Major Non-communicable Diseases Research Articles

Influence of major non-communicable chronic disease diagnoses on Chinese adult males' smoking behavior: is there a moderating role for the home environment?

Influence of major non-communicable chronic disease diagnoses on Chinese adult males' smoking behavior: is there a moderating role for the home environment?

ПРОФИЛАКТИЧЕСКИЕ МЕРОПРИЯТИЯ НА ОСНОВЕ ОЦЕНКИ РИСКА РАЗВИТИЯ ЗАБОЛЕВАНИЙ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ У РАБОТНИКОВ МЕТАЛЛУРГИЧЕСКОГО ПРОИЗВОДСТВА

Significance. The conducted studies are devoted to the analysis of the factors of disease development and prevention of major non-communicable diseases, the most common of which are cardiovascular diseases. The relevance of this work is determined by the possibility and need for timely identification of pre-pathological and pathological conditions, in order to develop optimal schemes of preventive measures to preserve professional longevity of workers. The purpose of the study was to develop a program of preventive measures based on the risk assessment of cardiovascular diseases in workers of metallurgical production, exposed to a complex of occupational risk factors. Material and methods. Results of periodic medical examination of workers of certain professional groups of a metallurgical enterprise have been analyzed. To determine the total fatal cardiovascular risk among workers, the SCORE (Systematic Coronary Risk Evaluation) was used. Results. A general sanitary audit of the working conditions of the metallurgical plant workers corresponds to hazardous class 3, degree 2-3 (3.2-3.3). According to the survey results, tobacco smoking is common among more than half of the surveyed workers - 56.8%. Among the professional group of temperers, tobacco smoking is more common (67.0%) compared to the professional group of wire-drawers (50.0%) and the control group (25.6%). The average body mass index among workers was 26.1±1.7 kg/m², and 27.8±1.5 kg/m² in the control group. Analysis of the average cholesterol group level was within the reference values of 4.8±0.1 mmol/l. 31.6% of the workers had high and very high levels of fatal cardiovascular risk, and 14.1% - a low one. Conclusion. Preventive measures to preserve professional longevity of metallurgical production workers should be carried out based on the cardiovascular risk assessment using the developed programs. Scope of application. The developed algorithm for selecting medical measures with due regard to cardiovascular risk assessment can be used as a corporate program for preserving health of the working population.

Trends of antihypertensive use in a tertiary care hospital in Nadia district of West Bengal, India

Background: Being a major non-communicable disease hypertension contributes significantly to disease burden and mortality. Poor control of blood pressure (BP) increases the chance of recurrent stroke and mortality. Although various guidelines have been published to inform practitioners about hypertension and its management, it is necessary to monitor to how much extent the guidelines are being followed. Aims and Objectives: The study aimed to observe antihypertensive medication prescription pattern among indoor patients in a tertiary medical college hospital and to know whether such trend of prescription is relevant and in conformity with the national and international guidelines. Materials and Methods: A prescription-based survey was conducted over 6 months among patients admitted to the medicine ward in a medical college hospital in Nadia district of West Bengal. Relevant data were collected and used for analysis. Results: A total of 500 prescriptions were evaluated. Two hundred and seventy-three patients were female (54.6%) and 227 patients were male (45.4%). About 56.2% of patients were in the senior age group with a higher contribution by the female subjects. Only 17% of patients had Grade 1 hypertension reflecting poor BP control among hypertensive patients. Combination drug was advised in more than half of cases (54.6%), whereas single drug was advised in 44.2% of cases. Amlodipine was the highest prescribing drug (66%) both as monotherapy and in combination followed by Lasix (54.6%), labetalol (31.6%), and telmisartan (11.4%). The thiazide group of drugs was used only in 1% of cases. Conclusion: Overall, the management guidelines for hypertension were adhered in the prescriptions. The underutilization of thiazide-type diuretics remains an area of concern and needs necessary action. The public health delivery system may need to take appropriate measures to make people aware of BP control.

Prevalence of major non-communicable diseases and their associated risk factors in Afghanistan: a systematic review and meta-analysis.

