Indian Journal of Preventive Medicine

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Diabetic neuropathy (DN) is a debilitating disorder that occurs in nearly 50 percent of patients with diabetes, causing motor deficits, silent cardiac ischemia, orthostatic hypotension, vasomotor instability, hyperhidrosis, gastroparesis, bladder dysfunction, and sexual dysfunction. The objective of his short communication was to provide an insightful overview of prevention of diabetic peripheral neuropathy (DPN), a common disabling microvascular complication of diabetes and its associated foot complications. Glycemic control is an essential intervention shown to be beneficial in both type-1 and type-2 diabetes patients in preventing microvascular and neuropathic foot complications. Medical management comprising of acetyl-L-carnitine, Aldose reductase inhibitors, antioxidants, essential fatty acids, chromium, ginkgolides, and pentoxifylline, Ciliary neurotrophic factor, coenzyme Q10, edaravone, Erythropoietin and its carbamylated derivative, gamma linolenic acid, gangliosides, GCPII (NAALADase) inhibitor, glutathione, IGF1, methylcobalamin, Olive (Oleaeuropaea L.) leaf extract, oxygen supplementation and Tolrestat (Giugliano et al, 1995) were reported for preventing DPN. Flexor tenotomy, insoles, Podikon digital silicone padding, tibial neurolysis, surgical decompression of lower extremity peripheral nerves were reported for their efficacy to prevent diabetes-related neuropathic foot complications. 

Keywords: Preventive medicine; Preventive endocrinology; Preventive neurology; Diabetic neuropathy; Primary and secondary prevention.   

Background: Rural areas, around Mysore urban agglomeration are influenced by urbanization and are in a phase of socioeconomic and epidemiological transition. Obesity has been one of the major risk factor for diabetes, hypertension and cardiovascular diseases. It is necessary to conduct epidemiological studies to know the burden and determinants of obesity, which helps in planning and implementation of any interventions and allocation of resources. Objectives: i) To estimate the prevalence of overweight and obesity among adults in a rural area of Mysore district. ii) To identify the factors associated with overweight and obesity. Materials and methods: 1423 individuals aged above 18 years were interviewed to collect information about their socio-demographic characteristics, risk profile and measurements of height and weight. Prevalence rate and chi square analysis for each factor was performed. Multiple logistic regression analysis was performed to identify the independent factors associated with overweight and obesity. Results: The overall prevalence of overweight and obesity was 13.2% (189) and 11.5% (164) respectively. Multivariate logistic regression model showed that 45-54 age group (OR 2.30, 95% CI 1.23- .30), professional adults (OR 3.12, 95% CI 1.36-7.14), class I socio-economic class (OR 2.30, 95% CI 1.03-5.130), increased oil intake (OR 1.50, 95% CI 1.03-2.17), sedentary physical activity (OR 1.84, 95% CI 1.13) as independent risk factors for overweight and obesity among the rural population of Mysore. Conclusions: Rural population of Mysore with high socio- economic status have high BMI status similar to their urban counterparts.

 Keywords: Obesity; Rural; Prevalence; Multivariate analysis; Mysore.

This is a public health report which analyses the district Kangra, right from the difficult geography and topography of the district to stabilizing population profile with increasing geriatric population to expanding laboratory linkages to NICD and PGIMER, Chandigarh to existing insufficient human resources and key public health problems and to compare the present health status indicators with the millennium development goals. 

Key Words: Public Health Report; MDGs; Nagarkot; Kangra.

Background: Diabetes epidemiological prevalence study is a preliminary step for planning community based intervention on diabetes care and prevention. Sporadic epidemiological studies on diabetes in India have been conducted but Community-based prevalence (self reported) estimates are unavailable for rural Mysore. Aims: Aim of this study was to estimate the prevalence of self-reported diabetes mellitus in rural Mysore. Setting and Design: This study was conducted in the field practice area of two Rural Health Centres (PHCs), JSS Medical College, Mysore with retrospective data from Comprehensive Data base of the family records. Methods: An individual should have been diagnosed to be a diabetic by a medical doctor and who was on anti diabetes treatment for at least the past six months. Results: We found 423 persons to be diagnosed with diabetes. Prevalence of known diabetes in the general population was 1.8% (423/23,281). Prevalence of known diabetes among persons aged above 35 years was 4.3%. Sex-specific prevalence of diabetes in rural Mysore was 2.1% (248/11,984) and 1.5% (175/11299) for men and women respectively. Conclusions: Community-based health surveillance data comprise a useful tool to measure the prevalence of diagnosed cases of diabetes mellitus within the Indian context. Low prevalence of known diabetics reflects ice berg phenomena in the burden of diabetes. High proportions of undiagnosed diabetic cases in the population are to be detected through screening programs. 

Key words: Community-based study; Diabetes prevalence; Self-reported-diabetes; Rural; Mysore. 

Background: Many students enter in Public Health discipline by default and not by genuine interest in the subject. Objective: To explore the views of post graduates students of public health regarding their career choice. Material and Methods: Two focus group discussions were done in Post Graduate Institute of Medical Educational Research (PGIMER), School of Public Health, Chandigarh among MD (Community medicine) and Master in Public Health (MPH) students. A questionnaire route was used for the Focus Group Discussion (FGD). Textual analysis was done. Results: Public health was not the 1st choice of any of the respondents. Many respondents pursuing MPH course quoted that “…Admission in MPH course is easier in comparison to MD…” Families of the respondents didn’t approve the career choice of their children. For many participants, Preventive and Social Medicine (PSM) meant WHO job, international assignments and good money ahead. Few respondents expect good opportunities for employment and promotions in government sector after completing MPH. Conclusion: Both positive and negative attitudes toward the public health discipline were witnessed among the participants of the study. However more of negative shades were seen. The image of Public health in family and in medical fraternity needs to be built. 

Key words: Public Health; Career options; Post graduate medical education; Community medicine.  

Context: Children under five years of age constitute approximately 15% of the country’s total population and are the most vulnerable section of the society and suffer from highest morbidity. The major diseases affecting this age group are mostly acute diarrheal diseases, acute respiratory infections, anaemia, skin infections, ear discharge, eye infections etc. Aims: To find the morbidity profile of under-five children in a rural area and also to find out the association between nutritional status and morbidity.  Settings and Design: Cross sectional study. Methods and Material: This study was carried out from January – December 2011 in Primary health centre, Handignur, Belgaum among children between 1-5 years of age who were selected by using simple random sampling method. Totally 933 children were included in the study. Every child was subjected to thorough clinical examination and anthropometric measurements in the anganwadi. Statistical analysis used: Chi-square test was used for testing association between morbidity and nutritional status. Results: In the present study, 933 children in the age group of 1-5 years were studied for the assessment of morbidity pattern. Among these, 48.55% were males and 51.45% were females. Nutritional status of children assessed by WHO classification showed that 21.9% were wasted, 32.3% were underweight and 34.1% were stunted. Acute respiratory infections were the most commonly reported morbidity (15.9%) in the past 15 days, followed by fever (4.9%). Acute Gastroenteritis was reported in 3.5% of children and eye, ENT and skin together contributed 3.6%. Conclusions: Acute respiratory infections and diarrheal diseases were common among under five children though Govt. of India has made sincere efforts to improve the overall health of under-five children using a multi- pronged approach under NRHM. 

Keywords: Morbidity profile; Under-five children; Rural area