Vitamin D is a fat-soluble vitamin playing a vital role in human physiology. Vitamin D deficiency is prevalent worldwide. This deficiency has many consequences which are still being explored, apart from the well-known skeletal complications. With this review, we aim to summarize the existing literature on Vitamin D status in India and understand the enormity of the problem. The prevalence of Vitamin D deficiency ranged from 40% to 99%, with most of the studies reporting a prevalence of 80%–90%. It was prevalent in all the age groups and high-risk groups alike. With the consequences of Vitamin D deficiency, namely, autoimmune diseases, cardiovascular diseases, cancer, and tuberculosis being explored, we can imagine the burden it would cause in our country. We need to create awareness among the public and healthcare providers about the importance of Vitamin D and the consequences of deficiency. Our Indian diet generally fails to satisfy the daily requirement of Vitamin D for a normal adult. This stresses on the need for fortifying various food with Vitamin D, through the national programs. This silent epidemic should be addressed appropriately with concrete public health action.
Context: A complex dysregulation of glucose homeostasis, Diabetes Mellitus (DM) is an iceberg disease with an ever-rising global (8.5%, 2018) and national prevalence (7.3% - ICMR-INDIAB study, 2017) amidst adults. Besides the micro and macrovascular complications, in virtue of diverse mechanisms that downplay the immune system culminating in an array of infections especially UTIs are commoner in routine diabetic clinics. The spectrum of UTI ranges from asymptomatic bacteriuria (ASB) to serious complications such as emphysematous pyelonephritis, renal abscesses that are encountered frequently among Diabetics than the general population. The risk stratification and varying modalities of presentation of UTIs in diabetics in contrast with non-diabetics are being studied. Methods and Material: A prospective comparative cross-sectional study was conducted in 250 adult consenting participants with equal diabetics and non-diabetics with culture-proven UTI, at the Department of Internal Medicine in a tertiary care hospital of National Capital Territory (NCT) of India, after fulfilling appropriate criteria. Alongside socio-demographic details and vitals parameters, glycaemic status assessment and relevant investigations were done in either group. Results: Mean age of the participants was 52.18 ± 9.06 with age and gender being reasonably distributed in both the groups. Fever ( P <0.01), dysuria ( P <0.01), urgency ( P <0.01) and urinary frequency ( P <0.01) found frequently among non-diabetics wherein vomiting ( P <0.01) and incontinence ( P <0.01) relatively commoner among diabetics. E. coli, Klebsiella sp., were the most common organisms in both groups with Proteus sp., and Pseudomonas sp., higher among diabetics. Severe infection and Pyelonephritis were frequent (AOR 2.64, 95% CI- 2.01-3.27, P <0.05) among diabetics. Antimicrobial sensitivity patterns were not significantly different among both groups. Conclusions: Primary care physicians are to be acquinted with the possibility that UTI in diabetics could exhibit relatively lesser symptoms or more severe forms of UTI at presentation and less favorable outcomes. Further validation from a larger cohort of diabetics is warranted in terms of symptomatology, diagnostic approach, and sensitivity patterns.
Background Chronic respiratory diseases (CRDs) are major causes of mortality and morbidity worldwide with a substantial burden of the disease being borne by the low and middle income countries (LMICs). Interventions to change health behaviour which aim to improve the quality of life and reduce disease burden due to CRD require knowledge of the problem and factors influencing such behaviour. Our study sought to appreciate the lived experiences of people with CRD, their understanding of the disease and its risk factors, and usual practice of health behaviour in a rural low-literate community in southern India. Methods Qualitative data were collected between September and December 2018 through eight focus group discussions (FGDs), five in-depth interviews and four key-informant interviews from patients and community members. Community engagement was undertaken prior to the study and all interviews and discussions were recorded with permission. Inductive coding was used to thematically analyse the results. Results Major themes included understanding of chronic lung disease, health behaviours, lived experiences with the disease and social norms, attitudes and other factors influencing health behaviour. Discussion Poor understanding of CRDs and their risk factors affect health seeking behaviour and/or health practices. Stigma associated with the disease and related health behaviours (e.g. inhaler use) creates emotional challenges and mental health problems, besides influencing health behaviour. However barriers can be circumvented by increasing community awareness; communication and connection with the community through community based health care providers can turn challenges into opportunities for better health care.
Introduction: Reproductive tract infection (RTI) is the infection of the reproductive tract. Due to the hesitation in reporting the symptoms and receiving the treatment from the health centers, there is a significant dropout. The health care-seeking actions of the women reflects the attentiveness of the disease in that community and the inadequacy of the health care facility. Since the women from the rural area belongs to high-risk group for RTI, this study was conducted with the objective to assess the health care-seeking behavior about reproductive tract infection among rural women in the reproductive age group in Kancheepuram district, Tamil Nadu. Primary care physicians play a vital role in improving health care system, assessing the health-seeking practice helps in improvement and decision making and implementing. Methods and Material: A community-based cross-sectional study was conducted in the rural field practice area of Chettinad hospital. A sample size of 330 was arrived by multi-stage random sampling and population proportion to size method. Data was collected using a standardized questionnaire of DLHS- 4 on RTI/STI. Data entered in MS-EXCEL and analyzed using SPSS version 21 and results interpreted. Results: The prevalence of RTI was found to be 50.3%. 60.8% of the affected females received treatment with majority of them in the group following home remedies. Significant association was noted between treatment seeking behavior, age, and the socioeconomic status ( P - < 0.05). Conclusions: The women in the reproductive age group in the rural areas should be provided with regular health education regarding the symptoms of the RTI and also motivate them to seek appropriate treatment.
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