Non-communicable diseases (NCDs) are the leading cause of mortality worldwide, and increasingly so in low- and middle-income countries. Afghanistan is dealing with a double burden of diseases, yet there has been no evidence synthesis on the prevalence of major NCDs and their risk factors. This study aims to provide a comprehensive synthesis of the existing data on the prevalence of major NCDs and the common related risk factors in Afghanistan. We systematically reviewed scientific articles from 2000 to 2022 that reported the prevalence of diabetes, chronic respiratory diseases (CRDs), cardiovascular diseases (CVDs) or cancer, and their risk factors in Afghanistan. Four online databases (PubMed, Web of Science, Cochrane and Google Scholar) and two local journals in Afghanistan (not indexed online) were systematically searched and screened. Two reviewers independently screened and appraised the quality of the articles. Data extraction and synthesis were performed using tabulated sheets. Among 51 eligible articles, 10 (19.6%) focused on cancer, 10 (19.6%) on diabetes, 4 (7.8%) on CVDs, 4 (7.8%) on CRDs and 23 (45.1%) on risk factors as the primary outcome. Few articles addressed major NCD prevalence; no evidence of CVDs, cancer was 0.15%, asthma ranged between 0.3% and 17.3%, and diabetes was 12%. Pooled prevalence of hypertension and overweight were 31% and 35%, respectively. Central obesity was twice as prevalent in females (76% versus 40%). Similarly, gender differences were observed in smoking and snuff use with prevalence rates of 14% and 25% among males and 2% and 3% among females, respectively. A total of 14% of the population engaged in vigorous activity. Pooled prevalence for physical inactivity, general obesity, fruit and vegetable consumption, dyslipidaemia and alcohol consumption couldn't be calculated due to the heterogeneity of articles. Only little evidence is available on the prevalence of major NCDs in Afghanistan; however, the NCD risk factors are prevalent across the country. The quality of the available data, especially those of the local resources, is poor; therefore, further research should generate reliable evidence in order to inform policymakers on prioritizing interventions for controlling and managing NCDs.

Effect of lifestyle on nitric oxide and lipid profile in Type 2 diabetes mellitus patients

Background: Sedentary lifestyle is among the forerunner causes of major non-communicable diseases, including cardiovascular disease, Type 2 diabetes, and diverse types of cancer, contributing substantially to the global burden of disease. There is a massive increase in the prevalence of Type 2 diabetes mellitus (DM) worldwide. Cardiovascular diseases, especially atherosclerosis, contribute significantly to diabetes related deaths. Aims and Objectives: The present study was designed to compare the body mass index (BMI), nitric oxide (NO), and lipid profile in physically active and sedentary Type 2 DM patients. Materials and Methods: The study included a total of 70 patients of Type 2 DM. The inclusion criteria were HbA1c ≥6.5%, age between 30 and 60 years, and a disease history of 5–10 years. The exclusion criteria were the presence of any other chronic/acute illness, patients having difficulty in walking, patients on any nitrate and nitrite drugs, patients on lipid-lowering drugs, history of alcohol, tobacco, or other substance abuse. Assessment of physical activity was done by International Physical Activity Questionnaire - long form. BMI, NO, and lipid profile were assessed for the two groups. Statistical analysis was carried out using GraphPad Prism 7.0. Groups of data were compared with an analysis of variance followed by the tukey test. A P < 0.05 was considered statistically significant. Results: In the physically active group, BMI (P = 0.0345), total cholesterol (P < 0.0001), low-density lipoprotein (P < 0.001), and triglycerides (P < 0.001) were significantly less; while their high-density lipoprotein (P < 0.0001) and NO (P < 0.0001) was significantly more as compared to the sedentary group. Conclusion: The conclusion of this study is that in patients of type 2 DM, a physically active lifestyle was associated with decreased cardiovascular risk.

