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admin | Bv Homeopathic Treatment | 26.03.2016
Burgar, Pizza, Fried Chips have got a serious attention as out meal because these are available on spot and can fulfill the desire of eating meal. There are many kinds of fast foods and drinks available in the market which are loaded with carbohydrates and, consequently, a lot of calories. Fast foods are mostly eaten at the same location where we go to buy these with some of our limited family members, friends or with a date which cause some lack of family gathering.
Fast food doesna€™t have a proper time to eat which is really important for aA healthy human body.
As well as loss of healthy body, we waste our valuable money on Fast Food because these consumes too much money as compared to home prepared food. A well-balanced food contains all essential elements which are necessary for human development. Fast Foods are loaded with obesity or fat which may cause of many diseases related to heart, blood vessels, liver etc etc. Today’s youth especially love to eat Pizza, Burgar, Shawarma etc and they they eat them on daily basis. Your digestive system breaks carbs down into sugar (glucose), which it then releases into your bloodstream.
It also happens that we buy and eat walking in the way, driving a vehicle and during his work in office. Sometimes we eat any time or some time twice or thrice a dayA which is really not good for health. Continues use of fast food may cause loss appetite, abnormal digestion and sometime food poisoning. Whereas fast food does not have all these elements, this type of food contains some elements in high quantity while others are absent. There are several reports by the speciallist that such diseases can be the reason of increases the level of stress.
There is also a huge quantity of cholesterol in Fast Foods which disturb the blood pressure. As compared with A home cooked food, it is served at proper time which provides opportunity to take rest after eating. The underlying CODs (UCODs) orig inally recorded in each death certificate were contrasted with those assigned by an expert re viewer.
Coding for the original and "new" UCODs was based on the three-digit category of the International Classification of Diseases, 10th Revision. Measurements of agreement be tween the two sets of UCODs were calculated and logistic regression was performed to deter mine factors associated with agreement.
Overestimation (false-positive reporting) was highest (13%) for peri natal conditions, while underestimation (false-negative reporting) was highest (71%) for cer tain infectious and parasitic diseases, and respiratory diseases. Agreement was associated with type of UCOD (endogenous versus exogenous) and time of death. Systematic assessments of the quality of COD statements may improve the quality of mortality statistics. Se contrastaron las CM subyacentes originales registradas en cada certificado de defunción con las CM subyacentes asignadas por un revisor experto. Many middle-income countries, including Mexico, have established vital registration systems to compile their mortality statistics. However, the utility and quality of the data generated from these systems usually compare information on death certificates with data from other sources, such as autopsies, medical charts, or evaluation by expert reviewer panels, to determine the completeness and accuracy of the death-certificate data (4-8). This article reviews the completeness and accuracy of COD statements recorded in a systematic random sample of infant death certificates and assesses the impact of inaccurate COD statements on mortality statistics in Hermosillo, the capital city of Sonora, Mexico. Hermosillo comprises an urban area, with an estimated population of 666 959 for the year 2003, plus a surrounding sparsely populated rural area. During the period 2002-2003, 23 858 births and 365 deaths of infants aged less than 1 year were registered in Hermosillo hospital facilities.


Of these 314 eligible death certificates, 200 were selected for study through systematic random sampling. All 200 death certificates included in the study sample were recorded at three public hospitals in the urban area of Hermosillo.
On an accurately completed death certificate, both the UCODs (the conditions that triggered the diseases, injuries, or complications leading to death) and the ICODs (the immediate or final complication resulting from the UCODs) are recorded in Part I (the "COD" portion) of the medical section of the death certificate (14, 15), while "other significant conditions" (those contributing to death but not resulting in its underlying causes) are recorded in Parts II and III (16).
The codes for the original UCODs were based on the three-digit category of the International Classification of Diseases, 10th Revision (ICD-10). Next, two physicians, blinded to the original COD statements, abstracted relevant COD information for each decedent from the corresponding medical chart of the hospital where the death occurred. Abstraction was done using a standardized form, and the physicians were trained in the WHO selection rules (guidelines) for completing Part I (the "COD" portion) of the medical section of the death certificate. Subsequently, expert reviewers examined the physicianassigned COD statements and the original COD statements and determined the correct UCODs (henceforth known as the "new" UCODs), resolving any discrepancies between the two sets of COD statements by checking the corresponding medical charts.
The new UCODs were then coded by the Sonora Health Department based on the three-digit category of the ICD-10. To measure concordance between the original and new UCODs, the rate of overall agreement, percent positive agreement (number of occurrences for which both data sets report a positive result), false-positive reporting, and false-negative reporting, and the kappa coefficient (the rate of agreement adjusted for agreement that may have occurred by chance) were estimated (19-22).
False-positive and false-negative rates higher than 10% and 40%, respectively, were considered unacceptably high based on previous reports (1, 19, 23).
Agreement between the original and new UCODs was determined based on the ICD-10 definitions.
To illustrate the net effect of false-positive and falsenegative reporting of UCODs on infant mortality statistics, mortality rate ratios (MRRs) (the ratios of rates determined according to the original UCODs versus those determined according to the new UCODs) were estimated for infants aged less than 28 days (perinatal period) and infants aged more than 28 days (postneonatal period) (19).
The association between these variables and the probability of agreement between the original and new UCODs was then analyzed using logistic regression.
Backward stepwise regression was used to determine the statistically significant factors to be included in the final model. Most of the deaths (76%) were certified by a physician other than the attending physician, 52% of the deceased did not have any medical insurance, and 58% of the deaths occurred in Pediatric Hospital at Sonora State, a public hospital for the uninsured. Overestimation (false-positive reporting) was highest (13%) for perinatal conditions, whereas underestimation (false-negative reporting) was highest (71%) for certain infectious and parasitic diseases, and respiratory diseases. When examining specific subgroups of CODs, the false-negative rate was high for birth asphyxia (80%), necrotizing enterocolitis (75%), disorders related to short gestation and low birth weight (67%) and congenital pneumonia (58%).
For perinatal deaths, the MRR was significantly elevated (2.0) for the group of causes including neoplasms, blood diseases, and endocrine and metabolic diseases. This study identified problems in the completeness and accuracy of COD statements in infant death certificates from Hermosillo. Because these COD statements are entered into the SEED database, and Sonora infant mortality statistics are derived from the SEED data, the results of this study suggest systematic inaccuracies may be causing underestimation of infectious and parasitic diseases and overestimation of conditions originating in the peri-natal period, neoplasms, blood diseases, and endocrine and metabolic diseases as UCODs among infants. A number of studies (15, 23-26) have reported that most problems with reliability of death certificates arise from failure to complete them properly.
Death certificates in Hermosillo public hospitals (where 95% of 2002-2003 infant deaths occurred) are often filled out by medical students and residents with little experience or training in completing death certificates (5). This study's findings suggest a need for improvement in the training of death certifiers, particularly medical students. As shown by Myers (15), specific training offered to first-year postgraduate students can lead to dramatic improvements in the accuracy and correct completion of death certificate. This frequency of discordance is higher than that reported in other studies investigating accuracy of COD statements for children (28, 29). However, meaningful comparison between this study and previous studies is difficult due to the difference in the age groups studied (with the majority of previous studies limited to analysis of death certificates of adolescents). However, there was substantial underestimation (false-negative reporting) of exogenous CODs, particularly of infectious diseases such as pneumonias and diarrheas, which may have significant implications for public health policy and programming. The study findings also suggest specific causes of perinatal mortality may be underestimated, including birth asphyxia, disorders related to short gestation and low birth weight, and necrotizing enterocolitis of fetus and newborn.


