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Lenalidomide, a thalidomide derivative, is prescribed as maintenance therapy for multiple myeloma (MM). Patients with MM receiving lenalidomide were found to develop a distinct therapy-related B cell acute lymphoblastic leukemia (B-ALL). However, the molecular mechanism by which lenalidomide drives B-ALL is unknown. We show that thalidomide treatment of B cell lines increased CD34 expression and fibronectin adhesion. This resembled the effects of Ikzf1 loss of function mutations in B-ALL. IKZF1 is a transcription factor that can act as both a transcriptional activator and a repressor depending upon the target loci. In our experiments, thalidomide-induced degradation of IKZF1 increased the expression of its transcriptional repression targets Itga5 and CD34 explaining the increased adhesion and stemness. Strikingly, withdrawal of thalidomide lead to the mis-localization of IKZF1 to the cytoplasm. Moreover, chromatin immunoprecipitation data showed a long-term effect of thalidomide treatment on IKZF1 target loci. This included decreased chromatin occupancy at early B cell factor 1 (EBF1) and Spi1 (PU.1). Consequently, B-cell lineage specifying transcription factors including Pax5, Spi1 and EBF1 were downregulated even after 7 days of thalidomide withdrawal. Our study thus provides a molecular mechanism of thalidomide-induced B-ALL whereby thalidomide alters the chromatin occupancy of IKZF1 at key B-cell lineage transcription factors leading to a persistent block in B-cell differentiation.
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BACKGROUND OBJECTIVES: In urban areas, upsurge in population has resulted in more breeding sites for malaria vectors, and hence this scenario potentially undermine malaria elimination and control programs. The change in land use due to urbanization may result in the presence and distribution of malaria vectors. Understanding potential malaria vectors is essential for current and future malaria transmission control strategies. This study investigated the effects of rapid urbanization on malaria vectors An. culicifacies s.l. and An. stephensi L. in Ghaziabad district. METHODS: Ghaziabad district which presents several levels of urbanization was selected for this study. Entomological investigations were conducted seasonally from 2014-2016 in the rural, urban, and peri-urban regions. Vector incrimination study was done using ELISA (confirmation by PCR) on suspected Anopheles vectors viz. An. culicifacies, An. stephensi, An. annularis and An. subpictus. RESULTS: An. culicifacies showed alteration in distribution influenced by rural and agricultural land whereas An. stephensi was found to be influenced by artificial habitats and population growth. INTERPRETATION CONCLUSION: The study also confirms the association between the abundance of malaria vectors and land use change.
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Anopheles , Malaria , Mosquitos Vectores , Urbanización , Anopheles/fisiología , Anopheles/crecimiento & desarrollo , India/epidemiología , Animales , Mosquitos Vectores/fisiología , Mosquitos Vectores/crecimiento & desarrollo , Malaria/transmisión , Malaria/epidemiología , Estaciones del Año , Ecosistema , Humanos , Población Rural , Distribución AnimalRESUMEN
BACKGROUND OBJECTIVES: Aedes aegypti and Aedes albopictus are two sympatric mosquito species that compete with each other for resources when their breeding habitats overlap. This study examines what happens when sympatric Aedes aegypti and Aedes albopictus mosquitoes' mate with each other and other species by looking at insemination rates, fecundity, and hatchability rate. METHODS: We performed controlled mating experiments in laboratory setting, assessing both conspecific and interspecific crosses. We measured insemination rates, egg numbers, and hatching success to examine the reproductive interference dynamics between these two distinct mosquito species. RESULTS: In the context of conspecific mating, it was observed that both female Ae. aegypti and Ae. albopictus exhibited high insemination rates, with percentages of 98% and 94%, respectively. However, interspecific mating exhibited interesting asymmetries: Ae. albopictus males achieved a notable insemination success rate of 28% when mating with Ae. aegypti females, while Ae. aegypti males achieved only 8% insemination success with Ae. albopictus females. Additionally, females that mated with interspecific males had reduced production of viable eggs compared to conspecific mating. Most notably, interspecific mating resulted in the production of infertile eggs, while conspecific mating led to successful hatching. INTERPRETATION CONCLUSION: The study reveals that, Ae. aegypti and Ae. albopictus can asymmetrically interfere with each other's reproduction, causing a 'satyr' effect. This understanding of interspecific competition and reproductive interference in these mosquito species could impact their coexistence in shared breeding habitats.
