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There is little information on comprehensive diabetes care comprising glycaemic, lipid, and blood pressure control in India; therefore, we aimed to assess the achievement of treatment targets among adults with self-reported diabetes.The Indian Council of Medical Research (ICMR)-India Diabetes (INDIAB) study is a cross-sectional, population-based survey of adults aged 20 years or older in all 30 states and union territories of India. We used a stratified multistage sampling design, sampling states in a phased manner, and selected villages in rural areas and census enumeration blocks in urban areas. We used a three-level stratification method on the basis of geography, population size, and socioeconomic status for each state. For the outcome assessment, good glycaemic control was defined as HbABetween Oct 18, 2008, and Dec 17, 2020, 113 043 individuals (33 537 from urban areas and 79 506 from rural areas) participated in the ICMR-INDIAB study. For this analysis, 5789 adults (2633 in urban areas and 3156 in rural areas) with self-reported diabetes were included in the study population. The median age was 56·1 years (IQR 55·7-56·5). Overall, 1748 (weighted proportion 36·3%, 95% CI 34·7-37·9) of 4834 people with diabetes achieved good glycaemic control, 2819 (weighted proportion 48·8%, 47·2-50·3) of 5698 achieved blood pressure control, and 2043 (weighted proportion 41·5%, 39·9-43·1) of 4886 achieved good LDL cholesterol control. Only 419 (weighted proportion 7·7%) of 5297 individuals with self-reported diabetes achieved all three ABC targets, with significant heterogeneity between regions and states. Higher education, male sex, rural residence, and shorter duration of diabetes (10 years) were associated with better achievement of combined ABC targets. Only 951 (weighted proportion 16·7%) of the study population and 227 (weighted proportion 36·9%) of those on insulin reported using self-monitoring of blood glucose.Achievement of treatment targets and adoption of healthy behaviours remains suboptimal in India. Our results can help governments to adopt policies that prioritise improvement of diabetes care delivery and surveillance in India.Indian Council of Medical Research and Department of Health Research, Ministry of Health and Family Welfare.

In the present work, 2-substituted benzoxazole derivatives were synthesized from 2-(benzo[d]oxazol-2-yl) aniline. All the synthesized compounds were purified and characterized by 1H NMR, 13C NMR, and mass spectroscopy. All the compounds were pharmacologically evaluated for its in vitro anti-inflammatory efficacy using membrane stabilization and proteinase inhibitory methods. In addition to this, in silico molecular docking studies were carried out to predict the binding affinity of the synthesized benzoxazole derivatives with prostaglandin H2 synthase (PGHS) protein and trypsin enzyme. The results obtained from in vitro anti-inflammatory studies showed that compound 3, 4, and 6a showed good efficacy with percentage inhibition of 74.26 ± 1.04, 80.16 ± 0.24, and 70.24 ± 0.68 for membrane stabilization activity 80.19 ± 0.05, 85.30 ± 1.04, and 75.68 ± 1.28 towards proteinase inhibitory efficacy at a concentration of 100 μg/mL which was on par to that of standards aceclofenac and etodolac. Molecular docking analysis showed that compounds 3 and 4 possess good binding affinity towards PGHS protein with a docking score of − 9.4 and − 9.3 kcal/mol respectively.

One-pot three-component reaction of substituted aromatic aldehydes, 2-cyanoacetamide and 4-hydroxycoumarin in the presence of Montmorillonite-KSF (MKSF) in ethanol results in the formation of pyrano[3,2-c]chromene-3-carboxylates (5a-m) has been described. The reaction was tested in different alcohols, afforded pyrano [3,2-c] chromene-3-carboxylates (5a-m) of the corresponding alcohols in good yield. The mechanism reveals that the alcohol (as solvent) plays a major role in the inter conversion of amide to the corresponding esters with Montmorillonite KSF (M-KSF) as a catalyst. Excellent yields, inexpensive and readily available substrates, environmentally benign reaction condition, shorter reaction time, and easy workup are the major advantageous features of this protocol.

