Common Non-communicable Diseases Research Articles

All-Cause, Cardiovascular and Respiratory Mortality in People with Type 2 Diabetes and Chronic Obstructive Pulmonary Disease (COPD) in England: A Cohort Study Using the Clinical Practice Research Datalink (CPRD).

Type 2 diabetes (T2D) and chronic obstructive pulmonary disease (COPD) are common non-communicable diseases. Both have an inflammatory nature and similar risk factors, and there is overlap and interaction between them. To date, there is a lack of research on outcomes in people that have both conditions. The aim of this study was to investigate whether the presence of COPD in people with T2D was associated with an increased risk of all-cause, respiratory-cause and cardiovascular-cause mortality. A three-year cohort study (2017-19) was done using the Clinical Practice Research Datalink Aurum database. The study population was 121,563 people with T2D aged ≥40. The exposure was COPD status at baseline. Incident rates for all-cause, respiratory-cause and cardiovascular-cause mortality were calculated. Poisson models for each outcome were fitted to estimate rate ratios for COPD status adjusted for age, sex, Index of Multiple Deprivation, smoking status, body mass index, prior asthma and cardiovascular disease. COPD was present in 12.1% people with T2D. People with COPD had a higher all-cause mortality rate (448.7 persons per 1000 person years) compared with people without COPD (296.6 persons per 1000 person years). People with COPD also had substantially higher respiratory mortality incidence rates and moderately raised cardiovascular mortality rates. Fully adjusted Poisson models showed that people with COPD had a 1.23 (95% CI 1.21, 1.24) times higher rate of all-cause mortality as compared with those without COPD and a 3.03 (95% CI 2.89, 3.18) times higher rate of respiratory-cause mortality. There was no evidence of an association with cardiovascular mortality after adjusting for existing cardiovascular disease. Co-morbid COPD in people with T2D was associated with increased mortality overall and particularly from respiratory causes. People with both COPD and T2D are a high-risk group who would benefit from particularly intensive management of both conditions.

Estimation of 10-year risk of fatal and non-fatal cardiovascular disease in a portuguese population

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiovascular disease (CVD) is the most common noncommunicable disease and actually the leading cause of death globally. Hence, it is important to identify individuals who may benefit from CVD preventive strategies. The European Society of Cardiology (ESC) has recently updated the European Systematic Coronary Risk Evaluation (SCORE) to SCORE2 and SCORE2-OP risk prediction algorithms. Those tools were recalibrated to four groups of countries (low, moderate, high and very high CVD risk) based on national CVD mortality rates published by the WHO, with Portugal being now considered a moderate risk country. Purpose To evaluate the application of SCORE2 and SCORE2-OP in a Portuguese population sample. Methods We conducted a cross-sectional study, including individuals aged 40-90 years, without known established Atherosclerotic Cardiovascular Disease, Diabetes mellitus, Chronic Kidney Disease or Familial Hypercholesterolemia. The sample was recruited at a local cardiovascular screening event in Portugal that took place in May 2022. The 10-year fatal and non-fatal CVD risk was calculated using SCORE2 (for individuals aged < 70 years) and SCORE2-OP (for individuals aged ≥ 70 years) tools. Based on CVD risk category, patients were stratified into 3 categories: low to moderate, high and very high risk according to new SCORE algorithms. Primary outcome was the assessment of 10-year risk of fatal and non-fatal CVD with SCORE2 e SCORE2-OP in a local Portuguese population. According to the data distribution, appropriate statistical tests were conducted to compare independent samples. Multivariable linear regression was used to analyze 10-year CVD risk. Results This cohort included 431 individuals. Median age was 71 years (Q1-Q3: 65-75) and 66.8% of individuals were women. Regarding baseline characteristics of the included individuals, 48.1% had hypertension, 38.3% had dyslipidemia, 25.5% were obese and 6.6% were smokers. Based on the SCORE2 model 92 (26.1%) individuals were classified into low to moderate risk, 162 (46.0%) into high risk and 98 (27.8%) into very high-risk category. SCORE2 median was 3.43 % (Q1-Q3: 5.5-8.0 p< 0.01) and SCORE2-OP median was 12.70 % (Q1-Q3: 9.7-12.7). Active smoking was the only independent predictor of 10-years CVD risk both in SCORE2 (RR 3.28, 95% CI: 1.93-4.66, p=0.001) and SCORE2-OP (RR 6.31, 95% CI: 2.67-9.52, p<0.001). Conclusions Most individuals in this sample were stratified into high or very high risk of developing 10-year fatal and non-fatal cardiovascular events. This data is in accordance with the updated risk category of Portugal based on World Health Organization cardiovascular mortality rates. These results not only validate the application of SCORE to the Portuguese setting, but also reinforce how this easily applicable tool can help to identify patients who will benefit from CVD preventive strategies.

