Risk Factors In India Research Articles

Analyzing stroke burden and risk factors in India using data from the Global Burden of Disease Study.

Stroke remains a critical global health issue, significantly impacting India with substantial contributions to mortality and disability. This study comprehensively analyses stroke incidence, mortality, and disability-adjusted life years (DALYs) across India from 1990 to 2021, using the latest Global Burden of Disease (GBD) 2021 data. We evaluate how Universal Health Coverage (UHC), health expenditure, human development index (HDI), and gross national income (GNI) influence stroke outcomes. Our findings reveal significant regional disparities, with higher stroke rates in urban areas and states like Goa and Kerala. Higher health expenditure and HDI are linked to lower stroke rates, while higher GNI per capita correlates with increased stroke incidence, likely due to lifestyle changes. Risk factors include air pollution, tobacco use, dietary risks, and high blood pressure. Air pollution notably impacts stroke mortality in Bihar and Jharkhand, while tobacco use is a major risk factor in Mizoram and Manipur. Dietary risks and hypertension are prevalent in Maharashtra and Jammu & Kashmir. The study highlights the need for targeted public health strategies addressing regional disparities and socioeconomic factors. Policymakers should focus on lifestyle modification programs, public awareness campaigns, and enhanced access to quality stroke care to reduce stroke-related morbidity and mortality effectively.

Population-Based Artificial Intelligence Assessment of Relationship Between the Risk Factors for Diabetic Retinopathy in Indian Population

ABSTRACT Purpose Risk factors (RFs), like ‘body mass index (BMI),’ ‘age,’ and ‘gender’ correlate with Diabetic Retinopathy (DR) diagnosis and have been widely studied. This study examines how these three secondary RFs independently affect the predictive capacity of primary RFs. Methods The dataset consisted of four population-based studies on the prevalence of DR and associated RFs in India between 2001 and 2010. An Autoencoder was employed to categorize RFs as primary or secondary. This study evaluated six primary RFs coupled independently with each secondary RF on five machine-learning models. Results The secondary RF ‘gender’ gave a maximum increase in Area under the curve (AUC) score to predict DR when combined separately with ‘insulin treatment,’ ‘fasting plasma glucose,’ ‘hypertension history,’ and ‘glycosylated hemoglobin’ with a maximum increase in AUC for the Naive Bayes model from 0.573 to 0.646, for the Support Vector Machines (SVM) model from 0.644 to 0.691, for the SVM model from 0.487 to 0.607, and for the Decision Tree model from 0.8 to 0.848, respectively. The secondary RFs ‘age’ and ‘BMI’ gave a maximum increase in AUC score to predict DR when combined separately with ‘diabetes mellitus duration’ and ‘systolic blood pressure,’ with a maximum increase in AUC for the SVM model from 0.389 to 0.621, and for the Decision Tree model from 0.617 to 0.713, respectively. Conclusion The risk factor ‘gender’ was the best secondary RF in predicting DR compared to ‘age’ and ‘BMI,’ increasing the predictive power of four primary RFs.

Prioritisation of emerging and epidemic-prone diseases and risk factors in India’s three western states using the One Health Risk and Disease (OHRAD) prioritisation tool

BackgroundThere have been numerous outbreaks of infectious diseases to date, and out of them, six events have been declared as Public Health Emergencies of International Concern by the World Health Organization (WHO). The outbreaks have been unprecedented, and the sudden anxiety associated with these makes the situation more complicated. Prioritisation of diseases has been a common process in public health, and it is important to identify infectious diseases that are important for human health. In addition, a One Health approach requires taking also animal origin and related risk factors for infectious diseases into account.MethodsState-level co-creation workshops were conducted in Gujarat, Rajasthan, and Maharashtra, the three western states of India. One Health Risk and Disease (OHRAD) prioritisation tool was used to prioritise emerging and epidemic-prone diseases and their risk factors.ResultsThe risk factors and diseases were scored using the OHRAD tool, and the ranks were obtained. Avian flu by A(H5N1), A(H7N9), and A(H9N2), swine flu by A(H1N1), A(H1N2) and A(H3N2), dengue, rabies, leptospirosis, bovine tuberculosis, salmonellosis, chikungunya, soil-transmitted helminths, and brucellosis were some of the 10 diseases prioritised in all the three western states of the country. Similarly, the presence of mosquito breeding sites near houses or workplaces, open defecation, poor hand hygiene, poor personal hygiene, reluctance to follow disease prevention measures and improper carcass disposal were prioritised as the risk factors for diseases in all three states.ConclusionThe emerging and epidemic-prone diseases and risk factors that are prioritised reflect state-specific scenarios and the gravity of the situation concerning risk factors for disease outbreaks. This can help in allocating resources and increasing efforts in the prevention and control of these diseases.

