Background: With increasing proportion of geriatric population across societies, the occurrence and prevalence of non-communicable diseases has been steadily increasing as well. The study tries to showcase the pattern and proportion of NCDs among the elderly population in a sub-urban part of Delhi. Aim & Objective: To assess the prevalence and study the morbidity profile of NCDs among geriatric population of Delhi. Materials & Methods: A community based cross sectional study was done in 350 elderly participants in Mehrauli, Delhi. Data was collected using a semi-structured questionnaire. Detailed general and systemic examination was also done. Results: A total of 87.4% of the study population was suffering from at least one NCD; 68% were having an already known NCD(s) while 19.4% were newly diagnosed during the study. 2.41 NCDs were found per patient. The prevalence of hypertension was 58%, 49.4% suffered from senile cataract, 32.9% had osteoarthritis, 30.3% had diabetes mellitus, and 26.9% had obesity. Hypertension and diabetes mellitus together were present in 18.3% while the combination of hypertension, diabetes mellitus and obesity was seen in 9.4% of the study participants. Conclusion: Burden of NCDs among the elderly was notably high with a large proportion of them having multimorbidity. It gets important to focus on preventive measures to delay the onset and stem the progression of NCDs to facilitate healthy ageing.

Background: Hepatocellular cancer (HCC) typically arises in the background of cirrhosis. Its epidemiology has been changing due to availability of antivirals, changing life-styles and early detection. We undertook a multicentric national sentinel surveillance for liver cirrhosis and HCC to assess the attributable risk factors for development of HCC, both with and without a background of cirrhosis. Methods: Data from January 2017 till August 2022 from hospital-based records of eleven participating centres was included. Diagnosed cases of cirrhosis [radiological (multiphase and/or histopathological] and HCC [as per AASLD 2018] were included. History of significant alcohol intake was elicited by AUDIT-C questionnaire. Results: Altogether 5798 enrolled patients were assessed, of which 2664 patients had HCC. The mean age was 58.2±11.7 years and 84.3% (n=2247) were males. Diabetes was found in over a third of those with HCC (n=1032;39.5%). The most common etiology of HCC was NAFLD (n=927;35.5%) followed by viral hepatitis B and C and harmful levels of alcohol. Among those with HCC, 27.9% (n=744) had no cirrhosis. Higher proportion of cirrhotic HCC patients had alcohol as an etiological factor as compared to non-cirrhotic (17.5% Vs 4.7%, p= <0.001). NAFLD was an etiological factor for a higher proportion of non-cirrhotic HCC patients as compared to cirrhotic HCC (48.2% Vs 30.6%, p=< 0.001). Diabetics more commonly had non-cirrhotic HCC (50.5% vs 35.2%). The odds of having cirrhotic HCC was 1.409 times greater for >60 years, 1.372 times for males and 3.472 times for harmful alcohol consumption. Those with NAFLD were 1.553 times more likely to develop non-cirrhotic HCC. Conclusion: This large multi-centric study demonstrates that NAFLD is the most important risk factor for development of both cirrhotic and non-cirrhotic HCC in India and has overtaken viral hepatitis. Awareness campaigns and large-scale screening are required to reduce the high burden of NAFLD related HCC in India.

Steady improvement in quality of life has led to increased survival time of elderly, especially of those with noncommunicable diseases. A study about their health-seeking behavior (HSB) and its determinants is essential for provision of comprehensive care and facilitate policy development. A cross-sectional study was conducted among 350 elderly participants over 60 years of age in an urbanized village of Delhi. Data was collected using a semi-structured questionnaire, and detailed general and systemic examination was done. Tests of significance were applied to assess the HSB with various demographic, clinico-social, and economic variables. A total of 87.4% of the study population was suffering from at least one noncommunicable disease (NCD). Majority of the study subjects’ NCDs (72.66%) were diagnosed while getting treatment for a symptom of the disease. Also, 52.94% of the participants had inappropriate HSB. HSB was significantly associated with gender, age, duration of illness, and importantly with modifiable variables like the level of literacy, distance of preferred health facility, and presence of multimorbidity. HSB was found to be inappropriate in over half of the participants. Policymaking should focus on modifiable variables like education, distance of health facility, and multimorbidity, especially for commonly ignored diseases like osteoarthritis and diabetes.

Background: Hepatocellular cancer (HCC) typically arises in the background of cirrhosis. Its epidemiology has been changing due to availability of antivirals, changing life-styles and early detection. We undertook a multicentric national sentinel surveillance for liver cirrhosis and HCC to assess the attributable risk factors for development of HCC, both with and without a background of cirrhosis.Methods: Data from January 2017 till August 2022 from hospital-based records of eleven participating centres was included. Diagnosed cases of cirrhosis [radiological (multiphase and/or histopathological] and HCC [as per AASLD 2018] were included. History of signi cant alcohol intake was elicited by AUDIT-C questionnaire.Results: Altogether 5798 enrolled patients were assessed, of which 2664 patients had HCC. The mean age was 58.2±11.7 years and 84.3% (n=2247) were males. Diabetes was found in over a third of those with HCC (n=1032;39.5%). The most common etiology of HCC was NAFLD (n=927;35.5%) followed by viral hepatitis B and C and harmful levels of alcohol. Among those with HCC, 27.9% (n=744) had no cirrhosis. Higher proportion of cirrhotic HCC patients had alcohol as an etiological factor as compared to non-cirrhotic (17.5% Vs 4.7%, p= <0.001). NAFLD was an etiological factor for a higher proportion of noncirrhotic HCC patients as compared to cirrhotic HCC (48.2% Vs 30.6%, p=< 0.001). Diabetics more commonly had non-cirrhotic HCC (50.5% vs 35.2%). The odds of having cirrhotic HCC was 1.409 times greater for >60 years, 1.372 times for males and 3.472 times for harmful alcohol consumption. Those with NAFLD were 1.553 times more likely to develop non-cirrhotic HCC.Conclusion: This large multi-centric study demonstrates that NAFLD is the most important risk factor for development of both cirrhotic and non-cirrhotic HCC in India and has overtaken viral hepatitis. Awareness campaigns and large-scale screening are required to reduce the high burden of NAFLD related HCC in India.

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