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   Table of Contents - Current issue
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October-December 2022
Volume 7 | Issue 4
Page Nos. 147-197

Online since Saturday, January 7, 2023

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EDITORIAL  

Impact of newer technologies in cancer research and its management p. 147
Rakesh Kapoor
DOI:10.4103/jncd.jncd_95_22  
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REVIEW ARTICLE Top

Adiponectin: A reliable marker p. 152
Geetha Bhaktha, Shivananda Nayak B, Manjula Shantaram
DOI:10.4103/jncd.jncd_77_22  
The biological functioning of adiponectin (APN) has been well understood for two decades. Numerous clinical and animal studies have paved an understanding of the exposed physiological functions of APN in obesity and its related disorders. APN mediates its action through its receptors to achieve its function. Apart from its contribution to metabolism, APN also defends the cells from cell death and decreases the inflammation in various cell types through receptor-dependent mechanisms and also contributes to the reproductive function. APN communicates between adipose tissue and other organs and hence is a potential therapeutic target for obesity and its related pathogenesis.
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ORIGINAL ARTICLES Top

Effectiveness of mHealth for modification of dietary habits and physical activity among individuals at risk or suffering from noncommunicable diseases in primary healthcare settings in South East Asian Region countries – A systematic review and meta-analysis p. 161
Bratati Banerjee, Debashis Dutt, Indranil Saha, Bobby Paul, Abhishek Shivanand Lachyan
DOI:10.4103/jncd.jncd_59_22  
Background: Noncommunicable diseases (NCDs) are increasing, for which some behavioral risk factors are major concerns. mHealth has been found to be effective in changing these behavioral patterns. Objective: To assess effectiveness of mHealth technology in modification of dietary habits and physical activity, among individuals having NCDs or their risk factors, in primary healthcare settings in South East Asian Region Countries. Materials and Methods: A systematic review and meta-analysis was done with the primary outcome as effectiveness of mHealth for improving dietary practices and increasing physical activity. Articles were retrieved from PubMed, Cochrane Central, Google Scholar, and Pre-print servers followed by forward and backward searching. Quality and risk of bias of included studies were assessed. Meta-analysis was performed using RevMan v. 5.4.1 software. Heterogeneity was tested using χ2 test and measured using I2 statistic, with Forest plots as the final outcome. Results: Nine publications from seven studies, of which seven were conducted in India and two in Bangladesh, qualified for the review. All studies used varied mHealth interventions. Most studies reported beneficial effects in reducing inadequate/improper diet and insufficient/improving physical activity, at community/workplace settings, except two studies reporting no apparent impact, both being from Bangladesh. Meta-analysis revealed statistically significant differences between intervention and control groups for pooled estimates of reduced dietary energy and increased fruits/vegetables. Although heterogeneity is absent between studies considered for fruits/vegetables, both studies were compromised in quality and bias. Studies on dietary energy intake had high statistical heterogeneity, in addition to having high risk of bias. Hence, the results need to be interpreted with caution. No effect was observed on increasing physical activity. Conclusion: mHealth interventions have huge potential to facilitate behavior change. However, more research is needed before its potential scale-up.
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Prevalence of risk factors for diabetes in adult offspring of type 2 diabetes mellitus patients p. 177
Ruchika Saini, Monica Gupta, Shivani Jaswal, Sarabmeet Singh Lehl, Gautam Jesrani, Samiksha Gupta
DOI:10.4103/jncd.jncd_82_22  
Background: The risk of developing type 2 diabetes mellitus (T2DM) and associated metabolic abnormalities is higher in adult offspring of patients with T2DM. Various genetic and environmental influences play a facilitatory role. These determinants can lead to the early onset of hyperglycemia, unrecognized end-organ changes, and cardiovascular morbidity. Objective: The objective of this study was to identify the presence of undiagnosed diabetes and prediabetes in the otherwise healthy adult offspring of patients with T2DM and to study early metabolic abnormalities among these individuals. Materials and Methods: The study population consisted of 100 healthy offspring aged 18 years and above, of parents with T2DM, enrolled from the medicine outpatient area. Anthropometric characteristics, routine investigations and diabetes defining parameters, fasting plasma insulin, and homeostatic model assessment-estimated insulin resistance (HOMA-IR) were assessed. Results: The age and body mass index of participants were 32.30 ± 9.33 years and 25.08 ± 4.58 kg/m2, respectively. About 33.3% of males and 76.4% of females had abnormal waist circumference and metabolic syndrome was found in 26% of the offspring. Twenty-eight participants displayed dysglycemia, of which 10 were diagnosed with prediabetes and 18 with diabetes. C-reactive protein, total cholesterol, triglyceride values, apolipoprotein A, B, and their ratio, and HOMA-IR were significantly raised, and high-density lipoprotein was found significantly low in patients with this newly diagnosed T2DM. Conclusion: A significant number of asymptomatic offspring of patients with T2DM have incipient diabetes and prediabetes status, which is unidentified. Further, metabolic parameters are more deranged in those with newly diagnosed diabetes and prediabetes. Therefore, opportunistic screening for these offspring should be done routinely.