AIM Achievement of treatment targets among individuals with diabetes remains suboptimal in many parts of the globe. We aimed to assess changes in diabetes prevalence and achievement of diabetes care goals in South Asia using two consecutive cross-sectional population-based surveys. METHODS Two representative samples of South Asian adults were recruited using identical methods from Chennai, Delhi, and Karachi in 2010-11 (n = 16,288; response rate-94.7%) and 2015-16 (n = 14,587; response rate-94.0%) through the Center for Cardio-metabolic Risk Reduction in South Asia (CARRS) Study. Quality of care goals were defined as HbA1c

The structural and spectroscopic characteristics of the synthesized structurally novel compound 4-chloro-6-methylquinoline-2(1H)-one (4C6MQ) and its isomer 4-chloro-8-methylquinoline-2(1H)-one (4C8MQ) have been examined by means of experimental and computational quantum chemical methods like density functional theory (DFT). The crystal structure of the 4C6MQ compound has been brought to light by single-crystal x-ray diffraction (SCXRD) method which consists of two independent molecules (A and B) in the asymmetric unit with similar conformations. Both the isomer compounds are characterized spectroscopically by FTIR, FT-Raman, UV-Vis, and NMR spectrum and compared with DFT results. The geometries of the isomer compounds have been optimized by using DFT/B3LYP method with the 6-311G++(d,p) basis sets. From the optimized geometry of the compounds, geometric parameters (bond lengths, bond angles, and torsion angles); vibrational analysis; chemical shifts; and electronic absorption of the isomer compounds have been computed and compared with the experimental result. The detailed assignments of vibrational wave numbers have been prepared based on potential energy distribution (PED) which was carried out in the VEDA4 program. In addition, natural bonding orbital analysis, frontier molecular orbital, and molecular electrostatic potential have been explained theoretically. The in silico (absorption, distribution, metabolism, excretion and toxicity) studies were analyzed to identify the potential drug likeliness of the isomer compounds. The implications of the inhibitory activity of isomer compounds against DNA gyrase and lanosterol 14 α-demethylase enzyme by molecular docking are discussed. Further, the isomer compounds were screened for their antibacterial and antifungal activities.

To assess the role of artificial intelligence (AI)-based automated software for detection of diabetic retinopathy (DR) and sight-threatening DR (STDR) by fundus photography taken using a smartphone-based device and validate it against ophthalmologist’s grading. Three hundred and one patients with type 2 diabetes underwent retinal photography with Remidio ‘Fundus on phone’ (FOP), a smartphone-based device, at a tertiary care diabetes centre in India. Grading of DR was performed by the ophthalmologists using International Clinical DR (ICDR) classification scale. STDR was defined by the presence of severe non-proliferative DR, proliferative DR or diabetic macular oedema (DME). The retinal photographs were graded using a validated AI DR screening software (EyeArtTM) designed to identify DR, referable DR (moderate non-proliferative DR or worse and/or DME) or STDR. The sensitivity and specificity of automated grading were assessed and validated against the ophthalmologists’ grading. Retinal images of 296 patients were graded. DR was detected by the ophthalmologists in 191 (64.5%) and by the AI software in 203 (68.6%) patients while STDR was detected in 112 (37.8%) and 146 (49.3%) patients, respectively. The AI software showed 95.8% (95% CI 92.9–98.7) sensitivity and 80.2% (95% CI 72.6–87.8) specificity for detecting any DR and 99.1% (95% CI 95.1–99.9) sensitivity and 80.4% (95% CI 73.9–85.9) specificity in detecting STDR with a kappa agreement of k = 0.78 (p

In the present work, we have designed and synthesized novel indolyl-4H-chromene-phenylprop-2-en-1-one derivatives (5a–o) using Amberlite SR1L Na (150 mg) as catalyst at 60 °C in DMSO. For the first time, a series of 2-alkoxy-2H-chromen chalcones (3a–h) are prepared by reacting 1-(2-ethoxy-2-methyl-2H-chromen-3yl)ethan-1-one with various substituted aldehydes in the presence of 20% ethanolic sodium hydroxide. After optimizing the reaction conditions, the synthesized chalcones (3a–h) were further reacted with various indoles (4a–b) via regioselective nucleophilic substitution to yield the corresponding derivatives (5a–o) in excellent yields by C C coupling reaction and confirmed by 1H, 13C NMR HRMS and UV–Visible spectroscopy analysis. The employed synthetic route offered several advantages such as simple reaction conditions, easy handling, short reaction time, environmentally benign, and reusability of the catalyst. The synthesized compounds (5a–o) was studied for their solvatochromic property with increasing polarity of solvents. The compounds (5a–o) were evaluated for their antioxidant activity by free radical screening using 2, 2-diphenyl-1-picrylhydrazyl (DPPH) method. Also, their in-vitro antibacterial activity has been investigated against gram positive (S. aureus and B. subtilis) and gram negative bacteria (Klebsiella and E. coli) by agar well technique. Among the compounds employed, 5g and 5h not only showed promising antioxidant activity but also significant antibacterial activity against S. aureus compared to the experimental standards.