Clinical Characteristics and Outcomes of Cancer Cases Among Syrian Refugees From Southern Turkey

Cancer was a common noncommunicable disease in Syria before the present conflict and is now a major disease burden among 3.6 million Syrian refugees in Turkey. Data to inform health care practice are needed. To explore sociodemographic characteristics, clinical characteristics, and treatment outcomes of Syrian patients with cancer residing in the southern border provinces of Turkey hosting more than 50% of refugees. This was a retrospective hospital-based cross-sectional study. The study sample consisted of all adult and children Syrian refugees diagnosed and/or treated for cancer between January 1, 2011, and December 31, 2020, in hematology-oncology departments of 8 university hospitals in the Southern province of Turkey. Data were analyzed from May 1, 2022, to September 30, 2022. Demographic characteristics (date of birth, sex, and residence), date of first cancer-related symptom, date and place of diagnosis, disease status at first presentation, treatment modalities, date and status at last hospital visit, and date of death. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision and International Classification of Childhood Cancers, Third Edition, were used for the classification of cancer. The Surveillance, Epidemiology, and End Results system was applied for staging. The diagnostic interval was defined as the number of days from first symptoms until the diagnosis. Treatment abandonment was documented if the patient did not attend the clinic within 4 weeks of a prescribed appointment throughout the treatment. A total of 1114 Syrian adult and 421 Syrian children with cancer were included. The median age at diagnosis was 48.2 (IQR, 34.2-59.4) years for adults and 5.7 (IQR, 3.1-10.7) years for children. The median diagnostic interval was 66 (IQR, 26.5-114.3) days for adults and 28 (IQR, 14.0-69.0) days for children. Breast cancer (154 [13.8%]), leukemia and multiple myeloma (147 [13.2%]), and lymphoma (141 [12.7%]) were common among adults, and leukemias (180 [42.8%]), lymphomas (66 [15.7%]), and central nervous system neoplasms (40 [9.5%]) were common among children. The median follow-up time was 37.5 (IQR, 32.6-42.3) months for adults and 25.4 (IQR, 20.9-29.9) months for children. The 5-year survival rate was 17.5% in adults and 29.7% in children. Despite universal health coverage and investment in the health care system, low survival rates were reported in this study for both adults and children with cancer. These findings suggest that cancer care in refugees requires novel planning within national cancer control programs with global cooperation.

A Study to Assess the Prevalence and Risk Factors of Hypertension among the Truck Drivers of district Shivpuri, Madhya Pradesh, India

INTRODUCTION: Hypertension is one most common non-communicable cardiovascular disease. It is the major risk factor for heart failure, coronary artery disease, chronic renal failure and cerebral vascular diseases. Hypertension has been found paramountly amongst long distance truck drivers. This could be due to the hectic nature of their job. AIM: The study was conducted to study the prevalence of hypertension among truck drivers of Shivpuri district of Madhya Pradesh and to study the associated risk of hypertension amongst them. MATERIALS AND METHOD: District Shivpuri of Madhya Pradesh has around 20 Truck operation unions all registered under which more than 1000 truck drivers are registered. Total 770 drivers were selected by using systematic random sampling. The present study was conducted from November 2022 to March 2023. Information regarding demographic profile and risk factors of hypertension were collected on pre-tested proforma. RESULTS: Out of total 770 truck drivers, prevalence of hypertension was found 45.6% including 15% self-reported and 30.6% detected in the study. Only about 7% of truckers who were pre-diagnosed had undergone treatment for a certain period of time. Highest prevalence of hypertension was reported in 40 to 49 years age group followed by 30 to 39 years. Hypertension was prevalent amongst the truck drivers who had been working for more than 10 years. Significant association found on assessing risk factors like lack of physical exercise, lack of proper sleep, high BMI, history of addiction. CONCLUSION: Hypertension was reported more in the age group and people who were in this profession for over 10 years. Age was found significantly associated with hypertension. Improper sleep, schedule, hectic routines, lack of proper nutrition, centric obesity, high BMI and addiction to tobacco and alcohol found significant risk factors for hypertension.

