A Review of Risk Factors for Non-Communicable Diseases Among Bus Drivers

A significant threat among the developing countries towards health and development in the current era is attributed by non-communicable diseases. These diseases contribute to major portion of morbidity and mortality globally. It has been predicted that with such an alarming rise in these cases, NCDs will ex-ceed communicable, maternal, perinatal, and nutritional disease as the common causes of death by 2030. Without any action towards this menace the burden of these diseases will continue to escalate over-whelming our capacity to address them. Metropolitan drivers are a group of people who spend their ma-jority of time in a polluted, noisy and a dangerous workplace. With the very few data on the predisposing risk factors among this population, this review helps us identifying such factors among the drivers which can help in formulating new policies and improve their health.

Visual Inspection with Acetic Acid (VIA) & Pap smear positivity rates according to socio demographic factors amongst rural married women

Background: Cervical cytology which is a standard screening tool in developed countries fails as a screening method in low-resource countries due to financial and technical constraints. Objective: To determine the prevalence of pre-malignant lesions of the cervix by VIA and Pap smear test among rural married women and to find out association of socio demographic factors with positive screening test results. Material & Methods: A community based cross-sectional study was carried out among rural married women in the field practice area. A pre-designed questionnaire was administered to collect information from 550 women. Results: The VIA and Pap smear tests were positive among 5.5% and 3.6%study subjects respectively. Pap smear test result presented with pre-cancerous lesions such as atypical squamous cell of undifferentiated significance (ASCUS)16 (2.90%), low grade squamous intraepithelial lesions (LSIL) 2 (0.36%) and high grade squamous intraepithelial lesions (HSIL) 2 (0.36%). The VIA & Pap smear positivity rate was found to be more in the age group of ≥40 years, Hindu, education above intermediate class, joint family and, upper & lower socio-economic status respectively. Conclusion: The prevalence of pre-malignant lesions of the cervix by VIA test was 5.5 % while 3.6% pre-malignant lesion was detected by Pap smear method.

Community perspectives on alcohol use among a tribal population in rural southern India.

Background. Alcohol use is common in many cultures. Excessive use of alcohol adversely impacts individuals, families and communities. Medicine, which uses biomedical models and perspectives, views alcohol dependence as a disease. Alcohol use and dependence are complex societal problems, which need to be viewed through multidisciplinary approaches and corrected by adopting intersectoral efforts involving local communities. Methods. We used qualitative methods such as focus group discussions and in-depth interviews to document perspectives on alcohol use among a tribal community in southern India. We recorded traditional norms, changing patterns of use of alcohol and its consequences for individuals, families and the community. Results. Eight focus group discussions and eleven in-depth interviews were conducted. Though consumption of alcohol is part of the local culture, changes in occupation and availability of alcohol has made its consumption a problem. The introduction and easy availability of Indian-made foreign liquor, which is stronger than the locally brewed variety, in government-run outlets has changed the culture of drinking at festivals to drinking more often. This leads to public fights, domestic violence and increasing mortality and morbidity due to road traffic incidents and ill health. The age of initiation into drinking has decreased. Conclusion. The introduction of non-traditional and commercial alcohol use has put a heavy price on tribal and rural people. Community-based interventions targeting young children and adolescents may pay more dividends than pursuing purely medical treatments for problem drinkers.

Cytokine gene polymorphism (interleukin-1β +3954, Interleukin-6 [−597/−174] and tumor necrosis factor-α −308) in chronic periodontitis with and without type 2 diabetes mellitus.

Background: Pro-inflammatory cytokine gene polymorphisms are potential candidates for susceptibility for both type 2 diabetes mellitus (DM) and chronic periodontitis (CHP). This study explored the association of interleukin‑1 beta (IL‑1 β) +3954, interleukin‑6 (IL‑6) −597/−174 and tumor necrosis factor‑alpha (TNF‑α) −308 single nucleotide polymorphisms in CHP with and without type 2 DM in Malayalam speaking subjects of Dravidian ethnicity. Materials and Methods: This case control study consisted of 51 chronic periodontitis with type 2 diabetes mellitus (CHPDM) and 51 CHP patients as cases and 51 healthy subjects as controls. Polymorphisms were identified by polymerase chain reaction amplification followed by restriction enzyme digestion and gel electrophoresis. Results: IL‑1 β (+3954) TT genotype and T allele were significantly associated with CHPDM group when compared with CHP (P = 0.001), whereas CC genotype and allele C was higher in CHP subjects (P = 0.001). For IL‑6 (−597) frequency of genotype GA/AA (P = 0.04) and allele A (P = 0.01) was lower in CHPDM group, and for TNF‑α −308 the frequency of genotype GA (P = 0.01) and allele A (P = 0.01) was higher in CHP subjects when compared with controls. Conclusions: In Malayalam speaking Dravidian population, IL‑6 (−597) genotype GA/AA and allele A appears to be protective for CHP with type 2 DM. Allele C of IL‑1 β +3954 and allele A of TNF‑α −308 appears to be risk factors for CHP individuals.