Comprehensive Analysis of Dementia Types and Risk Factors: A Study From a Tertiary Care Center in India.

Background and objective Dementia is a prevalent clinical syndrome characterized by memory impairment and cognitive dysfunction. Its global burden is expected to rise significantly, particularly in low- and middle-income countries. Understanding the spectrum of dementia types and associated risk factors is crucial for effective management. This study aims to elucidate the demographic profiles, clinical types, and risk factors of newly diagnosed dementia cases at a tertiary care hospital in India. Methods and materials A cross-sectional, hospital-based observational study was conducted on 81 patients at the Department of Medicine, Dr. D. Y. Patil Medical College, Hospital, and Research Centre, Pimpri, Pune, from February 2022 to January 2024. Ethical approval was obtained, and written consent was obtained from participants. Clinical diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria, supported by cognitive assessment tools and laboratory/radiological investigations. Inclusion criteria encompassed individuals aged 18 years or older, presenting with clinical symptoms suggestive of dementia, having a Mini-Mental State Examination (MMSE) score of less than 24 and Montreal Cognitive Assessment (MoCA) score of less than 25, according to DSM-V criteria for dementia. Exclusion criteria included individuals with a history of head trauma or those below 18 years of age. Results Of the 81 participants, the majority (74.1%) were over 60 years old, with females comprising 59.3% of the sample. Alzheimer's disease was the most prevalent dementia subtype (34.5%), followed by vascular dementia (19.7%) and mixed dementia (13.5%). Other causes included Lewy body dementia (2.46%), Parkinson's dementia (4.9%), frontotemporal dementia (4.9%), and Creutzfeldt-Jakob disease (1.2%). Reversible causes accounted for a significant proportion of cases: alcohol-associated dementia (6.1%), hypothyroid-associated dementia (3.7%), HIV-associated dementia (2.46%), herpes simplex dementia (1.2%), neurosyphilis-associated dementia (1.2%), and normal pressure hydrocephalus (NPH)-associated dementia (2.4%). Analysis of risk factors revealed distinct patterns among different dementia types, emphasizing the role of cardiovascular and metabolic health. Conclusion This study provides insights into the demographic profiles, clinical types, and dementia risk factors in India. Addressing causes and managing cardiovascular/metabolic health is crucial for dementia prevention and management. Comprehensive care strategies and ongoing research efforts are essential for improving dementia outcomes and enhancing the quality of life for affected individuals and their families.

An Examination and Evaluation of the Rising Incidence of Breast Cancer among Women and Impact on Society

The number of deaths from breast cancer is rising rapidly year by year. The most common kind of cancer named as breast cancer is an overall and the leading cause for women death rate all over India. A cancer patient can go for a long and healthy life by early detection and proper treatment of cancer. In India, where advanced stages of the disease at diagnosis, combined with rising incidence and death rates, make breast cancer the most frequent cancer among women now a days. It is demand of time to spread a better cancer literacy awareness among women of India. Therefore, we did secondary data collection using literature review in order to know patient survival parameters and treatment strategies, with high degree of accuracy in breast cancer detection . Online and offline structured questioners has been used to collect primary data from various participants. This research paper also used a large dataset of breast cancer patients from the UCI Machine Learning Repository. Our paper examined that there is a very low cancer literacy about breast cancer risk factors in India , irrespective of socio-economic and educational background of participant women . There is an urgent need for offline and online awareness programmes to improve cancer literacy in Indian Women .

A Comprehensive Review on Trends and Patterns of Non-communicable Disease Risk Factors in India.

