Prevention Of Non-communicable Diseases Research Articles

Prevalence and risk factors of hypertension and diabetes mellitus in riverine communities in Nigeria’s Niger delta: implications for community-based interventions

Background: The global burden of non-communicable diseases is enormous, especially in low- and middle-income countries. This study assessed the prevalence of hypertension and diabetes mellitus and associated factors among adult residents of riverine communities in Niger delta region of Nigeria. Methods: A community-based descriptive cross-sectional study. Adults aged 18 years and above residing in riverine communities who attended a free medical outreach programme were screened for hypertension and diabetes mellitus. Anthropometry and measurements were done using standard methods. Data was analysed using SPSS version 26. Results: Of the 1597 participants, 1066 (66.6%) were females, 470 (29.4%) overweight and 356 (22.3%) were obese. Their mean age was 41.0±14.5 years. The prevalence of hypertension diabetes mellitus and hypercholesterolemia was 37.6%, 3.9% and 65.6% respectively. Significant predictors of hypertension were age ≥40 years (OR =3.86, CI: 2.59-5.75, p<0.001), male sex (OR=1.78, CI: 1.19-2.65, p=0.005), overweight (OR=1.92, CI: 1.19-3.11, p=0.008) and obesity (OR=1.73, CI: 1.05-2.85, p=0.032). No statistically significant association between demographic characteristics and diabetes mellitus was observed. Conclusions: The high prevalence of hypertension and diabetes mellitus in the riverine communities calls for an urgent need to set up community based noncommunicable diseases prevention programmes and then develop and implement effective targeted interventions to help residents of the riverine communities diagnosed with these conditions to better manage the disease.

Non-Communicable Diseases Impact Low-Income Households in Malaysia.

Non-communicable diseases (NCDs) have a vast and rising impact on households at all income levels across the globe, particularly with poorer people bearing the burden. Hence, this study examines NCDs' effects on Malaysia's B40 group (low-income earners). This study used the 2015 National Health and Morbidity Survey, a population-based cross-sectional survey with 18,616 respondents from B40 households in Malaysia. Logistic regression analysis is used to assess NCDs' influence on poverty. In 2015, more than 20% of the B40 households lived below the poverty level. In addition, the B40 households had a greater prevalence of NCDs, with almost half of them diagnosed with at least one NCD (47.32%); hypertension (9.90%), diabetes mellitus (17.12%) and hypercholesterolemia (22.89%). Households with a member having an NCD are more likely to experience poverty than those without NCDs. The results also suggested that B40 households with catastrophic payments were at a 25% threshold; the elderly, individuals without formal education and unpaid workers were more likely to experience poverty. The findings suggest that NCDs increase the likelihood of B40 households falling into poverty. These facts highlight the necessity of safeguarding B40 households from the financial burden of NCDs by creating more effective financial protection plans for Malaysia's low-income earners.

Pattern of multimorbidity in middle-aged and older-aged people with mild intellectual disability in Australia.

Non-communicable diseases (NCDs), also known as chronic diseases, now constitute a major proportion of ill-health across most adult and older populations including in people with intellectual disability. The current paper is a comparative analysis of prevalence of NCDs across mid-aged and older-aged people with mild intellectual disability. Comparative data comes from two cross-sectional surveys using similar methodology and timeframes. The analysis sample comprises mid-aged group (30-50 years, N = 291) and older-aged group (≥60 years, N = 391). People with mild intellectual disability start developing NCDs in early to mid-adulthood and increases with age. The mean number of NCDs in mid-aged group was 0.86 (SD, 0.84) compared to 3.82 in older group (SD, 2.67). There needs to be early identification and management of NCDs using relevant health promotion and preventative measures at optimal intervention points. The training of healthcare professionals needs improvement.