Association of interleukin-4 and interleukin-17F polymorphisms in periodontitis in Dravidian ethnicity.

BACKGROUND: Complex network of pro and anti-inflammatory cytokines are known to act in inflamed periodontal tissue. This study explores the distribution of interleukin (IL)-4 (+33 C/T) and IL-17F (7383A/G, 7488A/G) gene polymorphism in chronic and aggressive periodontitis subjects of Dravidian ethnicity. MATERIALS AND METHODS: This case control study consisted of 124 periodontitis individuals comprising of 63 chronic and 61 aggressive periodontitis subjects as cases, and control group consisted of 101 healthy subjects. All subjects were genotyped for IL-4 + 33C/T, IL-17F 7383A/G, 7488A/G by polymerase chain reaction amplification followed by TaqMan assay for IL-4 + 33C/T, restriction enzyme digestion and gel electrophoresis for IL-17F 7383A/G and sequencing for IL-17F 7488A/G. RESULTS: IL-4 + 33C/T was significantly associated with periodontitis (P < 0.05) at both allelic and genotypic level. In subgroup analysis also significant difference (P < 0.05) in allelic distribution between aggressive periodontitis and control group for loci IL-4 + 33C/T was noted. However, there was a lack of association between IL-17F 7383A/G and IL-17F 7488A/G with periodontitis and its sub-groups at both allelic and genotypic levels. CONCLUSIONS: In Malayalam speaking Dravidian population IL-4 + 33C/T loci appears to be an important risk factor for periodontal disease with a leaning towards aggressive periodontitis. The association between IL-17F at 7383A/G and 7488A/G loci with either chronic or an aggressive periodontitis could not be ascertained.

Cancer and AIDS.

The occurrence of cancer as an AIDS defined disease is a subject that has received scant attention in the Indian medical establishments and lay public. It is important to know that the concept of acquired immunodeficiency syndrome was ushered in with reports of rare forms of cancers in HIV infected subjects. In the developed countries 34% of AIDS patients suffer from cancer, a cancer that is very aggressive, resistant to treatment and often fatal. On the other hand, incidence of cancer in patients infected with HIV virus is only 3%-4% in the Indian population. Nearly all patients with AIDS in India are victims of tuberculosis and opportunistic infections. Among the various cancers reported in the Indian population Kaposi's sarcoma is very rare indeed. AIDS associated malignant tumours tend to be more anaplastic and disseminate fairly early. The object of this review is to increase awareness of the various aspects of cancer and AIDS. There is an urgent need to improve gathering of epidemiological data and to direct research effort to explain a very strikingly low incidence of cancers in Indian subjects as compared to that in the West (prevalence of 4% versus 34% among HIV infected patients).

Incident HIV infection among men attending STD clinics in Pune, India: pathways to disparity and interventions to enhance equity.

Systematic disparities in rates of HIV incidence by socioeconomic status were assessed among men attending three sexually transmitted disease (STD) clinics in Pune, India, to identify key policy-intervention points to increase health equity. Measures of socioeconomic status included level of education, family income, and occupation. From 1993 to 2000, 2,260 HIV-uninfected men who consented to participate in the study were followed on a quarterly basis. Proportional hazards regression analysis of incident HIV infection identified a statistically significant interaction between level of education and genital ulcer disease. Compared to the lowest-risk men without genital ulcer disease who completed high school, the relative risk (RR) for acquisition of HIV was 7.02 (p < 0.001) for illiterate men with genital ulcer disease, 3.62 (p < 0.001) for men with some education and genital ulcer disease, and 3.02 (p < 0.001) for men who completed high school and had genital ulcer disease. For men with no genital ulcer disease and those with no education RR was 1.09 (p = 0.84), and for men with primary/middle school it was 1.70 (p = 0.03). The study provides evidence that by enhancing access to treatment and interventions that include counselling, education, and provision of condoms for prevention of STDs, especially genital ulcer disease, among disadvantaged men, the disparity in rates of HIV incidence could be lessened considerably. Nevertheless, given the same level of knowledge on AIDS, the same level of risk behaviour, and the same level of biological co-factors, the most disadvantaged men still have higher rates of HIV incidence.