Radiographic assessment of facial soft tissue thickness in South Indian population--An anthropologic study.

Facial reconstruction is a technique used in forensic anthropology to identify an unknown person. Various methods used for facial reconstruction are drawings, sculpture and computer aided image building which is mainly based on facial soft tissue thickness measurement. Several methods have been established for measuring facial soft tissue thickness (FSTT) with each one having certain limitations. There is limited data available on FSTT among South Indian population. Hence the present study was ventured to determine the FSTT among South Indian adults and also to find FSTT difference between male and female. 308 subjects of South Indian origin (18-27 years) having full set of permanent dentition who require orthodontic treatment were included in the study. Subjects were assessed for Body Mass Index (BMI) and diagnostic digital x-ray of lateral cephalogram (LC), Lateral oblique (LO) view and posterior-anterior (PA) view was obtained. The digital image was transferred to Adobe Photoshop CS4 software and 23 different soft tissue points were measured. Mean FSTT was more in males compared to females except for three landmarks. Statistically significant difference was observed in 20 landmarks when height and weight was compared in males, whereas in females only 12 landmarks showed significant difference. BMI showed good correlation with FSTT in both males and females, which was confirmed by linear regression. The best regressor in terms of estimating FSTT in association with age/sex/BMI were nasion, sub nasale, labial superioris, labrale inferius, gnathion, inferior border of zygomatic, right and left gonion. Stepwise discriminant analysis using all variables showed 94.8% of overall accuracy in sex determination. The observation of present study suggests that LO and PA view along with LC gives information regarding mean FSTT among South Indian population. Even though BMI plays a dominant role in determining FSTT, but age, sex, height and weight should also be considered with care while facial reconstruction. Additionally the present regression equation contributes towards increase in the specificity of the tissue depths and can be used in real cases by allowing the practitioners to calculate individual tissue depth.

Tumor budding is an independent prognostic factor for prediction of lymph node metastasis in oral squamous cell carcinoma.

OBJECTIVE: Despite the enormous advances in diagnostic and management modalities of oral squamous cell carcinoma (OSCC), the mortality rates have remained stagnant with a 5-year survival rate of <50% challenging the available methods of prognostic assessment. Presence of tumor budding has been associated with aggressive behavior and is correlated with lymph node metastasis, recurrence, distant metastasis, and decreased survival in several cancers. However, the prognostic significance of this apparently simple to evaluate parameter is sparse in OSCC. METHODS: A total of 75 cases of surgically excised OSCC were analyzed for tumor budding along with other clinicopathologic parameters. Tumor budding was graded as high and low intensity based on presence and absence of ≥10 or <10 budding foci in hematoxylin and eosin-stained sections. An association between the clinicopathological parameters, lymph node metastases with the budding index was examined using univariate and multivariate analyses. RESULTS: Tumor budding was evident in 89% of cases with around 45.3% of the cases demonstrated high-intensity budding. High-intensity tumor budding was significantly associated with lymph node metastasis and depth of invasion. Multivariate analysis demonstrated that tumor budding and depth of invasion were significant independent predictors for lymph node metastasis. CONCLUSION: Tumor budding is frequently encountered histologic marker in OSCC. High-intensity tumor budding is a strong independent prognostic factor for prediction of lymph node metastasis.

Infant rearing practices in South India: a longitudinal study.

BACKGROUND: Rearing practices are a major determinant of nutritional and health status of infants. Therefore these practices need to be better understood. OBJECTIVES: To find out infant rearing practices in the study area. MATERIALS AND METHODS: A longitudinal study was conducted on a birth cohort of 194 infants. Information on rearing practices and anthropometric measurements were recorded every month for a period of 1 year. RESULTS: Only 67 (34.5%) newborns were breast fed within half an hour of delivery. Prelacteal feeds was given to 65 (33.5%) newborns and this was seen more among home deliveries (P=0.018). Demand feeding was practiced by 169 (87.1%) mothers. Exclusive breast feeding (EBF) for 6 months was practiced by 81 (41.7%) mothers. Bottle feeding was seen in 7 (3.6%) cases. Weight gain during infancy was found to be maximum when infants were EBF for 6 months (P<0.001) and weaned with semi-solid and solid diet alone in the following 6 months (P=0.002). Gain in all anthropometric measurements was more in the initial 6 months of infancy compared to latter. Four (2.1%) infants were malnourished. Oil massage before bath was practiced by 189 (97.4%) mothers. Over 50% mothers practiced oil application to eyes or ears of infants. Delayed initiation of bath (beyond 1week) was seen in 15 (7.7%) cases. CONCLUSION: Faulty rearing practices need to be corrected in order to improve the health status of infants.

