Prevalence of Second Hand Smoke Exposure and Measures to Overcome: A Cross Sectional Study among Youth in Urban Hyderabad.

ABSTRACT: In India, the prevalence of secondhand smoke (SHS) exposure is 29.5% in general and 11.2% at home. The youth may expose themselves to SHS without knowing the risk factors and consequences involved. This study is intended to determine the prevalence of SHS exposure and the measures adopted by the youth to avoid exposure. A cross-sectional study was conducted among 338 youth in an urban area in Hyderabad. A modified Global Youth Tobacco Survey questionnaire was used for data collection on SHS exposure and avoidance. The total prevalence of SHS exposure was 35.21%. The mean days of SHS exposure/week were 1.419 (standard deviation -1.806) days. Belonging to the age group 18-21 years, and male gender were significant predictors of SHS exposure. Education of the head of family was a significant predictor of SHS avoidance behavior. Creating awareness among young adults regarding the deleterious effects and preventive strategies of SHS exposure, thereby making them responsible for the health of their family can be a protective long-term strategy.

Pre-operative mapping and structured reporting of pelvic endometriotic lesions on dynamic ultrasound and its correlation on laparoscopy using the #ENZIAN classification.

PURPOSE: The objective of this study was to evaluate and compare the diagnostic performance of ultrasonography (USG) assessment using structured reporting with intraoperative laparoscopic assessment in deep infiltrating endometriosis (DIE) using the recent update of the #ENZIAN classification. METHODS: This was a retrospective study conducted in Tertiary Multi-disciplinary Endometriosis Care Hospital over a period of 8 months which included 50 patients who underwent a planned laparoscopic endometriosis excisional surgery after a dedicated USG assessment using International Deep Endometriosis Analysis (IDEA) protocol and #ENZIAN score (updated ENZIAN classification), between Feb 2021 and Sept 2021 at Apollo Hospitals, Hyderabad. The pre-operative USG findings were reported in a structured reporting format and intraoperative findings were classified using the standard #ENZIAN classification. No prospective interventions were done. A review of pre-operative ultrasound and laparoscopic findings as per the #ENZIAN was done. RESULTS: Sensitivity and the negative predictive value of ultrasound were 86% and 84.2% for peritoneal lesions, 97% and 93.3% for left ovarian lesions, 93% and 91.6% for right ovarian lesions, 91% and 84% for left tubal lesions, 90% and 86.3% for right tubal lesions, 93% and 75% for uterosacral ligaments, 93.3% and 97% for rectal lesions and sensitivity and negative predictive values were 100% for rectovaginal lesions, adenomyosis, and ureteric lesions as confirmed on laparoscopy. CONCLUSION: Dynamic ultrasound assessment with a structured report based on IDEA protocol and #ENZIAN score is accurate for mapping of pelvic endometriosis in all forms, and it correlates with laparoscopic findings, thus helps surgeon for better planning and providing a road map for surgeons. From a clinical perspective, a uniform and shared reporting system across imaging and therapeutic modalities will simplify communication, improving patient management by conservative or surgical treatments, avoiding multiple repeat surgeries, and improving quality of treatment.

Evaluation of the relative accuracy of anthropometric indicators to assess body fatness as measured by air displacement plethysmography in Indian women.

OBJECTIVE: To assess the relative accuracy of anthropometric indicators of body fatness or adiposity as compared to the percent fat measured by air displacement plethysmography in Indian women with normal body mass index (BMI). METHODS: Percent body fat was assessed using the BodPod in 58 women, aged 30-56 years. The relative accuracy of anthropometric indicators of body fatness like BMI, waist-stature-ratio (WSR), waist-thigh-ratio (WTR), waist-hip-ratio (WHR), and circumferences at arm, neck, chest, waist, hip, and thigh were tested using an ROC curve analysis. RESULTS: Seventy-nine percent women had excess body fat (≥30%). Among the 10 indicators tested, BMI and arm circumference (AC) demonstrated high accuracy (AUC > 0.9) to assess body fatness with derived cutoffs of 21.2 kg/m(2) and 24.2 cm, respectively. WSR and circumferences at neck, chest, waist, hip, and thigh showed moderate accuracy to assess body fatness, whereas WHR and WTR demonstrated poor accuracy. CONCLUSIONS: BMI and AC were the best performing indicators of adiposity among the indicators studied. AC, being a single measurement, is practical and a good choice. Am. J. Hum. Biol. 28:743-745, 2016. © 2016 Wiley Periodicals, Inc.