Traditional remedies for diabetes used by the Ao (Naga) tribe in Mokokchung district, Nagaland, India

Diabetes, a metabolic disorder, poses a significant global health challenge and is recognized as a major non-communicable disease. This widespread issue not only impacts the well-being of individuals but also poses economic burdens, particularly on developing nations. Consequently, there is a pressing need for appropriate solutions and effective medicines, making it a focal point of research globally. Despite remarkable progress in modern allopathic medicine, there exists no definitive cure for diabetes within this system. Additionally, allopathic drugs, while beneficial, often come with severe side effects that can lead to various physiological disorders. In the light of these challenges, ethnobotanical exploration emerges as a viable alternative, providing an avenue to identify potential folk medicines for treating metabolic disorders.The current study aimed to investigate the diversity of medicinal plants traditionally used by the Ao (Naga) tribe in Mokokchung for diabetes treatment and to document these folk remedies. Mokokchung district, Nagaland, is home to the Ao (Naga) tribe, a community reliant on ethnomedicinal herbs for their daily needs and healthcare. The study, conducted between September 2021 and March 2022, involved structured interviews with traditional healers to collect information on their use of medicinal plants in managing various ailments. The study findings underscored the richness of medicinal plants and folk formulations employed in diabetes treatment within the Mokokchung district of Nagaland. A total of 32 medicinal plant species from 26 families were documented. Despite the advancements in modern medicine, traditional ethnomedicinal practices are gradually losing favor, particularly among younger generations, leading to the erosion of this invaluable knowledge. Hence, there is an urgent need for further scientific investigation to validate the claims and efficacy of folk medicines used for diabetes treatment. Inthis background, there is a critical requirement for inventory, documentation and scientific validation of these practices and folk medicines. Immediate attention to these efforts is crucial to preserve this invaluable knowledge and facilitate its integration with modern medical practices, ensuring the preservation and effective utilization of this traditional wisdom.

BRINGING COMMUNITY-BASED FALLS PREVENTION PROGRAM TO IMPROVE GLOBAL HEALTH (BRIGHT)

Abstract Older adults in low- and middle-income countries (LMICs) experience a disparate burden of non-communicable diseases (NCDs) and barriers to accessing health care. Unintentional injuries are among the major NCDs, and falls are the second leading cause of these injuries and deaths. Falls were reported in up to 50% of older people living in Asia, including Thailand. There is a lack of community-based multifactorial fall prevention interventions that target both older adults and the primary care systems. We aimed to culturally adapt the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) for Thai older adults and explore the feasibility, appropriateness, and acceptability of using STEADI by trained community health workers (CHWs) and care managers (CMs). STEADI consists of three steps: screening, assessing, and intervening. In Step a, CHWs screened fall risk using three key questions and found that all of participants had fall risk, then CHWs screened with a Stay Independent questionnaire (range 0-14) and found that 100% have high fall risk (total scores 9.7± 2.4). In Step b, CMs assessed risk factors and CHWs assessed home hazards. They found that 50% had poor balance, 70% took 4+ medications, 75% fell on the walkway, and 70% had no bathroom modifications. In Step c, individual participants received fall prevention interventions and participants attended all sessions. Our results indicated that STEADI delivered by CHWs and CMs is feasible and acceptable for older adults. The mean scores of acceptability, appropriateness, and feasibility were 19.20,18.80, and 18.60 out of 20 totals, respectively.

Mapping evidence on barriers to and facilitators of diagnosing noncommunicable diseases (NCDs) among people living with human immunodeficiency virus (PLWH) in low- and middle-income countries (LMICs) in Africa: A scoping review protocol

