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Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 10  |  Issue : 1  |  Page : 19-24

General health check-up of employees aged ≥40 years at a tertiary care hospital for their health status and to diagnose their health problems


1 Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
2 Department of Endocrinology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
3 Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
4 Department of Nuclear Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India

Date of Submission03-Jul-2020
Date of Decision18-Aug-2020
Date of Acceptance17-Sep-2020
Date of Web Publication4-Mar-2021

Correspondence Address:
Velam Vanajakshamma
Professor, Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Alipiri Road, Tirupati 517 507, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JCSR.JCSR_58_20

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  Abstract 


Background: The present study was undertaken to screen the employees of a tertiary care hospital aged ≥40 years to know their health status and to diagnose their new health problems.
Methods: This cross-sectional, descriptive study was conducted with 487 employees of our hospital aged ≥40 years from November 2019 to February 2020. Study procedures included haemogram, fasting plasma glucose, fasting lipid profile, thyroid profile, renal function test, electrocardiogram (ECG) and abdominal ultrasound for both the genders. For female employees, additionally, mammograms and pap smears were performed.
Results: A total of 487 hospital employees were studied. 43.5% were overweight and 17.0% were obese. Of these, 2.8% had abnormal ECG findings. A total of 131 (26.9%) new medical problems were detected. Among these, anaemia (8.0%), hypertriglyceridaemia (5.1%), hypothyroidism (4.5%), hypertension (4.1%) and diabetes mellitus (2.7%) constituted the major diseases.
Conclusions: This study has proved that the general health check-ups are important to diagnose minor to major health problems at early stages and to treat them properly to cure the problem or to prolong the advancement of the disease.

Keywords: General health check-up, health-care employees, non-communicable diseases, prevention


How to cite this article:
Vanajakshamma V, Latheef K, Reddy PM, Anusha ND, Rajasekhar D, Prayaga A, Kalawat T. General health check-up of employees aged ≥40 years at a tertiary care hospital for their health status and to diagnose their health problems. J Clin Sci Res 2021;10:19-24

How to cite this URL:
Vanajakshamma V, Latheef K, Reddy PM, Anusha ND, Rajasekhar D, Prayaga A, Kalawat T. General health check-up of employees aged ≥40 years at a tertiary care hospital for their health status and to diagnose their health problems. J Clin Sci Res [serial online] 2021 [cited 2021 Apr 12];10:19-24. Available from: https://www.jcsr.co.in/text.asp?2021/10/1/19/310766




  Introduction Top


Health check-ups are one of the many things that can help human beings to stay healthy and prevent disease and disability. Regular health check-ups and tests can help to find health issues/problems before they start, i.e., we can find problems early, when the chances for treatment and cure are better. Further, that improves the chances for living a longer and healthier life.

Non-communicable diseases (NCDs) are the most important health and financial issues worldwide. In 2008, global deaths due to NCDs were reported 63%, whereas it was reported 71% in 2016. Expenditure of >6.3 trillion US dollars was estimated due to the five major NCDs, including cardiovascular disease, diabetes mellitus, cancer, chronic obstructive pulmonary disease and mental illness. These health and economic burdens due to NCDs have been predicted to rise sharply by 2030 on a global scale.[1],[2]

In India, the burden of NCDs is escalating. In many developed countries, these NCDs typically present in individuals aged ≥55 years, while their onset in India occurs a decade earlier (≥45 years).[3],[4] In 2017, as a part of the global burden of diseases, risk factors and injuries study,[5] the India State-level disease burden initiative collaborators produced an analysis of state variations in epidemiological transition levels during 1990-2016.[6]

Undergoing general health check-ups is a common activity in many countries because the early diagnosis and treatment of NCDs is a principle of preventive medicine. Health check-ups are the preventive ways that can help one to understand the possibility of the onset of medical conditions, which can help in deferment of lots of diseases. These health check-ups reveal the smallest chance of developing any disease. Previous studies have reported that not undergoing health check-ups was associated with higher mortality in women[7] and health check-ups may increase survival[8] or decrease overall mortality among the elderly.[9] With this background, the present study was undertaken to screen the employees of a tertiary care hospital aged ≥40 years to know their health status and to diagnose new health problems.


