Advanced Research Publications: Medical Journals
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Youth Violence: An Emerging Public Health Problem
No full textYouth violence has been a major social problem for the Western world for long. The problem in South-East Asia is of recent origin. It is pervading the lives of significant portion of young people regardless of social class, race, ethnicity, culture or country. Youth violence includes various behaviors such as bullying, slapping or hitting and other behaviors such as robbery and assault could also be fatal. Violence involving young people adds greatly to the costs of health and welfare services, reduces productivity, decreases the value of property, disrupts a range of essential services and generally undermines the fabric of society. Thus it becomes pertinent to understand youth violence in all aspects so as to develop an appropriate prevention approach for tackling this menace. The current paper highlights the burden of youth violence in the region. It also attempts to describe various aspects of youth violence, its risk factors and what approach could be followed to tackle it
Diet and Yogic Practices: Ideal Ways to Kindle Agni and Prevent Lifestyle Disorders
Full text linkThe lifestyle disorders are increasing exponentially throughout the world with India as the capital city. Lifestyle modification is the only answer for the prevention and management of this epidemic. Diet or food is the most important component of life. It is responsible for the sustenance of Prana. Conducive food taken in proper amount at proper time helps in maintenance of Agni and enhancement of Ojas, consequently resulting in better health and longevity. Yogic practices undoubtedly help in reduction of stress, along with bringing about harmony of internal and external environment thus helping in physical, mental as well as spiritual wellbeing of an individual. Thus a holistic approach would result in efficient management and prevention of a variety of lifestyle disorders in a cost effective manner without any side effects
Metabolic Profile of Young Onset Type 2 Diabetes Mellitus Patients and Their First Degree Relatives
Full text linkObjective: There is a paucity of data on the metabolic profile of the first degree relatives of young onset type 2 diabetes mellitus especially from India. Therefore, this study was done to evaluate the metabolic profile of young- onset type 2 diabetic patients and their first degree relatives. Material and method: Thirty young- onset type 2 diabetic patients of age < 30 yrs and 89 first degree relatives (28 parents and 61 siblings) were assessed for anthropometric parameters such as BMI, waist circumference, waist hip ratio and body mass index. Various biochemical tests were done which included fasting and 2 hours post 75 gm glucose load, glycated haemoglobin (HbA1c), lipid profile and renal function test. Metabolic syndrome was diagnosed as per National Cholesterol Education Program- Third Adult Treatment Panel III (NCEP- ATP III) criteria and IDF criteria.Results: Mean age of the patients was 27.53 years whereas mean age of the first degree relatives was 36.53 years. Mean BMI of the patients and first degree relatives were 26.46 and 25.46 kg/m2 respectively. 60% of patients and their first degree relatives separately fulfilled the IDF criteria for central obesity. 51 (57.3%) first degree relatives fulfilled the WHO criteria for abdominal obesity. Family history of diabetes was seen in 60% of these young diabetics. Out of 89 first degree relatives, 32 relatives (35.9%) were found to have diabetes and additional 13(14.6%) relatives had either impaired fasting glucose or impaired glucose tolerance test results. 18 (60%) patients and 48 (54%) first degree relatives fulfilled the IDF criteria for metabolic syndrome. According to NCEP ATP III criteria, 73.3% of these young onset diabetic patients and 50% of their first degree relatives fulfilled the criteria for metabolic syndrome.Conclusion: More than 50% of the first degree relatives of the young onset type 2 DM patients fulfill the criteria of metabolic syndrome and 50% of these FDRs have diabetes or prediabetes. Hence, our study clearly reinforces the importance of screening the first degree relatives for metabolic parameters, as it will detect metabolic syndrome or diabetes early in this high risk group so that appropriate treatment can be started in time to prevent the complications
Susceptibility Status of Anopheles Culicifacies against DDT 4% & Malathion 5% in Districts of Madhya Pradesh