Background Noncommunicable diseases (NCDs) represent a global public health challenge in all population groups, but the prevalence of major NCDs, such as depression, hypercholesterolemia, hypertension, obesity and diabetes, is increasing at a rapid rate among people living with human immunodeficiency virus (PLWH). Studies show that integrated NCDs and human immunodeficiency virus (HIV) services have improved the patient outcome of PLWH with comorbidities with NCDs. It requires a strengthened and sustainable way of diagnosing major NCDs early among PLWH. However, there is limited evidence regarding the barriers to and facilitators of early diagnosis of NCDs (depression, hypercholesterolemia, hypertension, obesity and diabetes) among PLWH in low- and middle-income countries (LMICs). This review will systematically map the literature and describe the barriers and facilitators of diagnosing NCDs (depression, hypercholesterolemia, hypertension, obesity and diabetes) among PLWH in LMICs in Africa. Methods The methodology presented by Arksey and O’Malley and the recommendation set out by Levac and colleagues will be used. PubMed, MEDLINE with full text via the EBSCO host, Google Scholar, Science Direct and Scopus will be used for a comprehensive search for data extraction. The search will be conducted using keywords, Boolean terms, and Medical Subject Headings (MeSH). All studies with eligible titles will be exported to the EndNote citation manager for deduplication and imported to Rayyan software for screening. Two reviewers will independently screen abstracts, and the preferred reporting items for systematic review and meta-analysis extension to scoping review (PRISMA-Sc) guidelines will be used to guide the search in conducting the scoping review. We will perform descriptive data analysis for quantitative studies, NVivo software version 12 will be used for qualitative studies, and thematic content analysis will be carried out. This scoping review will include studies that included PLWH with those diagnosed with major NCDs (depression, hypercholesterolemia, hypertension, obesity, and diabetes) in LMICs in Africa. Discussion This scoping review will highlight evidence mapping on barriers and facilitators of diagnosing NCDs (depression, hypercholesterolemia, hypertension, obesity, and diabetes) among PLWH LMICs in Africa. Scoping Review Registration: registered on Open Science Framework (https://osf.io/xvtwd/).

Association between periodontitis stages and self-reported diseases in a Norwegian population: the HUNT study

BackgroundThe relationships between periodontitis and non-communicable diseases (NCDs) have been investigated through several different case-definitions. The differences in methodology may have hindered the basis of comparison between these studies. The classification from the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions offers a unison platform that may facilitate future comparison of such research. The present study aimed to reproduce associations between periodontitis and other NCDs using the 2017 Classification, in the Trøndelag Health Study (HUNT).Material and methodsThe fourth HUNT-survey was carried out between 2017 and 2019. Clinical variables, blood samples and answers to questionnaires were collected from 4933 participants. Periodontal status was assessed based on the latest staging system, and its associations with NCDs were estimated by logistic regression models adjusted for potential confounders.ResultsCompared to no or Stage I periodontitis, participants with Stage III/IV periodontitis (radiographic bone loss exceeding 33%) were associated with cardiovascular disease, hyperglycemia in participants with diabetes and chronic obstructive pulmonary disease (COPD)/emphysema. Associations with hyperglycemia in participants with diabetes and COPD/emphysema were also observed in participants with Stage II periodontitis. The only observed association when considering never-smokers alone, was with COPD/emphysema.ConclusionPeriodontitis Stage II and III/IV were associated with major NCDs. Effect sizes increased with increasing periodontitis stages, which implies greater occurrence of coincident comorbidities in patients with severe periodontitis.

Joint and Bone Exercises to Prevent Osteoporosis in the Elderly at the Tresna Werdha I Budi Mulya Social Home

Osteoporosis is a major non-communicable disease and the most common bone disease, affecting one in three women and one in five men over the age of 50 worldwide. The clinical consequence of osteoporosis is fragility fractures. With the rapid ageing of the population worldwide and the changes in lifestyle habits, the incidence of osteoporosis and related fractures has significantly increased and will continue to increase markedly in the future. Exercises such as walking, dancing, low-impact aerobics work directly on bones in the legs, hips and lower spine to slow bone loss. We provide osteoporosis prevention education to the elderly in nursing homes as an effort to prevent osteoporosis. We also provide training on joint and bone exercises to prevent osteoporosis.

Knowledge of Complications of Diabetes Mellitus Among Patients Visiting the Diabetes Clinics: A Cross-Sectional Study in the Qassim Region.

