BackgroundEfforts to assess the burden of non-communicable diseases risk factors has improved in low and middle-income countries after political declaration of UN High Level Meeting on NCDs. However, lack of reliable estimates of risk factors distribution are leading to delay in implementation of evidence based interventions in states of India.MethodsA STEPS Survey, comprising all the three steps for assessment of risk factors of NCDs, was conducted in Punjab state during 2014–15. A statewide multistage sample of 5,127 residents, aged 18–69 years, was taken. STEPS questionnaire version 3.1 was used to collect information on behavioral risk factors, followed by physical measurements and blood and urine sampling for biochemical profile.ResultsTobacco and alcohol consumption were observed in 11.3% (20% men and 0.9% women) and 15% (27% men and 0.3% women) of the population, respectively. Low levels of physical activity were recorded among 31% (95% CI: 26.7–35.5) of the participants. The prevalence of overweight and obesity was 28.6% (95% CI: 26.3–30.9) and 12.8% (95% CI: 11.2–14.4) respectively. Central obesity was higher among women (69.3%, 95% CI: 66.5–72.0) than men (49.5%, 95% CI: 45.3–53.7). Prevalence of hypertension in population was 40.1% (95% CI: 37.3–43.0). The mean sodium intake in grams per day for the population was 7.4 gms (95% CI: 7.2–7.7). The prevalence of diabetes (hyperglycemia), hypertriglyceridemia and hypercholesterolemia was 14.3% (95% CI: 11.7–16.8), 21.6% (95% CI: 18.5–25.1) and 16.1% (95% CI: 13.1–19.2), respectively. In addition, 7% of the population aged 40–69 years had a cardiovascular risk of ≥ 30% over a period of next 10 years.ConclusionWe report high prevalence of risk factors of chronic non-communicable diseases among adults in Punjab. There is an urgent need to implement population, individual and programme wide prevention and control interventions to lower the serious consequences of NCDs.

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Background: Substance abuse is a multidimensional problem, which threatens the quality of life of not only substance abusers but also the family members who live with them. Most of the time a member of the family assumes the role of caregiver and he or she is most burdened from this process. Considering that the involvement of family members is recommended for the recovery process of chemical dependents, it is necessary to appropriately provide the training to caregivers and evaluate their needs for caregiving.Methods: This cross sectional study was conducted at Swami Vivekananda Drug De-addiction Centre attached to the Government Medical College, Amritsar from January 2016 to December 2016. A total of 349 caregivers of substance abusers were interviewed by using pretested and semi structured questionnaire.Results: 44.69% caregivers were wives. Mean age of the caregiver was 33.45 years. 25.21% were high pass. 67.6% were housewives. None was trained in caregiving professionally. 37.53% provided family care while emotional support to the patients was provided by only 10% women and 2% men, no gender specific association with emotional support was statistically significant. 54.15% developed stress while caregiving, 12.60% had social and financial problems.Conclusions: Findings confirmed that quality of life is compromised and stress is high among caregivers, highlighting the need for providing emotional support.

Letters to the Editor high usage of topical traditional herbal medications in Sarawak. These agents were the culprit in 71.2% (n = 42) of cases. Eczematous changes were seen in 55.9% (n = 33) of drug-related dermatoses. Psoriasiform changes were seen in 18.6%, (n = 11), vasculitic in 13.6% (n = 8), lichenoid in 5.1% (n = 3), erythema multiforme in 5.1% (n = 3) and fixed drug eruption in 1.7% (n = 1). Other studies found morbilliform rash constituting majority of cases clinicopathologically. [2,3] This is in marked contrast with the current study where eczematous changes were the commonest drug-related dermatoses because maculopapular morbilliform rashes due to drugs are not biopsied in Sarawak.Another interesting finding was the high proportion of cutaneous lymphoma. Cutaneous lymphoma was seen as the third most common malignancy constituting 11.1% (n = 3) of the 27 cases of cutaneous malignancies. It ranked behind basal cell carcinoma with 51.9% (n = 14) and squamous cell carcinoma with 33.3% (n = 9). Malignant melanoma was seen in only 3.7% (n = 1) of cases. The malignant melanoma was of acral lentiginous type. In neighboring Singapore, Koh et al. noted that basal cell carcinoma make up 55.6% of the 4765 skin cancer cases seen from 1968 to 1997 followed by squamous cell carcinoma with 29.5% and malignant melanoma with 5.9%. [4] Although the frequencies of basal cell carcinoma and squamous cell carcinoma were almost similar, this study showed that cutaneous lymphoma was more common in Sarawak compared to malignant melanoma. However, due to the small number of cases, this finding cannot be conclusively confirmed.In conclusion, a high clinicopathologic correlation was noted in Sarawak and the pattern of drug-related dermatoses and cutaneous malignancies seen here differ from other studies.