Prevalence and Factors Associated With Selected Non-communicable Diseases (Hypertension, Type 2 Diabetes, and Depression) Among People Living With HIV at Kalisizo Hospital in Kyotera District, Uganda: A Cross-Sectional Study

BACKGROUND: In rural Uganda, there exists a paucity of data on the prevalence and factors associated with non-communicable diseases (NCDs) among people living with HIV, despite heightened concerns about their increased susceptibility. Therefore, this study aims to investigate the prevalence and assess factors associated with selected NCDs, namely hypertension, type 2 diabetes, and depression, among people living with HIV (PLHIV) seeking HIV care at Kalisizo Hospital. METHODS: A cross-sectional study was conducted at Kalisizo Hospital, involving a randomly selected sample of 290 individuals living with HIV between August 8th to 24th, 2020. Data on socio-demographics, lifestyle, and clinical characteristics were collected using an adapted WHO steps questionnaire, medical records review, and a patient Health Questionnaire-9. We further conducted anthropometric and laboratory measurements. Statistical analysis was performed using STATA Version 15.0, employing Modified Poisson regression. RESULTS: The overall prevalence of NCDs was 39.7% (95% CI=34.2%-45.4%). This prevalence was higher among participants with tertiary education (aPR=1.55, 95% CI=1.05,2.77, p=0.026), those who were obese (aPR=2.01, 95% CI=1.40,2.87, p<0.001), individuals in WHO clinical staging 3 and 4 of HIV (aPR=1.45, 95% CI=1.02,2.05, p=0.037), and those with unhealthy dietary habits (aPR=1.61, 95% CI=1.20,2.16, p=0.002). CONCLUSION: This study unveiled a significant prevalence of selected NCDs among PLHIV seeking HIV care at Kalisizo Hospital. This highlights the pressing necessity for swift and impactful measures to be taken by the Ugandan government, development partners, and other stakeholders. It is imperative to implement tailored interventions designed to address the high NCD prevalence observed in PLHIV who are obese, engage in unhealthy dietary habits, possess tertiary education, and fall into WHO clinical stage 3 or 4 of HIV.

Mass Communication Strategy in Encouraging the Adoption of a Healthy Lifestyle in Society

Healthy lifestyle has become the main focus in efforts to prevent the increasing prevalence of non-communicable diseases in society. In this context, mass communication strategies play a central role in forming awareness and encouraging the adoption of a healthy lifestyle. This research aims to explore and analyze mass communication strategies that are effective in changing people's behavior regarding healthy lifestyles. The main objective of this research is to identify the most effective mass communication strategies in encouraging the adoption of healthy lifestyles in society. In addition, this study aims to evaluate the impact of this strategy on the level of awareness and behavior change regarding various aspects of a healthy lifestyle. This research uses the literature review method as an analytical framework. Data was collected from various sources such as scientific journals, articles and books related to mass communication strategies and healthy lifestyles. Data analysis involves detailing the various mass communication strategies that have been implemented and identifying patterns of success in changing people's behavior. the use of N.Vivo analysis can help in identifying patterns, trends, and relationships between various concepts and findings that emerge from these articles. \The research results show that mass communication strategies that rely on interesting narratives, effective use of social media, and involvement of community leaders have a significant impact in encouraging the adoption of a healthy lifestyle. The ability to create community engagement and respond to local cultural dynamics also plays an important role in the success of this strategy.

Regional advocacy workshop on noncommunicable disease priorities among children and adolescents in the Eastern Mediterranean Region

Background: There has been a surge of noncommunicable diseases (NCDs) globally, and particularly in the Eastern Mediterranean Region. Data indicate a notable prevalence of NCD risk factors among children and adolescents, including physical inactivity, tobacco use, as well as high salt, sugar and fat intake, highlighting the need for urgent actions. Aim: To present key recommendations and follow-up actions from a workshop on noncommunicable diseases among children and adolescents in the Eastern Mediterranean Region. Method: In March 2023, the WHO Regional Office for the Eastern Mediterranean held a workshop in Oman which discussed the challenges, early interventions, policy changes, and prioritization of NCDs prevention for children and adolescents in the region. Results: Participants, including a considerable representation of the youth group, shared experiences on risk factors, prevention, treatment, and suitable platforms for NCD care among children and adolescents, and the importance of systematic monitoring and evaluation. Following the workshop, the youth were engaged in the development of a regionspecific NCDs intervention roadmap. Conclusion: Further youth engagement, multisectoral collaborations, and the establishment of dedicated national authorities to oversee proposed interventions are needed to reduce premature deaths due to NCDs by one-third by 2030, as indicated in the Sustainable Development Goals target 3.4.