Background and objectives Diabetes mellitus (DM) is a chronic complex metabolic disease characterized mainly by hyperglycemia. It appears to be a global epidemic and an increasingly major non-communicable disease, posing a threat to both affluent and nonaffluent societies. Diabetes dramatically increases the risk of developing stroke, chronic kidney disease, and coronary artery disease. These complications include chronic kidney disease, retinopathy, coronary artery disease, stroke, and diabetic foot ulcers. Compared to people without diabetes, adults with diabetes have a two to four times greater risk of dying from heart disease and stroke. This study aimed to assess the knowledge and attitude regarding complications among patients with diabetes visiting the Diabetes Clinics at King Fahad Specialist Hospital (KFSH) in the Qassim Region, Saudi Arabia. Methodology A cross-sectional study was conducted in which patients with DM who visited the Diabetic Clinics at KFSH from February 2023 to July 2023 were recruited using a nonprobability sampling technique. A validated questionnaire from previous research was used to collect data on the sociodemographic features of the participants and their knowledge regarding diabetic complications. Data were described using mean with standard deviation for continuous variables and proportion for categorical variables. Results A total of 368 patients were recruited. The majority of the respondents (144, 39.1%) had been living with diabetes for over 10 years, followed by 23.1% (85) of those with less than one year. Exactly 239 (64.9%) reported having a family history of diabetes. About 75% (276) of participants knew about diabetic complications, and 247 (67.1%) reported that their doctor had addressed them about diabetes complications. Among the sources of diabetes complication information, diabetologists were reported by 131 (35.6%) of the respondents, followed by 81 (22.0%) through social media, 65 (17.7%) from relatives, and 39 (10.6%) from family medicine doctors. On the other hand, the findings reveal that the different age groups have different levels of knowledge of hyperglycemia and hypoglycemia as diabetic complications (P = 0.031). However, there were no significant differences in the level of knowledge regarding complications between male and female patients (P > 0.05). Conclusions The study found that while the studied population had a relatively good knowledge of diabetic complications, some still lacked knowledge. The study also supports the need for individuals with a family history of diabetes to be aware of their risk and take steps for prevention, as a large proportion of participants reported having a family history of diabetes. Healthcare providers and diabetologists were the most frequent sources of information on diabetic complications. However, some also turned to social media. Focused education and awareness actions are crucial to ensure that people with diabetes have access to reliable information from various sources.

Effect of an educational intervention on diet and physical activity among school-aged adolescents in Delhi -The i-PROMISe (PROMoting health literacy in Schools) Plus Study.

Emerging lifestyle changes due to rapid urbanization have led to an epidemiological transition and the rising prevalence of obesity is responsible for major non-communicable diseases (NCDs) which have further aggravated due to the COVID-19 pandemic. This study aims to assess the effectiveness of a comprehensive school-based intervention on diet and physical activity-related behavior of adolescents. In 2019, a cluster-randomized controlled trial was conducted in randomly selected (n=8) private schools. A 2-year intervention program was implemented over consecutive academic years (2019-2020 and 2020-2021) with students who were in the 6th and 7th grades when the study began. Four schools were randomly assigned to the intervention (n=794) and four schools to the control group (n=774). The difference in changes in diet and physical-activity-related behaviors of the students between the intervention and control schools were not significant in the intention to treat analysis probably due to the large drop-out due to COVID-19 measures: 304 students were available for follow-up in the intervention group and 122 in the control group (391 cases were excluded to make data comparable with baseline survey). The intake of vegetables (once a day) [β=0.35, OR=1.42, 95% CI (1.03, 1.95)] in the per-protocol analysis has increased among adolescents in the intervention group as compared to the control group. The findings of this study indicated a positive effect of the intervention on diet and physical-activity-related changes in the expected direction and highlights the importance of addressing such behavior to prevent obesity among adolescents and thus NCDs in the later stage of life.

The Role of Perivascular Adipose Tissue in the Pathogenesis of Endothelial Dysfunction in Cardiovascular Diseases and Type 2 Diabetes Mellitus.

Cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2DM) are two of the four major chronic non-communicable diseases (NCDs) representing the leading cause of death worldwide. Several studies demonstrate that endothelial dysfunction (ED) plays a central role in the pathogenesis of these chronic diseases. Although it is well known that systemic chronic inflammation and oxidative stress are primarily involved in the development of ED, recent studies have shown that perivascular adipose tissue (PVAT) is implicated in its pathogenesis, also contributing to the progression of atherosclerosis and to insulin resistance (IR). In this review, we describe the relationship between PVAT and ED, and we also analyse the role of PVAT in the pathogenesis of CVDs and T2DM, further assessing its potential therapeutic target with the aim of restoring normal ED and reducing global cardiovascular risk.