Full text linkMadhya Pradesh is the largest state in the country having an area of 308,252 sq.km. Malaria control in Madhya Pradesh is complex because of the vast tracts of forests with tribal settlements. Anopheles culicifacies is the principal malaria vector in rural and peri- urban areas and contributes about 65% of malaria cases in India. Study was carried out to know the present status of susceptibility of An. culicifacies against DDT 4% and Malathion 5% in Madhya Pradesh. Today, the issue of major concern is the development of resistance among mosquito vectors as a result of abrupt and indiscriminate use of insecticides. In the present study, insecticide susceptibility of An. culicifacies against DDT and Malathion was tested in Seoni, Katni, Umaria, Anuppur, Satna, Chhindwara, Dhindori, Narsingpur and Mandla districts. The districts selected for assessment of susceptibility have almost similar ecotype, vector prevalence and employ same vector control strategies. Susceptibility test was done as per standard WHO susceptibility tests using DDT 4% & Malathion 5%. Results indicate that An. culicifacies was found resistant to DDT in all nine districts of Madhya Pradesh viz. Seoni, Katni, Umaria, Anuppur, Satna, Chhindwara, Dhindori, Narsingpur and Mandla. An. culicifacies was found susceptible to Malathion 5% in Umaria, Anuppur, Satna, Dindori, Narsinghpur and Mandla district and resistant to it in Chhindwara district of Jabalpur zone. Development of resistance to DDT and tolerance against Malathion in Seoni and Katni districts is of great concern to vector control programme. Complete resistance to DDT can be attributed to the fact that DDT has been in use since many decades (1953). DDT has also shown resistance in areas irrespective of its withdrawal from IRS. This could be due to increased genetic stability of DDT resistance gene. Malathion was not sprayed regularly but observed resistance and tolerance could be due to selection of its use by agriculture/ forestry
Vector Borne Diseases in Kolkata Municipal Corporation (KMC): Achievements and Challenges
Full text linkThe proposal to control malaria in towns, named as Urban Malaria Scheme was approved during 1971 and it was envisaged that 131 towns would be covered under the scheme in a phased manner. Madhok Committee in 1970 investigated the problem and assessed that 10 to 12% of the total cases of malaria were contributed by urban areas. The committee recommended anti larval measures for containment of urban malaria, because it was feared that proliferation from urban to rural may spread and nullify the gains already made. Demographic and societal changes, unplanned urbanization, construction activities, increase in slum clusters, large scale migration contributed to increased vector breeding potential in urban areas. Insufficient capacities of the civic bodies to deal with water supply, sewage and solid waste disposal led to an all round disruption. Intermittent water supply led to increased water storage practices, which resulted in extensive breeding of An. stephensi, vector of urban malaria. During XII Plan, it has been proposed to provide diagnostic and treatment facilities by establishment of malaria clinics @ 1 clinic per 20000 population with special focus to urban slums, involvement of other sectors/ private providers for diagnosis, treatment and reporting, Integrated Vector Management by larval control through source reduction, chemical larviciding and use of larvivorous fish and minor engineering and also adoption of Model civic bye- laws for prevention and control of vector breeding. The issue of increase in slum clusters, influx of population, construction activities, water scarcity, and storage practices need to be kept in mind for making a comprehensive action plan to deal with the vector borne disease in urban areas. The role of private practitioners in the urban areas is very crucial in the diagnosis and treatment following national guidelines.Presently, UMS is functional in metro cities namely Delhi, Mumbai, Kolkata, Chenna, Hyderabad, Bangalore, and Ahmedabad. The epidemiological situation is totally dependent on the local inherent factors such as level of migratory population, construction activities, developmental projects, creation of slum clusters and water storage practices etc., which play a key role in the transmission dynamics of VBDs in these mega cities. An attempt has been made to bring out the present situation of vector borne diseases (VBDs) in Kolkata Municipal Corporation (KMC) with respect to ongoing implementation of NVBDCP strategy for the prevention and control and the challenges faced