Impact of Training of Traditional Birth Attendants on Maternal Health Care: A Community-based Study.

OBJECTIVE: To study the impact of Training of Traditional Birth Attendants (TBAs) on maternal health care in a rural area. METHODS: An interventional study in the Primary Health Center area was conducted over 1-year period between March 2006 and February 2007, which included all the 50 Traditional Birth Attendants (30 previously trained and 20 untrained), as study participants. Pretest evaluation regarding knowledge, attitude, and practices about maternal care was done. Post-test evaluation was done at the first month (early) and at the fifth month (late) after the training. Analysis was done by using Mc. Nemer's test, Chi-square test with Yates's correction and Fischer's exact test. RESULTS: Early and late post-test evaluation showed that there was a progressive improvement in the maternal health care provided by both the groups. Significant reduction in the maternal and perinatal deaths among the deliveries conducted by TBAs after the training was noted. CONCLUSION: Training programme for TBAs with regular follow-ups in the resource-poor setting will not only improve the quality of maternal care but also reduce perinatal deaths.

A cross-sectional study of prevalence of overweight and obesity among bus drivers and conductors of North-West Karnataka Road Transport Corporation (NWKRTC) in Belgaum Division, Belgaum.

Obesity has become a major chronic disorder affecting a large population more than any other disease in the world. To study the prevalence of overweight and obesity among bus drivers and conductors of North-West Karnataka Road Transport Corporation (NWKRTC) in Belgaum, and to compare the prevalence of overweight and obesity among them the study had been undertaken in Belgaum. Randomly selected 365 drivers and 370 conductors were personally interviewed using predesigned, pretested structured questionnaire. Physical examination was done to measure height, weight, waist circumference and hip circumference. Body mass index was measured to assess overweight and obesity. Waist circumference and waist hip ratio were used to assess central obesity. Summary figures like rates were calculated. Chi- square test was used to test the difference of prevalence between drivers and conductors. The study showed that in drivers 43.3% were overweight, 22.2% were obese and 23.8% were having a waist circumference > or = 102 cm. Among conductors 28.1% were overweight, 16.2% were obese and 18.1% were having a waist circumference of > or = 102cm.The prevalence of over-weight and obesity was high among drivers compared to conductors. Drivers were also more centrally obese than conductors.These differences were found to be statistically significant. Considering the high prevalence of overweight and obesity among drivers and conductors, necessary preventive measures need to be promoted.

Morbidity pattern in foundry workers--a cross-sectional study in an urban area of north Karnataka.

Foundry industry which is a well established in India employs many workers. These workers are exposed to metal dusts, metal fumes, chemicals, heat and high temperature. To determine the morbidity pattern in foundry workers, a cross-sectional study was conducted in the semi-urban area of Belgaum in Karnataka. All the workers excluding the administrative staff working in the foundries in the specified area were included in the study. A structured questionnaire was used to collect the data. Thorough physical examination was carried out to find out existing morbidities followed by spirometry test to determine their lung function profile. Altogether 498 foundry workers participated in the study. More than 50% of them were working for five years and above. Most of the workers (91.57%) were not using any kind of personal protective devices and 38.55% were smokers. About 68.50% workers had some kind of morbidity. Respiratory system (18.10%) was involved in most of those with morbidities. Chronic bronchitis was the leading morbidity in these workers. There was an association between chronic bronchitis with increasing age of the workers, the number of years they were working in foundries and their smoking habits, which was statistically significant. Foundry workers are exposed to various risk factors like metal dusts, metal fumes and Chemicals which may affect their health. They suffer from various morbidities, particularly respiratory problems which needs periodic health examination. Personal protective devices use should be made compulsory in these workers.