Trends in nutritional status and nutrient intakes and correlates of overweight/obesity among rural adult women (≥18-60 years) in India: National Nutrition Monitoring Bureau (NNMB) national surveys.

OBJECTIVE: To assess trends in nutrient intakes and nutritional status of rural adult women (≥18-60 years) and the association of sociodemographic characteristics with overweight/obesity. DESIGN: Community-based cross-sectional studies carried out during 1975-79 to 2011-12 by the National Nutrition Monitoring Bureau (NNMB) were used. Anthropometric measurements such as height, weight and waist circumference, carried out during the surveys, were used. Association and logistic regression analyses between sociodemographic characteristics and overweight/obesity and abdominal obesity were conducted using a complex samples procedure. SETTING: Ten NNMB states of India. SUBJECTS: Non-pregnant and non-lactating rural women aged ≥18-60 years covered during the above periods from ten states in India. RESULTS: The prevalence of chronic energy deficiency has declined from 52 % during 1975-79 to 34 % during 2011-12, while that of overweight/obesity has increased from 7 % to 24 % during the same period. Median intakes of most of the nutrients have increased over the same period, although they were below recommended levels. The chance of overweight/obesity and abdominal obesity was significantly (P<0·01) higher among women aged 40-60 years, those belonging to Christian religion and other backward communities, women living in pucca houses, literate women, women engaged in service and business, and those having higher per capita income. CONCLUSIONS: Prevalence of chronic energy deficiency has declined significantly; however, overweight/obesity has increased during the same period. This increase in overweight/obesity may be attributed to increased consumption of fatty foods, sedentary lifestyle and improved socio-economic status. There is a need to educate the community about regular physical exercise, low intakes of fats and oils, and a balanced diet.

Status of Vitamin B12 and Folate among the Urban Adult Population in South India.

BACKGROUND: Deficiency of vitamin B12 (B12) and folate (FA) leads to a wide spectrum of disorders that affect all age groups. However, reports on B12 and FA status in healthy adults in India are limited. Hence, we determined the plasma levels and dietary intake of B12 and FA in the adult population. METHODS: We conducted a community-based cross-sectional study in an urban setup among 630 apparently healthy adults distributed into 3 age groups: 21-40, 41-60 and >60 years. Plasma concentrations of B12 and FA were analyzed by radio immunoassay and dietary intake by 24-hour recall method. RESULTS: The overall prevalence of FA deficiency was 12%, but there was no significant difference in plasma FA concentrations among the groups. While the overall prevalence of B12 deficiency was 35%, it was significantly higher in the 21-40 (44%) and 41-60 age groups (40%) when compared with the >60 group (30%). B12 deficiency was higher in vegetarians (54%) compared to those consuming mixed diet (31%), and the reverse was the case with FA. However, the dietary intakes of FA and B12 were not significantly different among the groups. CONCLUSIONS: These results indicate a higher prevalence of B12 deficiency in apparently healthy adults in an urban setup.

Socio-economic & demographic determinants of hypertension & knowledge, practices & risk behaviour of tribals in India.

