Received date: March 27, 2012; Accepted date: May 24, 2012; Published date: May 26, 2012
Citation: Kumar D, Chandel JK, Bhardwaj AK, Raina SK, Sharma YK (2012) Rationale of Integration of Complementary and Alternative Medicine (CAM) Health Facilities in Non Communicable Disease (NCDs) Surveillance, North India. J Community Med Health Educ 2:147. doi:10.4172/2161-0711.1000147
Copyright: © 2012 Kumar D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Ayurveda; Hypertension; Surveillance
Non Communicable Diseases (NCDs) contributes almost half of the all cause mortality in India . It is caused by the common risk factors like physical inactivity, unhealthy diet, tobacco use and stress. It is more on rise along with growth and development of the countries. Weighted prevalence of Ischemic Heart Diseases (IHD) is being reported to 25.3/1000 population, Diabetes of 118.0/1000 in urban and 38.7/1000 population in Rural India . Reduction in common risk factor is one of the important preventive and control strategy for NCDs in the World. Like modern medicine the Complementary and Alternative Medicine (CAM), Ayurveda is primarily concerned with the body. Ayurveda is “knowledge or science of life” in the meaning itself. It is mentioned that there are three pillars for healthy and long life are proper diet (ahar), proper activities (vihar) and divine lifestyle and control of sexuality (brahmacharya). Therefore, its traditional holistic approach and principles have potential in reduction of NCDs risk factors in the community. It is already evident that the use of CAM has been widely used in Africa (80.0%), Australia (49.0%), Indonesia (40.0%), France (75.0%) and United States (29.0%-42.0%). It is being widely used in India as well as about 2860 hospitals provide CAM services . Ease of access, convenience and faith are the primary reasons for the treatment . CAM has been integrated into primary health care of the country under the National Rural Health Mission (NRHM). Pattern of reported diseases at the CAM facilities is very less shared with the modern medicine in India despite provision of care to significant group of population. Therefore, the present study was undertaken to describe the clinical profile of the patients with Hypertension at tertiary care Ayurvedic hospital in North India.
The study was hospital descriptive study and was part of the short term (3 months) project of World Health Organization (WHO) fellowship course of “Role of AYUSH (Ayurveda, Unani, Siddha, and Homeopathy) in NCDs control, Health Promotion” at tertiary care allopathic hospital, Kangra, Himachal Pradesh. As per census 2011 the provisional population is 6856509 (49.3% females) and 1507223 (50.3% females) of the state and district respectively. Data was collected from the patients attended the Out Patient department (OPD) patients from January 2011 to October 2011 at Rajiv Gandhi Post Graduate Ayurvedic College, Kangra, Himachal Pradesh. In addition, 30 case files of admitted patients with hypertension and Diabetes Mellitus were selected randomly from Inpatient Department (IPD). Data was entered and analyzed by using windows excel spreadsheet.
Total 64524 patients attended the OPD over 10 months. Attendance of females (48.9%) was significantly (p=0.00) more than the males. Total 10276 (15.8%) children up to 5 year also age also sought treatment. Almost half (53.1%) of patients were unclassified and kept as “other” category. Commonly reported morbidities were of respiratory (10.5%), neuromuscular (9.5%), digestive (9.2%), circulatory (9.1%), and eye (8.4%) system.
IPD records of 30 hypertensive patients showed that the chest pain was the chief complaint (63.3%) of mild to moderate intensity (70.0%) and of radiating (56.7%) in nature. More than half (56.7%) of the patients sought treatment from private practitioners before admission. Admitted patients had history of hypertension of average 9 months and were on regular treatment of 21.3% of disease duration. Admitted patients with Diabetes Mellitus had diagnosed for average 145 month and on regular treatment for almost entire (90.3%) duration. Majority of patients with hypertension were managed with Aswaganda (66.0%) and Tagar powder (56.6%).
Elevated blood pressure along with overweight and high cholesterol is a risk factor for Cardiovascular Diseases (CVDs). CVDs contribute about 25.0% of the all cause mortality in India . Evidence from India reported prevalence of 10.0% in general population . High prevalence was reported from urban (36.4%) along with slum (25.4%) and rural (24.0%) . Present study showed 9.01% of patients were related to circulatory disorders. Based upon current study data about 0.4% of district population had treatment for circulatory disorders disease. Patients had withstanding disease of hypertension of average 9 months and diabetes mellitus for 145 month. OPD data classified patients into one group of circulatory disorders which makes difficult to assess the disease specific morbidity burden. Majority of the patients were even not classified at all based upon OPD register despite the complete diagnosis at the OPD. It is important to have standard method of case reporting along with covering of AYUSH health facilities with Integrated Disease Surveillance Project (IDSP) will help to capture exact disease burden. Significant number of patients are making available of CAM facilities along with allopathic discipline. Government of India has mainstreamed the AYUSH in primary health care delivery system by appointing at least one AYUSH specialist at the facility. Total 2860 CAM health facilities provide health care to the population in India. Sharing of knowledge and information along with allopathic and CAM institutions is very helpful to estimate the burden and control of disease in the population.
We Thank to Department of kayachikitsa of Rajiv Gandhi Post Graduate Ayurvedic College, Kangra, and Himachal Pradesh for providing the necessary information.