To assess the effect of migration (rural-to-urban and vice versa) on prevalence of diabetes and metabolic disorders in Asian Indians participating in the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study.The ICMR-INDIAB study is a national study on diabetes and associated cardiometabolic disorders in individuals aged ≥20 years from 28 states and 2 union territories of India. Individuals who moved to a different place from their place of birth and had resided in the new location for at least one year were considered as migrants. Anthropometric measurements, blood pressure estimation and a capillary oral glucose tolerance test were performed.Of the 113,043 participants, 66.4% were non-migrant rural dwellers, 19.4% non-migrant urban dwellers, 8.4% rural-urban migrants, 3.8% multiple migrants and 2.0% urban-rural migrants. Weighted prevalence of diabetes was highest in rural-urban migrants followed by urban dwellers, urban-rural migrants and rural dwellers [14.7%, 13.2%, 12.7% and 7.7% respectively (p 0.001)]. Rural-urban migrants had highest prevalence of abdominal obesity (50.5%) compared to the other three groups. The risk for diabetes was 1.9 times higher in rural-urban migrants than among rural dwellers. Five risk factors [hypertension, abdominal and generalized obesity, physical inactivity and low fruit and vegetable intake] together explained 69.8% (partial population attributable risk) of diabetes among rural-urban migrants and 66.4% among non-migrant urban dwellers.Rural-to-urban migration is associated with increased risk of developing diabetes and other cardiometabolic abnormalities. Adoption of healthier lifestyle patterns among migrants could help prevent/delay onset of these abnormalities in this population.

The synthesized novel chloroquinoline derivatives 1-(2-chloro-4-phenylquinolin-3-yl)ethanone (CPQE), 1-(2,6-dichloro-4-phenylquinolin-3-yl)ethanone (DCPQE), methyl 2,6-dichloro-4-phenylquinoline-3-carboxylate (MDCPQC),methyl 2-chloro-4-methylquinoline-3-carboxylate (MCMQC) were subjected to the elementary analysis like FT-IR, NMR and Mass spectra using GCMS. Also, single crystal X-ray diffraction study was executed for the compound MDCPQC. The crystal packing is stabilized by C–H…π and π–π interactions and also Chlorine–Chlorine short intermolecular contacts generating a three-dimensional supramolecular network. The antioxidant activity reduces high glucose level in the human body and hence the synthesized compounds were subjected for the estimation of antioxidant activity using DPPH method which exhibited good percentage of inhibition in comparison with ascorbic acid, a well-known anti-oxidant. The binding interaction of the chloroquinoline derivatives with calf thymus DNA (CT-DNA) has been explored by fluorescence quenching studies and molecular docking analysis has been employed to confirm the nature of binding. The prediction of pharmacological properties such as drug-likeness, molecular properties like absorption, distribution, metabolism, excretion and toxicity (ADMET) was carried out by computational studies to compare chloroquinoline derivatives with standard drug. Owing to the various potential biological activities of the quinoline compounds, molecular docking studies were also further carried out for the chloroquinoline derivatives, showing that they may act as effective anti-diabetic agents by inhibiting Glycogen Phosphorylase a protein.

A series of alkoxy-substituted 2H-chromenes were synthesized by a one-pot three-component reaction using salicylaldehydes, acetyl acetone and alcohol as reactant and medium with tetra-n-butylammonium fluoride (TBAF) as catalyst. Simple reaction conditions, short reaction time and overall good yield of products make this synthetic strategy an efficient one to synthesize 2H-chromene molecules. All the synthesized compounds were evaluated for antioxidant activities. Among all the new compounds, 5j and 5k showed good inhibition $$(70.41\, \pm \, 0.14$$ and $$64.71\, \pm \, 1.02\%$$ ) at 100 $$\upmu \hbox {g/mL}$$ concentrations.

