Urban Indian Population Research Articles

Aging population in urban India: Challenges and insights from Kolkata

In Kolkata, the elderly people represent 11.76% of the total population. Here we present new data on the aging population of Kolkata, and address its causes, and consequences. We interviewed 110 elderly male and female who are living with their family members and in old age homes in Kolkata. The data was collected from low, medium, and high-income groups from three urban housing societies as well as five old age homes. It has been observed that the elderly male and female of the low-income group have no medical and life insurance, and many of them are suffering from health issues. Although females up to 60 years are part of Self-Help Group, males are suffering from Loneliness. The elderly male and female of the medium, and high-income group do not have financial issues, but most of them do not visit doctors and health care centers for regular health check-ups. Digital literacy has to be improved. Elderly people staying in old age homes are mentally and physically much better than their counterparts who live with family members. Analysis of existing government policies reveal scope for improvement of the elderly people. We propose social innovation for the elderly population in Kolkata.

Marital quality of life, life satisfaction, and well-being among married couples: A community-based comparative study between the rural and urban populations in India

ABSTRACT Family is a social institution and the most important primary group. It is undergoing significant changes in the twenty-first century. The current study attempts to assess the marital quality of life, life satisfaction, and well-being among married couples in rural and urban populations. The study used descriptive design and multistage sampling technique in which 200 respondents were interviewed from the study population. The socio-demographic schedule, marital quality of life, life satisfaction, and general well-being scales were used to collect the data. The results show that one-third (34%) had an overall excellent marital quality life; about half of them either extremely satisfied or satisfied in life satisfaction, and two-third had good well-being. There was a positive correlation between the marital quality of life and well-being, well-being and life satisfaction, and well-being and education. In a changing society, marital quality of life determines life satisfaction and well-being of the married couple. Hence, there is a need to address the marital quality of life to keep the families intact.

Analysis of risk factors in angiographically proven coronary artery disease in rural and urban Indian population. Prospective observational multicentre study: Kashmir Heart Survey

ABSTRACT Background: The global burden of cardiovascular diseases is increasing rapidly, and changing trends in epidemiological risk factors are identified among diverse Indian population. There has been a significant increase in heart attack deaths over the past 3 years after the COVID-19 pandemic. Are we missing a link? There is an urgent need for studies to confirm any epidemiological shift in coronary artery disease (CAD) risk factors. Aims and Objectives: To analyse the risk factors in patients with established CAD in rural and urban Indian Kashmiri populations in the post-COVID period. Material and Methods: A prospective observational study of all patients with angiographically proven CAD who have undergone revascularisation or have a clinical suspicion of CAD on the basis of symptoms or positive stress test and later proven to have CAD on coronary angiograms, coming from rural and urban areas of Jammu and Kashmir were enrolled for the study and screened for various modifiable and non-modifiable CAD risk factors. Data was compiled and analysed to know the pattern of various CAD risk factors in our population. Results: The study included total 600 patients (rural and urban 300 each), mean age was 59.13 ± 11.62 years. Male patients were 65.50% with a mean age of 57.53 ± 14.17 years and female patients were 34.50% with a mean age of 62.16 ± 10.02 years. In rural subgroup of 300 patients mean age was 60.99 ± 16.86 years and in the urban population we found a mean age of 57.26 ± 16.21 years. The most common risk factor was smoking in 76% rural and 67% urban. Diabetes (39% rural, 43% urban), dyslipidaemia (47.33%, 48.66% urban), hypertension (61% rural, 66% urban), obesity (23% rural, 29.33% urban) and physical inactivity (33.66% rural, 37.33% urban. Conclusion: CAD manifests earlier in males and urban populations. Smoking is the most common risk factor for CAD in the Kashmiri Indian population and is more common in the rural population. Coronary artery disease risk factors, such as physical inactivity, diabetes, smoking, hypertension, obesity and dyslipidaemia, are more common in the urban population. Preventive strategies should focus on modifying the risk factors to decrease the prevalence of CAD in communities.