Prevalence of Vitamin D Deficiency in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study.

Background Type 2 diabetes mellitus (T2DM) is one of the most common non-communicable diseases, causing a high mortality rate globally. Vitamin D deficiency has been reported as a rising pandemic. Vitamin D levels have been found to be associated with obesity and insulin resistance. However, there is not much research done to study the various factors associated with the association between vitamin D levels and diabetes mellitus in the Indian population. Objective The objective of this study is to estimate the prevalence of vitamin D deficiency in T2DM patients and find the factors associated with vitamin D levels among type 2 diabetes mellitus patients. Materials and methods A cross-sectional analytical study was planned and done in the Urban Health Training Centre of Dr. D.Y. Patil Medical College. The sample size was calculated using published data on prevalence. Data from 116 T2DM patients were collected using a questionnaire about their socio-economic status, dietary patterns, outdoor activities, exercise, drug and supplement intake, occupation, and symptoms, which was filled out by the participants after written informed consent. Levels of serum vitamin D were estimated from the blood samples taken from the participants. Statistical analysis was done using MedCalc software. Results Vitamin D deficiency was found in 86 (74.14%) out of 116 diabetic patients. There were 63 males, and 71.43% of them had lower-than-normal vitamin D levels. The number of female participants was 53, and 77.36% were found to suffer from vitamin D deficiency. There were 88 obese participants, and only 22.73% were found to have sufficient levels of vitamin D. Conclusion The results depict a high prevalence of vitamin D deficiency in type 2 diabetes mellitus patients. Regular supplementation of vitamin D for diabetic patients can prevent them from developing any further complications. Increasing awareness about a healthy lifestyle, a proper diet, adequate sunlight, and exercise can help keep most non-communicable diseases at bay. Additional studies should be done to understand the pathophysiology better, which can aid in preventing diseases in the beginning stages of development.

Study of association of vitamin D levels in children and adolescents on antiepileptics drug therapy

Background: Epilepsy is a common non-communicable disease that affects both young and the elderly, with a cumulative lifetime incidence of 3%. Bone health may be impacted by prolonged AED use, and the study aims to investigate the relationships between long-term antiepileptic usage, vitamin D levels, and other outcomes. Methods: Comparative observational research was conducted on 60 children with 30 healthy controls and 30 cases of antiepileptic drug users. Low vitamin D levels were identified based on monotherapy versus polytherapy, treatment duration, and severity of seizure control. 25-hydroxyvitamin D separated from its binding protein during incubation and competed with labelled vitamin D. A wash cycle was used to remove unbound material and a flash chemiluminescent reaction was started. The statistical analysis was done using R software 3.2.2 with a power of 90% and an alpha error of 5%. Results: An observational comparative study found no significant relationship between vitamin D levels and antiepileptic drug therapy in children aged 4-16 years. Vitamin D levels in AED-treated children with well-controlled seizures and those with poorly controlled seizures were found to be statistically significant, with 77% of patients and none of the controls being vitamin D deficient. Conclusions: Vitamin D deficiency is linked to antiepileptic medication, length of antiepileptic therapy, and increased risk of vitamin D insufficiency. It is important for pediatric neurologists and paediatricians to pay attention to the vitamin D status of children with epilepsy.

