Urban Indian Population Research Articles

Skilled Counseling in Enhancing Early and Exclusive Breastfeeding Rates: An Experimental Study in an Urban Population in India

The study was conducted to evaluate the effect of breastfeeding counseling and breastfeeding support by trained counselors during the ante-natal period at health facility and post-natal period at home on breastfeeding practices during the first six months of life. This was a randomized controlled study that compared the effect of counseling on breastfeeding during the first 6 months of life. study was done in a government medical college in northern India, which is situated in an urban area. 300 healthy pregnant women from an urban population attending the antenatal clinic at Jawaharlal Nehru Medical College, Aligarh Muslim University were recruited for the study. Subjects were equally assigned randomly to the intervention (2 antenatal and 8 postpartum home counseling visits by the counselors) and control (non-counseling) group. Infant feeding practices including rates of initiation of the breastfeeding within one hour of birth; exclusive breastfeeding and bottle-feeding during the first 6 months of life. Initiation of breastfeeding within one hour of birth was 73.4% in intervention group as compared to 33.6% in control group (P=0.001). More mothers in the intervention group (88.2%) were able to sustain exclusive breastfeeding rates at 6 months of age in comparison to the control group (50%) (OR 7.44, 95% CI 3.98-13.92). This study substantiates positive role of skilled counseling by a trained dedicated breastfeeding counselor during the antenatal and post-natal periods on breastfeeding practices during the first six months of life.

Consumption of Decorticated Pulses Ensures the Optimum Intake of Isoflavones by the Urban Indian Population

Sample urban population was assessed for consumption of legumes. Genistein and daidzein content of commonly consumed legumes was evaluated to estimate the isoflavone intake through the consumption of these legumes by selected population. Total genistein content of all legumes considered for analysis was found to be in the range of 0.60 to 8.65 mg per 100 g whereas total daidzein content was found to be in the range of 1.10 to 30.37 mg per 100 g in selected legumes. Chickpea, kabuli, whole (Cicer arietinum), pigeon pea, split, decorticated (Cajanus cajan), chickpea, split, decorticated (Cicer arietinum) showed a high amount of genistein and daidzein among selected legumes. Average isoflavone consumption by selected population was found to be 18.22 mg/d through the consumption of legumes. Consumption of pigeon pea (split, decorticated) and chickpea (split, decorticated) was found to be highest at 371.6 g/month and 329.7 g/month, and hence were found to contribute 18% and 14% to total isoflavone intake, respectively. The comparatively high content of isoflavones and inclusion as a staple in the diet have resulted in making the split, decorticated pulses (chickpea, pigeon pea, lentil, green gram, black gram) a chief isoflavone source for selected population irrespective of their demographic differences.

Assessment of vaccine coverage and associated factors among children in urban agglomerations of Kochi, Kerala, India.

Context:Urban population in India is growing exponentially. The public sector urban health delivery system has so far been limited in its reach and is far from adequate.Aims:This study aims to estimate routine immunization coverage and associated factors among children (12–23 months and 60–84 months) in the urban Kochi Metropolitan Area of Kerala.Settings and Design:A cross-sectional study was conducted in Kochi Metropolitan area.Materials and Methods:A cluster sampling technique was used to collect data on immunization status from 310 children aged between 12 and 23 months and 308 children aged between 60 and 84 months.Statistical Analysis:Crude coverage details for each vaccine were estimated using percentages and confidence intervals. Bivariate and multivariate analysis were conducted to identify factors associated with immunization coverage.Results:Among the children aged 12–23 months, 89% (95% CI 85.5%-92.5%) were fully immunized, 10% were partially immunized, and 1% unimmunized. Less than 10 years of schooling among mothers (OR 2.40, 95% CI 1.20–4.81) and living in a nuclear family (OR 1.72, 95% CI 1.06–3.14) were determinants associated with partial or unimmunization of children as per multivariate analysis. The coverage of individual vaccines was found to decrease after 18 months from 90% to 75% at 4–5 years for Diphtheria Pertussis Tetanus (DPT) booster. Bivariate analysis found lower birth order and belonging to the Muslim religion as significant factors for this decrease.Conclusion:Education of the mother and nuclear families emerged as areas of vulnerability in urban immunization coverage. Inadequate social support and competing priorities with regard to balancing work and home probably lead to delay or forgetfulness in vaccination. Therefore, a locally contextualized comprehensive strategy with strengthening of the primary health system is needed to improve the immunization coverage in urban areas.