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BACKGROUND & OBJECTIVES: Aedes (Stegomyia) aegypti is a primary vector responsible for the transmission of various arboviral diseases in India. Without an effective drug or vaccine against these diseases, chemical insecticide-based vector control supplemented with source reduction remains the best option for their effective management. The development of insecticide resistance due to the continuous use of insecticides might affect the control operations. METHODS: Adults and larvae of Aedes aegypti were collected from different localities in Delhi. Larvae were exposed to discriminating (0.02mg/l) and application (1mg/l) doses of temephos. WHO tube assay was conducted for F1 adults using impregnated insecticide papers of dichlorodiphenyltrichloroethane (DDT), malathion, deltamethrin, permethrin, cyfluthrin, and lambda-cyhalothrin. RESULTS: Larvae of Ae. aegypti were found resistant (76.0%) to the discriminating dose of temephos, whereas suscep-tible (100.0%) to the application dose of the temephos. Adult Aedes (Fl) mosquitoes were resistant to DDT (23.7%), malathion (90.5%), deltamethrin (76.0%), permethrin (96.2 %) cyfluthrin (85.5%), and lambda-cyhalothrin (94.0%). INTERPRETATION & CONCLUSION: Indoor residual spray is not used in Delhi for vector control. Resistance in Aedes might be due to pesticide usage for agricultural activities in peripheral regions of Delhi. There is a need to investigate more on the insecticide resistance mechanisms for indirect resistance development. Understanding the insecticide susceptibility status of urban vectors is critical for planning effective control strategies.
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Aedes , Insecticidas , Piretrinas , Animales , Insecticidas/farmacología , Permetrina/farmacología , Malatión/farmacología , DDT/farmacología , Temefós/farmacología , Salud Pública , Mosquitos Vectores , Piretrinas/farmacología , Resistencia a los Insecticidas , Larva , IndiaRESUMEN
Sardar Sarovar Irrigation Canal system was constructed by Narmada Valley Development Authority (NVDA) to cater to drinking water as well as for irrigation purposes in Jalore and Barmer districts of Western Rajasthan. To cater to the needs of water for the villagers in the command areas, 'Diggies' (surface water tanks) with 'Sumpwells' (water supply surface tanks) were installed. In a health impact assessment study of the irrigation canals from December 2010 to February 2016, the breeding of two major malaria vectors. An. culicifacies and An. stephensi were observed in diggies and sumpwells. As a biological control, Gambusia affanis fishes were employed for larval control in such stagnated water sites during the intervention phase viz. February 2012 in 251 diggies and 251 sumpwells. A significant reduction of breeding in diggies (99.54%) and sumpwells (97.81%) was observed. The positivity and larval density (dip index) were monitored in the control from up to February 2016 for their sustainability.
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Anopheles , Ciprinodontiformes , Malaria , Animales , India , Larva , Malaria/epidemiología , Malaria/prevención & control , Mosquitos Vectores , AguaRESUMEN
Screen-based media usage among young people is blooming rapidly due to technological and digital revolution. We conducted community-based cross-sectional study to determine the prevalence of excess screen time and its association with sociodemographic and behavioral patterns in a rural block of Haryana, India. A semi-structured interview schedule was administered by trained physicians to ascertain screen time in a typical day and various socioeconomic and behavioral factors among a random sample of 860 young men aged 18-24 years. The prevalence of excess screen time was 61.8% (95% confidence interval [CI] 58.4-65.1). It was significantly associated with education (adjusted odds ratio [AOR] 1.7, 95% CI 1.1-2.6) and occupation (AOR 2.2, 95% CI 1.2-3.9) of the father and their sleep duration of ≤8 h (AOR 1.6, 95% CI 1.2-2.3). Limiting the screen time as per international standards and behavioral interventions are needed for this young population.