The novel title compound 4-chloro-8-methoxyquinoline-2(1H)-one (4CMOQ) has been synthesized by slow evaporation solution growth technique at room temperature. The synthesized 4CMOQ molecule was characterized experimentally by FT-IR, FT-Raman, UV–Vis, NMR and single crystal diffraction (XRD) and theoretically by quantum chemical calculations. The molecular geometry was also optimized using density functional theory (DFT/B3LYP) method with the 6-311++G (d,p) basis set in ground state and compared with the experimental data. The entire vibrational assignments of wave numbers were made on the basis of potential energy distribution (PED) by VEDA 4 programme. The nuclear magnetic resonance spectra (1H and 13C NMR) are obtained by using the gauge-invariant atomic orbital (GIAO) method. The change in electron density (ED) in the antibonding orbital's and stabilization energies E(2) of the molecule have been evaluated by natural bond orbital (NBO) analysis to give clear evidence of stabilization. Moreover, electronic characteristics such as HOMO and LUMO energies, Mulliken atomic charges and molecular electrostatic potential surface are investigated. Absorption spectrum analysis, nonlinear optical properties, chemical reactivity descriptors and thermodynamic features are also outlined theoretically. Molecular docking studies were executed to understand the inhibitory activity of 4CMOQ against DNA gyrase and Lanosterol 14 α-demethylase. The antimicrobial activity of 4CMOQ was determined against bacterial strains such as Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa and fungal strains such as Aspergillus niger, Monascus purpureus and Penicillium citrinum. The obtained results show that the compound exhibited good to moderate antimicrobial activity.

The title compound 1-(2-chloro-4-phenylquinolin-3-yl)ethanone (CPQE) was synthesised effectively by chlorination of 3-acetyl-4-phenylquinolin-2(1H)-one (APQ) using POCl3 reagent. Structural and vibrational spectroscopic studies were performed by utilizing single crystal X-ray diffraction, FTIR and NMR spectral analysis along with DFT method utilizing GAUSSIAN′ 03 software. Veda program has been employed to perform a detailed interpretation of vibrational spectra. Mulliken population analyses on atomic charges, MEP, HOMO-LUMO, NBO, Global chemical reactivity descriptors and thermodynamic properties have been examined by (DFT/B3LYP) method with the 6-311G(d,p) basis set level.

In the present investigation new series of quinoline substituted acridine analogues were synthesized through Knoevenagel condensation of acridine with various 2,4-dichlorothiazole-5-carbaldehyde derivatives. Shorter reaction time, simple work-up procedure, clean reaction profiles and reusability of the catalyst up to five cycles are some of the noteworthy highlights of the reported protocol. The synthesized compounds were successfully characterized by using 1H NMR, 13C NMR and HRMS. Molecular docking simulations were carried out to decipher the binding nature of the synthesized derivatives towards PPARγ protein. The results obtained from docking analysis showed that the synthesized derivatives possess good binding interaction towards PPARγ protein. Interestingly in-vitro testing of the compounds for hypoglycemic activity evaluation through α-amylase and α-glucosidase enzyme inhibition assays reveals that the compounds 3d and 3f possess good hypoglycemic efficacy comparable to standards pioglitazone and acarbose.

Over the past few years most of the biochemical industries are in a rapid stage of development. The major root cause responsible for this current state of excitement is a new technology-driven biocatalysis that pulled markets in to the new areas. The development of technology from scientific breakthroughs to the industrial applications is rapidly increasing all over the world. The substantial growth and increased emphasis on the development of biocatalysts is an huge achievement both for chemical and biotechnology related industries. In this present world ‘chemical biotechnology’ is rapidly growing hand-in-hand with maximum utilization of renewable feed stocks and made a big impact in the industrial revolution. The present review mainly summarizes a complete overview of lipases and its biocatalytic applications in pharmaceutical industries especially in the synthesis of (-)-Peroxetine hydrochloride, diltiazem hydrochloride, chiral β-azidoalcohols, primary amines and amides, vitamin D3 derivatives. The catalytic role of lipases in the epoxidation of unsaturated carboxylic acids, in the kinetic resolution of azirinol, aminolysis of dimethyl 3-substituted glutarates in addition to these lipase assisted synthesis of dihydropyrano [2,3-c] pyrazoles and 4-methoxy cinnamoyl glycerol was elaborated.