P076 FACTORS INFLUENCING POST-COVID HOME BP AND HR FLUCTUATION WITHIN THE URBAN INDIAN DIABETIC POPULATION

Objective: The impact of COVID-19 on cardiovascular health among adult diabetics remains underexplored, particularly concerning home blood pressure (BP) and heart rate (HR) variability. This study aims to elucidate the factors influencing post-COVID home BP and HR fluctuation within the urban Indian diabetic population. Design and Methods: A cross-sectional study was conducted, involving 1000 adult diabetic patients aged 30 to 80 years with prior COVID-19 infection. Home BP and HR readings were recorded twice daily over seven days, generating 28 measurements. Variability in BP and HR was determined using standard deviation calculations between morning and evening readings, as well as between consecutive measurements. Results: Older age (OR: 1.56, 95% CI: 1.23-1.98), cardiovascular comorbidities (OR: 2.09, 95% CI: 1.67-2.62), diabetes (OR: 1.84, 95% CI: 1.43-2.36), and elevated home BP (OR: 2.35, 95% CI: 1.87-2.95) emerged as independent predictors of increased morning-to-evening home BP variability. Similarly, older age (OR: 1.72, 95% CI: 1.34-2.21) and elevated home BP (OR: 2.14, 95% CI: 1.67-2.75) were determinants of heightened day-to-day BP variability, while a combination of older age (OR: 1.98, 95% CI: 1.52-2.58), female sex (OR: 1.43, 95% CI: 1.11-1.84), cardiovascular disease (OR: 1.89, 95% CI: 1.47-2.44), and elevated home BP (OR: 2.56, 95% CI: 1.98-3.31) predicted greater variability between consecutive readings. Conversely, younger age (OR: 0.76, 95% CI: 0.59-0.98) and elevated home HR (OR: 1.92, 95% CI: 1.51-2.44) were associated with increased morning-versus-evening HR variability. Additionally, younger age (OR: 0.67, 95% CI: 0.51-0.88), female sex (OR: 1.34, 95% CI: 1.04-1.73), and elevated home HR (OR: 1.78, 95% CI: 1.39-2.29) were predictive of greater variability between consecutive HR measurements. Conclusion: Understanding the determinants of home BP and HR variability post-COVID infection is crucial for prognostication and clinical management. Clinicians should prioritize counseling incorporating regular home blood pressure measurements, diabetes management, and cardiovascular disease prevention, particularly for high-risk diabetic patients.

Micronutrient deficiency, dietary diversity, and sociodemographic and lifestyle determinants of dietary diversity among pregnant slum-dwelling women in Pune, India

BackgroundIncreasing dietary diversity is a sustainable solution to combat micronutrient deficiencies. Given the large slum population in urban India, double burden of malnutrition, nutritional transition among slum-dwellers, and limited studies focusing on dietary intake and diversity among pregnant slum-dwellers, this study aimed to 1) describe macro- and micronutrient intakes and compare them with guidelines, 2) describe dietary diversity and intake of unhealthy foods and, 3) investigate the sociodemographic and lifestyle determinants of adequate dietary diversity among pregnant slum-dwellers in Pune, Maharashtra, India.MethodsThis study presents cross-sectional data of 454 pregnant slum-dwelling women completing mid-pregnancy visit collected from a larger cohort study. Sociodemographic and lifestyle data were collected at baseline (< 12 weeks gestation). Dietary data (24-h dietary recall) were collected in mid-pregnancy (23 ± 2 weeks). Nutrient intakes were compared with the Estimated Average Requirements (EAR) for pregnant Indian women. Dietary diversity score (DDS, range 0–10) and unhealthy food (sweet snacks, sweet beverages, fried and salty food) group score (range 0–3) were calculated as per FAO guidelines. Multivariate logistic regression was conducted to examine determinants of adequate dietary diversity (DDS ≥ 5).ResultsThe average age of women was 25 (4.5) years. The median (Q1, Q3) total energy and protein intakes were 1771 (1456, 2185) kcal/d and 44.7 (34.7, 55.0) g/d, respectively. Total energy and protein were consumed as per EAR by 37% and 54% of women, respectively. Forty percent of women exceeded the recommended energy intake from carbohydrates. Diets of slum-dwelling women were lacking in multiple micronutrients (especially iron, zinc, riboflavin, thiamine, folate). The mean DDS was 4.2 ± 1.2 and 36.5% of the women had DDS ≥ 5. All women consumed mainly cereal-based starchy staples; 80% consumed pulses and legumes, and 60% consumed other vegetables. Fifty-nine percent of women consumed ≥ 2 unhealthy food groups. Higher educational and occupational status of the primary earning members of the family and lower parity were determinants of adequate dietary diversity.ConclusionThe diets of pregnant slum-dwelling women were lacking in numerous micronutrients. Dietary counselling programs need to be tailored to the socioeconomic backgrounds of pregnant slum-dwelling women and involve their family members to improve reach and effectiveness.