Regional prevalence of gestational diabetes mellitus in North India

Background and Objective: Incidence of gestational diabetes mellitus (GDM) varies globally from 2% to 14%. These cases in India are also increasing and emerging as a major public health problem. The prevalence of GDM among urban population of India has been reported as 16% and 17.8%, respectively. We conducted this study at three different regions of North India to estimate the prevalence of GDM. Materials and Methods: This pilot prospective cross-sectional study was conducted at three centres of North India with a base at Max Super Speciality Hospital, Saket, New Delhi, over a period of 10 months (December 2015–October 2016). Pregnant females attending gynaecology clinic at these centres were screened and enrolled as per the study inclusion criteria, after taking informed consent. Medical records were reviewed for recent haemoglobin levels, fasting blood sugar levels and other clinical parameters. Results: A total of 230 participants were enrolled in this study with 65 from Muzaffarpur, 65 from Bhilai and remaining 100 from Delhi, which include a mixed population. The overall prevalence of GDM was observed as 10%, with a regional prevalence of 10.77% at Bhilai, lower prevalence at Muzaffarpur (3.07%) and 14% in Delhi with a mixed population. A significant difference (P

Critical Success Factors Affecting E-learning Quality for Management Students in Delhi-NCR

The urban population in India is projected to grow faster than its overall population by 2030. This rapid increase in population will create pressure on the economy as well as on the education system. With the changing time, psychology of students is also changing. Today, attending hours of face-to-face lectures in schools/colleges in today's dynamic scenario is passe. And this can be suspected as a major reason of dropouts Government schools. Time has come. Teaching needs to be changed. There is a growing need for teachers to make their classes more dynamic as to suit the demand of today's youth. Another problem which is faced in Indian education system is the shortage of education institutes and faculty. This limitation can be overcome if the learning resources can be provided on cloud and the relevant technology can be made accessible to everyone. Technology, therefore has the capability to address all these issues. Prime Minister Narendra Modi's emphasis on the Digital India campaign aims to ensure better connectivity and maximize the potential of India's youth. Growing penetration of internet and increasing smartphone penetration along with a strong thrust from the Government are accelerating the transformation of India's education system. World is being digitized and therefore, the need of the hour is to make the youth of today, technology friendly. The key to success is in catching them young. In this paper, factors affecting the e-learning quality for Management students of Delhi NCR also derived. The exploratory factor analysis was conducted and five critical factors for the successful implementation of e-learning for management students were derived. These five critical factors were termed as Utilitarian factors, Facilitating conditions, Progress tracking, Content quality and Hedonic factors.

Prevalence of oral diseases and risks to oral health in an urban community aged above 14 years

Oral health is a requisite to general health and quality of life. The public health problems associated with oral diseases are a serious burden in every nation around the globe. The aim of this study is to assess the prevalence of dental problems and the oral health seeking behavior of an urban south Indian population aged >14 years. In this population-based cross-sectional study, 101 households were selected through systematic random sampling. About 419 participants were interviewed and information on sociodemographic characteristics, personal, and dental history was obtained and a complete oral cavity examination was performed. The prevalence of dental caries, periodontal problems, and tooth wear were 78.75%, 74.7%, and 72.3%, respectively. The mean number of overall affected teeth in the population by one dental problem is 16 ± 8.13. The mean Decayed, Missing and Filled Teeth (DMFT) score was 4.5. The risk factors that were significantly associated with the poor oral health status were age >31 years (Odds Ratio (OR), 2.88), education less than eighth grade (OR, 2.35), inadequate oral hygiene practices (OR, 1.61), use of any form of tobacco (OR, 2.08), and alcohol consumption (OR, 2.02). Only 185 (44.1%) participants perceived that they had a dental problem at the point of the survey and only 20 of them (10.81%) visited a dentist. This study showed a high prevalence of dental caries, periodontal problem, and tooth wear. This emphasizes the need for community-based awareness program on dental health and recommends periodic dental health screening program at the community level for early diagnosis and better treatment.

Risk of developing Diabetes Mellitus among urban poor South Indian population using Indian Diabetes Risk Score.