This review explores the trends and patterns of non-communicable disease (NCD) risk factors in India, with a focus on tobacco use, unhealthy diet, physical inactivity, and air pollution. Drawing upon existing literature and data, the review highlights the substantial burden imposed by NCDs and their associated risk factors on public health and healthcare systems in India. Key findings reveal the widespread prevalence of these risk factors, particularly among certain demographic groups and in urban areas. Socioeconomic disparities also play a significant role in shaping the distribution of NCD risk factors across the population. The review underscores the importance of addressing NCD risk factors through evidence-based interventions and policies tailored to the Indian context. Furthermore, it emphasizes the need for multi-sectoral collaboration among government agencies, healthcare providers, civil society organizations, academia, industry partners, and communities to mitigate the NCD epidemic effectively. By mobilizing collective efforts and resources, India can make significant strides in preventing and controlling NCDs, thereby enhancing population health and well-being.

The Association of Total Meat Intake with Cardio-Metabolic Disease Risk Factors and Measures of Sub-Clinical Atherosclerosis in an Urbanising Community of Southern India: A Cross-Sectional Analysis for the APCAPS Cohort.

Meat is commonly consumed in India; however, in comparison to Western settings, it is eaten in relatively lower quantities and with minimal processing. The association between meat intake and cardio-metabolic diseases (CMDs) and their risk factors in India is currently uncertain. We examined whether meat intake is associated with risk factors for CMDs and the measures of subclinical atherosclerosis in urbanising villages in southern India. We conducted a cross-sectional analysis of 6012 adults (52.3% male) participating in the Andhra Pradesh Children and Parents' Study (APCAPS), which is a large prospective, intergenerational cohort study in Southern India that began with the long-term follow-up of the Hyderabad Nutrition Trial (1987-1990). We used cross-sectional data from the third wave of data collection conducted in 2010-2012, where total meat intake was assessed using 100-item, semi-quantitative validated food frequency questionnaires (FFQ). The FFQs were validated using multiple weighed 24 h dietary recalls. The main predictor, 'total meat intake', was calculated as the sum of chicken, red meat, and fish consumption. The risk factors for CMDs [systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), waist circumference (WC), fasting glucose, total cholesterol, homeostasis model assessment insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides, and C-reactive protein] and measures of subclinical atherosclerosis [Carotid Intima-Media Thickness, Pulse Wave Velocity, and Augmentation Index] were assessed using standardised clinical procedures. Stratified by gender, the association of meat intake with the risk factors of CMDs and measures of subclinical atherosclerosis was examined using linear multilevel models with random intercept at the household level. The mean (SD) age of the male (n = 3128) and female participants (n = 2828) was 34.09 years (15.55) and 34.27 years (12.73), respectively. The median (IQR) intake of meat was 17.79 g/day (8.90, 30.26) in males and 8.90 g/day (4.15, 18.82) in females. In males, a 10 g increase in total meat intake/1000 Kcal/day was positively associated with DBP, BMI, WC, total cholesterol, LDL-C, and triglycerides, whereas in females, a 10 g increase in total meat intake/1000 Kcal/day was positively associated with SBP, DBP, fasting glucose, HOMA-IR, total cholesterol, LDL-C, and triglycerides. There was no relationship between meat consumption and measures of subclinical atherosclerosis. Meat intake had a linear positive association with CMD risk factors among the relatively younger Indian population who were consuming meat at lower levels compared to their European counterparts.

Spatial Clustering of Malnutrition and Anemia Among Reproductive Women and Its Associated Risk Factors in India: Evidence From National Family Health Survey-5.