Treatment-seeking behaviour among 15–49-year-olds with self-reported heart disease, cancer, chronic respiratory disease, and diabetes: a national cross-sectional study in India

BackgroundEighty per cent of India´s non-communicable disease (NCD) mortality is due to four conditions: heart disease, cancer, chronic respiratory disease, and diabetes, which are primarily cause-amenable through treatment. Based on Andersen’s behavioural model of health services use, the current study aimed to identify the predisposing, enabling, and need factors associated with treatment-seeking status among people self-reporting the four main NCDs in India.MethodsCross-sectional study using secondary data. Usual residents aged 15–49 who self-reported cancer (n = 1 056), chronic respiratory disease (n = 10 534), diabetes (n = 13 501), and/or heart disease (n = 5 861) during the fifth National Family and Health Survey (NFHS-5), 2019–21, were included. Treatment-seeking status was modelled separately for each disease using survey-adjusted multivariable logistic regression.Results3.9% of India´s 15–49-year-old population self-reported ≥ 1 of the four main NCDs (0.1% cancer, 1.4% chronic respiratory disease, 2% diabetes, 0.8% heart disease). The percentage that had sought treatment for their condition(s) was 82%, 68%, 76%, and 74%, respectively. Greater age and having ≥ 1 of the NCDs were associated with greater odds of seeking disease-specific treatment. People in the middle or lower wealth quintiles had lower odds of seeking care than the wealthiest 20% for all conditions. Women with diabetes or chronic respiratory disease had greater odds of seeking disease-specific treatment than men. Muslims, the unmarried, and those with health insurance had greater odds of seeking cancer treatment than Hindus, the married, and the uninsured.ConclusionPredisposing, enabling, and need factors are associated with treatment-seeking status among people reporting the four major NCDs in India, suggesting that multiple processes inform the decision to seek disease-specific care among aware cases. Successfully encouraging and enabling as many people as possible who knowingly live with major NCDs to seek treatment is likely contingent on a multi-pronged approach to healthcare policy-making. The need to improve treatment uptake through accessible healthcare is further underscored by the fact that one-fifth (cancer) to one-third (chronic respiratory disease) of 15–49-year-olds reporting a major NCD have never sought treatment despite being aware of their condition.

A clinical study to ascertain the effectiveness of homoeopathic medicines in the treatment of scalp psoriasis

Objectives: Psoriasis was recognised as a major non-communicable disease in the World Health Assembly decision WHA67 on 24 May 2014. One of the most typical locations for psoriasis manifestations is the scalp; this has a detrimental effect on the patient’s quality of life. Materials and Methods: Study participants were chosen from among patients who attended the psoriasis research outpatient clinic at the Government Homoeopathic Medical College Thiruvananthapuram, Kerala. With the help of a dermatologist, the patients were clinically identified and case documentation was completed using a standardised case record format. The gathered data were analysed using the Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) following the administration of the homoeopathic medicine. Results: It is clear from the current study of 30 instances that by comparing the PASI scores and DLQI ratings for the area of psoriasis lesions on the scalp before and after therapy, the study’s overall effectiveness was determined. After the medication was administered, PASI scores and DLQI considerably reduced and patients reported an improvement in their quality of life. Conclusion: Homoeopathy can effectively treat scalp psoriasis. It most frequently affects the scalp, which has a detrimental effect on people’s quality of life. The proper treatment and limiting of impairments depend on early detection and intervention. In the current scenario, our statistical data depict that homoeopathy holds a pivotal role in the choice of various health systems for cost-effective and successful treatment of scalp psoriasis.