Background:Diabetes mellitus is increasing its share of burden to the health-related problems in developing countries such as India. Urban slum residents constitute the “vulnerable population” who lack the basic health amenities. Lack of effective screening for primary prevention has been one of the reasons for the rising burden.Materials and Methods:The cross-sectional study was conducted among 400 adults aged between 30 and 60 years residing in a settled slum of Rukmini Nagar area of Belagavi city, Karnataka. Data were collected after taking written informed consent from each participant using a pretested questionnaire that included demographic information and details of the risk factors. Risk of developing diabetes was assessed by using Indian Diabetes Risk Score. Results are expressed as proportions, and analysis was done using Chi-square test and multiple logistic regression analysis.Results:The mean age of participants was 44.3 ± 8.7 years. The proportion of low, moderate, and high risk of developing diabetes mellitus was 7%, 63%, and 30%, respectively. The prevalence of newly diagnosed cases was 10.25%. Moreover, 57.1% of them with positive family history were in the high risk category; 76.9% of the sedentary workers were at higher risk; overweight and obese individuals had higher proportion of the high and moderate risk (P < 0.0001). Correlation coefficient (R) was 0.782, and coefficient of determination (R2) was 0.61.Conclusions:Our study demonstrated that advancing age, low physical activity, family history, overweight, and obesity were the prominent factors that predicted the risk of diabetes in the near future. Hence, focused interventions for urban slum dwellers are imperative and draw special attention.

Identification of New Bacteria Scardovia wiggsiae in Caries Risk Indian Adolescent Population - Polymerase Chain Reaction Analysis

BACKGROUND: The independent association of S. mutans andScardovia wiggsiae and their association in ECC and as a risk indicator have been reported in the literature. Its prevalence in low and high caries risk of urban adolescent Indian population has not been reported so far. Hence the primary objective of the study is to identify the prevalence of new bacteria Scardovia wiggsiae in low and high caries risk urban adolescent population. METHODS: 50 adolescent subjects were screened based on ADA risk assessment criteria. Group 1(n=25) - Low caries risk (saliva, plaque) and Group 2 (n=25) - High caries risk (saliva, plaque and dentinal caries) were evaluated for the presence of Scardovia wiggsiae by PCR analysis. FINDINGS: Highest prevalent was found in dentinal caries followed by plaque and saliva samples of high caries risk subjects; whereas it was totally absent in both the samples of low risk caries subjects. INTERPRETATION: Scardovia wiggsiae could be one of the predominant microorganism for initiation and progression of caries and can be used as a risk indicator for dental caries assessment in a given population. Thus by identifying the actual predominant genera in the microbial communities, preventive strategies can be targeted specifically to decrease the level of prevalence, thereby lowering caries experience in a given population. FUNDING STATEMENT: The authors stated: Nil. DECLARATION OF INTERESTS: The authors have no financial interest in any of the companies or products mentioned in this article. ETHICS APPROVAL STATEMENT: Ethical clearance was obtained from Institutional Review Board (IRB) of S.R.M University (SRMDC/IRB/2014/MDS/No.307).

Low bone mineral density and its risk factors in an urban adult population of South India

BACKGROUND AND OBJECTIVES: Low bone mineral density (BMD) is widely prevalent in Indian populations. Very few studies that reported risk factors for low BMD and osteoporosis did not explore its relationship with age and sex. Objectives were to determine the prevalence of low BMD and osteoporosis in urban adults, and study the age- and sex-wise trends of changing BMD. METHODOLOGY: BMD of 521 healthy adults aged 20 years or more was tested using quantitative ultrasound of right tibia, and T-scores thus obtained indicated normal or low BMD. Multivariate analysis was done to calculate odds ratios for risk factors for low BMD and osteoporosis. RESULTS: Eighty-four percent participants had low BMD. Low BMD increased significantly with increasing age in both genders. An increase in age per standard deviation (SD) was associated with four-fold increase in risk of low BMD for both women (odds ratio [OR]: 4.83, 95% confidence interval [CI]: 2.61–8.92) and men (OR: 4.14, 95% CI: 2.44–7.05). Age per SD (OR: 2.28, 95% CI: 1.37–3.81) and age–gender interaction (OR: 1.09, 95% CI: 1.02-1.17) was positively associated with osteoporosis. Increasing age by one SD was associated with seven-fold increase (OR: 7.35, 95% CI: 3.51–15.40) in risk of osteoporosis among women. CONCLUSIONS: Low BMD is highly prevalent in South Indian urban population. Low BMD and osteoporosis were positively associated with increasing age. Loss of BMD appeared to begin at young ages thereby indicating the need for early institution of prevention measures.