Emergence of Dengue Problem in India – A Public Health Challenge
Full text linkIndia contains approximately half of the 205 billion people worldwide who are at risk of dengue fever. The virus causing Dengue/ DHF is believed to have established in almost all parts of India and has emerged as a major public health concern. Dengue is found in tropical and sub- tropical regions around the world, predominantly in urban and semi- urban areas. It is the most common mosquito- borne viral disease of humans. Globally, 2.5 billion people live in areas where dengue viruses can be transmitted. Aedes aegypti is the main vector playing a major role in the transmission of dengue/ DHF. Dengue fever and its severe complication i.e. DHF are caused by one of four types of distinct, but closely related, viruses namely DEN1, DEN2, DEN3 and DEN4 of genus flavivirus. By the last decade of the 20th century, Aedes aegypti and the four dengue viruses had spread to nearly all the countries of the tropical world. Some 2 billion persons live in dengue- endemic areas with tens of millions infected annually. Dengue pandemics were also documented in the 18th and 19th centuries; they were contained by organized anti- Aedes aegypti campaigns and urban improvements. The 20th century dengue pandemic has brought with it the simultaneous circulation of multiple serotypes and in its aftermath, endemic dengue haemorrhagic fever/ dengue shock syndrome (DHF/ DSS). At the national level, dengue control is coordinated by the National Vector Borne Diseases Control Programme (NVBDCP). NVBDCP is the agency responsible for framing national dengue guidelines and policies for guiding the implementations of programme strategies at the state level.In the absence of a vaccine, vector control is the main strategy to prevent dengue outbreaks. The country paradigm for dengue control is largely passive surveillance and early case detection coupled with rapid mobilization in the case of an outbreak. The first outbreak of DHF occurred in Calcutta in 1963. After that disease outbreaks reported from different states. The first major outbreak of dengue fever (DF) was reported in Calcutta in 1963. Since then, more than 60 outbreaks have been reported in India from different states. During recent years, it has become a major public health problem in the urban areas of India and is gradually spreading to the rural areas. The problem of dengue is increasingly becoming important in most tropical countries due to the expanding urban areas, limited piped water supply, constant influx of people from rural to urban areas, creation of slums, and high rise buildings with increased use of water coolers during the summer season. An epidemic of dengue was also reported in Rajasthan in 1985. A severe outbreak of dengue was reported in 1996 in Delhi with more than 400 deaths. Gurgaon town of Haryana state faced similar outbreak of dengue with 1137 cases and 9 deaths in 2008. During 2009, Pune Corporation in Maharashtra state reported an outbreak of dengue. The state reported 2255 cases and 20 deaths. The maximum dengue deaths were reported from Haryana, Kerala, and Punjab state.Aedes aegypti was the only vector in all these outbreaks. The epidemic, which occurred during 2005- 06 in certain islands of Indian Ocean and in Kerala strongly suggests that Aedes albopictus played an alternate role. Ae. albopictus invaded the peridomestic settings, hitherto the exclusive domain of Ae. aegypti. The aggressive nature of Aedes albopictus, when compared that of to Ae. Aegypti, may help them to out compete the latter and could play a crucial role in the disease transmission due to aggressive bites in Kerala state. Ae. albopictus, a secondary vector for dengue, is likely a significant factor in the persistence of dengue in the environment through vertical transmission and may be replacing Ae. aegypti in semi- urban areas. The diverse breeding habitats of the dengue vector, Aedes spp. mosquitoes, demand community education and mobilization for effective control. However, community involvement for dengue control has mixed results in the country. Improper water management, lack of public awareness, inadequate solid waste disposal mechanisms, urbanization, lack of communication and integration between governing agencies, all contribute to increased number of dengue cases. This article highlights the state of dengue control in India, explores vector control mechanisms that have worked elsewhere, to strengthen dengue control activities by policy and practice