Prevalence of hepatitis C infection in HIV-seropositive individuals in and around Belgaum, south India.

India has high prevalence of HIV infection. As HIV and HCV share common routes of transmission, there is every chance of an HIV-infected patient also having HCV infection. We investigated the prevalence of HCV infection in HIV seropositive individuals attending a tertiary care hospital at Belgaum, south India. A total of 16,124 serum samples from suspected patients were screened for the presence of HIV antibodies and those who tested positive for HIV were screened for HCV antibodies by using enzyme-linked immunosorbent assay (ELISA). A total of 24 (3.52%) patients were found to be co-infected with HIV and HCV. Among them, 16 (66.66%) were male and 8 (33.33%) were female. This study has revealed a relatively high prevalence of HIV/ HCV co-infection in and around Belgaum which suggests preventive and control measures should be taken against the spread of such infection in this part of India.

Prevention of postpartum haemorrhage with sublingual misoprostol or oxytocin: a double-blind randomised controlled trial.

OBJECTIVE: Sublingual misoprostol produces a rapid peak concentration, and is more effective than oral administration. We compared the postpartum measured blood loss with 400 µg powdered sublingual misoprostol and after standard care using 10 iu intramuscular (IM) oxytocin. DESIGN: Double-blind randomised controlled trial. SETTING: A teaching hospital: J N Medical College, Belgaum, India. SAMPLE: A cohort of 652 consenting eligible pregnant women admitted to the labour room. METHODS: Subjects were assigned to receive the study medications and placebos within 1 minute of clamping and cutting the cord by computer-generated randomisation. Chi-square and bootstrapped Student's t-tests were used to test categorical and continuous outcomes, respectively. MAIN OUTCOME MEASURES: Measured mean postpartum blood loss and haemorrhage (PPH, loss ≥ 500 ml), >10% pre- to post-partum decline in haemoglobin, and reported side effects. RESULTS: The mean blood loss with sublingual misoprostol was 192 ± 124 ml (n=321) and 366 ± 136 ml with oxytocin IM (n=331, P ≤ 0.001). The incidence of PPH was 3.1% with misoprostol and 9.1% with oxytocin (P=0.002). No woman lost ≥ 1000 ml of blood. We observed that 9.7% and 45.6% of women experienced a haemoglobin decline of >10% after receiving misoprostol and oxytocin, respectively (P ≤ 0.001). Side effects were significantly greater in the misoprostol group than in the oxytocin group. CONCLUSION: Unlike other studies, this trial found sublingual misoprostol more effective than intramuscular oxytocin in reducing PPH, with only transient side effects being greater in the misoprostol group. The sublingual mode and/or powdered formulation may increase the effectiveness of misoprostol, and render it superior to injectable oxytocin for the prevention of PPH. Further research is needed to confirm these results.

Determination of palatal rugae patterns among two ethnic populations of India by logistic regression analysis.

Palatal rugae patterns are relatively unique to an individual and are well protected by the lips, buccal pad of fat and teeth. They are considered to be stable throughout life following completion of growth, although there is considerable debate on the matter, they can be used successfully in post mortem identification provided an antemortem record exists. Thus the aim of this study was to examine palatal rugae shape among two Indian populations and determine the accuracy in defining the Indian population using logistic regression analysis. The study comprises two groups from geographically different regions of India with basic origin from Maharashtra and Karnataka state. The sample includes 100 plaster cast equally distributed between two populations and genders with age ranging between 18 and 40 years. Impression of maxillary arch was obtained using alginate impression material and plaster cast was made. The rugae was delineated on the cast using a sharp graphite pencil under adequate light and magnification and recorded according to classification given by Kapali et al. and Thomas and Kotze (1983). Chi-Square analysis showed significant difference in wavy, circular and divergent pattern between the two populations. The straight and wavy forms were significant in logistic regression analysis. A predictive value of 71% was obtained in determining the original cases correctly when straight, wavy, curved and circular patterns were assessed. 70% of predictive value was achieved when all rugae patterns were assessed. Mean number of rugae was greater in females compared to males with straight pattern showing statistically significant difference between males and females. Significant difference was recorded among straight, wavy, circular and divergent pattern between two populations. Consequently this study demonstrates moderate accuracy of palatal rugae pattern using logistic regression analysis in identification of Indians.