Association between APOE genotypes and metabolic syndrome in a middle aged and elderly Urban South Indian population

BackgroundThis study examines the association between apolipoprotein E (APOE) genotypes and metabolic syndrome (MetS) in an older urban population in South India, as part of the Tata Longitudinal Study on Aging. MethodsA total of 618 participants aged 45 and above were analyzed cross-sectionally for the association between APOE carrier status and MetS (based on both NCEP ATP III and Consensus criteria). ResultsDespite the high prevalence of MetS observed in this cohort (51.62 % by NCEP-ATP III and 61.33 % by Consensus criteria), multivariable logistic regression revealed no significant association between APOE genotypes and MetS under both criteria. However, specific associations were noted in age and sex-stratified analyses; notably, E2 carriers under 60 showed 0.42-fold decreased odds (95%CI:0.20,0.89, p-value-0.023) for an increased waist circumference, and E4 carriers above 60 were at 1.85 times increased odds (95 % CI:1.04,3.28, p-value<0.05) for decreased HDL. ConclusionThese findings suggest that while APOE genotypes influence certain metabolic parameters, their impact on MetS may be limited in this urban setting, possibly overshadowed by environmental factors and lifestyle influences, which was highlighted by the differences seen in its sister rural cohort.

Prevalence and Risk Factors of Cerebral Microbleeds in Community-Dwelling Adults in Urban Delhi.

Several observational studies have reported the prevalence of cerebral microbleeds (CMBs) and their risk factors in an elderly population. Any information in this regard is currently lacking from India. Aim of this study was to estimate the prevalence, risk factors of CMBs, and association with cognition in an Indian urban population aged 50 years and above. Household surveys were conducted as part of ongoing Longitudinal Cognition and Aging Research on Population of the National Capital Region (LoCARPoN) study in areas of urban Delhi. Magnetic resonance imaging of the brain was performed in 2599 participants. Using standard neuropsychological battery, mean Z-scores for each domain (memory, executive, information) were derived. Binary and stepwise logistic regression models were used to determine associated risk factors for the presence of CMB and its association with cognitive domains. The prevalence of CMBs was 14.42% (95% confidence interval [CI]: 13.06-15.73). Of these, 203 (7.81%) participants had single CMBs and 172 (6.61%) had multiple microbleeds (≥2). Higher prevalence was observed in older age (60-70 years: odds ratio [OR]: 1.25 [95% CI: 0.93-1.67]; 70-80 years: OR: 2.05 [95% CI: 1.48-2.84]; ≥80 years: OR: 3.27 [95% CI: 1.97-5.44]) compared to individuals in the age group 50-60 years. History of stroke (OR: 2.97 [95% CI: 1.56-5.66]), hypertension (OR: 1.36 [95% CI: 1.05-1.75]), and smoking (OR: 1.43 [95% CI: 1.11-1.85]) was associated with at least one CMB. Multiple CMBs were associated with worse scores in memory and executive domains. Older age, hypertension, history of stroke, and history of smoking emerged as important risk factors for the presence of multiple CMBs. Follow-up study is required to determine implications of CMBs.

Evaluation of CD44 antigen in type 2 diabetic patients with periodontitis: An immunohistochemical study.

Type 2 diabetes mellitus (DM) is a known systemic risk factor for periodontitis. An increased expression of CD44 has been suggested in type 2 diabetics and periodontitis patients. The present study aimed to assess the expression of CD44 antigen in patients with chronic periodontitis (CP) and type 2 DM in a South Indian urban population. Additionally, the relationships between the expression of CD44 antigen in gingival tissues, periodontal clinical parameters, and the random blood sugar (RBS) and glycated hemoglobin (HbA1c) levels were assessed. A total of 63 subjects were divided into 3 groups: systemically and periodontally healthy controls (group H); CP patients, otherwise healthy (group CP); and CP patients with type 2 DM (group CP+DM). Periodontal parameters were recorded for all groups, and additionally the RBS and HbA1c levels for group CP+DM. Gingival tissue samples were obtained and subjected to immunohistochemical analysis for CD44. The expression of CD44 was significantly higher in the diseased groups. Epithelial CD44 expression was significantly stronger in group CP+DM as compared to groups CP and H (p < 0.001), whereas connective tissue CD44 expression was similar in groups CP and CP+DM (p = 0.657). Furthermore, an inverse relationship was observed between blood glucose parameters and CD44 expression in the epithelium and connective tissue. The expression of CD44 increased with the severity of periodontal disease. Additionally, glycemic control in patients with CP and type 2 DM had an impact on CD44 expression. Our findings indicate a possible destructive role of CD44 in the pathogenesis of periodontal diseases in individuals with type 2 DM.