An efficient microwave assisted synthesis of 2-substituted benzoxazole derivatives from antiinflammatory drugs aceclofenac and mefenamic acid using amberlite-IRA-402 (OH) ion exchange resin as a base catalyst were reported. The synthesized compounds were purified and characterized by 1H NMR, 13C NMR and Mass spectroscopy. In silico molecular docking studies were carried out to predict the binding affinity of the synthesized benzoxazole derivatives with COX-2 protein. Molecular Docking analysis showed that compounds 4 and 7 possess excellent binding affinity towards COX-2 with a docking score of −11.6 and −10.4 kcaL/mol respectively. The results obtained from in vitro antiinflammatory studies towards membrane stabilization and proteinase inhibitory activities showed that the synthesized benzoxazole compounds 4 and 7 possess better efficacy when compared to that of standards aceclofenac and etodolac with a percentage inhibition of 74.22 ± 0.15, 70.64 ± 0.24 for membrane stabilization and 75.19 ± 0.12, 71.80 ± 0.49 for proteinase enzyme assay at 100 μmoL/L. The synthesized compounds 4 and 7 were also evaluated for antioxidant activity which showed good inhibition (70.16 ± 0.31 and 68.25 ± 0.49) at 100 μmoL/L which was on Par to that of standard ascorbic acid.

Background & objectives: Overweight and obesity are rapidly increasing in countries like India. This study was aimed at determining the prevalence of generalized, abdominal and combined obesity in urban and rural India. Methods: Phase I of the ICMR-INDIAB study was conducted in a representative population of three s0 tates [Tamil Nadu (TN), Maharashtra (MH) and Jharkhand (JH)] and one Union Territory (UT)[Chandigarh (CH)] of India. A stratified multi-stage sampling design was adopted and individuals ≥20 yr of age were included. WHO Asia Pacific guidelines were used to define overweight [body mass index (BMI) ≥23 kg/m [2] but

Flash Glucose Monitoring (FGM) is a newly introduced Glucose Monitoring system. FGM provides both graphical representation of qualitative and quantitative changes in glucose levels occurring over 14-day period collapsed into single modal day graph as well as day by day graphs. In this report, we present our experience with FGM in different clinical situations. In our experience FGM is an extremely useful clinical tool for detection of glucose variability, hyperglycemia and hypoglycemia. It can also be used as an effective educational tool when the data from FGM is shared with the patient. This helps in motivating the patient in achieving better glycemic control.

Previous studies have not adequately captured the heterogeneous nature of the diabetes epidemic in India. The aim of the ongoing national Indian Council of Medical Research-INdia DIABetes study is to estimate the national prevalence of diabetes and prediabetes in India by estimating the prevalence by state.We used a stratified multistage design to obtain a community-based sample of 57 117 individuals aged 20 years or older. The sample population represented 14 of India's 28 states (eight from the mainland and six from the northeast of the country) and one union territory. States were sampled in a phased manner: phase I included Tamil Nadu, Chandigarh, Jharkhand, and Maharashtra, sampled between Nov 17, 2008, and April 16, 2010; phase II included Andhra Pradesh, Bihar, Gujarat, Karnataka, and Punjab, sampled between Sept 24, 2012, and July 26, 2013; and the northeastern phase included Assam, Mizoram, Arunachal Pradesh, Tripura, Manipur, and Meghalaya, with sampling done between Jan 5, 2012, and July 3, 2015. Capillary oral glucose tolerance tests were used to diagnose diabetes and prediabetes in accordance with WHO criteria. Our methods did not allow us to differentiate between type 1 and type 2 diabetes. The prevalence of diabetes in different states was assessed in relation to socioeconomic status (SES) of individuals and the per-capita gross domestic product (GDP) of each state. We used multiple logistic regression analysis to examine the association of various factors with the prevalence of diabetes and prediabetes.The overall prevalence of diabetes in all 15 states of India was 7·3% (95% CI 7·0-7·5). The prevalence of diabetes varied from 4·3% in Bihar (95% CI 3·7-5·0) to 10·0% (8·7-11·2) in Punjab and was higher in urban areas (11·2%, 10·6-11·8) than in rural areas (5·2%, 4·9-5·4; p0·0001) and higher in mainland states (8·3%, 7·9-8·7) than in the northeast (5·9%, 5·5-6·2; p0·0001). Overall, 1862 (47·3%) of 3938 individuals identified as having diabetes had not been diagnosed previously. States with higher per-capita GDP seemed to have a higher prevalence of diabetes (eg, Chandigarh, which had the highest GDP of US$ 3433, had the highest prevalence of 13·6%, 12.8-15·2). In rural areas of all states, diabetes was more prevalent in individuals of higher SES. However, in urban areas of some of the more affluent states (Chandigarh, Maharashtra, and Tamil Nadu), diabetes prevalence was higher in people with lower SES. The overall prevalence of prediabetes in all 15 states was 10·3% (10·0-10·6). The prevalence of prediabetes varied from 6·0% (5·1-6·8) in Mizoram to 14·7% (13·6-15·9) in Tripura, and the prevalence of impaired fasting glucose was generally higher than the prevalence of impaired glucose tolerance. Age, male sex, obesity, hypertension, and family history of diabetes were independent risk factors for diabetes in both urban and rural areas.There are large differences in diabetes prevalence between states in India. Our results show evidence of an epidemiological transition, with a higher prevalence of diabetes in low SES groups in the urban areas of the more economically developed states. The spread of diabetes to economically disadvantaged sections of society is a matter of great concern, warranting urgent preventive measures.Indian Council of Medical Research and Department of Health Research, Ministry of Health and Family Welfare, Government of India.