Strategy for the management and prevention of psycho-emotional disorders in the GP’s practice

Psycho-emotional disorders, such as anxiety disorders, acute and chronic stress, are significant risk factors for the development and complicated course of both major cardiovascular and other common chronic non-communicable diseases. The psycho-emotional disorders significantly reduce patients’ motivation and adherence to lifestyle changes and drug therapy, significantly worse quality of life, increase the risk of disability and healthcare system expenditures. The topicality of the issues of diagnosis and management of psycho-emotional disorders in the general practitioner’s practice is caused, on the one hand, by high rates of these disorders in patients with cardiovascular and other chronic diseases, deterioration in quality of life and an increase in adverse outcomes, and on the other hand, inadequate awareness of the risks associated with the sphere of psycho-emotional status in patients. The management of psycho-emotional disorders includes both pharmacological and non-pharmacological treatments. Antidepressants that fall into the class of selective serotonin or serotonin and norepinephrine reuptake inhibitors are the first-line drugs used for the treatment of most of the disorders discussed. However, prescription of these drugs requires to take into account a wide range of possible side effects in patients with chronic diseases, including CVDs. Drugs that have fast onsets of sedative and anti-anxiety action, also known as tranquilizers, are more widely used in real-world clinical practice. Tofisopam is the most promising from this group of drugs in therapeutic and cardiological practice. The efficacy and safety of tofisopam have been studied in numerous studies in patients with chronic non-communicable diseases and a wide range of anxiety disorders, including the long-term use of the drug.

Survivability of patients admitted for stroke in a primary stroke center, Penang, Malaysia: a retrospective 5-year study

BackgroundStroke is one of the most common noncommunicable diseases, with significant public health implications both globally and in Malaysia. The aim of this study was to evaluate post-stroke survivability as well as the major drug classes prescribed for hospitalized stroke patients.MethodsA 5-year retrospective study was carried out on the survival of stroke patients admitted to Hospital Seberang Jaya, a main stroke center in the state of Penang, Malaysia. Patients admitted for stroke were first identified using the local stroke registry database, and their medical records were then accessed for data collection, which included demographic information, comorbid conditions, and medications prescribed during admission.ResultsThe Kaplan-Meier overall survivability analysis performed indicated 50.5% survival for the duration of 10 days (p < 0.001) post-stroke. Ten-day survivability differences (p < 0.05) were observed for the categories of type of stroke (ischemic stroke (60.9%) and hemorrhagic stroke (14.1%)); stroke episodes (first (61.1%) and recurrent (39.6%)); anti-platelets (prescribed (46.2%) and not prescribed (41.5%)); statins (prescribed (68.7%) and not prescribed (28.1%)); anti-hypertensive (prescribed (65.4%) and not prescribed (45.9%)); and anti-infectives (prescribed (42.5%) and not prescribed (59.6%)) respectively. Higher risks of mortality were observed among patients with hemorrhagic stroke (HR: 10.61, p = 0.004); with 3 or more comorbidities (HR:6.60, p = 0.020); and not prescribed with statins and anti-diabetic. Patients prescribed anti-infectives, on the other hand, had a higher risk of mortality when compared to patients who did not receive anti-infectives (HR: 13.10, p = 0.019). The major drug classes prescribed for stroke patients were antiplatelet drugs (86.7%), statins (84.4%), and protein pump inhibitors (75.6%).ConclusionThe findings of the study are intended to encourage more non-stroke hospitals in Malaysia to increase their efforts in treating stroke patients, as early treatment can help reduce the severity of the stroke. With the incorporation of evidence-based data, this study also contributes to local data for comparison and improves the implementation of regularly prescribed stroke medication.

Black to Dental Update and beyond!

Dental caries is one of the most common non-communicable diseases globally, and while entirely preventable, it still accounts for a huge economic burden in the form of operative management, which ranges from minimally invasive techniques to extensive direct and indirect restorations, root canal treatment and ultimately extraction. In this article, we look at the marked changes in caries epidemiology, detection, diagnosis, assessment and management that has taken place in the past five decades since Dental Update was first published, and reflect on how this has had an impact on the oral health of our patients today. CPD/Clinical Relevance: Awareness of changes in caries understanding over the last five decades is of value to clinicians.