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Población Rural , Tiempo de Pantalla , Adolescente , Estudios Transversales , Humanos , India/epidemiología , Masculino , PrevalenciaRESUMEN
Measurable residual disease (MRD) is an important parameter to predict outcome in B-cell acute lymphoblastic leukemia (B-ALL). Two different approaches have been used for the assessment of MRD by multiparametric flow cytometry that include the "Leukemia Associated Aberrant Immunophenotype (LAIP)" and "Difference from Normal (DFN)" approach. In this retrospective study, we analyzed 539 samples obtained from 281 patients of which 258 were paired samples and the remaining 23 samples were from post-induction time point only, to explore the utility of baseline immunophenotype (IPT) for MRD assessment. Single-tube 10-color panel was used both at diagnosis and MRD time points. Out of 281 patients, 31.67% (n = 89) were positive and 68.32% (n = 192) were negative for MRD. Among 258 paired diagnostic and follow-up samples, baseline IPT was required in only 9.31% (24/258) cases which included cases with hematogone pattern and isolated dim to negative CD10 expression patterns. Comparison of baseline IPT with post-induction MRD positive samples showed a change in expression of at least one antigen in 94.04% cases. Although the immunophenotypic change in expression of various antigens is frequent in post-induction samples of B-ALL, it does not adversely impact the MRD assessment. In conclusion, the baseline IPT is required in less than 10% of B-ALL, specifically those with hematogone pattern and/or dim to negative expression of CD10. Hence, a combination of DFN and LAIP approach is recommended for reliable MRD assessment.
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Neoplasia Residual/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras B/diagnóstico , Antígenos CD/análisis , Citometría de Flujo , Humanos , Inmunofenotipificación , Neoplasia Residual/terapia , Neprilisina/análisis , Leucemia-Linfoma Linfoblástico de Células Precursoras B/terapia , Estudios RetrospectivosRESUMEN
BACKGROUND: Western Rajasthan in India has a typical desert climate. Until the introduction of the canal water irrigation system, malaria was an unstable and seasonal occurrence. Due to the scarcity of water, the community practised having one large underground tank (locally known as the tanka) in their house to collect rainwater for long-term household use. Anopheles stephensi, one of the major malaria vectors, breeds in improperly covered "tankas" if not properly covered and harbours a vector population throughout the year. METHODS: Two villages, Ajasar (intervention) and Tota (control), with similar ecological features, were selected for the study. A pre-intervention survey was carried out in both villages to assess the presence and quality of lids of tankas, and mosquito breeding and adult mosquito density. Awareness of the community about malaria and mosquitoes was also assessed during the pre-intervention period. In the intervention village, damaged or improper lids were replaced with improved mosquito proof polyvinyl chloride plastic (PVC) lids and lasted longer than the conventional lids. The fitness of the lids was assessed one year after the pre-intervention survey. The entomological assessment was carried out in both intervention and non-intervention villages. The level of community awareness about malaria, mosquitoes, their breeding places, and the role of tankas in malaria transmission was assessed both during pre- and post-intervention. RESULTS: During the pre-intervention survey, Anopheles breeding was found in 22.1% (58/262) of tankas in the intervention village and 27.1% (19/70) in tankas in the control village. Mosquito breeding was observed in the tankas with iron lids in the intervention village (48.3%) and the control village (42.1%). In the intervention village, out of 262 tankas in the village, 200 lids were replaced, resulting in the complete absence of mosquito breeding. In the pre-intervention survey conducted in May 2018, Anopheles stephensi consisted of 46% of adult mosquitoes in the intervention village and 55% in the control village. Its density was significantly reduced to 0.55 per man-hour (94.95%) and 0.22 per man-hour (97.8%) in the post-intervention survey in June 2018 and a follow-up survey in May 2019, respectively, in the intervention village. DISCUSSION: The density of Anopheles stephensi adults was reduced significantly (97.8%) in the intervention village due to complete prevention of breeding in the underground tankas in the intervention village as compared to the control with no density reduction. The awareness level of the community was also improved due to their involvement in the study. CONCLUSION: Provision of proper metal lids or replacement of damaged lids on underground water storage tanks as an environmental management approach prevented the breeding of the malaria vector, Anopheles stephensi, in a desert village in western Rajasthan.