Non-Communicable Diseases among Women of Reproductive Age Visiting the Department of Obstetrics and Gynecology of a Tertiary Care Hospital.

Non-communicable diseases are a significant cause of mortality worldwide, posing a substantial risk to women's health, as stated by the World Health Organization. In Nepal, a survey revealed that 10.5% of the population suffers from hypertension. The primary objective of this study was to determine the prevalence of non-communicable diseases among women of reproductive age visiting the Department of Obstetrics and Gynecology of a tertiary care hospital. A descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynecology among women of reproductive age presented from 6 November 2023 to 6 January 2024. The data was retrieved from the medical record during 1 November 2023 to 1 December 2023. Ethical approval was taken from the Institutional Review Committee. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. The prevalence of non-communicable diseases was 608 (39.02%) (36.60-41.45, Confidence Interval). The mean age was 29.26±3.46 years. The most common non-communicable disease reported was hypertension 204 (33.55%) followed by chronic respiratory diseases 200 (32.89%) and diabetes mellitus 154 (25.34%). The prevalence of non-communicable diseases among women of reproductive age group was higher as compared to other studies done in similar setting. The study underscores the urgency for stakeholders to implement health education, early detection, and preventive strategies, emphasizing the necessity of targeted interventions and broader public health initiatives to address non-communicable diseases. chronic disease; non-communicable disease; prevalence; risk factors.

Eosinophilic Asthma: Pathophysiology and Therapeutic Horizons.

Asthma is a prevalent chronic non-communicable disease, affecting approximately 300 million people worldwide. It is characterized by significant airway inflammation, hyperresponsiveness, obstruction, and remodeling. Eosinophilic asthma, a subtype of asthma, involves the accumulation of eosinophils in the airways. These eosinophils release mediators and cytokines, contributing to severe airway inflammation and tissue damage. Emerging evidence suggests that targeting eosinophils could reduce airway remodeling and slow the progression of asthma. To achieve this, it is essential to understand the immunopathology of asthma, identify specific eosinophil-associated biomarkers, and categorize patients more accurately based on the clinical characteristics (phenotypes) and underlying pathobiological mechanisms (endotypes). This review delves into the role of eosinophils in exacerbating severe asthma, exploring various phenotypes and endotypes, as well as biomarkers. It also examines the current and emerging biological agents that target eosinophils in eosinophilic asthma. By focusing on these aspects, both researchers and clinicians can advance the development of targeted therapies to combat eosinophilic pathology in severe asthma.

Multisectoral action to address noncommunicable diseases: lessons from three country case studies.

Multisectoral action is a central component of the global response to the rising prevalence of non-communicable diseases (NCDs). In this paper we aimed to unpack the definition of multisectoral action and provide an overview of the historical context, challenges, and recommendations alongside three country case studies: salt reduction in the UK, tobacco legislation in Nigeria, and regulation of edible oils in Iran. We used an iterative review process to select three country case studies from a list of 20 potential cases previously identified by WHO. At our third round of review we unanimously agreed to focus on salt reduction in the UK, tobacco regulation in Nigeria, and edible oil regulation in Iran as these represented rich cases on diverse risk factors from three different world regions that we felt offered important lessons. We conducted literature reviews to identify further data for each case study. Across the three studies a number of important themes emerged. We found that multisectoral approaches demand the often difficult reconciliation of competing and conflicting values and priorities. Across our three chosen cases, commercial interests and free trade agreements were the most common obstacles to successful multisectoral strategies. We found that early consultative stakeholder engagement and strong political and bureaucratic leadership were necessary for success. The complex multi-rooted nature of NCDs requires a multisectoral approach, but the inevitable conflicts that this entails requires careful navigation.