BACKGROUND & OBJECTIVES: An increase in prevalence of hypertension has been observed in all ethnic groups in India. The objective of the present study was to estimate prevalence and determinants of hypertension among tribals and their awareness, treatment practices and risk behaviours in nine States of India. METHODS: A community based cross-sectional study adopting multistage random sampling procedure was carried out. About 120 Integrated Tribal Development Authority villages were selected randomly from each State. From each village, 40 households were covered randomly. All men and women ≥ 20 yr of age in the selected households were included for various investigations. RESULTS: A total of 21141 men and 26260 women participated in the study. The prevalence of hypertension after age adjustment was 27.1 and 26.4 per cent among men and women, respectively. It was higher in the s0 tates of Odisha (50-54.4%) and Kerala (36.7-45%) and lowest in Gujarat (7-11.5%). The risk of hypertension was 6-8 times higher in elderly people and 2-3 times in 35-59 yr compared with 20-34 yr. Only <10 per cent of men and women were known hypertensives and more than half on treatment (55-68%). Men with general and abdominal obesity were at 1.69 (CI: 1.43-2.01) and 2.42 (CI: 2.01-2.91) times higher risk of hypertension, respectively, while it was 2.03 (CI=1.77-2.33) and 2.35 (CI 2.12-2.60) times higher in women. Those using tobacco and consuming alcohol were at a higher risk of hypertension compared with the non users. INTERPRETATION & CONCLUSIONS: The study revealed high prevalence of hypertension among tribals in India. Age, literacy, physical activity, consumption of tobacco, alcohol and obesity were significantly associated with hypertension. Awareness and knowledge about hypertension and health seeking behaviour were low. Appropriate intervention strategies need to be adopted to increase awareness and treatment practices of hypertension among tribals.

Assessment of malaria incidence using the Richards model in Arunachal Pradesh, India.

Monitoring of malaria intensity in terrain regions of Arunachal Pradesh, India is very difficult as the dynamics of mosquito populations varies to a large extent due to altitude and frequent changes in climatic conditions. There is a scarcity of information on the influence of climatic factors on malaria morbidity in Arunachal Pradesh. Hence, a pilot study was conducted from 2006 to 2010 to understand malaria transmission dynamics, seasonal distribution and disease morbidity. Plasmodium vivax and P. falciparum are the two major parasites for malaria transmission in Arunachal Pradesh. Out of 142 558 malaria cases analysed from 2006 to 2010, P. vivax infection contributed 72·1% followed by P. falciparum (27·9%). However, the overall morbidity of malaria declined from 37/1000 in 2006 to 18/1000 population in 2010. From this study it was observed that the temporal distribution of malaria cases varied between districts and high morbidity rates were reported mostly during the wet season. To understand malaria transmission dynamics in the study area, the Richards model was used to predict malaria cases. The output of the results from this model predicted a higher number of malaria cases (K) during 2006 and a gradual decline in subsequent years. Similarly, the growth rate r, and exponential deviation α, were almost identical for all the years, which shows that the Richards model is the most suitable model for the prediction of malaria cases.

Evaluation of vaginal pH for detection of bacterial vaginosis.

BACKGROUND & OBJECTIVES: Bacterial vaginosis (BV) is highly prevalent among women in reproductive age group. Little information exists on routine vaginal p H measurement in women with BV. We undertook this study to assess the utility of vaginal p H determination for initial evaluation of bacterial vaginosis. METHODS: In this cross-sectional study vaginal swabs were collected from women with complaints of white discharge, back ache and pain abdomen attending a government hospital and a community health clinic, and subjected to vaginal p H determination, Gram stain, wet mount and whiff test. Nugent score and Amsel criteria were used for BV confirmation. RESULTS: Of the 270 women included in the analysis, 154 had BV based on Nugents' score. The mean vaginal p H in women with BV measured by p H strips and p H glove was 5 and 4.9, respectively. The vaginal p H was significantly higher in women with BV. Vaginal discharge was prevalent in 84.8 per cent women, however, only 56.8 per cent of these actually had BV by Nugent score (NS). Presence of clue cells and positive whiff test were significant for BV. Vaginal p H >4.5 by p H strips and p H Glove had a sensitivity of 72 and 79 per cent and specificity of 60 and 53 per cent, respectively to detect BV. Among the combination criteria, clue cells and glove p H >4.5 had highest sensitivity and specificity to detect BV. INTERPRETATION & CONCLUSIONS: Vaginal p H determination is relatively sensitive, but less specific in detecting women with BV. Inclusion of whiff test along with p H test reduced the sensitivity, but improved specificity. Both, the p H strip and p H glove are equally suitable for screening women with BV on outpatient basis.