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Anopheles/fisiología , Malaria/epidemiología , Mosquitos Vectores/fisiología , Abastecimiento de Agua/métodos , Animales , Clima Desértico , Vivienda , Vivienda para Animales , Humanos , India/epidemiología , Malaria/prevención & control , Malaria/transmisión , Encuestas y Cuestionarios , Abastecimiento de Agua/normasRESUMEN
Background & objectives: Uncorrected refractive error and cataract are the two most common causes of impairment of vision among elderly persons, and both are treatable. Treatment-seeking in patients is driven by symptom (decreased vision) rather than any anatomical or physiological measurement. The objective of this study was to evaluate the treatment-seeking behavior and barriers to treatment-seeking among elderly persons with impairment of vision in an urban resettlement colony of New Delhi, India. Methods: This community-based, cross-sectional study was conducted among 604 persons aged ≥60 yr selected by the simple random sampling. House-to-house visit was done, and a self-developed pretested semi-structured interview schedule was used to collect socio-demographic information, treatment-seeking behaviour and barriers to treatment-seeking. Results: Majority of participants reported impairment of vision (84%); 16.5 per cent of them did not visit any healthcare facility for their vision problem. Lack of felt need (48.1%) was the most common barrier to visiting healthcare facility. Of the 401 participants who gave a history of being prescribed spectacles, 277 (69%) used spectacles. Discomfort, lack of improvement in vision and lack of felt need were the most common reasons cited for non-usage. Among 300 participants who gave a history of cataract, 61 (20.3%) had not undergone cataract surgery. Lack of felt need was the most common barrier to cataract surgery. Interpretation & conclusions: A substantial proportion of elderly persons in the urban community have impairment of vision. Lack of felt need was the main reason for not visiting healthcare facility. As quality of spectacles was an important reported deterrent to use of spectacles, provision of appropriate refraction services and low-cost, good quality spectacles would be important.
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Catarata , Errores de Refracción , Anciano , Estudios Transversales , Anteojos , Humanos , India/epidemiología , Prevalencia , Errores de Refracción/diagnóstico , Errores de Refracción/epidemiología , Errores de Refracción/terapiaRESUMEN
Background & objectives: Chronic obstructive pulmonary disease (COPD) is a major public health problem in India. Its magnitude is particularly high among the elderly. Old age and comorbidity may lead to misdiagnosis and under treatment of this condition. COPD is not curable; however, various forms of treatment can help control symptoms and improve the quality of life. Most of the earlier studies lacked uniformity in definitions, designs, methodology and reporting techniques. Studies based on spirometry are only a few. Understanding the current prevalence and associated factors of COPD is important for planning control strategies. Hence, this study was conducted to determine the prevalence of COPD and associated factors among the elderly. Methods: In this community-based study among 449 elderly persons in a rural area, information regarding socio-demographic details, selected health conditions and exposure to risk factors was recorded. The assessment of airway obstruction was done by using a portable spirometer (MIR Spirolab). The diagnosis of COPD was based on the GOLD criteria. The association of COPD with sociodemographic and other variables was analysed by the multivariate logistic regression. Results: Acceptable spirometry findings were available for 392 (87.3%) participants. The prevalence of COPD was 42.9 per cent (95% confidence interval 37.9-47.7%). The prevalence was 54.5 per cent among men and 33.4 per cent among women. Smoking, higher age group and low body mass index were significantly associated with COPD. Interpretation & conclusions: The prevalence of COPD was found to be high among the rural elderly in this study. Interventions aimed at cessation of smoking and preparedness of health systems for diagnosis and management of COPD are hence required.
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Vida Independiente , Enfermedad Pulmonar Obstructiva Crónica , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Calidad de Vida , Factores de Riesgo , EspirometríaRESUMEN
Background & objectives: Healthcare workers (HCWs) are considered to be at a high risk of contracting COVID-19 infection. Besides, control of nosocomial infections transmitted from HCWs to the patients is also a cause of concern. This study was undertaken to investigate the seroprevalence of antibodies against the SARS-CoV-2 virus among the hospital staff of a tertiary care health facility in north India. Methods: The HCWs were tested for SARS-CoV-2 serology (IgG+IgM) using chemiluminescence immunoassay between June 22 and July 24, 2020. Venous blood (2 ml) was collected and tested for SARS-CoV-2 IgG and IgM antibodies. Results: Of the 3739 HCWs tested, 487 (13%) were positive for total SARS-CoV-2 antibodies. The highest seroprevalence was observed in administrative staff (19.6%) and least in physicians (5.4%). The staff who used public (20%) and hospital transportation (16.9%) showed higher seroprevalence compared to staff using personal transportation (12.4%). No difference was observed between HCWs posted in COVID versus non-COVID areas. All seropositive symptomatic HCWs in our study (53.6%) had mild symptoms, and the remaining 46.4 per cent were asymptomatic. The antibody positivity rate progressively increased from 7.0 per cent in the first week to 18.6 per cent in the fourth week during the study. Interpretation & conclusions: The presence of antibodies to SARS-CoV-2 in a significant number of asymptomatic HCWs, association with the use of public transport, relatively lower seroprevalence compared with the non-HCWs and rising trend during the period of the study highlight the need for serosurveillance, creating awareness for infection control practices including social distancing and study of infection dynamics in the community for effective control of an infectious pandemic.