HIV, multimorbidity, and health-related quality of life in rural KwaZulu-Natal, South Africa: A population-based study.

Health-related quality of life (HRQoL) assesses the perceived impact of health status across life domains. Although research has explored the relationship between specific conditions, including HIV, and HRQoL in low-resource settings, less attention has been paid to the association between multimorbidity and HRQoL. In a secondary analysis of cross-sectional data from the Vukuzazi ("Wake up and know ourselves" in isiZulu) study, which identified the prevalence and overlap of non-communicable and infectious diseases in the uMkhanyakunde district of KwaZulu-Natal, we (1) evaluated the impact of multimorbidity on HRQoL; (2) determined the relative associations among infectious diseases, non-communicable diseases (NCDs), and HRQoL; and (3) examined the effects of controlled versus non-controlled disease on HRQoL. HRQoL was measured using the EQ-5D-3L, which assesses overall perceived health, five specific domains (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), and three levels of problems (no problems, some problems, and extreme problems). Six diseases and disease states were included in this analysis: HIV, diabetes, stroke, heart attack, high blood pressure, and TB. After examining the degree to which number of conditions affects HRQoL, we estimated the effect of joint associations among combinations of diseases, each HRQoL domain, and overall health. Then, in one set of ridge regression models, we assessed the relative impact of HIV, diabetes, stroke, heart attack, high blood pressure, and tuberculosis on the HRQoL domains; in a second set of models, the contribution of treatment (controlled vs. uncontrolled disease) was added. A total of 14,008 individuals were included in this analysis. Having more conditions adversely affected perceived health (r = -0.060, p<0.001, 95% CI: -0.073 to -0.046) and all HRQoL domains. Infectious conditions were related to better perceived health (r = 0.051, p<0.001, 95% CI: 0.037 to 0.064) and better HRQoL, whereas non-communicable diseases (NCDs) were associated with worse perceived health (r = -0.124, p<0.001, -95% CI: 0.137 to -0.110) and lower HRQoL. Particular combinations of NCDs were detrimental to perceived health, whereas HIV, which was characterized by access to care and suppressed viral load in the large majority of those affected, was counterintuitively associated with better perceived health. With respect to disease control, unique combinations of uncontrolled NCDs were significantly related to worse perceived health, and controlled HIV was associated with better perceived health. The presence of controlled and uncontrolled NCDs was associated with poor perceived health and worse HRQoL, whereas the presence of controlled HIV was associated with improved HRQoL. HIV disease control may be critical for HRQoL among people with HIV, and incorporating NCD prevention and attention to multimorbidity into healthcare strategies may improve HRQoL.

Assessment of Health Education in The Prevention of Non-Communicable Chronic Disease Complications: Systematic Review

Objective: To evaluate the effectiveness of health education in the prevention of non-communicable chronic diseases. Method: This is a systematic literature review, guided by the question "In patients with non-communicable chronic diseases (NCDs), does health education compared to conventional clinical practice contribute to the prevention of complications?". The selected articles were extracted from the following databases: Biblioteca Virtual em Saúde (BVS), National Library of Medicine (PUBMED), Scientific Electronic Library Online (Scielo), Regional Online Information System for Scientific Journals from Latin America, the Caribbean, Spain, and Portugal (Latindex), and Cochrane Library. Randomized clinical trials in English, Portuguese, and Spanish from the last 10 years with full-text availability were chosen as eligibility criteria, resulting in a final sample of 10 articles. Results: Positive findings were observed regarding the complications of non-communicable diseases, such as: improvement in quality of life and cardiac anxiety scores; reduction in anxiety and depression; increased therapeutic adherence, diabetic foot care, physical activity stimulation, adoption of healthy eating habits, blood glucose self-monitoring and health literacy improvement; reduction in systolic and diastolic blood pressure; improvement in self-management of Type 2 Diabetes Mellitus; overall prevention of NCDs; promotion of motivation for behavioral change in smoking patients, and improvement in renal function with a considerable decrease in serum creatinine and a stable glomerular filtration rate. Implementing educational programs can be helpful in enhancing the quality of life in chronic diseases. Conclusion: Despite the limitation resulting from the diversity of interventions, the consistency in results highlights the beneficial impact of educational approaches, calling for attention from healthcare professionals and public policymakers to expand the use of these strategies in the management of NCDs.