Insulin resistance, age and depression’s impact on cognition in middle-aged adults from the PREVENT cohort

BackgroundAlzheimer’s disease (AD), type 2 diabetes mellitus (characterised by insulin resistance) and depression are significant challenges facing public health. Research has demonstrated common comorbidities among these three conditions, typically focusing...

Assessment of routine medical checkups for common noncommunicable diseases and associated factors among healthcare professionals in Addis Ababa, Ethiopia, in 2022 a cross-sectional study.

A facility-based cross-sectional study was conducted, enroling 422 healthcare providers in Addis Ababa. A simple random sampling method was used to select study participants. Data entry was made using Epi-data and exported to STATA for further analysis. A binary logistic regression model was used to determine predictors of routine medical checkups. In the multivariable analysis, the adjusted odds ratio along with a 95% confidence interval were determined. Explanatory variables whose p value less than 0.05 were selected as significant factors. The overall uptake of routine medical checkups for common noncommunicable disease was 35.3% (95% CI: 32.34-38.26). Moreover, being married [adjusted odds ratio (AOR)=2.60, 95% CI=1.42-4.76], income level less than 7071 (AOR=3.05, 95% CI=1.23-10.05), absence of chronic medical disease (AOR=0.40, 95% CI=0.18-0.88), good provider commitment (AOR=4.80, 95% CI=1.63-14.05), drinking alcohol (AOR=0.35, 95% CI=0.19-0.65), and poor perception of health status (AOR=2.1, 95% CI=1.01-4.44) were the significant factors. The uptake of routine medical checkups was found to be low, owing to marital status, level of income, perception of health status, drinking alcohol, the absence of chronic medical conditions, and the availability of committed providers, which needs intervention. We recommend using committed providers for noncommunicable diseases and considering fee waivers for healthcare professionals to increase uptake of routine medical checkups.

Oral Health Status of Children Age 6-12 Years in Rawalpindi, Islamabad Pakistan

Dental caries seems to be a significant public health issue and a common non-communicable disease. And is more prevalent in age group 6-12 years. There has never been a national oral health survey conducted in Pakistan between age 6-12 years in recent years. The purpose of this study was to look into the dental health of children between the ages of 6 and 12. Objectives: To determine the oral health status of children age 6-12 years using Decayed, Missed, Filled tooth Index. Methods: A cross-sectional study was carried out which included 385 children age between 6-12 years, using a simple random sampling. Children were evaluated in schools, and data collected included details on caries and the condition of the gingiva. The WHO's methodology and standards were used for oral examination. Results: Mean DMFT index of children age 6-12 years came out to be 2.28 ± 0.97. More than 2/3rd of children age between 6-12 years needs urgent dental care. Conclusion: The oral health status of children age between 6-12 years is unsatisfactory and higher DMFT index than expected. To effectively prevent and control burden of dental caries and promote gingival health, the oral health program must be implemented. Dental caries seems to be a significant public health issue and a common non-communicable disease. And is more prevalent in age group 6-12 years. There has never been a national oral health survey conducted in Pakistan between age 6-12 years in recent years. The purpose of this study was to look into the dental health of children between the ages of 6 and 12. Objectives: To determine the oral health status of children age 6-12 years using Decayed, Missed, Filled tooth Index. Methods: A cross-sectional study was carried out which included 385 children age between 6-12 years, using a simple random sampling. Children were evaluated in schools, and data collected included details on caries and the condition of the gingiva. The WHO's methodology and standards were used for oral examination. Results: Mean DMFT index of children age 6-12 years came out to be 2.28 ± 0.97. More than 2/3rd of children age between 6-12 years needs urgent dental care. Conclusion: The oral health status of children age between 6-12 years is unsatisfactory and higher DMFT index than expected. To effectively prevent and control burden of dental caries and promote gingival health, the oral health program must be implemented.