  Material and Methods Top


This was a cross-sectional, descriptive study conducted in our tertiary care teaching hospital from November 2019 to February 2020. This study was approved by the Institutional Ethics Committee. Written informed consent was obtained from all the study participants. The study population included employees of either sex, aged ≥40 years who were willing to participate in the study. Employees aged <40 years were excluded from the study. Enrolment flow chart is shown in [Figure 1].
Figure 1: Study plan

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Five mL peripheral venous blood was collected in fasting state from all the study participants after obtaining the consent. Samples were sent to the hospital laboratory for analysis as per the laboratory standard procedures.

Haemogram, fasting plasma glucose, fasting lipid profile, renal function test, electrocardiogram and abdominal ultrasound for all the participated employees; mammogram and pap smear for female participants.

Statistical analysis

Data were captured on paper case record forms initially and transformed into MS-Excel spreadsheets. Data were analysed using SPSS version 20.0 (IBM Corp., Somers, NY, USA). Data were expressed as either mean with standard deviation or median with intra-quartile range for continuous variables and frequencies with percentages for categorical variables.


  Results Top


Of the 487 subjects studied, 247 were male employees. The mean age of the study participants was 48.3 ± 5.7 years. The baseline characteristics of the study population are summarised in [Table 1]. Majority of the employees were in their fifth decade (69.2%) followed by sixth (27.5%) and seventh decades (3.3%). Higher proportion of study participants were hospital workers (40.7%) followed by nurses (20.7%), administrative staff (13.8%), security (11.5%), doctors (8.6%) and paramedical staff (4.7%). Majority of the employees were overweight (43.5%), whereas underweight, normal weight and obese were observed in 2.5%, 37% and 17%, respectively.
Table 1: Baseline characteristics of the study population.

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Haematological (haemoglobin and erythrocyte sedimentation rate) and serum chemistry (creatinine, thyroid stimulating hormone, serum total cholesterol, triglycerides and high-density lipoprotein cholesterol) parameters are summarised in [Table 2].
Table 2: Haematology and serum bio chemistry

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Electrocardiographic (ECG) observations are summarised in [Table 3]. Normal sinus rhythm, bradycardia ad tachycardia were observed in 92.2%, 4.7% and 3.1% of the subjects, respectively. Normal heart rate was observed in 92.2%, while abnormal heart rate was observed in 7.8%. Abnormal ECG findings were observed in 2.8%.
Table 3: Electrocardiographic findings

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Abnormal findings in ultrasound were observed in 227 (46.7%) subjects. Ultrasound findings are shown in [Table 4]. Fatty liver, hepatomegaly, prostatomegaly, renal cyst, fibroid uterus and cholelithiasis were found as major abnormalities.
Table 4: Abdominal ultrasonography findings (n=487)

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Out of 240 female subjects, 200 subjects underwent mammogram. Only one subject was diagnosed to have Breast Imaging-Reporting and Data System (BI-RADS)-4,[10] which indicates suspected malignancies and rest all showed normal. Details of mammography observations are shown in [Table 5].
Table 5: Mammography observations

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Among 240 female subjects, 191 underwent Pap smear. Among 191 subjects, 106 (55.5%) were diagnosed as negative for intraepithelial lesion or malignancy. Abnormal findings were found in 44.5% of the female subjects [Table 6].
Table 6: Pap smear observations (n=191)

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A total of 131 (26.9%) findings were detected among 487 subjects. Among the newer health problems identified during the general health check-up, the frequency of occurrence of varius diseases is as follows: anaemia (n = 39, 8%), hypertriglyceridemia (n = 25, 5.1%), hypothyroidism (n = 22, 4.5%), hypertension (n = 20, 4.1%), diabetes mellitus (n = 13, 2.7%), renal calculus, renal cyst, bacterial vaginosis, cholelithiasis, prostatomegaly 0.4% (n = 2 each), adenocarcinoma and fibroadenoma (n = 1 each).

Among the 39 newly detected anaemic subjects, mild, moderate and severe and very severe anaemia was observed in 12 employees, 20 employees and 7 employees, respectively. Among the newly detected hypertensive subjects, one was diagnosed with stage-I and 19 were diagnosed with stage-II hypertension.