Knowledge and lifestyle practices associated with non-communicable diseases risk factors among undergraduate students, Thiruvananthapuram, India: a mixed method study

Background: Behaviors established in youth especially in college, have lifelong implications on themselves and their close family members. We intended to assess the knowledge of non-communicable diseases (NCDs) risk factors and associated lifestyle practices among undergraduate students. Methods: We conducted a cross-sectional concurrent mixed method study among undergraduate students (n=486) aged 18-21 years, Kerala, India. A self-administered structured questionnaire was used to collect data. In-depth interviews of five students were conducted from each college. Physical measurements including height and weight of the students were measured and reported to the participants. Data was collected from January to March 2019. Results: Forty-four percent (n=200) participants’ fathers were laborers or semi-skilled workers. Only 42.8% (n=208) of students had body mass index (BMI) within normal range. Nearly three fifth of students (58%, n=282) had poor knowledge of NCDs and proportion of students with knowledge of balanced breakfast was 11% (n=53). Regarding lifestyle practices, daily fruit intake was low (10%, n=45) and participants consuming vegetables daily was less than 40% (n=191). Lack of infrastructure supporting physical activities and healthy food choices at home and outside are some reasons mentioned by participants for sedentary lifestyle and unhealthy dietary practices. Parental involvement played an important role in practicing healthy dietary practices and performing physical activity for leisure. Conclusions: The knowledge and practices of undergraduate students regarding primary prevention of NCDs was poor. Community level action with involvement of parents will be helpful in the primary prevention of NCDs.

Validation of a Design Architecture to Deliver Health Management and Behavior Change Evidence at Scale.

Forty-four percent of Canadians over the age of 20 have a non-communicable disease (NCD). Millions of Canadians are at risk of developing the complications of NCDs; millions have already experienced those complications. Fortunately, the evidence base for NCD prevention and behavior change is large and growing and digital technologies can deliver them at scale and with high fidelity. However, the current model of in-person primary care is not designed nor capable of operationalizing that evidence. New developments in artificial intelligence that can predict who will develop NCD or the complications of NCD are increasingly available, making the challenge of delivering disease prevention even more urgent. This paper presents findings from stakeholder engagement on a design architecture to address three initial barriers to large-scale deployment of health management and behavior change evidence: 1) the challenges of regulating mobile health apps, 2) the challenge of creating a value-based rationale for payers to invest in deploying mobile health apps at scale, and 3) the high cost of customer acquisition for delivering mobile health apps to those at risk.

Workplace health promotion management of non-communicable disease prevention and implementation among organizational leaders and human resource executives in Thailand: A qualitative study

In Thailand, the Cabinet has outlined a national reform plan (public health), which emphasizes the concept of health promotion in alignment with the United Nations' Sustainable Development Goals. The plan focuses on policies and measures within the workplace and setting goals to establish workplace health policies. Workplace health promotion yields positive effects on businesses by enhancing work productivity and reducing costs. However, national policies specifically aimed at promoting good health and well-being in the workplace are still limited in scope and are predominantly implemented by governmental agencies in Thailand. This study aimed to investigate the management and implementation of health promotion policies in the workplace by organizational leaders and human resource (HR) executives. We conducted exploratory research using the inductive approach of conventional content analysis. Data were collected through in-depth interviews with senior-level and HR executives affiliated with influential bodies of the Joint Standing Committee on Commerce, Industry, and Banking (JSCCIB), the Personnel Management Association of Thailand (PMAT), industrial estates, and prominent businesses representing all eight industry groups in Thailand between May and November 2022. In-depth interviews were conducted with all key informants, totalling 35 individuals, representing 27 businesses and organizations. The findings were categorized into three main themes: 1) Management including organizational policies, and leadership, 2) Operations including budget allocation, activities, and operational tips, and 3) Challenges including operational challenges and individual factors. This study has outlined strategies for more effective management and implementation to enhance workplace health promotion, and refined policies for improvement of health promotion initiatives in Thai workplaces.