Assessment of Immunization Coverage and its Determinants Amongst Children in an Urban Area. Study Protocol of a Cross Sectional Study

Abstract* Introduction The country’s immunization rate is frequently below the international and national goals, and it is not distributed evenly. Children should be immunized for several reasons, chief among them being that it is the main defense against a variety of serious and frequently life-threatening illnesses. Every year, it prevents debilitating illness and disability and saves millions of lives throughout the world. The urban population in India is experiencing exponential growth. However, the public sector’s urban healthcare delivery system has encountered difficulties in keeping up with the rapid pace, exhibiting limitations in its reach and falling short of meeting the increasing demands. There is a need for government to pay attention at immunization rates and related variables in children (12–23 months) in the urban area. Objectives • To assess the overall immunization coverage rate for children in the urban area. • To assess the determinants associated with immunisation coverage in an urban area. • To explore healthcare access and infrastructure: Examine the availability and accessibility of healthcare facilities and vaccination services within the urban area. Method Information will be collected using semi- structured questionnaire in kobo collect tool. The parents of the child will be asked whether they have their immunization cards with complete immunization of their children. Study implications This study seeks to appraise the participant’s current immunization status with association to various determinants related to immunisation coverage. The study will also explore the availability of health infrastructure in association with immunization coverage. Furthermore, the gathered data may be utilized in further studies.

Impact of maxillary incisor trauma on child psychology in patients with Class II Div 1 malocclusion in urban population of India

Traumatic injuries to maxillary incisors can occur at any age, but its prevalence is high among children. Earlier studies also suggested that patients with increased overjet and lip incompetence were more prone to have trauma to maxillary incisors. The effect of Traumatic dental injuries is not only physical damage but also psychological damage as aesthetic issues are involved. Measures of oral-health-related quality of life (OHRQoL) provide essential information when assessing the treatment needs of individuals and populations. A total of 300 patients with age group 11-14 years with Class II div 1 malocclsion were included in the study. Patients were further subdivider into three group depending upon the severity of maxillary incisal trauma and no trauma group, further to that the psychological evaluation of all the patients were done using short-form of the Child Perceptions Questionnaire to ascertain the impact of oral health conditions (incisal trauma) on their quality-of-life. Mean functional limitation score was lowest for group 1 and highest with group 3 with 0.46, 0.626 and 4.191.405 respectively. Mean emotional wellbeing score was lowest in group 1 and highest in group 3 with 1.381.14 and 6.101.46 respectively Overall statistically significant differences were found between three groups w.r.t oral symptoms, functional limitation, emotional wellbeing and social wellbeing with p=0.001.Traumatic dental injury to maxillary incisors is associated with significant impairment of functionality and significant psychological implications with overall CPQ index scoring being highest in patients with more severe maxillary incisor trauma.

Association of early life factors with metabolic syndrome in school going adolescents of an urban south Indian population: a case control study

Background: Multiple factors are attributed for the increase in the prevalence of metabolic syndrome (MS) in adolescents. Association of early life factors like birth weight with adolescent MS is not clearly understood. Objectives were to study the association of early life factors with adolescent MS between aged 10- 15 years of Belagavi city. Methods: Study design: Case control Study. Study period: January 2018 to December 2018. Study population: Adolescents of age group, 10 to 15 years from the schools of Belagavi, 400 adolescents (186-cases and controls-214) were enrolled and who were having waist circumference ≥90th percentile for that age and gender were subjected to the laboratory investigations to diagnose MS. Data regarding early life factors like birth weight, gestational age and breast feeding was obtained by parental interview. Results: Overall prevalence as per the international diabetes federation criteria was 11% and a significant difference in the prevalence between cases and controls (15.05% vs 7.48%) (p=0.0160) was observed. Positive association was observed between initiation, exclusivity, and total duration of breast feeding with MS (OD: 3.66, 2.01, 1), indicating no protection of these factors for development of MS. Birth weight had a positive association with MS (OD=7.26). Conclusions: The study showed no protective association between the initiation, exclusivity and the total duration of breastfeeding with MS. However, lower middle SES, family history of hypertension (HTN), central obesity, high BMI, high TG, and low HDL were significantly associated with increased risk of MS.