Prevalence of major noncommunicable diseases and their associated risk factors in Afghanistan

Abstract Objective Afghanistan is dealing with a double burden of diseases and yet there has been no evidence synthesis of the scientific literature on noncommunicable disease (NCDs), thus this study fills the gap by systematically analysing the prevalence of four major NCDs and the associated risk factors. Methods We performed a systematic review and meta-analysis of the studies published since 2000, reporting the prevalence of diabetes, chronic respiratory diseases (CRDs), cardiovascular disease (CVDs) or cancer, and their risk factors in Afghanistan. Four online databases (PubMed, Web of Science, Cochrane, and Google Scholar) and two local peer reviewed journals in Afghanistan were systematically searched using the predefined keywords. Two reviewers independently screened and appraised the quality of the papers. Data extraction and data synthesis were carried out using tabulated template. Stata 13 was used to perform the meta-analysis. Results 58 articles included in this review of which 13 focused on cancer, 10 on diabetes, 7 on CVDs, 5 on CRDs, and 23 on any of the risk factors as primary outcome. Very few articles reported the prevalence of 4 NCDs in general population where cancer was reported 0.15%, asthma ranged between 12.5% to 17.3% and no evidence on CVDs. The pooled prevalence for diabetes, hypertension, and overweight were 12%, 31%, and 35% respectively. Central obesity was almost twice prevalent in females (76% vs 40%). Similarly, the pooled prevalence of smoking and snuff use were 14% and 25% in males, and 2% and 3% in females respectively. Conclusions Less evidence is available on the prevalence of major NCDs in Afghanistan, however, the risk factors for NCDs are prevalent across the country. The quality of the available data specially those of the local resources are poor, therefore, further research should be conducted to generate reliable evidences to inform the policy makers on prioritization of the interventions for the control of NCDs in Afghanistan. Key messages • The prevalence of NCDs is escalating in Afghanistan, and the local data show higher estimates of NCDs and their associated risk factors. • Prevalence of NCD risk factors is relatively high in Afghanistan, and considering the political emergency situation, if preventive measures are not taken properly, the burden of NCDs may increase.

Assessing care quality: impact on renal outcomes in non-diabetic chronic kidney disease patients

Abstract Background Chronic kidney disease (CKD) is a major global noncommunicable disease, with significant burden on healthcare systems. Quality indicators (QIs) are useful tools for evaluating healthcare quality, but existing QIs for renal care mainly focus on dialysis population. This study aims to explore the association between quality of renal care and outcomes in non-diabetic CKD patients. Methods This study utilized Taiwan's National Health Insurance claims data and death registries to enroll non-diabetic adults with advanced CKD (stage 3B-5) from 2016 to 2019, following them through 2020. QIs evaluated included prescription of renin-angiotensin system (RAS) inhibitors, testing for proteinuria, and avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs). An overall quality score was calculated by summing scores of each QI. The primary outcome was long-term dialysis, and secondary outcomes included death, acute kidney injury (AKI), hyperkalemia, and acidosis. Univariate and multivariate Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the effects of QIs on outcomes. Results Among 27,842 patients, 59.8% received RAS inhibitors, 56.5% underwent proteinuria testing, and NSAIDs were avoided in 97.9% of cases. Only 33.5% received the highest QI score of 3. Multivariate Cox proportional hazard models showed that higher overall quality scores were associated with a lower risk of long-term dialysis (HR 0.87, 95% CI 0.83-0.92), death (HR 0.90, 95% CI 0.86-0.94), and acidosis (HR 0.87, 95% CI 0.79-0.96). Additionally, higher overall quality scores were borderline associated with a lower risk of AKI and hyperkalemia. Conclusions QIs for renal care were associated with better outcomes in non-diabetic patients with advanced-stage CKD, particularly in long-term dialysis, death, and acidosis. More patients need to be prescribed RAS inhibitors and tested for proteinuria to achieve better quality of renal care. Key messages • Our study shows quality of renal care can impact outcomes for non-diabetic CKD patients, with higher quality indicator scores associated with lower risk of long-term dialysis, death, and acidosis. • Prescription of RAS inhibitors had the most significant protective effect, but more patients need to be prescribed RAS inhibitors and tested for proteinuria to achieve better renal care quality.

Dietary fiber - a scoping review for Nordic Nutrition Recommendations 2023.