Therapeutic Potential of Pectin and Its Derivatives in Chronic Diseases.

Non-communicable diseases (NCDs) are described as a collection of chronic diseases that do not typically develop from an acute infection, have long-term health effects, and frequently require ongoing care and therapy. These diseases include heart disease, stroke, cancer, chronic lung disease, neurological diseases, osteoporosis, mental health disorders, etc. Known synthetic drugs for the treatment or prevention of NCDs become increasingly dangerous over time and pose high risks due to side effects such as hallucination, heart attack, liver failure, etc. As a result, scientists have had to look for other alternatives that are natural products and that are known to be less detrimental and contain useful bioactive compounds. The increasing understanding of the biological and pharmacological significance of carbohydrates has helped to raise awareness of their importance in living systems and medicine, given they play numerous biological roles. For example, pectin has been identified as a class of secondary metabolites found in medicinal plants that may play a significant role in the treatment and management of a variety of NCDs. Pectin is mainly made of homogalacturonan, which is a linear polymer composed primarily of D-galacturonic acid units (at least 65%) linked in a chain by α-(1,4)-glycosidic linkages. There are also modified pectins or derivatives that improve pectin's bioavailability. Pectin is found in the cell walls of higher plants (pteridophytes, angiosperms, and gymnosperms), particularly in the middle lamella of the plant material. Citrus pectin is used in various industries. This article compiles information that has been available for years about the therapeutic importance of pectin in chronic diseases, different modes of pectin extraction, the chemistry of pectin, and the potency of pectin and its derivatives.

A tryst of ‘blood pressure control- sex- comorbidities’: the odyssey of basic public health services in Yunnan in quest for truth

BackgroundThe Basic Public Health Service (BPHS), a recently announced free healthcare program, aims to combat the most prevalent Noncommunicable Disease-“Hypertension” (HTN)-and its risk factors on a nationwide scale. In China, there is a rife that HTN less impacts women during their lifetime. We, therefore, aimed to evaluate the sex disparity in hypertension patients with comorbidities among south-west Chinese and the contribution of BPHS to address that concern.MethodsWe have opted for a multistage stratified random sampling method to enroll hypertensive patients of 35 years and older, divided them into BPHS and non-BPHS groups. We assessed the sex disparity in HTN patients with four major comorbidities- Dyslipidemia, Diabetes Mellitus (DM), Cardiovascular Disease (CVD), and Chronic Kidney Disease (CKD), and descriptive data were compiled. Odds ratios from logistic regression models estimated the effectiveness of BPHS in the management of HTN with comorbidities.ResultsAmong 1521 hypertensive patients,1011(66.5%) were managed in the BPHS group. The proportion of patients who had at least one comorbidity was 70.7% (95% confidence interval [CI]: 66.3-76.8%), patients aged 65 years and older were more likely to have coexisting comorbidities. Participants who received the BPHS showed significant blood pressure (BP) control with two comorbidities (odds ratio [OR] = 2.414, 95% CI: 1.276–4.570), three or more (OR = 5.500, 95%CI: 1.174–25.756). Patients with dyslipidemia and DM also benefited from BPHS in controlling BP (OR = 2.169, 95% CI: 1.430–3.289) and (OR = 2.785, 95%CI: 1.242–6.246), respectively. In certain high-income urban survey centers, there was sex differences in the HTN management provided by BPHS, with men having better BP control rates than women.ConclusionsPerhaps this is the first study in China to succinctly show the effectiveness and sex disparity regarding “management of hypertensive comorbidities”. This supports that the BPHS program plays a pivotal role in controlling BP, therefore should recommend the national healthcare system to give women a foremost priority in BPHS, especially to those from low-socioeconomic and low-scientific literacy regions.