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Anticuerpos Antivirales/sangre , COVID-19/diagnóstico , Personal de Salud , Control de Infecciones , COVID-19/sangre , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , India/epidemiología , SARS-CoV-2 , Estudios Seroepidemiológicos , Atención Terciaria de SaludRESUMEN
BACKGROUND & OBJECTIVES: Malaria control strategies for a particular area largely depends on the correct identification of the mosquito species prevalent in that area. This study aimed to develop an android mobile app named 'Pictorial Indian anophelines key', which can be used to identify the 58 species of Indian female adult anophelines based on morphological characteristics. METHODS: The pre-requisite to use this app requires a minimum basic knowledge of mosquito morphological characteristics and features. The user needs to view the collected mosquito under a dissecting binocular microscope and has to select the observations on the app presented in the form of labelled picture format. The app uses a divide and conquer algorithm which narrows the selection from genus level to final identification of species. RESULTS: The app is user-friendly, quick and it accurately identifies the mosquito species in a maximum of six consecutive clicks. The result displays a complete image of identified mosquito along with its quick identification features. It can be used for both subgenus Cellia and Anopheles. INTERPRETATION & CONCLUSION: This pictorial key-based mobile app could be helpful for entomologists, malariologists, researchers, public health workers as well as students in the quick and correct identification of anopheline mosquitoes prevalent in India which in turn could be helpful in devising appropriate approaches towards malaria control and prevention. The app can be modified as per future requirements.
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Anopheles , Malaria , Aplicaciones Móviles , Animales , Femenino , Humanos , India , Malaria/diagnóstico , Malaria/prevención & controlRESUMEN
BACKGROUND & OBJECTIVES: In India, vector-borne diseases, dengue and chikungunya are major public health concerns. In recent decades, dengue outbreaks have been reported in almost every part of India. In 2016, India recorded 101388 dengue cases and 210 deaths, including 4337 cases and six deaths in Delhi, whereas Chikungunya outbreaks were reported from several states in 2006, with 1.3 million cases. The Dengue virus (DENV) and Chikungunya virus (CHIKV) are both transmitted by the same Aedes mosquito species. DENV and CHIKV co-infections have been reported in 13 of 98 countries, with both viruses being transmitted locally. The reasons for the sudden upsurge in cases of these diseases are undetermined. METHODS: From March to December 2016, a study was carried out in 66 localities of Delhi in collaboration with the Municipal Corporation of Delhi. Localities were selected on the basis of confirmed dengue cases reported during the last five years and the study area was visited once a month. A door-to-door entomological survey was conducted to identify Aedes breeding in all water-filled containers in and around houses. Both immature and mature stages of Aedes mosquitoes were collected. Mosquitoes were pooled (n≤10 each for male and female) breeding site-wise and stored in Trizol at -80°C. The Chikungunya and dengue viruses were detected using a multiplex RT-PCR. RESULTS: A total of 981 Aedes mosquitos were distributed among 146 Pools, and DENV and CHIKV were detected using Multiplex Reverse Transcriptase-PCR. Chikungunya virus was identified in 19 pools of females captured adults, whereas dengue virus was found in 8 pools of females captured adults. There was no evidence of coinfection in any of the pools. INTERPRETATION & CONCLUSION: In endemic areas, continuous surveillance for both dengue and Chikungunya viruses is required to identify and characterize these viral pathogens. This information will also help implement effective strategies to combat outbreaks produced by these emerging viral pathogens.
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Aedes , Fiebre Chikungunya , Virus Chikungunya , Virus del Dengue , Dengue , Animales , Virus Chikungunya/genética , Virus del Dengue/genética , Femenino , India/epidemiología , Masculino , Mosquitos VectoresRESUMEN
RNA-seq was used to identify the partner gene and confirm the presence of a BCR-PDGFRB fusion. Identification of this fusion product resulted in successful treatment and long-term remission of this myeloid neoplasm. Based on our results, we suggest that despite current WHO recommendations, screening for PDGFRB rearrangement in cases of leukocytosis with eosinophilia and no other etiologic explanation is necessary, even if the karyotype is normal.