Malnutrition and anemia are 2 severe public health concerns, predominantly in low-and middle-income nations. Malnutrition is defined as poor nutritional condition that encompass both under nutrition and over nutrition. The prevalence of overweight or obesity and anemia has increased in India from 2016 to 2021. The study aims to investigate the spatial clustering and factors responsible for underweight, overweight/obesity, and anemia among reproductive women (15-49 years) in India using the data from National Family and Health Survey-5 (2019-2021). We conducted hot-spot analysis using Moran's Index (MI) with the help spatial analysis software (i.e., GeoDa 1.18 and ArcGIS 10.8). It also demonstrates the autocorrelation. Multivariable logistic regression analysis has been performed to examine different determinants and risk associated with underweight, overweight/obesity, and anemia with various dependent variable by using Stata-14 software. Moran's Index for underweight (MI = 0.68), overweight/obesity (MI = 0.72), and anemia (MI = 0.62) indicates a high level of spatial-autocorrelation (P < .001) exists across the districts in India. As a result, a total of 156, 143, and 126 hot-spot districts are detected for underweight, overweight/obesity, and anemia, respectively. The burden of undernutrition and anemia is higher in rural areas. Risk of under nutrition and anemia are both reduced by media exposure and eating habits. Moreover, low income and low education level raises the risk of anemia and undernutrition, while obesity shows an inverse trend with income and education level. The study recommends targeting hot-spot districts for malnutrition and anemia, and policy level initiatives by addressing the responsible risk factors.

Recent studies on hypertension prevalence and control in India 2023.

Hypertension is the most important chronic disease risk factor in India. Recent epidemiological studies have reported that hypertension is increasing in India with a more rapid increase in rural and young populations. Fifth National Family Health Survey (NFHS-5) and Indian Council of Medical Research-INDIAB surveys have reported that there are substantial geographic variations in hypertension prevalence with greater prevalence in more developed states and districts of the country. There is a high prevalence of young-age hypertension, especially in the less developed states. The incidence of adverse events from hypertension-related cardiovascular disease is significantly greater in India than in more developed countries. A low level of hypertension awareness, treatment, and control, especially in rural and underserved urban populations is an important finding. In this narrative review, we highlight recent nationwide studies and unique features of hypertension in India and suggest strategies for better hypertension management and control.

Quantifying effects of long-range transport of NO2 over Delhi using back trajectories and satellite data

Abstract. Exposure to air pollution is a leading public health risk factor in India, especially over densely populated Delhi and the surrounding Indo-Gangetic Plain. During the post-monsoon seasons, the prevailing north-westerly winds are known to influence aerosol pollution events in Delhi by advecting pollutants from agricultural fires as well as from local sources. Here we investigate the year-round impact of meteorology on gaseous nitrogen oxides (NOx=NO+NO2). We use bottom-up NOx emission inventories (anthropogenic and fire) and high-resolution satellite measurement based tropospheric column NO2 (TCNO2) data, from S5P aboard TROPOMI, alongside a back-trajectory model (ROTRAJ) to investigate the balance of local and external sources influencing air pollution changes in Delhi, with a focus on different emissions sectors. Our analysis shows that accumulated emissions (i.e. integrated along the trajectory path, allowing for chemical loss) are highest under westerly, north-westerly and northerly flow during pre-monsoon (February–May) and post-monsoon (October–February) seasons. According to this analysis, during the pre-monsoon season, the highest accumulated satellite TCNO2 trajectories come from the east and north-west of Delhi. TCNO2 is elevated within Delhi and the Indo-Gangetic Plain (IGP) to the east of city. The accumulated NOx emission trajectories indicate that the transport and industry sectors together account for more than 80 % of the total accumulated emissions, which are dominated by local sources (&gt;70 %) under easterly winds and north-westerly winds. The high accumulated emissions estimated during the pre-monsoon season under north-westerly wind directions are likely to be driven by high NOx emissions locally and in nearby regions (since NOx lifetime is reduced and the boundary layer is relatively deeper in this season). During the post-monsoon season the highest accumulated satellite TCNO2 trajectories are advected from Punjab and Haryana, where satellite TCNO2 is elevated, indicating the potential for the long-range transport of agricultural burning emissions to Delhi. However, accumulated NOx emissions indicate local (70 %) emissions from the transport sector are the largest contributor to the total accumulated emissions. High local emissions, coupled with a relatively long NOx atmospheric lifetime and shallow boundary layer, aid the build-up of emissions locally and along the trajectory path. This indicates the possibility that fire emissions datasets may not capture emissions from agricultural waste burning in the north-west sufficiently to accurately quantify their influence on Delhi air quality (AQ). Analysis of daily ground-based NO2 observations indicates that high-pollution episodes (&gt;90th percentile) occur predominantly in the post-monsoon season, and more than 75 % of high-pollution events are primarily caused by local sources. But there is also a considerable influence from non-local (30 %) emissions from the transport sector during the post-monsoon season. Overall, we find that in the post-monsoon season, there is substantial accumulation of high local NOx emissions from the transport sector (70 % of total emissions, 70 % local), alongside the import of NOx pollution into Delhi (30 % non-local). This work indicates that both high local NOx emissions from the transport sector and the advection of highly polluted air originating from outside Delhi are of concern for the population. As a result, air quality mitigation strategies need to be adopted not only in Delhi but in the surrounding regions to successfully control this issue. In addition, our analysis suggests that the largest benefits to Delhi NOx air quality would be seen with targeted reductions in emissions from the transport and agricultural waste burning sectors, particularly during the post-monsoon season.

