicine, 030212 general & internal medicine, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Context: Among the college population, it is assumed that medical students have better knowledge about healthy lifestyle and dietary practices when compared to other students. However, there is no evidence to indicate that this knowledge translates into practice in terms of maintaining good health. Also, medical students have been known to exhibit early risk factors for chronic diseases. Aim: To assess dietary practices and physical activity among medical students. Materials and Methods: A cross-sectional study was done among 438 medical students from a teaching hospital in South India. A predesigned questionnaire was used to assess diet and current physical activity levels [using the International Physical Activity Questionnaire (IPAQ) short version] among consenting medical students. Statistical Analysis Used: Data were analyzed using statistical package for social sciences (SPSS) version 15.0 from SPSS South Asia Bangalore, India. Chi-square test was used for univariate analysis. Results: Among 438 medical students, 97% were aware of balanced diet, but only 42.9% were following it. Nearly, 9.4% of students consumed junk foods everyday. Compared to the previous year, junk food intake had increased in 40.4% and fruit intake had decreased in 50% of students. Significant association was noted between overweight and obesity and daily consumption of junk foods. Over 95% of students were physically active. In comparison to the previous year, nearly 67% of students had increased their physical activity by walking. Conclusions: Although unhealthy eating habits were prevalent among medical students, practice of physical activity was good. It is, therefore, essential to identify and take corrective actions to promote healthy lifestyle practices.

Published
2016

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