Entrepreneurial Value Creation by Rural Enterprises: A Process Model

The Indian Economy is greatly benefitted by rural enterprises which provide essential goods and services to rural and urban populations of India. In addition, they contribute to direct and indirect employment. Rural enterprises have been increasing in the country for the last two decades, in the fields of agriculture, agriculture and allied products, dairy, poultry, khadi and food. The present article discusses how rural entrepreneurs create value at each stage of the enterprise, taking evidence from rural India. Further, the article develops an entrepreneurial value creation model which may help young entrepreneurship aspirants, investors and policymakers to contribute to the rural economy through rural enterprises.

Health-Seeking Behaviour and the use of Artificial Intelligence-based Healthcare Chatbots among Indian Patients

Artificial Intelligence (AI) based healthcare chatbots can scale up healthcare services in terms of diagnosis and treatment. However, the use of such chatbots may differ among the Indian population. This study investigates the influence of health-seeking behaviour and the availability of traditional, complementary and alternative medicine systems on healthcare chatbots. A quantitative study using a survey technique collects data from the Indian population. Items measuring the awareness of chatbot’s attributes and services, trust in the chatbots, health-seeking behaviour, traditional, complementary and alternative medicine, and use of chatbots are adapted from previous scales. A convenience sample is used to collect the data from the urban population. 397 samples were fetched, and statistical analysis was done. Awareness of the chatbot’s attributes and services impacted the trust in the chatbots. Health-seeking behaviour positively impacted the use of chatbots and enhanced the impact of trust of a chatbot on the use of a chatbot. Traditional, complementary and alternative medicine was not included in the chatbot, which negatively impacted the use of chatbots. At the same time, it dampened the impact of trust in chatbots on the use of chatbots. The study was limited to the urban population and a convenience sampling because of the need to use the Internet and a smart device for accessing the chatbots. The results of the study need to be used cautiously. The results can be inferred from the relationships’ existence rather than the impact’s magnitude. The study’s outcome encourages the availability of chatbots due to the health-seeking behaviour of the Indian urban population. The study also highlights the need for creating intelligent agents with knowledge of Traditional, complementary and alternative medicine. The study contributes to the knowledge of using chatbots in the Indian context. When earlier studies focus mainly on the chatbot features or user characteristics in the intention studies, this study looks at the healthcare system and the services unique to India.

Effectiveness of a Culturally Responsive mHealth Gaming Application to Improve Diabetes Health Literacy in India: A Randomized Controlled Trial.

The purpose of this study was to determine the effectiveness of a culturally responsive interactive gaming mHealth educational application designed to improve diabetes health literacy among an underserved urban population in India when compared with a traditional approach of verbal education. In addition, relationships between participant sociodemographic variables and participant knowledge were assessed. A randomized controlled trial was conducted using a two-arm parallel, single-blinded intervention and control group design. The parallel groups were the mHealth Education group serving as the intervention group and the Verbal Education group serving as the control group. The mHealth application was as effective in improving diabetes health literacy as verbal education. Results for the difference in posttest and pretest score between the two groups indicated there was no statistically significant difference between groups (P = .9306). However, there was a significant improvement in the difference in posttest and pretest scores for each group (P < .0001), indicating that the culturally responsive type 2 diabetes educational content was effective in improving type 2 diabetes health literacy among both groups. This study answers a call by the World Health Organization that advocates for evidence-based mHealth interventions that offer unique opportunities for cost-effective informatics service delivery in low- and middle-income countries.