A case study of rhino orbito cerebral Mucormycosis (ROCM) in a diabetic patient reported from a multispeciality hospital in Tamil Nadu

ROCM is the most common type of Mucormycosis and it can rapidly spread from the paranasal sinuses to orbit and brain which can be fatal in most patients. Diabetes mellitus is the most common risk factor in India. As invasive fungal diseases present with nonspecific clinical features, increasing awareness and education among clinicians about this deadly enemy is very crucial for early diagnosis and prompt initiation of appropriate therapy. We are reporting a case study on ROCM in a Diabetic patient caused by species along with a short review on the taxonomy, risk factors, pathogenesis, clinical forms, diagnosis and management of mucormycosis. We hope that this will help in expanding awareness among medical community about mucormycosis which is a lethal opponent of patients with Diabetes Mellitus.

Source Contributions to Fine Particulate Matter and Attributable Mortality in India and the Surrounding Region.

Fine particulate matter (PM2.5) exposure is a leading mortality risk factor in India and the surrounding region of South Asia. This study evaluates the contribution of emission sectors and fuels to PM2.5 mass for 29 states in India and 6 surrounding countries (Pakistan, Bangladesh, Nepal, Bhutan, Sri Lanka, and Myanmar) by combining source-specific emission estimates, stretched grid simulations from a chemical transport model, high resolution hybrid PM2.5, and disease-specific mortality estimates. We find that 1.02 (95% Confidence Interval (CI): 0.78-1.26) million deaths in South Asia attributable to ambient PM2.5 in 2019 were primarily from three leading sectors: residential combustion (28%), industry (15%), and power generation (12%). Solid biofuel is the leading combustible fuel contributing to the PM2.5-attributable mortality (31%), followed by coal (17%), and oil and gas (14%). State-level analyses reveal higher residential combustion contributions (35%-39%) in states (Delhi, Uttar-Pradesh, Haryana) with high ambient PM2.5 (>95 μg/m3). The combined mortality burden associated with residential combustion (ambient) and household air pollution (HAP) in India is 0.72 million (95% CI:0.54-0.89) (68% attributable to HAP, 32% attributable to residential combustion). Our results illustrate the potential to reduce PM2.5 mass and improve population health by reducing emissions from traditional energy sources across multiple sectors in South Asia.

Evaluating the Pre-Hypertension and Hypertension with Associated Risk Factors in India: Evidence From LASI 2017–2018 Data

India’s cardiovascular conditions and healthcare systems are significantly impacted by hypertension. This study aims to provide estimates of the prevalence of hypertension, and pre-hypertension, in India. Furthermore, it identifies lifestyle modifications to reduce hypertension in age groups of 45–59 and 60+. This study uses data from the Longitudinal Ageing Study in India, 2017–2018, which includes information on 31,197 adults (45–59) and 28,567 older adults (60+). Descriptive, multivariate, and multinomial regression analyses have been performed to ascertain the prevalence and correlation of socioeconomic characteristics and related risk factors. The finding of this study suggests that individuals in the 60+ age group have a higher prevalence of hypertension. In contrast, a higher prevalence of pre-hypertension can be seen in the 45–59 age group. Gender, place of residence, living arrangement MPCE quintile, family history of hypertension, body mass index, self-rated health, and alcohol consumption are significantly associated with pre-hypertension and hypertension. There is a need for public awareness and control since people with age 45–59 are less aware of hypertension; otherwise, unintentionally, they can develop more risk with aging. Methods of modifying one’s lifestyle and dietary changes have a significant impact on the prevention of hypertension; that is why there is a great need for people to be aware of all these.