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Eosinofilia , Trastornos Mieloproliferativos , Neoplasias , Proteínas de Fusión Oncogénica/genética , Eosinofilia/diagnóstico , Eosinofilia/genética , Humanos , Mesilato de Imatinib , Trastornos Mieloproliferativos/complicaciones , Trastornos Mieloproliferativos/diagnóstico , Trastornos Mieloproliferativos/genética , Neoplasias/diagnóstico , Neoplasias/genética , Receptor beta de Factor de Crecimiento Derivado de Plaquetas/genética , Translocación GenéticaRESUMEN
Background: . Falls are one of the leading causes of death and disability among elderly persons. In India, there is paucity of data on the prevalence of falls, particularly among community-dwelling elderly persons. To estimate healthcare costs related to falls and formulation of fall prevention strategies, there is a need of reliable estimates of magnitude of falls. We aimed to provide a community-based pooled estimate of the burden of falls among elderly persons in India. Methods: . A systematic literature search was done manually as well as electronically through PubMed, Google Scholar, Cochrane library, IndMed, Embase and WHO databases. Community-based original studies conducted in India were included. No restriction for the date was used. Meta-analysis was done using the random effects model. Results: . Sixteen studies were included in the review and meta-analysis. These studies included a total of 14 844 elderly persons, of which 2707 reported falling. The pooled prevalence of falls was found to be 31% (95% CI 23%-39%). There was significant heterogeneity between the studies (I2 = 98.08%, p<0.01). Conclusion: . There is a high prevalence of falls among elderly persons in India. However, the available studies have considerable methodological variations and are of limited quality. Realistic estimates are required for designing programmes for prevention of falls and for rehabilitation.
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Accidentes por Caídas , Vida Independiente , Anciano , Humanos , India/epidemiología , PrevalenciaRESUMEN
As part of the MD/MS thesis, a postgraduate resident plans, conducts, analyses, and reports a research study under the guidance of the faculty members of the department. At the end of this process, the resident is expected to know the principles of conducting scientific research. Such an integral component of the resident's training program bears close examination. The thesis does help a resident plan a research study, collect and analyze data, and compile the results. However, lack of dedicated time for thesis-work (especially in patient-care disciplines), the absence of intermediate timelines, and variation in the research ability and interest of faculty guides limit its usefulness. Addressing these issues, ensuring availability and the optimal use of resources, as well as regular monitoring and evaluation at the departmental level, shall go a long way in meeting the goals of a thesis.
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Internado y Residencia/organización & administración , Investigación/organización & administración , Humanos , India , Internado y Residencia/normas , Investigación/normas , Proyectos de Investigación , Apoyo a la Investigación como Asunto , Factores de TiempoRESUMEN
BACKGROUND: Monitoring of population salt intake is essential for compliance with the WHO target of a 30% relative reduction in mean population salt intake. OBJECTIVE: This study was conducted to estimate the daily salt intake and find the associated variables among adult women in an urban resettlement colony of Delhi. METHODS: In this community-based cross-sectional study, 426 women aged 20-59 years from an urban resettlement colony were randomly selected. Sociodemographic details, anthropometric measurements, blood pressure, and morning spot urine samples were obtained. INTERSALT equation was used to estimate the 24-h salt intake from spot urine sodium. Association of salt intake with related variables was studied using t-test/analysis of variance, and P < 0.05 was considered to be significant. RESULTS: A total of 426 women participated in the study, and 381 participants' urine samples could be collected. The study participants' mean age (standard deviation [SD]) was 34.5 (9.4) years. The mean salt intake (SD, 95% confidence interval) of the participants calculated using the INTERSALT equation was 7.6 (1.7, 7.5-7.8) g/day. The salt intake was significantly associated with educational status, occupation, marital status, socioeconomic status, blood pressure, and waist circumference. Waist circumference was found to have a significant positive linear relationship with daily salt intake. CONCLUSION: The daily salt intake of this population was well above the recommendation and had a positive linear relationship with waist circumference. Reduction in daily salt intake is a must to control the epidemic of hypertension.