A302 NON-INVASIVE BIOMARKERS PREDICTING THE PROGRESSION OF MASLD TO ADVANCED FIBROSIS: A PROSPECTIVE COHORT STUDY

Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD) affects around 30% of the global population and is one of the most prevalent non-communicable diseases. Due to its high prevalence, it is becoming the most common cause of liver-related mortality in all populations worldwide. Current standards of care for the treatment of MASLD encompass mostly lifestyle measures that are nonspecific and difficult for clinicians to ensure compliance. Although not all patients with MASLD progress to more advanced disease, the high prevalence of MASLD in the general population means the absolute number of “at risk” individuals are substantial and places a significant burden on the healthcare system. As a result, MASLD is currently viewed as a heterogeneous disease with varying rates of disease progression. Aims We aim to elucidate the predictors of disease progression in MASLD to develop and guide interventions while the disease is reversible. Methods Prospective chart review on patients seen in MASLD clinic at LHSC on CERNER from Sept. 2021 – Apr. 30, 2023. A REDCap database was constructed pertaining to a) basic patient information b) basic medical history c) patient lifestyle habits d) InBody bioimpedance analysis if available f) laboratory data g) elastography, including liver stiffness measurement (LSM) and controlled attenuation parameter (CAP). Collected data were exported into a spreadsheet to allow for analysis. IBM SPSS was used to analyze descriptive statistics and regression analyses. Results A total of 116 encounters were reviewed, including both enrolment and follow-ups. HbA1c percent is positively correlated with LSM (r=0.28, pampersand:003C0.05). The longer that the patient has been diagnosed with NAFLD (current age minus age of initial diagnosis), the more likely the patient has higher LSM scores (r= 0.23, pampersand:003C0.05). Platelet levels are negatively correlated with LSM (r=-0.28, pampersand:003C0.05). There is no difference between cannabis users and non-users in the degree of CAP or LSM. Only n=15 InBody bioimpedance analyses were included; preliminary results showed Trunk Reactance at 250kHz is correlated with LSM with (r=0.593 pampersand:003C0.05). Conclusions Patients with higher HbA1c, lower platelets and longer duration of disease are at higher risk for developing advanced fibrosis. This can allow the development of a better predictive model to find F2-F3 patients without using FibroScan or a liver biopsy, which is helpful in the primary care setting, given the prevalence of MASLD. InBody bioimpedance studies are a useful tool to predict LSM, although more data is needed to ensure the correlation is sufficiently powered. Phenotyping patients would lead to more accurate prognostication, facilitate better monitoring to prevent decompensation and allow for the development of precision-based, personalized management plans. Funding Agencies None

Importance of Super-Specialty Courses in Ayurveda for Addressing Contemporary Healthcare Challenges

The focus of Ayurvedic education policy has traditionally centered on mainstreaming basic knowledge and promoting community practices. Efforts to reintroduce specialty courses and revitalize familial practices through Gurukula training have been undertaken, showcasing the clinical applications and practices of Ayurveda. However, the presence of super specialty clinics specializing in areas such as eye treatment, arthritis, urology, pediatric care, and maternity care remains sparse and largely unrecognized by the mainstream population. These clinics, though limited in number, face challenges in disseminating their principles of practice to the wider medical community due to a lack of standardized practices, skills, documentation, and scientific publications. With the rising prevalence of non-communicable diseases, malignancies, environmental and occupational hazards, and the growing geriatric population, there is an urgent need to modernize and advance the principles of Ayurveda. Therefore, the introduction of super-specialty courses in Ayurveda is imperative to provide comprehensive knowledge and expertise in specific areas of Ayurvedic medicine. These courses will cater to the increasing demand for highly skilled professionals capable of addressing complex health issues using Ayurvedic principles. Therefore, prioritizing super-specialty education is imperative. It necessitates a deliberate, thorough, and rational approach, taking into account the advancements in technology, when designing the curriculum and course structure.

Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa

BackgroundLow-and-middle income countries face a disproportionate burden of non-communicable diseases (NCDs) that threaten to overwhelm under-resourced health systems. Community health workers (CHWs) can promote NCD prevention, reach patients, and connect them to local community health resources; however, little has been done to examine how referrals to these resources are utilized by community members. The purpose of this study is to examine the use of referrals to community-based health resources and investigate the factors influencing patient utilization of referrals connecting them to appropriate health resources for elevated blood pressure (BP).MethodsCHWs conducted home visits, which included BP screening and brief counseling, with community members in Soweto, South Africa. Participants with elevated (systolic BP: 121–139/ diastolic BP: 81–89 mmHg) or high (≥ 140/90 mmHg) BP were referred to either a local, community-based physical activity (PA) program managed by a non-governmental organization or local health clinics. The number of participants that received and utilized their referrals was tracked. Follow-up interviews were conducted with individuals given a referral who: (1) went to the PA program, (2) did not go to the PA program, (3) went to a clinic, and (4) did not go to a clinic. Interviews were transcribed and analyzed to identify common themes and differences between groups regarding their decisions to utilize the referrals.ResultsCHWs visited 1056 homes, with 1001 community members consenting to the screening; 29.2% (n = 292) of adults were classified as having optimal BP (≤120/80 mmHg), 35.8% (n = 359) had elevated BP, and 35.0% (n = 350) had high BP. One hundred and seventy-three participants accepted a referral to the PA program with 46 (26.6%) enrolling. Five themes emerged from the interviews: (1) prior knowledge and thoughts on BP, (2) psychosocial factors associated with BP control, (3) perception about receiving the referral, (4) contextual factors influencing referral utilization, and (5) perceived benefits of utilizing the referral.ConclusionCHWs can successfully increase community members’ access to health resources by providing appropriate referrals. However, greater attention needs to address community members’ barriers and hesitancy to utilize health resources.

Gender characteristics of the prevalence of noncommunicable diseases in the adult population of the Vladimir region

Aim. To assess the prevalence of major noncommunicable diseases (NCDs) taking into account gender characteristics in a random sample of adults in 5 cities of the Vladimir region.Material and methods. This cross-sectional population-based study (May 2018 — March 2020) included 1350 people (men and women aged 30-69 years) from 5 cities of the Vladimir region. The response rate was 87%. A total of 1174 people completed the study. Of these, 424 (36,1%) were men and 750 (63,9%) women. Respondents were surveyed using a standard questionnaire prepared by the National Medical Research Center for Therapy and Preventive Medicine, which included socio-demographic characteristics, behavioral risk factors, data on somatic diseases and medications taken.Results. The prevalence of coronary artery disease among men was 14,1%, among women — 9,5% (p=0,016). In men, the second most common disease is chronic obstructive pulmonary disease (COPD), which was 2,5 times more common than in women — 10,6 and 4,5%, respectively (p=0,001). Among women, the second most common disease was type 2 diabetes (T2D), accounting for 7,6%. Cerebrovascular diseases occupy fourth place in the NCD structure. Their prevalence was 6,1% among men and 4,4% among women. Cancer diseases were less common than other chronic diseases without sex differences — 2,8 and 3,1%, respectively. In certain cities, the prevalence of NCDs varied. Every third man and fourth women had a positive family history for cardiovascular diseases (CVDs) (p=0,005). About 20% of men reported a positive family history for COPD, while among women this figure was 2 times lower (p=0,001). Men and women were comparable in terms a family history for T2D — 10,4 and 12,5%, respectively. A positive family history for tumors of various locations was recorded in ~5%.Conclusion. In the adult working-age population of the Vladimir region, atherosclerosis-related CVDs was identified in 17% of cases. The incidence of T2D and COPD in the adult population was approximately the same and amounted to &gt;7%. The prevalence of cancer was 3%. Sex differences were identified in the prevalence of coronary artery disease and COPD.