Rambha Pathak

Patterns of glycemic control using glycosylated hemoglobin in diabetics.

Aim: Till now estimation of blood glucose is the highly effective method for diagnosing diabetes mellitus but it provides a short-term picture of control. More evidence is required to prove that plasma glucose and glycosylated hemoglobin levels together gives a better estimate of glycemic control and compliance with treatment. Indian diabetes risk score (IDRS) is a simplified screening tool for identifying undiagnosed diabetic subjects, requires minimum time, and effort and can help to considerably reduce the costs of screening. Objective: To study patterns of glycemic control using glycosylated hemoglobin in diabetic patients. To find out correlation between levels of plasma glucose and glycosylated hemoglobin in diabetics and to calculate IDRS of the study population. Materials and Methods: A cross sectional study was conducted among 300 known diabetic patients attending outpatient department of a rural medical college in Haryana, India. Following standard procedures and protocols FPG and glycosylated hemoglobin were measured to find out a pattern of glycemic control in them after taking their written and informed consent. A correlation between the levels of glycosylated hemoglobin and fasting blood glucose was also calculated. These patients were made to fill a performa and their demographic and clinical risk factors were noted and based on this, their IDRS was calculated. This was done to validate the IDRS in Indian rural population. Results: Fifty-two percent of the population had fasting plasma glucose level between 125-150 mg/dl, 21% had this level between 151-175 mg/dl. Thirteen percent of the study subjects had HbA1C between 6.5-7.5, more than half (57.3%) had this value between 7.5-8.5, 12% and 18% had values between 8.5-9.5 and 9.5-10.5, respectively. Twelve percent of the participants had HbA1C level higher than 10.5. Correlation of fasting plasma glucose level and HbA1C was also studied and found that correlation coefficient came out to be .311. This correlation was found to be statistically significant (P = .007). Sixty-five percent of the case had IDRS higher than 60. Conclusions: Glycaemic control in diabetics can be better assessed with glycosylated hemoglobin and FPG together. A positive correlation between FPG and HbA1c allows for the use of HbA1c along with FPG in diagnosing type 2 DM but the two should not be used interchangeably. IDRS can be used as a screening tool for diabetes.

Iodine deficiency disorder in children aged 6–12 years of Ambala, Haryana

We conducted this study to assess the prevalence of goitre among 2700 children (6–12 yr) of district Ambala in Haryana. Children were examined as per standards laid by National iodine deficiency disorder control programme (NIDDCP). Multi stage cluster sampling method was used. Urine and salt samples were also studied for iodine concentration. The overall prevalence of goitre in the studied subjects was 12.6%. The median urinary iodine excretion in the study sample was more than 100μg/L Iodine content was found to be adequate in 88% of salt samples. We conclude that there was a high prevalence of goitre in young children despite iodine repletion. This calls for identification of factors to strengthen NIDDCP and the need to emphasize use of iodized salt in Haryana.

Assessment of prevalence of anemia in and its correlates among community-dwelling elderly of Assam, India: A cross-sectional study

Background: Anemia in the elderly can have tremendous impact on their health and functionality. Many a time, anemia in the elderly is overlooked and due priority is not given regarding its causes and impact. Objectives: The present study was conducted to assess the prevalence of anemia in the elderly and study the various correlates associated with it. Materials and Methods: This cross-sectional study was conducted from December 2011 to May 2012 in Boko-Bongaon block, Kamrup District, Assam, India. A total of 30 clusters were selected and 11 elderly from each cluster were taken to get the desired sample size of 330. Hemoglobin estimation was performed to assess the presence of anemia. Results: Prevalence of anemia was 45.5% in the present study. Elderly with severe anemia constituted 15.3%. The associations of anemia with age, gender, calorie intake, type of diet, iron supplementation, and worm infestation were found to be significant. Conclusion: Further in-depth studies are needed regarding the causes of anemia and the role of nutritional prophylaxis. The provisions for adequate health care measures and services to combat anemia in the elderly is needed for timely action.