  Discussion Top


BMI corresponding to the obesity and over-weight groups were observed in 17.0% and 43.5% of the subjects. ECG reports suggested that 2.8% of the subjects had abnormal ECG findings, which required further preventive attention. Investigations revealed that a total of 131 (26.9%) findings were detected in 487 subjects. Among the new problems detected, anaemia (8.0%), hypertriglyceridaemia (5.1%), hypothyroidism (4.5%), hypertension (4.1%) and diabetes mellitus (2.7%) constituted the major proportion. To the best of our knowledge, this is the first study of this kind from India.

Health examinations, including preventive health check-ups are the basic health examinations with special investigations when indicated. Preventive health check-ups on an annual basis in middle age group people (≥40 years of age) may benefit human beings from major health conditions and also will prevent them from the major financial burden.

As per preventive health measures, in the existing literature, the positive relationship between the whole spectrum of physical health and actual daily good health habits has been demonstrated.[11],[12] Another randomised study[13] suggested that health checks at 3-month interval resulted in reductions in mortality rate and duration of hospital stay. A study[14] also showed an apparent reduction in mortality and few studies[15],[16] have shown improvements in morale.

In the USA and UK, large randomised controlled trials have thrown doubts on the benefits of medical screening and health check-ups.[17],[18] In Japan, even though such evidence that medical screening is beneficial was curtailed, the government has started to provide preventive health services on the assumption that health maintenance in middle-aged people will promote better health and contribute to enduring healthy when they become elderly. It was reported in a nationwide survey that basic health check-ups provided from middle age are useful for reducing the demands for inpatient care of those 70 years or older age.[19]

In this study, the incidence of new hypertension, diabetes mellitus, anaemia and hypothyroidism were found 4%, 2.7%, 8% and 4.5%. The overall prevalence of hypertension, diabetes mellitus and hypothyroidism in this study was 23.1%, 20.8% and 14.3%, respectively, while the reported Indian prevalence was 30.7%, 7.3% and 11%, respectively.[20],[21],[22],[23] We observed a lower prevalence of hypertension and a higher prevalence of diabetes and hypothyroidism when compared with the reported national prevalence. The observed incidence of diabetes (2.7%) was correlated with the reported incidence of diabetes mellitus in Andhra Pradesh state (2.6%).[21]

In this study, we took an initiative and directed all the employees with abnormal findings to the concerned physicians to get those problems to be resolved. If it could have not done, all these employees may encounter a serious health problem such as cardiac problems, diabetes mellitus, hypertension, hypothyroidism, metabolic syndrome, anaemia, renal dysfunction, breast cancer, cervical cancer and prostate cancer in the future. Based on our results, 26.9% of the subjects may get benefited from this basic preventive health check-up.

This is a single-centre study and sample size is relatively small. The study sample was geographically homogeneous. Haemogram included only estimation of haemoglobin and ESR due to financial constraints. Regular preventive health check-ups are important in the diagnosis of newer health problems and to prevent NCDs and disability in elderly subjects. Early detection of small abnormalities can increase the chances for treatment and cure of that particular problem, which can make them to stay healthy for longer durations.

Acknowledgements

The authors would like to thank all the study participants for their participation. The authors also would like to thank the (NABH) cell of our institute for their help and cooperation in coordinating the study related administrative procedures.

Financial support and sponsorship

This study was financially supported by Sri Balaji Aarogya Varaprasadini (SBAVP) scheme of Tirumala Tirupati Devasthanams and Sri Venkateswara Institute of Medical Sciences. SBAVP Grant No.: SBAVP/ERPW/82/2019-20.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Siegel KR, Patel SA, Ali MK. Non-communicable diseases in South Asia: Contemporary perspectives. Br Med Bull 2014;111:31-44.  Back to cited text no. 4
    
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GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: A systematic analysis for the global burden of disease study 2016. Lancet 2017;390:1151-210.  Back to cited text no. 5
    
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Ramakrishnan S, Zachariah G, Gupta K, Shivkumar Rao J, Mohanan PP, Venugopal K, et al. Prevalence of hypertension among Indian adults: Results from the great India blood pressure survey. Indian Heart J 2019;71:309-13.  Back to cited text no. 20
    
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Alvarez-Uria G, Naik PK, Midde M, Yalla PS, Pakam R. Prevalence and severity of anaemia stratified by age and gender in rural India. Anemia 2014;2014:176182.  Back to cited text no. 22
    
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Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian J Endocrinol Metab 2013;17:647-52.  Back to cited text no. 23
    


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  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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