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Cloruro de Sodio Dietético , Sodio , Adulto , Estudios Transversales , Conducta Alimentaria , Femenino , Humanos , India/epidemiologíaRESUMEN
BACKGROUND: Uncorrected refractive errors contribute enormously to the burden of avoidable visual impairment worldwide. There is a huge disparity in different parts of the globe in context to spectacle coverage for distance vision. This study was undertaken with objectives of determining prevalence of spectacle coverage, unmet needs and associated factors among adults in a rural community of north India. METHODS: A community-based cross-sectional study was carried out within selected clusters of Jhajjar district of Haryana. All participants aged > 15 years underwent visual acuity assessment by LogMAR "E" screening chart. Participants with presenting visual acuity < 6/12 in any eye and all current spectacle users underwent detailed ophthalmic examination and refraction. Additional details about spectacles, barriers for their use and willingness to pay for them were collected. Participants with met and unmet need for spectacle use at visual acuity > 6/12 was computed. These are reported as proportions with 95% confidence intervals. Associated factors with unmet need were determined using bivariable and multivariable logistic regression analysis. RESULTS: A total of 6910 participants were examined. The current spectacle use was 7.5% (95% Confidence Interval CI: 6.5, 8.7). The spectacle coverage was found in 33.3% (95% CI: 30.0, 36.7) participants among those in need. The unmet need was found in 10.8% of participants (95% CI: 10.1, 11.6). On multivariable analysis, odds of unmet need was associated with age, gender, level of education and marriage status. The most common barrier for refractive correction was lack of perceived need for refraction and its correction. CONCLUSION: There is substantial unmet need for distance vision spectacles in this population. It is imperative that multi-component intervention be implemented to improve spectacle coverage in this rural north Indian setting.
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Anteojos/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Errores de Refracción/terapia , Población Rural/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Errores de Refracción/epidemiología , Distribución por Sexo , Pruebas de Visión , Agudeza Visual/fisiología , Adulto JovenRESUMEN
History of medicine is rich with the achievements and successes of years of research and development. The Medical Council of India incorporated teaching 'History of Medicine' in the undergraduate medical curriculum in India nearly a decade ago. Despite being included in the medical curriculum by the Medical Council of India, it is not yet a part of the teaching curriculum in the top-ranking medical institutions. Teaching 'History of Medicine' to undergraduate medical students may be a good divergence from the fact-based teaching of undergraduate medical curriculum. It will also help students cherish medical achievements of the past and inculcate in them a sense of pride and belongingness to the medical fraternity.
Asunto(s)
Curriculum/tendencias , Educación de Pregrado en Medicina/métodos , Historia de la Medicina , Educación de Pregrado en Medicina/tendencias , Humanos , India , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , EnseñanzaRESUMEN
Background: The National Programme for Control of Blindness and Visual Impairment modified the definition of blindness in 2017 in line with the internationally accepted definition. We did a systematic review and meta-analysis to compute pooled estimate of blindness in India among adults aged 50 years and above by using recent and old definitions of blindness. Methods: We retrieved population-based studies/surveys reporting the prevalence of blindness using recent (presenting vision <3/60 better eye) and previous (presenting vision <6/ 60 better eye) definitions in India during 1990-2017 from key search engines and grey literature. Two authors did an independent literature search and extracted relevant information. Pooled prevalence estimates were computed using Stata 12.0 by using the random effects model. Forest and funnel plots were generated. Stratification of results was also performed using two time periods: 1995-2005 and 2006-17. Results: A total of 18 published articles/reports were included for recent and 20 for previous definitions of blindness, involving 211 502 participants. The pooled prevalence (95% confidence interval [CI]) obtained for recent and previous definitions of blindness in India was found to be 6.11% (5.07%-7.14%) and 9.91% (8.57%-11.25%), respectively. The stratified pooled prevalence (95% CI) from rapid surveys was 4.81% (3.26%-6.35%) and 4.68% (2.91%-6.46%) for studies published during 1995-2005 and 2006-17, respectively, using the new definition. The corresponding figures for comprehensive surveys were 9.22% (95% CI 6.48%-11.96%) for the period 1995-2005 and 3.81% (95% CI 2.76%-4.84%) for the period 2006-17. Conclusion: There is a decrease in the prevalence of blindness in India using recent and previous definitions and a declining trend over time. High quantum of blindness remains an unfinished public health agenda for implementing programmes in larger populations to reduce its burden.