Urbanization in India and Korea–India Economic Cooperation

The rapid economic growth that has taken place in India recently is expected to accelerate urbanization in the country. The urban population in India is estimated to grow more than twofold by the year 2050. As urbanization accelerates due to the urbanization policies carried out by the Indian government, the cities are expanding their power and water supply, public transportation, communication, waste disposal, and residential convenience centers, as well as expanding their consumption markets. Against this backdrop, this research examines urbanization policy in India, going on to analyze the relationship between urbanization and economic growth. Based on these analyses, this research suggests political directions and tasks in the urban development cooperation between Korea and India.

A study of morbidity pattern among elderly population in urban India

Background: The people in urban area were suffering from different type of morbidities like chronic lung disease, depression, angina, diabetes, etc. Therefore, this study was designed to explore the age pattern of morbidities, level of substance use among elderly, and relationship between substances used and selected morbidities among elderly in urban India. Material and Methods: The information on morbidity was obtained from Study on Global Ageing and Adult Health (SAGE) - 2007. The methods bivariate and multivariate were used for analyzing the data. Results and Discussion: The hypertension, depression, diabetes and disease-related to oral health were highly prevalent in the age group of 50-59 years, while cataracts, asthma, and stroke were more frequent in 60-69 years. In urban India, around every second people in the age group of 50-59 years were smokers whereas people were more alcoholic in 60-69 years. In urban India, Assam was the state where the prevalence of smoking was highest while alcohol consumption was highest in the state of Rajasthan and lowest was in Assam. Moreover, among the elderly people; the third most powerful killer disease (diabetes) was highest in the age the group of 50-59 years. Age, tobacco consumption and improvements in wealth quintile were significant risk factors associated with the presence of morbidities like diabetes, hypertension, and stroke. Asthma and oral health were significant increases along with age. Conclusion: Study confirm that, for reducing these non communicable diseases, there is need to improve old age policy to make proper intension towards the health facility especially among the elderly of middle and higher economic households.

Construction and demolition waste (C&DW) in India: generation rate and implications of C&DW recycling

Construction and demolition waste (C&DW) management is gaining attention from policy makers in India. This article estimates C&DW generation from urban building, rural building, and non-building sectors in India and calculates material, energy, and emissions savings from C&DW recycling. The method used in this study is top down up material flow analysis approach. The results indicate that India generated between 112 and 431 million tonnes of C&DW in 2016 depending upon the assumptions, which are orders of magnitude higher than official records indicate. Although per capita waste generation from rural area is less than urban areas, rural areas as a whole generate more waste than urban areas, as rural population is still over two times the urban population in India. Additionally, it was estimated that formal C&DW recycling can save upto 2–8% of natural minerals, such as sand and aggregate in urban areas, energy and emissions savings were negative, implying that recycled C&DW materials are likely to be more resource and environmentally intensive as compared to natural materials.

Prevalence of vitamin B12 deficiency in South Indians with different grades of glucose tolerance.

To determine the prevalence of vitamin B12 deficiency in an urban south Indian population in individuals with different grades of glucose tolerance. A total of 1500 individuals [900 normal glucose tolerance (NGT), 300 prediabetes and 300 type 2 diabetes (T2DM)] who were not on vitamin B12 supplementation were randomly selected from the Chennai Urban Rural Epidemiological Study (CURES) follow-up study. Anthropometric, clinical and biochemical investigations, which included vitamin B12, insulin, homocysteine, HbA1c and serum lipids, were measured. Vitamin B12 ≤ 191pg/ml was defined as absolute vitamin B12 deficiency and vitamin B12 > 191pg/ml and ≤ 350pg/ml as borderline deficiency. The mean levels of vitamin B12 significantly decreased with increasing degrees of glucose tolerance (NGT 444 ± 368; prediabetes 409 ± 246; T2DM 389 ± 211pg/ml, p = 0.021). The prevalence of absolute vitamin B12 deficiency was 14.9% while 37.6% had borderline deficiency. The prevalence of absolute vitamin B12 deficiency was significantly higher among individuals with T2DM (18.7%) followed by prediabetes (15%) and NGT(13.7%) [p for trend = 0.05]. The prevalence of vitamin B12 significantly increased with age (p < 0.05) and in those with abdominal obesity (p < 0.001). Men and vegetarians had twice the risk of vitamin B12 deficiency compared to women and non-vegetarians, respectively. Among individuals with NGT, prediabetes and T2DM, vitamin B12 negatively correlated with homocysteine. This study reports that the levels of vitamin B12 decreased with increasing severity of glucose tolerance.