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Patient compliance, comorbidities, and challenges in the management of hypertension in India p. 183
Prateek Singh, TR Dilip
DOI:10.4103/jncd.jncd_72_22  
Background and Objectives: As of now, only one-third of those with hypertension in India are unaware of the existence of this condition, and only a negligible share of those diagnosed can control it through medication. There is a need to understand the characteristics and behaviors of patients treated for hypertension for generating evidence for better management of this condition. In this context, the study examines the key factors associated with uncontrolled blood pressure (BP) levels in patients under medication for hypertension. Subject and Methods: Data from the nationally representative Longitudinal Ageing Study of India survey, 2017–18, are used for the analysis. This study is restricted to 12,353 respondents aged 45 years and above who were already diagnosed with hypertension before the survey and are under medication. BP level at the point of the survey was used to classify the respondents as hypertension under control (systolic <140 mm and diastolic <90 mm), Grade-1 Hypertension (systolic 14–159 mm or diastolic 90–99 mm), Grade-2 Hypertension (systolic160–179 mm or diastolic 100–109 mm), and Grade-3 Hypertension (systolic 180 or above mm or diastolic 110 or above mm). Bivariate and multivariate logistic regression analysis is performed to study the association between hypertension control in these patients and their demographic, socioeconomic, and behavioural characteristics. Results: A critical proportion of respondents have uncontrolled hypertension of Grade 1 (31%), Grade 2 (15%), and Grade 3 (2%), despite taking medication for the same. As compared to their remaining counterparts, the risk of uncontrolled hypertension is high in rural areas (odds ratio [OR] = 1.37, 95% confidence interval [CI], P < 0.01), old-adults living alone (OR = 1.63, 95% CI, P < 0.05), patients having no schooling (OR = 1.18, 95% CI, P < 0.05), patients with obesity (OR = 1.2, 95% CI, P < 0.05), moderate alcohol drinkers (OR = 2.1, 95%CI, P < 0.01), abusive alcohol drinkers (OR = 1.6, 95% CI, P < 0.01). Interpretation and Conclusions: Poor control over BP levels among patients from rural areas, the poorest and most vulnerable sections, supports the governmental efforts initiated since 2018 to expand community-level screening and provisioning of noncommunicable diseases, including that for hypertension. In addition, concrete efforts for health promotion within patients under medication for hypertension too are essential for better management of this condition.
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Noncommunicable diseases associated with household air pollution from biomass fuel in South-East Asia region: A systematic review and meta-analysis protocol p. 192
Anjali Rana, Rajbir Kaur, Samir Malhotra, JS Thakur
DOI:10.4103/jncd.jncd_69_22  
Introduction: The WHO states that around 2.6 billion people still cook using solid fuels (such as wood, crop wastes, charcoal, coal, and dung) and kerosene in open fires and inefficient stoves. Evidence suggests that exposure to indoor air pollution by biomass fuel cooking is associated with chronic obstructive pulmonary disease, asthma, cardiovascular diseases, lung cancer, hypertension, depression, breast cancer, and cataract. This systematic review aims at providing evidence-based insight into indoor air pollution by comprehensively assessing the association of major noncommunicable diseases with the household air pollution from biomass solid fuel. Methods and Analysis: We will undertake a systematic search in PubMed, EMBASE, Scopus, OVID, MEDLINE, and Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library from January 2000 to April 2022. The study designs to be included will be cross-sectional, case-control, cohort, and randomized controlled trials. Subgroup analyses will be performed, and sensitivity analyses will be conducted to assess the robustness of the findings. Ethics and Dissemination: No ethical issues are foreseen. Dissemination will be done by submitting scientific articles to academic peer-reviewed journals. We will present the results at relevant conferences and meetings. Study Design: Systematic review and meta-analysis. Conclusion: This systematic review will collate empirical evidence to assess the association of NCDs with the household air pollution from biomass fuel. Prospero Registration: CRD42022356857.
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LETTER TO THE EDITOR Top

New-onset diabetes in COVID-19: An emerging threat to global health p. 196
Thirunavukkarasu Sathish
DOI:10.4103/jncd.jncd_83_22  
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