Background:The aim of this study was to identify the prevalence and risk factors for hypertension in a rural community in north-east India.Materials and Methods:A door-to-door survey was conducted amongst all residents of a village in Uttarakhand province. All residents were interviewed and data were was relating to the demographics of the individuals, dietary habits, alcohol consumption, tobacco use, psychosocial stress, past medical history and drug history. Blood pressure (BP) and anthropometric data was recorded and blood samples taken.Results:We identified 1348 people living in the village. Assessment was carried out on all those aged 15 years and over (n=968, 71.8%). Hypertension, defined as BP ≥ 140/90 mmHg or cases of known hypertensive on medication, were present in 30.9% (95% CI 25.6 to 36.0) of males and 27.8% (95% CI 23.4 to 32.2) of females. Standardisation to the World Health Organization (WHO) world population gives an overall prevalence of 32.3% (95% confidence interval, CI 28.9 to 35.8). Increasing age and higher body mass index (BMI) were independent predictors of hypertension in both sexes, with psychosocial stress an additional independent predictor in males.Conclusions:Rates of hypertension in the rural community under study are similar to those seen in high-income countries and in urban India. With the exception of age, all the risk factors identified were potentially modifiable.

Adolescent boys are recognized as a vulnerable group to substance abuse. The present study has the objective to study the biosocial profile and habit pattern of substance abusers. The study was conducted on 511 male adolescents, students of 10 th to 12 th class from the four intermediate schools of the Doiwala block of Dehradun district. 46.9% students accepted substance abuse. In 75.5% cases, friends were providing the substances. 80.2% substance abusers expressed their desire to quit the habit. The study is indicative of need for developing a supportive environment involving both parents and teachers so that adolescent can decide and sustain with the right choices for healthy life.

Background:Village Health and Nutrition Day (VHND) was identified to provide primary care services (health, nutrition and sanitation) at village level under National Rural Health Mission.Aim:The study aimed to assess availability of health, nutrition and sanitation services, required instruments/equipment and medicines at VHND with client satisfaction from the VHND services.Materials and Methods:A cross-sectional study was conducted in three districts of Uttarakhand at Nainital, Tehri-Garhwal and Chamoli involving 24 villages in six blocks using multistage stratified sampling using predesigned pretested observation checklists (quantitative data). All the concerned functionaries of health, Integrated Child Development Services and Panchayati Raj Institution were interviewed (qualitative data) to understand the gap in services and remediation.Results:Of the 24 VHNDs observed, blood pressure measurement was done at 11 (45.83%) and weight at 13 (54.17%) sites in ante-natal care services; non-availability of blood pressure instrument and adult weighing machine were 45.83% and 41.66% sites, respectively. Immunization for children was provided at 22 sites; however, availability of other services were poor-vitamin A (three), growth monitoring of children (seven); supplementary nutrition (five); identification of households for construction of toilet (eight). Yet, one-third of clients provided three and four for satisfaction from VHND services on the scale score of 1–5.Conclusion:It was noted that none of the VHND site was providing all the stipulated services, though immunization was provided mostly. Anganwadi centers were lacking availability of various essential instruments and equipment. So regular orientation of village functionaries for ensuring all the VHND services with the availability of required logistic is recommended.

Nutritional inadequacy leads to health problems, especially during the period of increased demand. Adolescents are a potential group in view of rapid growth and maturation which demands extra nutrients. With the multitude of social customs and beliefs cited against adolescents especially adolescent girls it is no wonder that they form the vulnerable group of under nutrition. With poor socio economic status, hostile living conditions and food influenced by vagaries of nature, adolescents living at hills form the distinct group to be studied. This cross-sectional prevalence study included 45 adolescent girls of age group 12-19 years residing in hills of Garhwal. The outcome measures for nutritional status were stunting, thinness and proportion of underweight/under nutrition. In this study 34.61% of adolescents' girls were found to be stunted. The stunting was more (33.33%) in 16 to 19 years of age group. The overall prevalence of thinness was 43.47%. However percentage of thinness was higher (56.25%) in the lower age group (12-15 years). Under nutrition was prevalent in similar proportions in both the age groups with > 50% of the rural adolescent girls having less than 3 rd percentile of weight for age by NCHS standards. The prevalence of stunting, thinness and underweight was high among adolescent girls living at high altitudes. In this regard special attention should be paid to the girls of hills and specific strategies should be formulated for meeting their nutritional demands.

BACKGROUND: Various indices for estimating insulin sensitivity, based on glucose tolerance test and fasting insulin levels, have been devised. However, they are laborious, time-consuming, and costly. Recently, a new index, single point insulin sensitivity estimator (SPISE) based on TG, high-density lipoproteins (HDL), and body mass index (BMI) was proposed in the European population and was found comparable to gold standard test. Decreased insulin sensitivity is a hallmark of metabolic syndrome (MetS). Hence, the current study was planned to determine the optimal cutoff of SPISE with high sensitivity and specificity in MetS patients of the North Indian population. MATERIALS AND METHODS: A community-based cross-sectional study including 229 MetS cases and 248 controls was conducted. MetS was defined according to the South Asian Modified National Cholesterol Education Program criteria. SPISE index was calculated for cases and controls using the formula devised by Paulmichl et al.: SPISE = 600 × HDL-C0.185/(TG0.2 × BMI1.338). Receiver operating characteristic (ROC) curve was plotted for determining optimal cutoff for SPISE in MetS. RESULTS: SPISE was significantly lower in MetS patients (5.35 ± 1.35) than that for controls (7.45 ± 2) with P < 0.05 (confidence interval [CI]: 1.79—2.41). ROC curve showed area under the curve = 0.83 for SPISE (P < 0.05, CI: 0.79—0.86), showing SPISE to have good predictive ability to discriminate MetS cases from controls. The cutoff value of SPISE index for predicting insulin sensitivity in MetS was found out to be 5.82 with sensitivity and specificity of 73% and 80%, respectively. This cutoff is lower than the European population (6.61), indicating higher insulin resistance (IR) in the study population. CONCLUSION: SPISE could be a useful potential low-cost indicator with high sensitivity and specificity for predicting IR in MetS.

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Introduction Major non-communicable diseases (NCDs) include cardiovascular diseases, cancers and type 2 diabetes mellitus. The important risk factors identified for NCDs are high blood pressure, high cholesterol, being overweight or obese, and tobacco use. Primary prevention of risk factors, along with their early identification and management can help delay the progress of NCDs. The present study was undertaken with the objective of profiling riskfactors for NCDs in the rural population of Uttarakhand, India. Methods 707 participants aged over 15 years were included. Behavioural risk factor profiles were obtained by interview, followed by anthropometric measurements and biochemical assessment of all the individuals. Results 14.8% of the study population was found to be overweight or obese (BMI$25 kg/m

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