Disease pattern and satisfaction about health care services among patients attending a selected geriatric hospital in Dhaka city

Background: The proportion of elderly people is increasing at an unprecedented rate globally as well as in Bangladesh. Exploring the current situation it terms of magnitude and pattern of diseases suffered by elderly people would be a good resource for the policy makers in considering health care services and other supports for the elderly.&#x0D; Methods: A cross sectional descriptive study was done during January 2021 to December 2021 among elderly patients aged 60 years and above. A total of among 203 Patients form both indoor and outdoor department were included. A pretested questionnaire was used to collect the data collection. SPSS V23 software program were using analyzed data.&#x0D; Results: Among them 98 (48.25%) patients were suffering from communicable disease of which the most common (38.9%) was tuberculosis. On the other hands 201 patients were suffering from non- communicable disease of which the most common was Hypertension (HTN) (73.4%) followed by diabetes mellitus (DM) (36.5%), peptic ulcer (33%) and COPD (31%). The higher educated patients were significantly more dissatisfied compared to lower educated patients about drug dispensing (77.9% vs. 59.6%). Similarly, higher educated patients were significantly more dissatisfied compared to lower educated patients about nursing care (41.3% vs. 26.3%). The patients from urban area were significantly more dissatisfied compared to that of rural area about drug dispensing (76.7% vs. 58.6%).&#x0D; Conclusions: The study findings reveal that non-communicable diseases are the major bulk of diseases in elderly population in comparison to communicable diseases and HTN, DM, peptic ulcer, COPD were the common non-communicable diseases.

A multicentre survey of asthma-related quality-of-life and treatment in Egypt during the COVID-19 pandemic

Background: Asthma is a common chronic noncommunicable disease which can impair the health-related quality-of-life (HRQOL) of patients. Aims: To investigate treatment-related experiences and HRQOL of asthma patients in Egypt during the COVID-19 pandemic. Methods: A multicentre cross-sectional study was conducted from 21 July to 17 December 2020 in 3 teaching hospitals in Egypt among a convenience sample of asthma patients. We used socioeconomic and clinical variables, perceived threat level of COVID-19, experiences before and during COVID-19, the Asthma Control Questionnaire (ACQ), and the mini Asthma Quality of Life Questionnaire (mini-AQLQ) to collect data. Results: Among the 200 respondents (66.0% male; mean age 40.2 years), 80.0% had uncontrolled asthma. The greatest impairment to HRQOL was due to limitation of activity. Females reported a higher level of perceived threat from COVID-19 (Chi squared = –2.33, P = 0.02). Before the pandemic, more patients visited the clinician when they had symptoms but did so more regularly during the pandemic. Over 75% could not differentiate between asthma and COVID-19 symptoms. Perceived uncontrolled asthma and poor compliance with treatment were significantly associated with impairment of HRQOL (P &lt; 0.05) before COVID-19. Conclusion: The COVID-19 pandemic improved some asthma-related health behaviours, but limitations in HRQOL were still evident. Uncontrolled asthma is a key factor for HRQOL and should remain a focus for all patients.

Precision medicine in complex diseases-Molecular subgrouping for improved prediction and treatment stratification.

Complex diseases are caused by a combination of genetic, lifestyle, and environmental factors and comprise common noncommunicable diseases, including allergies, cardiovascular disease, and psychiatric and metabolic disorders. More than 25% of Europeans suffer from a complex disease, and together these diseases account for 70% of all deaths. The use of genomic, molecular, or imaging data to develop accurate diagnostic tools for treatment recommendations and preventive strategies, and for disease prognosis and prediction, is an important step toward precision medicine. However, for complex diseases, precision medicine is associated with several challenges. There is a significant heterogeneity between patients of a specific disease-both with regards to symptoms and underlying causal mechanisms-and the number of underlying genetic and nongenetic risk factors is often high. Here, we summarize precision medicine approaches for complex diseases and highlight the current breakthroughs as well as the challenges. We conclude that genomic-based precision medicine has been used mainly for patients with highly penetrant monogenic disease forms, such as cardiomyopathies. However, for most complex diseases-including psychiatric disorders and allergies-available polygenic risk scores are more probabilistic than deterministic and have not yet been validated for clinical utility. However, subclassifying patients of a specific disease into discrete homogenous subtypes based on molecular or phenotypic data is a promising strategy for improving diagnosis, prediction, treatment, prevention, and prognosis. The availability of high-throughput molecular technologies, together with large collections of health data and novel data-driven approaches, offers promise toward improved individual health through precision medicine.