PHARMACOGNOSTICAL AND PHYTOCHEMICAL EVALUATION OF A POLYHERBAL ANTIHYPERTENSIVE AYURVEDIC FORMULATION [NIA/DG/2015/01

Introduction: Hypertension is a complex clinical illness with a frequency of 40.8 percent in the urban Indian population and 17.9 percent in the rural population. Multiple antihypertensives are used to treat hypertension. However, many have adverse effects and are hazardous. NIA/DG/2015/01 is a polyherbal antihypertensive ayurvedic ghan formulation, containing Arjuna (Terminalia arjuna Roxb.), Ashwagandha (Withania somnifera Linn.), Jatamansi (Nardostachys jatamansi DC.), Shankhpushpi (Convolvulus pluricaulis Choisy.), Punarnava (Boerhavia diffusa Linn.). Aim and objective: To evaluate a polyherbal antihypertensive Ayurvedic formulation [NIA/DG/2015/01] in terms of pharmacognosy, physiochemistry, phytochemistry and chromatography. Materials and methods: A polyherbal antihypertensive ayurvedic formulation [NIA/DG/2015/01] was evaluated for purity, safety, and quality using pharmaco-gnostical, physiochemical, phytochemical, and chromatographic methods. Observations and Results: The pharmaco-gnostical, physiochemical, phytochemical, and chromatographic results were within normal limits per API. Conclusion: The present sample of a polyherbal antihypertensive ayurvedic formulation [NIA/DG/2015/01] met quality standards for purity, safety and authenticity.

Pharmacognostical and Phytochemical Evaluation of a New Anti-Hypertensive Ayurvedic Formulation [NIA/DG/2020/01

Hypertension, also known as high or raised blood pressure, is a multifactorial disease with multiple causes and multiple treatments. The prevalence of hypertension in the urban Indian population was estimated to be 40.8% and in the rural population was 17.9%. Though there are multiple treatment of disease still it is challenge to manage this disease effectively with lower side effects as all available treatments are full of side effects and toxic effects. NIA/DG/2020/01 is a new anti-hypertensive Ayurvedic ghan formulation, containing Arjuna (Terminalia arjuna Roxb.), Ashwagandha (Withania somnifera Linn.), Jatamansi (Nordostachys jatamansi DC.), Shankhpushpi (Convolvulus pluricaulis Chois.), Punarnava (Boerhavia diffusa Linn.), Gojihwa (Onosma Bracteatum Wall.), Guduchi (Tinospora cordifolia Willd.), Mukta Shukti (Margarita) and Praval Pisti (Corrallium Rubrum). All these components are very well known for Hridya, Mootral, Rasayana, Pitta shamak effect and pharmacological actions like cardioprotective, anti-Hypertensive, antioxidant, antimicrobial, antifungal, Antidepressant or anxiolytic, anti-inflammatory, psycho-immunomodulatory effect and acetyl-cholinesterase inhibitory activity etc. Aim and Objective: To perform pharmacognostical, physio-chemical, phytochemical and chromatography evaluation of a new anti-hypertensive Ayurvedic formulation [NIA/DG/2020/01]. Material and Methods: This study involves pharmacognostical, physio-chemical, phytochemical and chromatography evaluation of a new anti-hypertensive Ayurvedic formulation [NIA/DG/2020/01] to ensure its purity, safety and quality. Observations and Results: All the findings of the pharmacognostical, physio-chemical, phytochemical and chromatography evaluation were within the standards of quality. Conclusion: The present sample of a new anti-hypertensive Ayurvedic formulation [NIA/DG/2020/01] was found to be rich in quality and was safe, pure and authentic.

Nutrient Diversity and its Association with Type 2 Diabetes Mellitus in Urban Indian Population

Background: Nutrient diversity is one of the key factors of a balanced diet because of its correlation with macronutrients and micronutrients. Aims and Objectives: The objective of the study was to assess daily dietary intake and get urban Indian data based on the regional dietary intake of the subjects. Materials and Methods: Nutrient diversity was inferred using a food frequency questionnaire and 24-h dietary recall along with other variables such as demographic data, income, education, lifestyle, number of meals per day, and addictions. Average, mean, and standard deviation were calculated for all of these. Results: Results showed a positive correlation between nutrient diversity and its association with type 2 diabetes mellitus. The average dietary intake of the study showed that the subjects consumed a diet high in carbohydrates and fat while the protein and micronutrient intake was on the lower side. A large variation was observed in the average nutrient intake from different food groups. Conclusion: The current study concluded that the nutrient diversity amongst the subjects is an indicator to risk of diabetes and pre–diabetes.

