Potential contribution of monoamine oxidase a gene variants in ADHD and behavioral co-morbidities: scenario in eastern Indian probands.

Attention deficit hyperactivity disorder (ADHD) is the most frequently diagnosed behavioral disorder in children with a high frequency of co-morbid conditions like conduct disorder (CD) and oppositional defiant disorder (ODD). These traits are controlled by neurotransmitters like dopamine, serotonin and norepinephrine. Monoamine oxidase A (MAOA), a mitochondrial enzyme involved in the degradation of amines, has been reported to be associated with aggression, impulsivity, depression, and mood changes. We hypothesized that MAOA can have a potential role in ADHD associated CD/ODD and analyzed 24 markers in a group of Indo-Caucasoid subjects. ADHD probands and controls (N = 150 each) matched for ethnicity and gender were recruited following the Diagnostic and Statistical Manual for Mental Disorders-IV. Appropriate scales were used for measuring CD and ODD traits. Markers were genotyped by PCR-based methods and data obtained analyzed using the Cocaphase program under UNPHASED. Only eight markers were found to be polymorphic. rs6323 "G" allele showed higher frequencies in ADHD (P = 0.0023), ADHD + CD (P = 0.03) and ADHD + ODD (P = 0.01) as compared to controls. Haplotype analysis revealed statistically significant difference for three haplotypes in ADHD cases (P < 0.02). Statistically significant differences were also noticed for haplotypes in ADHD + CD and ADHD + ODD cases (P < 0.01). LD analysis showed significant variation in different groups. Multidimensionality reduction analysis showed independent as well as interactive effects of markers. Genotypes showed correlation with behavioral problems in ADHD and ADHD + CD. We interpret that MAOA gene variants may contribute to the etiology of ADHD as well as associated co-morbid CD and ODD in this ethnic group.

The prevalence of low vision and blindness in a Canadian inner city.

PURPOSE: To ascertain the prevalence and primary causes of visual impairment in a sample of patients from Vancouver's downtown eastside (VDES). MATERIALS AND METHODS: A total of 200 patients seeking nonophthalmic medical care at the Vancouver Native Health Society (VNHS) clinic in Vancouver's inner city (downtown eastside) participated in this observational case-series study. For each participant, we obtained demographic information, a medical and ocular history, and performed a complete eye exam. The prevalence of visual disability using standard North American criteria was reported. Causes of visual loss were also reported based on Canadian National Institute for the Blind (CNIB) guidelines. RESULTS: A total of 200 patients participated in our study. The median age of our sample was 46 years, 69% were male. There were very high rates of comorbid medical conditions including HIV, Hepatitis B/C, IV drug use, and diabetes. The raw prevalence of visual disability based on best-corrected visual acuity (BCVA) was 500 per 10,000; this was over nine times greater than in the general Canadian population. The raw prevalence rate of 'presenting visual disability' based on presenting visual acuity (PVA) was 2400 per 10,000. Major causes of visual disability were cataract and retinal disease. Although age-related macular degeneration and diabetic retinopathy represent major causes of vision loss in North America, no cases were noted in our sample. CONCLUSION: The overall prevalence of visual disability was alarmingly high in this disadvantaged community. These results identify both ophthalmic disease and access to refraction and prescription spectacles as a significant health concern among people living in the VDES.

Demographic effect consequent upon change in age pattern of marriage: an Indian example.

PIP: Marital status composition of a population is influenced by socioeconomic as well as political, religious, cultural and regional factors, but demographic factors such as mortality and marriage patterns play an important role in modifying that composition and consequent effect on fertility. This paper attempts to isolate the influence of mortality and marriage pattern on marital status distribution using 2 alternative models, 1 where the marriage pattern is constant and mortality changes and the 2nd where both marriage pattern and mortality are changing. Projections have been made of the never married and currently married female population of West Bengal based on these alternative models. Results show an initial decline in fertility because of changes in number married in earlier age groups in both projections, with the decline relatively higher in the 2nd. After 25 years the % reduction in fertility would be 1.8 and 12.2 respectively.^ieng

Rural-urban mortality differential in Indian states: effect of environmental inequality and associated factors.

PIP: Differential mortality in five Indian states is analyzed by means of multiple and partial correlation analyses using official data from various sources. The author investigates the extent to which rural-urban mortality differentials are explained by environmental factors, along with related socioeconomic variables such as literacy, housing, and medical facilities. It is recommended that development programs should include large expenditures on general education and health education in order to reduce mortality in the least privileged areas.^ieng