Subgingival instrumentation for the treatment of periodontitis

Periodontal disease is the most common chronic inflammatory non-communicable disease in the human population. It is estimated that severe periodontitis affects 11% of the world’s population, with prevalence increasing with age. Subgingival instrumentation refers to all non-surgical procedures, either performed by hand (i.e., curettes) or with power-driven instruments (i.e., sonic/ultrasonic devices).

Prevalence of diabetes and its correlates among Iranian adults: Results of the first phase of Shahedieh cohort study.

The diabetes is one of the most common noncommunicable diseases, the prevalence of which is increasing worldwide. This study aimed to determine the prevalence, and correlates the factors of diabetes in the setting of Shahedieh cohort study in Yazd, Iran. The present study is a cross-sectional study conducted on the data of the initial stage of Shahdieh Yazd cohort. This study examined the data of 9747 participants aged from 30 to 73 years. The data included demographic, clinical, and blood test variables. Multivariable logistic regression was used to calculate the adjusted odds ratio (OR), and the risk factors of diabetes were studied. Meanwhile, population attributable risks for diabetes were estimated, and reported. The prevalence of diabetes was 17.9% (CI95%: 17.1-18.9); 20.5% in women, and 15.4% in men. Based on the results of multivariable logistic regression showed female sex (OR = 1.4, CI95%: 1.24-1.58), waist-hip ratio (OR = 1.4, CI95%: 1.24-1.58), high blood pressure (OR = 2.1, CI95%: 1.84-2.4), cardiovascular diseases (CVD) (OR = 1.52, CI95%: 1.28-1.82), stroke (OR = 1.91, CI95%: 1.24-2.94), age (OR = 1.81, CI95%: 1.67-1.96), hypercholesterolemia (OR = 1.79, CI95% triglyceride: 1.59-2.02), and low-density lipoprotein (LDL) (OR = 1.45, CI95%: 1.4-1.51), as risk factors for diabetes. Among the modifiable risk factors, high blood pressure(52.38%), waist-to-hip ratio (48.19%), the history of stroke (47.64%), hypercholesterolemia (44.13%), history of CVD (34.21%), and LDL ≥ 130 (31.03%) had the greatest population-attributable, respectively. The results showed that some of the main determinants of diabetes are the modifiable risk factors. Therefore, implementing early detection, and screening programs for people at risk and preventive measures, such as lifestyle modification programs, and control of risk factors can prevent this disease.

Prevalence of Non-Communicable Diseases

Non-communicable diseases (NCDs) are a growing health concern in Pakistan, with a significant impact on the country's population and economy. NCDs are chronic conditions that are not caused by infectious agents and are generally linked to lifestyle factors, such as unhealthy diets, lack of physical activity, and tobacco and alcohol use.&#x0D; The prevalence of NCDs in Pakistan has increased rapidly over the past few decades, with estimates suggesting that more than 60% of deaths in the country are now attributed to NCDs. The most common NCDs in Pakistan are cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases. These conditions not only have a devastating impact on individuals and families, but also place a significant burden on the healthcare system and the economy.&#x0D; There are several reasons why NCDs are on the rise in Pakistan. One of the key factors is the changing lifestyle patterns in the country, with increasing urbanization, sedentary lifestyles, and unhealthy diets. Poverty, lack of education, and poor healthcare infrastructure are also contributing factors, as they limit access to healthy foods, physical activity, and medical care.&#x0D; To address the growing prevalence of NCDs in Pakistan, there is an urgent need for a coordinated and comprehensive approach. This should involve a range of stakeholders, including the government, healthcare professionals, civil society organizations, and the private sector.&#x0D; One of the key interventions that can be implemented is to promote healthy lifestyles and prevent risk factors for NCDs. This includes initiatives to improve access to healthy foods, promote physical activity, and reduce tobacco and alcohol use. Health education and awareness campaigns can also play a critical role in raising awareness of the risks associated with NCDs and promoting healthy behaviors.&#x0D; Another critical intervention is to strengthen healthcare systems to ensure that NCDs are diagnosed and treated early. This requires investments in healthcare infrastructure, including training healthcare professionals and improving access to medical equipment and supplies. It also involves developing effective referral systems to ensure that patients receive appropriate care and treatment.&#x0D; Finally, there is a need for research and innovation to better understand the causes and mechanisms of NCDs in Pakistan. This includes developing locally relevant research studies and using the findings to inform policy and practice.&#x0D; In conclusion, the prevalence of NCDs in Pakistan is a significant public health concern that requires urgent attention. By adopting a comprehensive approach that addresses both prevention and treatment, and by engaging a range of stakeholders, it is possible to mitigate the impact of NCDs and improve the health and wellbeing of the Pakistani population