Influence of matrix metalloproteinase-1 gene -1607 (1G/2G) (rs1799750) promoter polymorphism on circulating levels of MMP-1 in chronic pancreatitis.

This study investigated the role of -1607 (1G/2G) (rs1799750) polymorphism of the MMP-1 gene in chronic pancreatitis. We genotyped 100 patients with chronic pancreatitis and 100 control subjects using tetra-primer ARMS-PCR followed by agarose gel electrophoresis. Serum levels of MMP-1 were determined by Elisa. Statistical analysis was applied to test the significance of the results. The genotypic and allelic distribution varied significantly between the disease group and the control subjects [OD = 1.981 (1.236-3.181), p = 0.004]. MMP-1 levels were higher in subjects homozygous for the 2G allele than in subjects with the 1G allele. The present study revealed a significant association of the MMP-1 -1607 1G/2G (rs1799750) gene promoter polymorphism with chronic pancreatitis, and it can be considered a biological marker in the etiology of chronic pancreatitis.

Do ACE I/D gene polymorphism serve as a predictive marker for age at onset in PCOS?

BACKGROUND: Polycystic ovary syndrome (PCOS) is an endocrine disorder exhibiting variable age at onset of clinical features allied with complex diseases in the later life. ACE is a pleiotropic molecule associated with various pathophysiological functions. The present study was aimed to establish the frequency of ACE I/D gene polymorphism in patients and controls and to assess the influence of this polymorphism on anthropometric and various clinical features of the condition. METHODS: ACE I/D genotyping was carried out in 259 PCOS patients and 315 healthy ultrasound scanned women of South Indian origin. RESULTS: The distribution of DD, ID and II genotypes in patients was 39, 37 and 24 %, whereas in the controls it was 31, 51 and 18 % respectively. Significant difference was observed in the genotypic frequency distributions between the patients and controls, however the allelic frequencies did not vary between the groups (p>0.05). Quartile analysis revealed preponderance of DD genotype in the first two quartiles and a linear increase of II genotype from first to the last quartiles. Further, Multiple Logistic regression analysis revealed significant association of ACE I/D gene polymorphism with acanthosis and age at onset (AAO) of the syndrome (p<0.05). CONCLUSION: The present study is the first report to highlight the predisposing role of DD and protective role of ID genotype towards PCOS. Patients with single or double dose of D allele may develop PCOS symptoms at an early age and also significantly associated with acanthosis, a marker of insulin resistance.

Impact of COVID-19 during pregnancy on placental pathology, maternal and neonatal outcome - A cross-sectional study on anemic term pregnant women from a tertiary care hospital in southern India.

Background: SARS-CoV-2 infection during pregnancy may cause adverse maternal, neonatal and placental outcomes. While tissue hypoxia is often reported in COVID-19 patients, pregnant women with anemia are suspected to be more prone to placental hypoxia-related injuries. Methods: This hospital-based cross-sectional study was conducted between August-November 2021, during COVID-19 second wave in India. Term pregnant women (N=212) admitted to hospital for delivery were enrolled consecutively. Since hospital admission mandated negative RT-PCR test for SARS-CoV-2 virus, none had active infection. Data on socio-demography, COVID-19 history, maternal, obstetric, and neonatal outcomes were recorded. Pre-delivery maternal and post-delivery cord blood samples were tested for hematological parameters and SARS-CoV-2 IgG. Placentae were studied for histology. Results: Of 212 women, 122 (58%) were seropositive for SARS-CoV-2 IgG, but none reported COVID-19 history; 134 (63.2%) were anemic. In seropositive women, hemoglobin (p=0.04), total WBC (p=0.009), lymphocytes (p=0.005) and neutrophils (p=0.02) were significantly higher, while ferritin was high, but not significant and neutrophils to lymphocytes (p=0.12) and platelets to lymphocytes ratios (p=0.03) were lower. Neonatal outcomes were similar. All RBC parameters and serum ferritin were significantly lower in anemic mothers but not in cord blood, except RDW that was significantly higher in both, maternal (p=0.007) and cord (p=0.008) blood from seropositive anemic group compared to other groups. Placental histology showed significant increase in villous hypervascularity (p=0.000), dilated villous capillaries (p=0.000), and syncytiotrophoblasts (p=0.02) in seropositive group, typically suggesting placental hypoxia. Maternal anemia was not associated with any histological parameters. Univariate and multivariate logistic regression analyses of placental histopathological adverse outcomes showed strong association with SARS-CoV-2 seropositivity but not with maternal anemia. When adjusted for several covariates, including anemia, SARS-CoV-2 seropositivity emerged as independent risk factor for severe chorangiosis (AOR 8.74, 95% CI 3.51-21.76, p<0.000), dilated blood vessels (AOR 12.74, 95% CI 5.46-29.75, p<0.000), syncytiotrophoblasts (AOR 2.86, 95% CI 1.36-5.99, p=0.005) and villus agglutination (AOR 9.27, 95% CI 3.68-23.32, p<0.000). Conclusion: Asymptomatic COVID-19 during pregnancy seemed to be associated with various abnormal placental histopathologic changes related to placental hypoxia independent of maternal anemia status. Our data supports an independent role of SARS-CoV-2 in causing placental hypoxia in pregnant women.