DOP60 Environmental risk factors for Inflammatory bowel disease: A large prospective case-control study in India

Abstract Background Increasing urbanization and westernization of lifestyles have been implicated for the rising incidence of IBD in the developing world. However real world data is very limited. We planned a comprehensive assessment of environmental exposures in a large cohort of patients with and without IBD in India to identify key risk factors. Methods This study is a part of a wider epidemiologic colonoscopic screening program for detection of IBD on all symptomatic patients attending the hospital and specially conducted rural health camps. A detailed questionnaire based survey of environmental risk factors including diet, smoking, antibiotic use, hygiene status, microbial exposures, vaccination, water supply, rural/urban residence was conducted prior to colonoscopy. The risk factors were compared among the IBD and non IBD patients with normal colonoscopy. Univariate logistic regression was done initially adjusting for age and sex followed by multivariate analysis to estimate adjusted ORs (aOR) and 95% CIs. Results 13421 completed environmental risk questionnaire.1306 IBD(576 CD;730 UC) cases diagnosed.12115 with normal colonoscopy served as the controls. In multivariate model, current smoking(aOR 5.66; 95% CI 4.41-7.26),ex-smoking (aOR 1.79;1.24-2.58), regular alcohol intake (aOR 1.82, 1.14-2.9), non-vegetarian diet(aOR 1.8; 1.48-2.23),daily bakery/fast food consumption(aOR 1.57; 1.31-1.88),soft drink consumption(&amp;gt; 2/week)(aOR 1.37,1.14-1.66), delivery by cesarean section (aOR 1.49, 95% CI 1.28-1.76), antibiotic use(&amp;lt;1 yr age) (aOR1.33;1.1-1.58), exposure to pets(aOR 1.68;1.39-2.03), Western toilets (aOR3.52, 2.56-3.58)and childhood infections (aOR 1.74; 1.45-2.028) increased risk of UC (Fig 1, 2). Increased risk of CD was seen with current smoking(aOR 6.16; 95% CI 4.68-8.11), ex-smoking(aOR2.15; 1.43-3.22),non-vegetarian diet (aOR 1.69;1.34-2.13), soft drink consumption(&amp;gt; 2/week)(aOR 1.84,1.51-2.24),daily bakery/fast food consumption(aOR 2.24;1.85-2.71), oral contraceptive pill use (aOR 3.79, 1.29-12.17) antibiotic use (&amp;lt;1 year age)(aOR 1.27; 1.04-1.54),exposure to pets(aOR 1.79; 1.45-2.2), caesarean section(aOR 1.48;1.23-1.77), Western toilets (aOR 2.98, 2.47-3.59), non-human milk exposure (&amp;lt;6 months age) (aOR 1.28, 1.03-1.6) and childhood infections(aOR 2.51; 2.1-3.04)(Fig 3, 4). Breastfeeding &amp;gt;6 months, daily fruit consumption and daily exercise were protective for both UC and CD (Fig1-4).Rural habitat was not protective for development of IBD both UC and CD. Conclusion This large prospective case control study of IBD risk factors in India identifies environmental triggers including childhood immunological, hygiene and dietary factors which modulate risk of IBD later in life.

Socioeconomic Disparity and Risk Factors of Non-communicable Diseases: Analysis of Longitudinal Ageing Study in India using a Decomposition Approach.

Many countries prioritize health-related research and policy around socioeconomic inequality. In India, data on socioeconomic disparity and risk factors for noncommunicable diseases (NCDs) are limited. The study provides empirical information on socioeconomic disparities in NCD risk factors in India as part of a preventative and policy initiative. The study used nationally representative data from wave 1 of the Longitudinal Ageing Study in India which adopted a multistage random sampling design. To achieve the objectives of the study, binary logistic regression was used to demonstrate the association between socioeconomic status and NCD risk factors, and further analysis was conducted employing the decomposition method approach using STATA 14 software to assess socioeconomic disparity. Concentration Indices (CIs) revealed that overweight/obesity (CI = 0.157) was more prevalent among the nonpoor, whereas smoking (CI = -0.067) and alcohol consumption (CI = -0.014) were more prevalent among the poor. Wealth status was identified as the primary contributor to socioeconomic inequality for all of the risk factors of NCDs. Education was also the leading cause of socioeconomic inequality with respect to alcohol, smoking, high blood pressure, and obesity. Identifying the specific needs of impoverished and nonpoor populations is necessary for addressing NCD risk factors and inequalities. It is essential to implement interventions that address the underlying social determinants of health and promote health equality to reduce the burden of NCDs and enhance health outcomes for all.