Impact of Diet on Nutrient Intake, Glycemic Index and Glycemic Load of Meals of Urban Indian Diabetic Population

Background: India is heading toward becoming the global diabetic capital directly interconnected to poor lifestyle and obesity. Aims and Objectives: The aim of the study was to find an association between glycemic index (GI) and glycemic load (GL) with macronutrients and fiber in the diet of the urban Indian population. Materials and Methods: The dietary intake using food frequency questionnaire and 24–h dietary recall of 240 recruited subjects (male and female), between 25 and 60 years were taken in the study. GI and GL of all meals were calculated using values from National and the International Table of GI and GL. Results: Average mean and standard deviation of GI and GL of major meals were on the higher side. A significant correlation between GI of lunch and dinner with total available carbohydrate (CHO) and total starch intake. A positive significant correlation was observed between GI to energy intake at dinner, total available CHO, and total starch. GL of breakfast was negatively correlated to iron, zinc, insoluble, and soluble fiber intake in females. GL for lunch was positively correlated to the intake of total available CHO, total starch, insoluble, and soluble fiber. Conclusion: The present study showed high GI and GL of processed foods and refined CHO indicating that dietary habits with high GI and GL foods are an indicator to risk of diabetes and pre-diabetes among both genders.

Epidemiological pattern of COVID-19 and its association with periodontal health in an urban Indian cohort.

Studies have highlighted a possible influence of gingival and periodontal disease (PD) on COVID-19 risk and severity. However, the evidence is based on hospital-based studies and community-level data are sparse. We described the epidemiological pattern of SARS-CoV-2 infection in Delhi and evaluated the associations of gingival and PD with incident COVID-19 disease in a regionally representative urban Indian population. In a prospective study nested within the Centre for Cardiometabolic Risk Reduction in South-Asia (CARRS) study, participants with clinical gingival and periodontal status available at baseline (2014-16) (n = 1,727) were approached between October 2021 to March 2022. Information on COVID-19 incidence, testing, management, severity was collected as per the WHO case criteria along with COVID-19 vaccination status. Absolute incidence of COVID-19 disease was computed by age, sex, and oral health. Differences in rates were tested using log-rank test. Poisson regression models were used to evaluate independent associations between gingival and PD and incidence of COVID-19, adjusted for socio-demographic and behavioral factors, presence of comorbidity, and medication use. Among 1,727 participants, the mean age was 44.0 years, 45.7% were men, 84.5% participants had baseline gingival or PD and 89.4% participants had received at least one dose of COVID-19 vaccine. Overall, 35% (n = 606) participants were tested for COVID-19 and 24% (n = 146/606) tested positive. As per the WHO criteria total number of cases was 210, constituting 12% of the total population. The age and sex-specific rates of COVID-19 were higher among men and older participants, but women aged >60 years had higher rates than men of same age. The incidence rate did not differ significantly between those having gingival or PD and healthy periodontium (19.1 vs. 16.5/1,000 person-years) and there was no difference in risk of COVID-19 by baseline oral disease status. Gingival and PD were not associated with increased risk of COVID-19.

Assessment of quality of care of diabetic patients by health-care professionals in a city – A community-based cross-sectional study

Background: Diabetes is undoubtedly one of the most challenging health problems of the 21st century. Patients from poor parts of the Indian urban population do not frequently have access to these health benefits despite having access to reliable screening methods and antidiabetic drugs. Hence, this study was designed to assess the quality of care of diabetic patients by health-care professionals in a city. Aims and Objectives: This study aims to assess the quality of care of diabetic patients by health-care professionals in a city. Materials and Methods: A community-based cross-sectional study was conducted in the city of Aurangabad, Maharashtra. The sample size calculated was 145 and we used the probability proportionate to size sampling technique to identify the number of participants. Results: Overall 9% of patients had good quality of care. Almost 61.4% were dissatisfied with their treating physician. Almost all patients going to public health centers complained of the unavailability of medications whereas three-fourth (73.5%) of patients complained of unavailability of investigations. Only 23.4% of diabetic patients were referred to a specialist for screening or management of complications. Conclusion: Quality of care assessed through patient’s opinion showed that most diabetic patients were not well informed about comprehensive diabetic management by the health-care providers. Glycemic controls in diabetic patients were far below recommended standards.