Background: Due to the large population size, India has the third largest HIV epidemic in the world. There is a need to study the socio-demographic and clinical profile of HIV/AIDS patients for planning services for them. Moreover, it is important to understand the presentation of HIV disease in the local context and culture. There is paucity of studies related to socio-demographic profile of HIV/AIDS patients in Punjab.Methods: This cross sectional study was conducted at anti-retroviral therapy (ART) centre, Government Medical College, Amritsar from January 2016 to December 2016. A total of 400 patients with age more than 18 years and residents of district Amritsar were interviewed by using semi-structured questionnaire.Results: Most of the patients (73.8%) belonged to the age group 41-60 years, 57.75% were males and 42.25% were females. Out of the total patients, 63.8% were married and 29% were widow/widower. There was a predominance of patients from rural areas and from the lower middle and upper lower socio-economic classes. Heterosexual contact was the commonest mode of transmission (66.5%) and felt sick was commonest reason (56.8%) for being tested for HIV. The most common presenting complaints were fever, weakness and weight loss.Conclusions: Majority of patients belonged to low socioeconomic status and productive age group with heterosexual contact being commonest mode of transmission. Females were usually infected secondarily and were diagnosed after the diagnosis of their husband.

Background: Adolescents undergo the transition period of adolescence with little knowledge of body’s impending physical, physiological and psychological changes. After parents, teachers have maximum opportunity to support and educate adolescents. This study attempts to study effectiveness of health education on knowledge, attitude and practices of teachers regarding physical and psychosocial health of adolescents.Methods: The study was started with 155 teachers (teaching class 9th -12th) who willingly participated from 50 senior secondary schools of Amritsar district. After taking informed consent, teachers filled a pretested questionnaire which was followed by an interactive session on adolescent health. To study impact of health education, they were again administered same questionnaire after a period of 3 months. Statistical analysis was on Microsoft Excel, Chi square test, SPSS.Results: Maximum 74 (47.7%) teachers were aware of psychosocial problems of adolescents as compared to the physical and sexual problems. Only 11 (7.1%) teachers had adequate knowledge about changes occurring during adolescence. Majority 125 (80.6%) of teachers had no knowledge regarding height and weight gained during adolescence and more than 2/3rd [110 (71%)] of teachers were unaware of daily calorie and protein requirements. Only 28 (18.1%) had adequate knowledge about drug abuse. After intervention significant favourable changes were observed in their knowledge, attitude and practices regarding most of above mentioned topics.Conclusions: Overall knowledge of teachers in most aspects of adolescent health was found to be low, however significant favourable changes were observed after health education was provided to them.

Background: Hypertension is a major public health problem in India and its prevalence is high among rural and urban population. All the risk factors of lifestyle are known to cause the early onset and rapid worsening of hypertension. Methods: A cross sectional study was conducted. 1000 participants (500 rural and 500 urban) between the age group of 18-69 years were selected by systematic random sampling method from 5 villages and 5 urban wards of Amritsar city. Out of total, 500 males and 500 females were selected. Results: This study shows that 332 (33.2%) participants were hypertensive out of total 1000. The chances of Hypertension are directly proportional to age and shows peak between 50-59 years of age, 86 (59.72%). The prevalence among males and females was 32.4% and 34% respectively. Hypertension is highest in respondents with body mass index (BMI >30) i.e. 53.43%. The prevalence of hypertension was slightly higher among smokers than non-smokers and among vegetarians than non-vegetarians. Conclusions: Hence, it becomes necessary to adopt a lifestyle with regular physical activity for at-least 30 min a day, for 5 days of the week, to decrease prevalence of obesity and to maintain BMI within normal range. Thus awareness among communities should be raised regarding prevention of the risk factors for hypertension.

Background: Slums are most vulnerable and deprived areas within a city. The unhygienic and polluted environment, overcrowding, poor housing and absence of educational exposure affect youth in slums. Consequently, their health is affected adversely.Methods: This cross-sectional study was conducted in four slums, one each from four different directions (north, south, east and west) of Amritsar city. A total of 1000 respondents, 250 from each slum were interviewed by using pre-tested semi-structured questionnaire. Data was compiled and statistically analysed.Results: Out of total study population, 41.2% of the families had migrated from other states, Overcrowding was present in majority (92%) of the families, 20% of the respondents didn’t have latrine facility at their home, 44.4% respondents throw their garbage waste in the open space nearby their dwellings and 45% of population was not satisfied with the cleanliness of their slum, 54.6% of the respondents reported to have some kind of health problem during last three months. Educational status, socio-economic status and overcrowding were significant factors affecting their health.Conclusions: Important factor in causation of disease were found to be poor socio-economic status, lack of education and overcrowding. There is a strong need to intensify the IEC/BCC activities to raise the awareness about the health-related issues.