Association of hormonal and reproductive risk factors with breast cancer in Indian women: A systematic review of case-control studies.

The incidence of breast cancer in India has seen a rapid increase in recent years. Hormonal and reproductive risk factors for breast cancer have been affected by socioeconomic development. Studies on breast cancer risk factors in India are limited by the small sample size and specific geographical area. The current systematic review was carried out to assess the association of hormonal and reproductive risk factors with breast cancer in Indian women. A systematic review of MEDLINE, Embase, Scopus, and Cochrane database of systematic reviews were done. Relevant case-control studies published in peer-reviewed indexed journals were analyzed for hormonal risk factors such as age at menarche, menopause, and first childbirth; breastfeeding; abortion; and oral contraceptive pills use. Younger age (<13 years) at menarche was associated with high risk (odds ratio 1.23-3.72). Other hormonal risk factors with strong association were age at first childbirth and menopause, parity, and duration of breastfeeding. Abortion and the use of contraceptive pills did not have a clear association with breast cancer. Hormonal risk factors have a higher association in premenopausal disease and estrogen receptor-positive tumors. There is a strong association between hormonal and reproductive risk factors and breast cancer in Indian women. The protective effect of breastfeeding is related to the cumulative duration of breastfeeding.

Spatial epidemiology of acute respiratory infections in children under 5 years and associated risk factors in India: District-level analysis of health, household, and environmental datasets.

In India, acute respiratory infections (ARIs) are a leading cause of mortality in children under 5 years. Mapping the hotspots of ARIs and the associated risk factors can help understand their association at the district level across India. Data on ARIs in children under 5 years and household variables (unclean fuel, improved sanitation, mean maternal BMI, mean household size, mean number of children, median months of breastfeeding the children, percentage of poor households, diarrhea in children, low birth weight, tobacco use, and immunization status of children) were obtained from the National Family Health Survey-4. Surface and ground-monitored PM2.5 and PM10 datasets were collected from the Global Estimates and National Ambient Air Quality Monitoring Programme. Population density and illiteracy data were extracted from the Census of India. The geographic information system was used for mapping, and ARI hotspots were identified using the Getis-Ord Gi* spatial statistic. The quasi-Poisson regression model was used to estimate the association between ARI and household, children, maternal, environmental, and demographic factors. Acute respiratory infections hotspots were predominantly seen in the north Indian states/UTs of Uttar Pradesh, Bihar, Delhi, Haryana, Punjab, and Chandigarh, and also in the border districts of Uttarakhand, Himachal Pradesh, and Jammu and Kashmir. There is a substantial overlap among PM2.5, PM10, population density, tobacco smoking, and unclean fuel use with hotspots of ARI. The quasi-Poisson regression analysis showed that PM2.5, illiteracy levels, diarrhea in children, and maternal body mass index were associated with ARI. To decrease ARI in children, urgent interventions are required to reduce the levels of PM2.5 and PM10 (major environmental pollutants) in the hotspot districts. Furthermore, improving sanitation, literacy levels, using clean cooking fuel, and curbing indoor smoking may minimize the risk of ARI in children.

Cardiovascular Disease Risk Profile and Risk Prediction Among Unskilled Workers of a Tertiary Care Teaching Hospital

