Preeti Singh

Objectives We assessed the effectiveness of community health workers (CHWs)-led, technology-enabled programme as a large-scale, real-world solution for screening and long-term management of diabetes and hypertension in low-income and middle-income countries. Design Retrospective cohort design. Setting Forty-seven low-income neighbourhoods of Hyderabad, a large Indian metropolis. Participants Participants (aged ≥20 years) who subscribed to an ongoing community-based chronic disease management programme employing CHWs and technology to manage diabetes and hypertension. Primary and secondary outcome measures We used deidentified programme data between 1 March 2015 and 8 October 2018 to measure participants’ pre-enrolment and post-enrolment retention rate and within time-interval mean difference in participants’ fasting blood glucose and blood pressure using Kaplan-Meier and mixed-effect regression models, respectively. Results 51 126 participants were screened (median age 41 years; 65.2% women). Participant acquisition rate (screening to enrolment) was 4%. Median (IQR) retention period was 163.3 days (87.9–288.8), with 12 months postenrolment retention rate as 16.5% (95% CI 14.7 to 18.3). Reduction in blood glucose and blood pressure levels varied by participants’ retention in the programme. Adjusted mean difference from baseline ranged from −14.0 mg/dL (95% CI −18.1 to −10.0) to −27.9 mg/dL (95% CI −47.6 to −8.1) for fasting blood glucose; −2.7 mm Hg (95% CI −7.2 to 2.7) to −7.1 mm Hg (95% CI −9.1 to −4.9) for systolic blood pressure and −1.7 mm Hg (95% CI −4.6 to 1.1) to −4.2 mm Hg (95% CI −4.9 to −3.6) for diastolic blood pressure. Conclusions CHW-led, technology-enabled private sector interventions can feasibly screen individuals for non-communicable diseases and effectively manage those who continue on the programme in the long run. However, changes in the model (eg, integration with the public health system to reduce out-of-pocket expenditure) may be needed to increase its adoption by individuals and thereby improve its cost-effectiveness.

Blindness is a public health problem in developing and developed countries. According to WHO global data for visual impairments 2010, common occurence of blindness was 20.5%.One of the major cause for this is Cataract. Cataract is responsible for about 62.6% of all cases of blindness in India. If cataract left untreated most of the people will in due course become acutely visionless. The motive behind the present study is to find the connection between hypertension and development of cataract. A comparative study was carried for the two months of duration. 200 patients divided in two groups (hypertensive and non-hypertensive) were included in our study. We observed that prevalence of cataract is significantly higher in hypertensive (83.15%) patients as compared to non-hypertensive (70.01%) patients. Hypertension is involved in the pathological pathway of cataract development through an inflammatory mechanism. Nuclear cataract was found to be most common followed by cortical and posterior subcapsular cataract.

Evidence from India, a country with unique and distinct food intake patterns often characterized by lifelong adherence, may offer important insight into the role of diet in breast cancer etiology. We evaluated the association between Indian dietary patterns and breast cancer risk in a multi-centre case-control study conducted in the North Indian states of Punjab and Haryana. Eligible cases were women 30–69 years of age, with newly diagnosed, biopsy-confirmed breast cancer recruited from hospitals or population-based cancer registries. Controls (hospital- or population-based) were frequency matched to the cases on age and region (Punjab or Haryana). Information about diet, lifestyle, reproductive and socio-demographic factors was collected using a structured interviewer-administered questionnaire. All participants were characterized as non-vegetarians, lacto-vegetarians (those who consumed no animal products except dairy) or lacto-ovo-vegetarians (persons whose diet also included eggs). The study population included 400 breast cancer cases and 354 controls. Most (62%) were lacto-ovo-vegetarians. Breast cancer risk was lower in lacto-ovo-vegetarians compared to both non-vegetarians and lacto-vegetarians with odds ratios (95% confidence intervals) of 0.6 (0.3–0.9) and 0.4 (0.3–0.7), respectively. The unexpected difference between lacto-ovo-vegetarian and lacto-vegetarian dietary patterns could be due to egg-consumption patterns which requires confirmation and further investigation.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: In 2017, the Indian Supreme Court ruled that privacy is a fundamental right of every citizen. While smartphone apps have the potential to help people with non-communicable diseases, they often contain complex privacy policies which consumers may not understand. This complexity may impede consumers’ ability to make decisions regarding privacy, a critical issue due to the stigma of mental illness. Objective: Our objective is to determine whether mental health apps have more complex privacy policies than diabetes apps. Methods: The study utilizes privacy policies extracted from apps. Apps pertained to diabetes or mental health, and were of Indian origin. Privacy policy reading complexity was compared between the two types of apps using a series of fifteen readability measures. The universe of applicable apps on the Google Play store, as viewed between May and June 2017, was considered. The measures of readability were compared using Chi-square tests. Results: No significant difference was found between the privacy policy readability of the diabetes apps versus the mental health apps for each of the measures considered. As the mean Flesch-Kincaid Grade Level was 13.9 for diabetes apps and 13.6 for mental health apps, the mean policy was written at a college level. Privacy policies in the 25th percentile of complexity were also written at a college level for both types of apps. Conclusions: Privacy policy complexity may be a barrier for informed decision making. Clinical Trial: NA