A prospective observational study of role of pedis scoring in predicting complications of diabetic foot in a tertiary centre

Background: Diabetes mellitus is one of the most common non-communicable diseases affecting major population in the world. Diabetic foot ulcer still remains the most common manifestation of diabetes mellitus requiring hospitalisation and invariably resulting in increased risk of morbidity. Our aim is to know the usefulness of PEDIS scoring in identifying the severity of diabetic foot ulcer and its management. Methods: In this prospective observational study, data of patients with foot ulcer who came to Apollo hospital in Chennai were collected for one year from July 2021 to May 2022. They were followed up for a period of six months. Patients were assessed and classified according to the PEDIS scoring system. All the data were analyzed by IBM SPSS statistics for windows version 25.0 (IBM corp, Armonk, Newyork USA). All p values &lt;0.05 were considered as statistically significant. Results: Out of one seventy-five patients, one hundred and thirteen were categorized as low risk group with a score between 0-7 and sixty-two as high-risk group with a score between 8-12. Majority of the high-risk groups developed complications like non healing ulcer, osteomyelitis, amputation. It is more prevalent among men with age preponderance for elderly. Whereas management of low-risk groups were limited only to conservative management and debridement. Of twenty-one patients with osteomyelitis, thirteen patients underwent amputation. Conclusions: Based on our study, we have come to a conclusion that the PEDIS scoring system actually helps in grading the diabetic foot and its management.

Significance of Serum Ferritin and Vitamin-D Level in Coronary Artery Disease Patients

Introduction: Coronary artery disease is one of the most common noncommunicable diseases that affects both men and women worldwide. Chronic inflammation and mineral nutrient deficiency, in addition to diet and sedentary lifestyle, contribute to this disease. The purpose of this study is to look at the relationship between serum ferritin, serum vitamin D levels, and serum lipid profile in patients with Coronary Artery Disease. Methods: The research was carried out at the Mahatma Gandhi Medical College and Research Institute in Puducherry. A standardised health questionnaire was distributed to study participants, which included 30 patients with Coronary Artery Disease (cases) and 30 healthy controls. It detailed current and previous medication use, hypertension, and coronary artery disease. Subjects were chosen based on their responses to study-related questions. For both cases and controls, means and standard deviations (SD) were computed. To determine the relationship between the parameters, ANOVA and Pearson's correlation were used, and it was used to find the statistical significance and correlation of Serum Ferritin, Serum Vitamin D, and Serum Lipid Profile among both groups. Results: The serum ferritin levels among cases (208.87±143.01 µg/lit) were found to be high when compared to controls (99.52 ± 61.19 µg/lit) with a significant p value of 0.0003. The Serum vitamin D value of cases (21.14 ± 12.9 ng/dl) was low when compared to controls (56.54 ± 18.88 ng/dl) with a significant p value of 0.0000. Serum LDL of cases (129.1 ± 26.91 mg/dl) were found to be higher than controls (105.1 ± 25.43 mg/dl). HDL of cases (33.83±6.82mg/dl) was found to be lower than controls (49.53±6.12 mg/dl). Conclusion: Altered lipid profile with low HDL-C, high LDL-C, and high LDL-C/HDL-C suggested an increased risk for CAD. Low vitamin D levels were also associated with a higher risk for CAD. According to this study, CAD patients had high serum ferritin levels, low serum vitamin D levels, and an altered lipid profile status.