Background: Cardiovascular disease is the single largest cause for mortality and morbidity in the world and also in India. The prevalence of CVD risk factors in India is steadily increasing moreover CVD in Indians has been shown to occur prematurely. The study was designed to estimate the 10-year cardiovascular risk using region specific WHO/ISH risk prediction chart among unskilled workers of a tertiary care teaching hospital and to determine factors associated with risk. Material and methods: It were a hospital based cross sectional study. Based on the calculated sample size, 250 eligible workers were selected by simple random sampling. Using structured questionnaire, life style related risk factors namely, average daily consumption of fruits and vegetables, physical activity, perceived stress, tobacco and alcohol use was collected. BMI and BP were measured using standard protocol and classified following standard guidelines. Bio-chemical parameters were also measured. Results: Among 250 workers 37.2% and 10% consumed daily minimal recommended level of vegetables and fruits respectively, 21.1% was current tobacco user, 17.2% was alcohol drinkers, 50.4% were obese, 18.8% had high blood pressure, 6% had elevated cholesterol levels. Among the workers 46.7 % had &lt;10% risk, 5.3% had 10% to &lt;20% risk and, 3.3% had 20% to &lt;30% risk to develop CVD within future 10 years of lifetime. Drivers and current alcoholics were significantly associated with being in the high-risk group. Conclusion: Employer initiated regular work place health screening and services need to be aimed at the unskilled workers, especially for CVD targeting drivers and alcoholics.

The burden of transport injury and risk factors in India from 1990 to 2019: evidence from the global burden of disease study

BackgroundIndia is one of the fastest-growing developing economies associated with many socio-demographic challenges that include a high density of population, growing urbanization, and poor road infrastructure. These challenges might lead to the cause of injury, especially transport related. Therefore, we aim to analyze the burden of Transport Injury (TI) and associated risk factors in India using the required data from 1990 to 2019.MethodsThis study has used the latest Global Burden of Disease Study (GBD) 2019 data set and estimated TI-related incidence rate, mortality (death) rate, and Disability-Adjusted Life Years (DALYs) lost for India over the period from 1990 to 2019. The latest round of GBD survey-2019 provides information about 369 diseases and injuries and 87 risk factors across age groups and gender.ResultsAround 25% of the death rate of all ages was caused due to TI in 2019, significantly higher than in 1990 (20%). However, between 1990 and 2019, the DALYs rate per 100,000 people due to TI decreased slightly by 1.6% for all ages and both gender while more reduction has been observed in under 5- and 5–14-years age groups. On the contrary, the incidence rate and DALYs rate had increased substantially in the age group above 50 years which could be a serious issue for the safety of aging people. By analyzing the sub-cause of TI, we found that motorcyclist road injuries and pedestrian road injuries have been major causes of deaths in India during the last three decades. Further, we have found four risk factors associated with environmental change, occupational hazard, behavioral risk, and metabolic risk that cause TI injuries.ConclusionsTI-related disease burden has not been reduced over the years in India despite improvements in road infrastructure and digital technology. Improvement in transport policies; awareness about traffic rules and laws among citizens, and improvement in governance in the road & transport sector could change the behavioral risk factors of TI and reduce population unwanted death and suffering.

Overweight/Obesity Prevalence among Under-Five Children and Risk Factors in India: A Cross-Sectional Study Using the National Family Health Survey (2015-2016).

The occurrence of overweight and obesity has increased in recent years in India. In this study, we investigate the prevalence and associated risk factors of overweight/obesity among children aged 0–59 months in India. Using data from the 2015–2016 National Family Health Survey-4 (NFHS-4), the research sample included 176,255 children aged 0 to 59 months. Bivariate and multivariate techniques were used to analyze children’s risk factors for overweight/obesity. We identified that the prevalence of overweight/obesity among children aged 0–59 was 2.6% in India. The study findings reveal that factors such as child sex, age, birth weight, birth rank, maternal education, number of children, age at marriage, mother’s BMI, media exposure, social group, and dietary diversity score were most significantly correlated with childhood overweight and obesity in India. Furthermore, we found that male children (ARR: 1.08) aged between 0 and 11 months (ARR: 3.77) with low birth rank (ARR: 1.24), obese (ARR: 1.81) children whose mothers married after the age of 18 (ARR: 1.15), children who belong to a scheduled tribe family (ARR: 1.46), and children who consumed 7–9 food items (ARR: 1.22) were at highest risk of being overweight and obese. However, breastfeeding (ARR: 0.85) and Muslim families (ARR: 0.87) appeared to be protective factors with respect to childhood overweight and obesity in India. Pertinent public health programs, clinical follow-up, and awareness about sedentary lifestyles can help to reduce overweight/obesity risks in children.