Prevalence of and factors contributing to anxiety, depression and cognitive disorders among urban elderly in Odisha – A study through the health systems’ Lens

IntroductionGrowing geriatric mental health needs of urban population in India pose several programmatic challenges. This study aimed to assess anxiety, depression and cognitive disorders among urban elderly, and explore availability of social support mechanisms and of a responsive health system to implement the national mental health programme. Methods244 respondents were randomly selected from Berhampur city. We administered a semi-structured interview schedule to assess substance abuse, chronic morbidity, anxiety, depression and cognitive abilities. Further, in-depth interviews were conducted with 25 key informants including district officials, psychiatrists, and programme managers. We used R software and ‘thematic framework’ approach, respectively, for quantitative and qualitative data analysis. Ethical standards were complied with. ResultsAbout half of the respondents were economically dependent; 57.3% had moderate to severe anxiety; 46.7% had moderate to severe depression; while about 25% had severe cognitive impairments. We found association of chewing tobacco (1.34(0.28–2.40)) and depression (0.52(0.37–0.68)) with anxiety; negative perception about elderly-friendly society (1.64(0.75–2.53)) and physical inactivity (2.88(1.60–4.16)) with depression; and age (-0.11(-0.20 – -0.02)) and physical inactivity (-3.44(-5.13 – -1.74)) with cognitive disorders. Qualitative analysis revealed lack of awareness, social stigma, poor availability of trained human resources, and poor political commitment as important systemic barriers to early detection and treatment of mental ailments among the elderly. ConclusionEstablishing tobacco cessation centres, sensitizing community about mental health needs of elderly, incentivizing physical activity of elderly, integrating mental health with primary care, multi-skilling providers and developing a cadre of community counsellors need urgent attention of policy makers and programme implementers.

Fetal sex modifies the effect of maternal macronutrient intake on the incidence of small-for-gestational-age births: a prospective observational cohort study

Maternal macronutrient intake is likely to play a pivotal role in fetoplacental growth. Male fetuses grow faster and their growth is more responsive to maternal size. We assessed the role of fetal sex in modifying the effect of maternal macronutrient intake on the risk of small-for-gestational-age (SGA) birth. This was a prospective, observational cohort study of 2035 births from an urban South Asian Indian population. Maternal intakes of total energy and macronutrients were recorded by validated food-frequency questionnaires. The interaction of trimester 1 macronutrient intake with fetal sex was tested on the outcome of SGA births. The prevalence of SGA was 28%. Trimester 1 macronutrient composition was high in carbohydrate and low in fat (means±SDs-carbohydrate: 64.6%±5.1%; protein: 11.5%±1.1%; and fat: 23.9%±4.4% of energy). Higher carbohydrate and lower fat consumption were each associated with an increased risk of SGA [adjusted OR (AOR) per 5% of energy (95% CI): carbohydrate: 1.15 (1.01, 1.32); fat: 0.83 (0.71, 0.97)] specifically among male births (males: n=1047; females: n=988). Dietary intake of >70% of energy from carbohydrate was also associated with increased risk (AOR: 1.67; 95% CI: 1.00, 2.78), whereas >25% of energy from fat intake was associated with decreased risk (AOR: 0.61; 95% CI: 0.41, 0.90) of SGA in male births. Higher carbohydrate and lower fat intakes early in pregnancy were associated with increased risk of male SGA births. Therefore, we speculate that fetal sex acts as a modifier of the role of maternal periconceptional nutrition in optimal fetoplacental growth.