A Study to Assess Prevalence of Metabolic Syndrome and its Socio Demographic Risk Factors in Rural Area of District Ambala, Haryana

Introduction: Metabolic Syndrome is a state of deranged metabolic and anthropometric status. Its prevalence is on the rise in most part of the world. It is considered as a precursor to various cardiovascular and metabolic diseases. Objectives: 1. to determine the prevalence of Metabolic Syndrome in adults aged 20 years and above in rural area of district Ambala, Haryana. 2. To determine the socio-demographic factors associated with Metabolic Syndromes. Methods: In a community based cross-sectional study, total 1200 subjects aged 20 yrs and above were studied using multistage random sampling. Results: Prevalence of Metabolic Syndrome was estimated by using criterion given by International Diabetes Federation. Metabolic Syndrome was found in 110 (9.2%) subjects and it was more prevalent among females 73 (66.36%) as compared to males 37(33.63%).Sedentary occupation and age were significantly associated with Metabolic Syndrome. Conclusions: Metabolic Syndrome is a health problem in the region and proper emphasis should be given on its prevention and control.

Prevalence and correlates of nicotine dependence among construction site workers: A cross-sectional study in Delhi.

Introduction: Workers represent half the world′s population and are major contributors to economic and social development. Tobacco consumption in construction site workers has been considered a big challenge. Objectives: (1) To assess the prevalence of nicotine dependence among tobacco users. (2) To study the correlates of nicotine dependence among the construction site workers. Methodology: A cross sectional study was conducted using a predesigned and pretested structured proforma. The study was conducted among all construction site workers aged 18yrs and above in campus of Hamdard Institute of Medical Sciences and Research and associated HAH centenary hospital, New Delhi.Karl Fagerstrom Nicotine Dependence Questionnaire was used to assess dependence on nicotine. Results: The mean age of construction site workers was 32.04±11.6 years. Among the workers, majority (91%) were tobacco user. Among the users, 60% found it difficult to refrain from smoking/chewing in places where use of tobacco is not allowed (e.g. hospitals, government offices, cinemas, Libraries etc). 55% of the users smoked or chewed tobacco during the first hours after waking than during the rest of the day. On multivariate analysis, the factors which were found to be significantly associated with nicotine dependence were lower income group (OR 2.57, CI:1.66-3.99), smokeless tobacco use (OR 2.36,CI:1.30-4.27) and lower education (OR = 2.86 (95% CI 1.97-4.16) for illiterate). Discussion: The prevalence of tobacco use (91%) among construction workers is very high compared to that in the general population. Recognition of construction sites as work places and proper implementation of law is needed.

Paley–Wiener–Schwartz type theorem for the wavelet transform

ABSTRACT In the present paper, we discuss about extension of the wavelet transform on distribution space of compact support and develop the Paley–Wiener–Schwartz type theorem for the wavelet transform on the same. Furthermore, Paley–Wiener–Schwartz type theorem for the wavelet transform is also established using the relation between the wavelet transform and double Fourier transform.

A community-based case-control study to investigate the role of iron deficiency in the persistence of goiter.

Objectives: To find out the magnitude of iron deficiency anemia in the age group of 6–12 years and investigate the role of iron deficiency as a possible contributor to endemic goiter in school children in Ambala. Materials and Methods: The present study was conducted as a subset of a cross-sectional study among 2700 children from 6 to 12 years of age to find out the prevalence of goiter. All the subjects who were found to be suffering from goiter in the cross-sectional study were enrolled in the case–control study as cases and were compared with age- and sex-matched controls (children without goiter) from the same cohort. The study was conducted from February 2011 to January 2012. Results: Out of total, goiter was observed in 12.6% of the subjects. Urinary iodine excretion was found to be <100 μg/L in 57 (10.5%) children. Mean hemoglobin (Hb) level of the study population was 11.9 g/dL. It was noted that 71% of the goitrous children had anemia (Hb <12 g/dL) as compared to 63.7% of the control group. Serum ferritin (SF) was <15 ng/mL in 70% of the children. The mean ± standard deviation of SF in the goitrous and nongoitrous children was 19.65 ± 32.51 μg/L and 27.55 ± 21.07 μg/L, respectively (P = 0.012). Conclusion: The findings in the study suggest that iron deficiency anemia in children is contributing toward the persistence of goiter in the postiodization phase.