Effectiveness of vaginal tablets containing lactobacilli versus pH tablets on vaginal health and inflammatory cytokines: a randomized, double-blind study.

The purpose of this study was to evaluate the effectiveness of lactobacilli on vaginal health and proinflammatory cytokines. Sixty-seven patients with bacterial vaginosis (BV), 50 with intermediate flora and 42 with normal vaginal flora were enrolled in this double-blind study. The subjects were randomized to receive probiotic lactobacilli vaginal tablets (L. brevis CD2, L. salivarius subsp. salicinius, L. plantarum) or the vaginal pH tablet (active comparator). Cervico-vaginal lavage was collected to measure the concentrations of IL-1ß, TNFα and IL-6 by ELISA. Neutral sphingomyelinase activity was also quantified in both arms before and after treatment. The probiotic vaginal tablet was well tolerated and no side effects were reported. The study demonstrated a cure rate of nearly 80 %; i.e., 32 % of the women could restore normal vaginal flora and 47 % had improved Nugent score, whereas 20 % of the subjects did not clear BV in the first follow-up (after 8 days treatment). The pH tablet containing pH lowering compounds induced resolution of BV and restoration of normal vaginal flora in 74 % and 26 %, respectively. The lactobacilli tablet was found to be better than the pH tablet in preventing BV in healthy subjects. A significant reduction in IL-1ß and IL-6 vaginal cytokines was observed after treatment with lactobacilli, while the active comparator did not have any effect on local proinflammatory cytokines. Vaginal neutral sphingomyelinase activity was not modified in either group. Vaginal tablets containing lactobacilli can cure BV and reduce vaginal inflammatory response.

Correlation of Fat Mass Index and Fat-Free Mass Index with percentage body fat and their association with hypertension among urban South Indian adult men and women.

BACKGROUND: The assessment of Fat Mass and Fat-Free Mass indices provides valuable information about changes in body composition. AIM: To identify cut-off points for Fat Mass Index (FMI) to predict an upper limit of percentage body fat of men (25%) and women (30%) for defining obesity and its association with hypertension. SUBJECTS AND METHODS: A total of 436 men and 596 women were included in the study. Fat mass was calculated using skin-fold measurements. FMI cut-off points to predict an upper limit of percentage body fat of 25% (men) and 30% (women) for defining obesity were assessed using Receiver Operating Characteristic (ROC) curve analysis. RESULTS: ROC curve analysis indicated that the level of FMI was 6.59 kg/m(2) in men and 6.64 kg/m(2) in women at 25% and 30% body fat, respectively. Risk estimation for hypertension with FMI indicated high risk of hypertension in men (OR: 3.4, CI: 2.1-5.5) as well as in women (OR: 5.3, CI: 2.3-12.4). CONCLUSION: The level of FMI was 6.6 kg/m(2) in men and women predicted at upper limits of 25% and 30% body fat, respectively, for defining obesity.

Prevalence and determinants of undernutrition and its trends among pre-school tribal children of Maharashtra State, India.