BACKGROUND In 2017, the Supreme Court of India ruled that privacy is a fundamental right of every citizen. Although mobile phone apps have the potential to help people with noncommunicable diseases, such as diabetes and mental illness, they often contain complex privacy policies, which consumers may not understand. This complexity may impede the ability of consumers to make decisions regarding privacy, a critical issue due to the stigma of mental illness. OBJECTIVE Our objective is to determine whether mental health apps have more complex privacy policies than diabetes apps. METHODS The study used privacy policies extracted from apps. The apps pertained to diabetes or mental health, and were all of Indian origin. Privacy policy reading complexity was compared between the two types of apps using a series of 15 readability measures. The universe of applicable apps on the Google Play store, as viewed between May and June 2017, was considered. The measures of readability were compared using chi-square tests. RESULTS No significant difference was found between the privacy policy readability of the diabetes apps versus the mental health apps for each of the measures considered. The mean Flesch-Kincaid Grade Level was 13.9 for diabetes apps and 13.6 for mental health apps; therefore, the mean policy grade level for both types of apps was written at a college level. Privacy policies in the 25th percentile of complexity were also written at a college level for both types of apps. CONCLUSIONS Privacy policy complexity may be a barrier for informed decision making.

An experiment was carried out with 5 parent and 3 hybrid papaya genotypes to study the genetic variabilityand correlation between different yield attributing traits by evaluating 16 vegetative, reproductive, and fruit yieldcontributing traits during 2016–2017. The findings indicate that the maximum fruiting zone (129.8 cm) was in PS3 followed by PS 3 × P-7-9 (128 cm). The hybrid PS 3 × P-7-9 had maximum number of fruits per plant (44.67), minimum fruit weight (1020g) and maximum yield per plant (46.33 kg/plant) among the three hybrids evaluated. The phenotypic coefficient of variation (PCV) is higher than the genotypic coefficient of variation (GCV) for allthe traits studied. The genotypic variance and phenotypic variance were high for traits like leaf width, stemdiameter and fruit weight. Traits such as leaf length, petiole length, number of fruits per plant, fruit diameterand fruit yield exhibited higher value of GCV and PCV. Heritability for traits ranged from 53.83 to 99.49, of whichmajority of traits showed very high heritability, except some traits such as inflorescence size and fruit lengthwhich showed moderate heritability. Genetic advance (GA) was recorded highest for fruit length (179.13). Traitslike fruit yield, petiole length and leaf length exhibited high heritability accompanied by high to moderate geneticadvance indicating additive gene action, which suggest that selection may be effective for these traits. The trait, fruit yield was positively associated with plant height at flower initiation and maturity stage, stem diameter, daysto flowering, fruiting zone, number of fruits per plant and fruit diameter.

An association between smoking and poor tuberculosis (TB) treatment outcomes has been globally established. Various smoking cessation interventions (SCIs) have been proven worldwide to curb smoking behavior. There is a need for evidence to assess if SCI increases the chance of successful treatment outcome among TB patients. To assess the effectiveness of a brief SCI; The Ask, Brief, Cessation support (ABC) package, on treatment outcomes and smoking cessation in smear-positive adult pulmonary TB patients. A cluster, randomized controlled trial was conducted wherein 17 designated microscopic centers of Chandigarh, India were randomly assigned using a computer-generated randomization sequence to receive SCI within directly observed treatment, short (DOTS) services, or existing standard of care. Eligible and consenting smokers (15 + years) registered as smear-positive pulmonary TB for DOTS (n = 156) between January and June 2013 were enrolled. Smoking cessation (self-reported) was assessed at intervals till the end of treatment. End TB treatment outcomes were extracted from patient records. Treatment success was lower in intervention arm (83.6%) as compared control arm (88.2%), but the difference was statistically insignificant (P = 0.427). Smoking cessation was higher in intervention arm (80.2%) compared to comparison arm (57.5%) (adjusted incidence risk ratio = 1.56; 95% confidence interval = 1.24-1.93; P < 0.0001). SCI is effective in inducing smoking cessation among TB patients. No association of SCI with TB treatment outcomes could be detected.

Research shows that risk factors for noncommunicable diseases (NCDs) are associated with behaviors that either begin or are reinforced during adolescence. Yet, focus on this age group in national NCDs policies globally or regionally in South-East Asia Region (SEAR) has not been adequately addressed. This overview of strategies to prevent NCDs among adolescents in SEAR countries provides a benchmark against which policy response can be assessed and strengthened. We reviewed all publically available documented strategies issued by governments in the 11 SEAR member countries of the World Health Organization on NCDs, published between January 1, 2002, and December 31, 2015. NCDs are currently a policy priority in many of the countries with school-based campaigns on healthy lifestyles; alcohol and tobacco-free environment and public ban on advertisements glamorizing unhealthy food among others. However, major challenges such as lack of specific focus on adolescents, lack of recognition of all major risk factors in national policies/programs, weak surveillance, unavailability of age disintegrated data, inefficient program management, low community awareness, and absence of multistakeholder policies persist. Of the countries reviewed, only 54.5% (6/11) proposed a policy that addressed all four of the main NCD risk factors - alcohol and tobacco use, physical inactivity, and obesity. This review demonstrates the disconnection between NCDs, adolescent health, and national policies.