Knowledge, Attitude and Practices on Cancer Education and Prevention: A Cross-Sectional Survey

Background: Lifestyle associated cancers are 1 of the top 5 leading causes of death in the world and India sees a million new cases yearly. Early detection is an effective way to reduce incidences and mortality for preventable cancers. There is significant delay in detection for a large proportion of cancer patients in India. Lack of awareness about cancer has been shown to be a major contributor to treatment delay in many countries. The current study looked at the cancer awareness in an urban Indian population to address the gap of information about cancer prevention. Aim: To quantify knowledge about cancer in an urban population and find sociodemographic associations of lack of knowledge. We also wanted to compare knowledge of people from general population with those having some knowledge due to a family member being under treatment. Methods: Data were collected from 2 stratums: family members of cancer patients, Internet using community from general population, non-Internet using community dwellers. Subject selection was randomized. A prevalidated questionnaire was used. Data were analyzed using STATA 13. Results: Respondents (n = 846) were family of cancer patients (n = 146, 17.3%), community dwellers (n = 175, 20.7%) and community Internet users (n = 525, 62.1%). No association of knowledge with age, gender, and income was found ( P values 0.84, 0.25, 0.93 respectively). Statistically significant association of cancer knowledge with education was found ( P &lt; 0.001). There is significant difference in knowledge between Internet using and non-Internet using community ( P &lt; 0.001). Conclusion: Education impacts cancer knowledge of the population. The population having access to Internet has a higher knowledge than nonusers; but exposure to cancer treatment does not result in higher knowledge on cancer. These results will inform prevention and health education policies and aid in designing awareness and screening programs for preventing cancer.

A study on associations and influence of health determinants on systolic and diastolic blood pressure

Background: The aim of the study was to assess the prevalence of hypertension among Indian urban educated population and evaluate the association of various modifiable and non-modifiable risk factors on the development of systolic blood pressure (SBP) and diastolic blood pressure (DBP).Methods: The retrospective study comprised of medical data obtained from 175 individuals who had undergone routine annual medical check-up during the period 2016 -2017. The data was analysed and interpreted using summary statistics, correlations and linear regression analysis. Most of the variables were measured values.Results: Out of 175 reports analysed, 40 (22.9%) individuals comprising of 29 males and 11 females were found to be hypertensives. Isolated systolic hypertension was present in 4 (2.3%) individuals, isolated diastolic hypertension in 26 (14.9%) individuals and in 10 (5.7%) individuals both systolic and diastolic blood pressure was raised. Significant correlations were observed. Multiple linear regression showed significant positive influence of DBP, age and BMI on SBP whereas serum vitamin D level and left ventricular cardiac ejection fraction was negatively influencing SBP (R²=0.638, p=0.000). furthermore, multiple regression analysis with DBP as the dependent variable showed SBP, and serum vitamin D level to be the significant influencing determinants (R²=0.602, p=0.000).Conclusions: The present study on the Influence of modifiable and non-modifiable risk factors on development of SBP and DBP improves knowledge for better preventive strategies.

Vitamin D Deficiency in Asthmatics from an Urban Population in India

Vitamin D Deficiency in Asthmatics from an Urban Population in India

Leveraging Policies for Self Sufficiency in Pulses in India

Although pulses are a major source of protein integral to the Indian diet, there has been a consistent demand–supply gap. Barring the last five years, total production of pulses remained stagnant at 12–14 million tonnes (mt) over the past five decades. Over the last 20 years, more than 550 improved varieties of different maturity periods and for different regions have been released by public research organisations, but the availability of quality seeds remained a serious concern, thereby resulting in yield uncertainty. The domestic supply fell short by 3–4 mt every year. Also, owing to increased consumption by the diet-conscious growing urban population in India, prices rose by 150 per cent to 200 per cent in recent years. The supportive trade policy has cooled down the pulses price during the deficit year, while encouraging price support policy and good monsoon helped in a big way to allocate 20 per cent more area to the crop, which resulted in record pulses production of 23 mt in 2016–2017. This article captures the influence of government policy on pulses production and suggests paradigm shift in strategy through short-, medium- and long-term plans to achieve self-sufficiency in pulses production and ensure nutritional security for population.

Increasing Incidence of Malignancy Among Male Breast Lesions in The Urban Population of India

Increasing Incidence of Malignancy Among Male Breast Lesions in The Urban Population of India