A community-based cross-sectional study carried out in tribal areas of Maharashtra covering 1751 pre-school children to assess nutritional status. Nutritional status was assessed using new WHO Growth Standards. Household wealth index was constructed using principle component analysis. The prevalence of underweight, stunting and wasting was 64, 61 and 29%, respectively. There was a significant (p < 0.05) reduction in the prevalence of underweight and stunting over two time periods (1999 and 2008). Logistic regression showed that the risk of underweight was 1.7 times higher among children of illiterate mothers and those suffering from morbidities, while stunting was 1.4 times higher among children belonging to lowest and middle household's wealth indexes. Undernutrition is a public health problem and is associated with literacy of mother, household wealth index and morbidities. Therefore, improving socio-economic condition along with literacy of mothers and preventing infections through personal hygiene might help in improving the nutritional status of children.

Role of lifestyle variables on the lipid profile of selected South Indian subjects.

OBJECTIVE: To study the associations between diet, exercise. and the serum lipid profile. MATERIALS AND METHODS: Hospital based cross-sectional study. The study participants were selected through purposive sampling. The study participants comprised 316 men and women above 20 years of age from a disease-free cohort and included healthy subjects visiting the lifestyle clinic of CARE Hospitals, Hyderabad, India for health check-up. RESULTS: Among the participants of the study, 28.5% of the males and 42.2% of the females had hypercholesterolaemia. Body weight was significantly associated with total cholesterol and low-density lipoprotein (LDL) cholesterol. Of the subjects studied, males had a higher mean calorie and fat intake than the females. A positive association was observed between waist circumference and both total cholesterol and LDL cholesterol. Waist circumference was also positively correlated with systolic and diastolic blood pressure and triglycerides. There was a significant difference in the total cholesterol levels of subjects who exercised and those who were not involved in any physical activity. There was a significant difference between the high-density lipoprotein (HDL) cholesterol values of the subjects based on exercise levels. High-density lipoprotein cholesterol levels were significantly higher in males than in females and this is corroborated by the finding of increased exercise levels in males. Duration of exercise had a significant impact on the total cholesterol levels. CONCLUSION: Our results confirm that diet and exercise routines significantly affect the serum lipid profile. Obesity and overweight constitute a risk factor for the development of hypercholesterolaemia and hypertriglyceridaemia.

Association of tumor necrosis factor-α and matrix metalloproteinase-3 gene variants with stroke.

BACKGROUND AND PURPOSE: There is increasing evidence that the genetic variation in the genes coding for pro-inflammatory markers and matrix metalloproteinase may play an important role in the pathogenesis of various human diseases including stroke. The aim of this study was to evaluate the association of genetic variants within the genes encoding tumor necrosis factor-α (TNF-α) and matrix metalloproteinase-3 (MMP-3), with stroke. METHODS: Five hundred and twenty-five ischemic stroke patients and 500 age- and sex-matched controls were included in this study. We analyzed +488 G/A polymorphism in TNF-α gene and -1612 5A/6A polymorphism in MMP-3 gene. The genotypes were determined by Amplification Refractory Mutation System PCR. The strength of association between genotypes and stroke was measured by the odds ratio with 95% confidence interval (CI) and chi-squared analysis. RESULTS: Allelic and genotypic frequencies of TNF-α G/A polymorphism differed significantly between patients and healthy controls (P < 0.001). A stepwise logistic regression analysis confirmed these findings (P < 0.001). Further, evaluating the association of this polymorphism with stroke subtypes, we found significant association with intracranial large artery atherosclerosis, extracranial large artery atherosclerosis, and stroke of undetermined etiology. As far as MMP-3-1612 5A/6A polymorphism is concerned, there was no significant difference in genotypic distribution and allelic frequency between the patients and healthy controls (P = 0.5 and 0.9, respectively). We tested the gene-gene interaction between TNF-α and MMP-3 genes using the logistic regression model. However, there was no evidence for a gene-gene interaction between TNF-α and MMP-3. CONCLUSION: TNF-α +488 G/A variant is an important risk factor for ischemic stroke in the South Indians from Andhra Pradesh, whereas MMP-3-1612 5A/6A polymorphism is not associated with stroke in the same population.