Nutritional status of under-fives in rural area of South India.

BACKGROUND: Malnutrition is widely recognized as a major health problem in developing countries. It is wide spread in rural, tribal and urban slum areas. Growing children are most vulnerable to its consequences. Anthropometry is a simple field technique for evaluating physical growth and nutritional status of the children. OBJECTIVE: To assess the nutritional status of under-fives'. MATERIALS AND METHODS: This cross sectional study was conducted in Kakati-A sub-centre, under Primary Health Centre Vantamuri of Belgaum district. The sample size was 290. Data collection was done using pre-designed and pre-tested questionnaire. STATISTICAL ANALYSIS: Distribution of variables was assessed and comparison was done using chi square test and P value. RESULTS: The prevalence of underweight, stunting and wasting was observed to be 26.55%, 31.38% and 7.59%, while severe degree of underweight, stunting and wasting was observed in 5.86%, 27.24% and 6.51% respectively according to World Health Organization (WHO) 2006 classification. According to the Indian Academy of Pediatrics (IAP) classification the prevalence of Grade I malnutrition was 121 (47.10%), Grade II was 29 (10.00%) and Grade III and IV were 4 (1.40%). CONCLUSION: Majority of the children's diet was not adequate for calories and proteins as per Indian Council for Medical Research (ICMR) guidelines. Less than half of children were underweight, nearly one third were stunted and one fifth of children were wasted. No child was found to be overweight or obese.

Morbidity among infants in South India: a longitudinal study.

To study the incidence and types of morbidity in the first year of life in a birth cohort, a longitudinal study. This study was undertaken in northern part of Karnataka state in India. Birth cohort consisted of all the children born during first six months of the study period. They were assessed at the time of enrollment and monthly follow up was done till they attained one yr of age. Out of the 194 newborns, 46.4% were boys and 53.6% were girls. 24.8% of newborns were of low birth weight and 5.1% were preterm. Four (2.1%) had congenital anomalies and 2.5% developed birth asphyxia. Diarrhea (10.8%) and skin diseases (8.2%) were the commonest morbidities in the neonatal period. The incidence of morbidity was 3.28 per infant per yr. It was more among boys and in the second half of infancy. Commonest morbidities during infancy were respiratory tract infection (62.4%), diarrhea 42.8% and skin diseases (21.6%). Incidence of disease in infancy highlights the need to improve and plan health programmes.

Impact of training of traditional birth attendants on the newborn care.

OBJECTIVE: To study the impact of training of Traditional Birth Attendants (TBAs) on the Newborn care in resource poor setting in rural area. METHODS: A community based study in the Primary Health Center (PHC) area was conducted over one year period between March 2006 to February 2007. The study participants were 50 Traditional Birth Attendants (TBAs)who conduct home deliveries in the PHC area. Training was conducted for two days which included topics on techniques of conducting safe delivery and newborn care practices. Pre-test evaluation regarding knowledge and practices about newborn care was done. Post-test evaluation was done at first month (early) and at fifth month (late) after the training. Analysis was done by using Mc. Nemer's test, Chi- square test with Yates's correction and Fischer's exact test. RESULTS: Pre-test evaluation showed that, knowledge and practices about newborn care services provided by the previously trained TBAs and untrained TBAs were poor. Early and late post-test evaluation showed that, there was a progressive improvement in the newborn care provided by both the groups. Preintervention period (one year prior to the training) and postintervention period (one year after the training) showed that, there was a statistically significant (p<0.05) reduction in the perinatal deaths (11 to 3) and neonatal deaths (10 to 2) among the deliveries conducted by TBAs after the training. CONCLUSION: Training programme for TBAs with regular reinforcements in the resource poor setting will not only improve the quality of newborn care but also reduces perinatal deaths.