Given that in Hermosillo, 3 out of 4 infant deaths occur during the perinatal period, it is essential for public health interventions to accurately determine the CODs in this category. Equally important is the need to assess problems in the process of assigning CODs of perinatal deaths, with particular focus on the use of codes P20, P21, and P07 (corresponding to intrauterine hypoxia, birth asphyxia, and disorders related to short gestation and low birth weight, respectively).
Future studies in Hermosillo should focus on determining the actual incidence of perinatal conditions and investigate other potential factors associated with the risk of death, such as deficiencies in prenatal care and structural flaws in neonatal units.
A possible explanation for this is the compensatory effect of errors (17), in which diseases are over-coded in some individuals and under-coded in others due to erroneous or missing information on the death certificate.
The second factor that could have obscured the net effect of UCOD discordance on mortality rates as detected in this study is the small sample size. Due to this limitation (the potential under-representation of the population in the study sample), no attempt is made to interpret the results beyond the study setting. However, the poor agreement rates and high false-negative and false-positive rates observed for some UCODs clearly suggest flaws in infant death certification in Hermosillo and therefore a high inaccuracy and low reliability in the corresponding infant mortality statistics.
It should be noted that type of hospital (facility for uninsured versus facility for insured) and type of personnel certifying the death (attending physician versus "other" physician) have been associated with poor agreement of UCODs in other studies (23, 34). Therefore, efforts to improve mortality statistics in Hermosillo should include analysis of the reliability of the UCOD codification process. The SEED database currently has limited manpower and does not use an automated coding process, which may have a negative impact on the reliability of the resulting mortality statistics. To improve the accuracy of the information from this database, the SEED database could be linked to automated software such as the Automated Classification of Medical Entities (ACME) system developed by the U.S. National Center for Health Statistics, which standardizes the coding process, reduces the need for trained manpower (35), and serves as a helpful tool for monitoring and evaluating the quality of mortality statistics (36, 37).
These study results suggest that strengthening educational interventions targeted at medical students and introducing automated tools in the UCOD coding process may improve the quality of the Sonora death certification system. Improving this system would, in turn, allow for more effective public health policy-making in Hermosillo by improving the accuracy of mortality statistics. The results of this study also underscore the usefulness of the SEED database utilized by the Sonora Health Department.
This database could be used to facilitate (1) future evaluations of mortality data quality at state and local levels and (2) the examination of infant deaths in non-hospital settings (combined with the approach used in this study). The authors thank the Fogarty International Center (FIC) and the Office of Behavioral and Social Science Research of the National Institutes of Health (Bethesda, Maryland, USA) for their support of this study, under the auspices of the FIC Maternal and Child Health Research Training Grant (TW01276).
Ill-defined and multiple causes on death certificates-a study of misclassification in mortality statistics. Counting the dead and what they died from: an assessment of the global status of cause of death data. Validity of death certificates for coding coronary heart disease as the cause of death in Bahrain. Time-trends and causes of infant, neonatal and postneonatal mortality in Mexico, 1980-1990. Accuracy of cause-of-death coding in Taiwan: types of miscoding and effects on mortality statistics. Trends in the sensitivity, positive predictive value, falsepositive rate, and comparability ratio of hospital discharge diagnoses codes for acute myocardial infarction in four US communities, 1987-2000.
Diagnosis of causes of childhood deaths in developing countries by verbal autopsy: suggested criteria. Using ACME (Automated Classification of Medical Entry) software to monitor and improve the quality of cause of death statistics.



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