Micronutrient deficiency disorders among the rural children of West Bengal, India.

BACKGROUND: Multiple micronutrient deficiencies continue to be a major nutritional problem of public health significance in India. AIM: To assess the prevalence of micronutrient deficiencies among rural children of West Bengal, India. SUBJECTS AND METHODS: A community-based cross-sectional study was carried out on 9228 and 437 pre-school children, respectively, for assessment of vitamin A deficiency (VAD) and anaemia. Iodine deficiency disorders (IDD) were assessed in 3490 children of 6-12 years. RESULTS: The prevalence of Bitot's spots, an objective sign of clinical VAD, was 0.6% and was significantly (p < 0.01) higher among children of 3-5 years. Prevalence of blood vitamin A deficiency ( < 20 µg/dL) was 61% and ∼81% of children were anaemic. About 25% children had both sub-clinical VAD and anaemia. The children of Scheduled Caste and Scheduled Tribe (OR = 2.3: 95% CI = 1.3-3.9) were at higher risk of anaemia, whereas children of Scheduled Tribe (OR = 4.5; 95% CI = 2.1-10.5) and 3-5 years (OR = 1.4; 95% CI = 1.0-2.0) were at risk for VAD. The prevalence of goitre was 9%. CONCLUSIONS: Micronutrient deficiencies were found to be of public health significance among rural children of West Bengal. Therefore, there is a need to initiate sustainable long-term interventions for prevention and control of micronutrient deficiencies in children.

Prevalence of vitamin A deficiency and its determinants among the rural pre-school children of Madhya Pradesh, India.

BACKGROUND: Vitamin A deficiency (VAD) continues to be a major public health nutritional problem in India, even though the National Vitamin A Prophylaxis Programme has been in operation for more than three decades. AIM: To assess the prevalence of vitamin A deficiency among rural pre-school children. SUBJECTS AND METHODS: A community-based cross-sectional study was carried out in rural Madhya Pradesh. A total of 8777 pre-school children were clinically examined for VAD and blood vitamin A levels were estimated in a sub-sample by dried blood spot method. RESULTS: Prevalence of night blindness and Bitot's spot, an objective sign of VAD, was 0.8% and 1.4%, respectively, and prevalence increased significantly (p < 0.001) with age. The proportion of children with blood vitamin A deficiency ( < 20 µg/dL) was 88% (95% CI: 84.8-91.2).The prevalence of Bitot's spot was significantly (p < 0.001) higher among children of lower socio-economic communities, 3-5-year age group and those of illiterate mothers. CONCLUSIONS: VAD is a major public health problem among rural children of Madhya Pradesh. Children of 3-5 years and those belonging to lower socio-economic communities are at high risk of VAD. Therefore, appropriate intervention measures are to be initiated to improve the vitamin A status of children.

Carotenoid status in type 2 diabetes patients with and without retinopathy.

Diabetic retinopathy (DR) is one of the leading causes of blindness. Carotenoids are plant-derived pigments required for general health and particularly for vision. In this study, we evaluated the dietary intake and blood carotenoid levels of type 2 diabetes (T2D) patients with and without DR. A cross-sectional case-control study was conducted among 151 age-matched controls and 344 T2D patients, of which 194 had DR and 150 had no DR (NDR). After a complete ophthalmic examination, the demographic, anthropometric and clinical profiles were obtained. Carotenoids in the plasma were measured by HPLC and dietary intakes were obtained using a food frequency questionnaire. The mean plasma levels of carotenoids (except γ-carotene) were significantly lower in the DR group compared to the Control and NDR groups. The dietary intakes of zeaxanthin, lycopene, α-carotene and ß-carotene were significantly lower in the NDR group compared to the Control group, and were further lower in the DR group compared to the NDR group. Plasma carotenoid levels were significantly inversely associated with the duration of diabetes, RBS and HbA1c but positively associated with HDL. This study demonstrated decreased plasma levels and lower dietary intakes of carotenoids in DR subjects.