Dietary fiber is a term crudely defined as carbohydrates (CHOs) that escape digestion and uptake in the small intestine. Lignin, which is not a CHO, is also a part of the dietary fiber definition. Dietary fibers come in different sizes and forms, with a variety of combinations of monomeric units. Health authorities worldwide have for many years recommended a diet rich in dietary fibers based on consistent findings that dietary fibers are associated with reduced incidences of major non-communicable diseases, including obesity, type 2 diabetes, cardiovascular disease, and colorectal cancer. Most fibers come from common edible foods from the plant kingdom, but fibers are also found in food additives, supplements, and breast milk. The recommended intake in Nordic Nutrition Recommendations 2012 (NNR2012) is 25 g/d for women and 35 g/d for men, whereas the actual intake is significantly lower, ranging from 16 g/d to 22 g/d in women and 18 g/d to 26 g/d in men. New studies since NNR2012 confirm the current view that dietary fiber is beneficial for health, advocating intakes of at least 25 g/day.

Prescription audit and drug interactions of anti-diabetic drugs at Outpatient Department at a tertiary care teaching hospital in Eastern Nepal

Type 2 diabetes mellitus (T2DM) is the third major non-communicable disease in Nepal. Drug utilization studies help in reducing the patient’s expenditure, adverse drug reactions and drug-drug interactions. It would help in understanding of consumption of drugs including newer ones. Objective was to analyze the prescribing pattern and drug interactions of anti-diabetic drugs. A prospective cross-sectional study was conducted among patients having T2DM at Birat Medical College and Teaching Hospital (BMCTH), Biratnagar, Nepal from May 2019- August 2019. WHO core drug use indicators were used to analyze the obtained data. Descriptive statistics like mean, standard deviation, frequency and percentage were calculated using Microsoft Excel 2013. Out of 200 patients, 104 (52.0%) were females and 49.5% were from the age group of 41-60 years. Average number of drugs per patient was 5.74. Biguanides (40.7%) were the most common prescribed oral antidiabetic drugs followed by Sulfonylureas (23.3%). The percentage of drugs prescribed by generic name and from WHO essential drug list was 0.6% and 15.4% respectively. A total of 95 (47.5%) patients has potential drug-drug interaction (DDI) and it was most common in the age group of 41-60 years (43.2%). Among 95 DDI, Metformin+Amlodipine ranked in 1st position (16 encounters). Polypharmacy was prevalent in the present study. Metformin was the most commonly prescribed anti-diabetic drug. The percentage of drugs from the WHO essential medicine list and prescribed by generic names was low. Prevalence of potential DDI was high.

A protocol of Chinese expert consensuses for the management of health risk in the general public.

Non-communicable diseases (NCDs) represent the leading cause of mortality and disability worldwide. Robust evidence has demonstrated that modifiable lifestyle factors such as unhealthy diet, smoking, alcohol consumption and physical inactivity are the primary causes of NCDs. Although a series of guidelines for the management of NCDs have been published in China, these guidelines mainly focus on clinical practice targeting clinicians rather than the general population, and the evidence for NCD prevention based on modifiable lifestyle factors has been disorganized. Therefore, comprehensive and evidence-based guidance for the risk management of major NCDs for the general Chinese population is urgently needed. To achieve this overarching aim, we plan to develop a series of expert consensuses covering 15 major NCDs on health risk management for the general Chinese population. The objectives of these consensuses are (1) to identify and recommend suitable risk assessment methods for the Chinese population; and (2) to make recommendations for the prevention of major NCDs by integrating the current best evidence and experts' opinions. For each expert consensus, we will establish a consensus working group comprising 40-50 members. Consensus questions will be formulated by integrating literature reviews, expert opinions, and an online survey. Systematic reviews will be considered as the primary evidence sources. We will conduct new systematic reviews if there are no eligible systematic reviews, the methodological quality is low, or the existing systematic reviews have been published for more than 3 years. We will evaluate the quality of evidence and make recommendations according to the GRADE approach. The consensuses will be reported according to the Reporting Items for Practice Guidelines in Healthcare (RIGHT).