This study estimated the levels of glycemic control among subjects with self-reported diabetes in urban and rural areas of four regions in India.Phase I of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) Study was conducted in a representative population of three states of India (Tamil Nadu, Maharashtra, and Jharkhand) and one Union Territory (Chandigarh) and covering a population of 213 million people. Using a stratified multistage sampling design, individuals ≥20 years of age were recruited. Glycemic control among subjects with self-reported diabetes was assessed by measurement of glycated hemoglobin (HbA1c), estimated by the Variant™ II Turbo method (Bio-Rad, Hercules, CA).Among the 14,277 participants in Phase I of INDIAB, there were 480 subjects with self-reported diabetes (254 urban and 226 rural). The mean HbA1c levels were highest in Chandigarh (9.1±2.3%), followed by Tamil Nadu (8.2±2.0%), Jharkhand (8.2±2.4%), and Maharashtra (8.0±2.1%). Good glycemic control (HbA1c7%) was observed only in 31.1% of urban and 30.8% of rural subjects. Only 22.4% of urban and 15.4% of rural subjects had reported having checked their HbA1c in the past year. Multiple logistic regression analysis revealed younger age, duration of diabetes, insulin use, and high triglyceride levels to be significantly associated with poor glycemic control.The level of glycemic control among subjects with self-reported diabetes in India is poor. Urgent action is needed to remedy the situation.

The aim of the study is to determine the prevalence of hypertension (HTN) and its risk factors in urban and rural India. In Phase I of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study, individuals aged ⩾20 years were surveyed using a stratified multistage sampling design, in three states (Tamil Nadu, Maharashtra and Jharkhand) and one union territory (Chandigarh) of India. Blood pressure was measured in all study subjects (n=14 059). HTN was defined as systolic blood pressure ⩾140 mm Hg, and/or DBP ⩾90 mm Hg and/or use of antihypertensive drugs. Overall age-standardized prevalence of HTN was 26.3% (self-reported: 5.5%; newly detected: 20.8%). Urban residents of Tamil Nadu, Jharkhand, Chandigarh and Maharashtra (31.5, 28.9, 30.7 and 28.1%) had significantly higher prevalence of HTN compared with rural residents (26.2, 21.7, 19.8 and 24.0%, respectively). Multivariate regression analysis showed that age, male gender, urban residence, generalized obesity, diabetes, physical inactivity and alcohol consumption were significantly associated with HTN. Salt intake ⩾6.5 g per day, showed significantly higher risk for HTN (odds ratio: 1.4, 95% confidence interval: 1.0-1.9, P=0.042) even after adjusting for confounding variables. In conclusion, prevalence of undiagnosed HTN is high in India and this calls for regular screening.

Background The rising prevalence of diabetes and obesity in India can be attributed, at least in part, to increasing levels of physical inactivity. However, there has been no nationwide survey in India on physical activity levels involving both the urban and rural areas in whole states of India. The aim of the present study was to assess physical activity patterns across India - as part of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. Methods Phase 1 of the ICMR-INDIAB study was conducted in four regions of India (Tamilnadu, Maharashtra, Jharkhand and Chandigarh representing the south, west, east and north of India respectively) with a combined population of 213 million people. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) in 14227 individuals aged ≥ 20 years [urban- 4,173; rural- 10,054], selected from the above regions using a stratified multistage design. Results Of the 14227 individuals studied, 54.4% (n = 7737) were inactive (males: 41.7%), while 31.9% (n = 4537) (males: 58.3%) were active and 13.7% (n = 1953) (males: 61.3%) were highly active. Subjects were more inactive in urban, compared to rural, areas (65.0% vs. 50.0%; p