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Impacts of river discharge on coastal ocean processes are multi-dimensional. Studies on sinking particle fluxes, composition and their seasonal variability in coastal oceans are very limited. In this study, we investigated the impact of river discharge on seasonal variability in sinking fluxes of total mass, biogenic and lithogenic material in a river-dominated continental margin, western coastal Bay of Bengal. Higher POC, lithogenic and total mass fluxes were found during early southwest monsoon, and are decoupled with peak river discharge and elevated primary production. It is attributed to cross-shelf transport of re-suspended surface sediments from shelf region. Peak river discharge followed by elevated chlorophyll-a suggest nutrients supply though river discharge support primary production. Elemental C:N ratios, δ13C and δ15N results likely suggest that both marine and terrestrial sources contributed to sinking POM, . Overall, higher sinking fluxes during southwest monsoon than rest of the year suggest that seasonal river discharge exerts considerable impact on sinking fluxes in the western coastal Bay of Bengal.
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Bahías , Material Particulado , Monitoreo del Ambiente/métodos , Sedimentos Geológicos , Ríos , Carbono/análisisRESUMEN
Recently, everolimus (Evl) has been introduced in the management of hormone receptor-positive metastatic breast cancer, in combination with aromatase inhibitors. Evl-induced acute kidney injury has hitherto been described in other malignancies, especially renal cell cancer, but only once before in a patient with breast cancer. We describe two cases of Evl-associated nephrotoxicity in patients with breast cancer, one of whom underwent a renal biopsy showing acute tubular necrosis. Both our patients improved after withdrawal of the offending agent and have normal renal functions on follow-up.
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CONTEXT: It is common practice to unravel signs of possible cardiac ischemia by exposing the heart to graded degrees of exercise stress on treadmill under close monitoring and terminating it at safe limit. The safe limit of exercise duration and intensity is based on subjects who report a sense of exhaustion or appearance of any defined adverse sign whichever is earlier. Commonly, endurance is determined by subjective perception of distress leading to discontinuation of exercise. AIM: Scope of favourable manipulation of perception of stress was evaluated to extend the duration of exercise, and thereby the endurance. MATERIALS AND METHODS: The indices of endurance such as duration of exercise, the distance covered and equivalents of O2 consumption (METs) as well as Cardiovascular adaptational changes of 30 young healthy male medical students are compared between two sets of conditions; {1} Routine treadmill exercise without intervention (Mode A) and later {2} same exercise repeated with individualized musical experience to favourably distract the perception of stress (Mode B). RESULT: It has been conclusively demonstrated that perceptual modification of stress in Mode B caused significant improvement in endurance profiles, reflected by sustenance of longer duration of exercise, correspondingly greater cumulative distance covered and greater METs. Cardiovascular parameters of heart rate and blood pressure rise are comparatively less in Mode B, though not significant. The extent of cardiac stress evaluated by Rate-Pressure (R-P) product is also lesser spite of longer duration of exercise, pointing to better cardiovascular adaptational changes under states of perceptual modification (Mode B). CONCLUSION: Its relevance to day-to-day physical activities including exercise is obviously to make them enjoyable, rather than monotonous, for maximal benefit to health and endurance.
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Glucagon receptor (GCGR) is a secretin-like (class B) family of G-protein coupled receptors (GPCRs) in humans that plays an important role in elevating the glucose concentration in blood and has thus become one of the promising therapeutic targets for treatment of type 2 diabetes mellitus. GCGR based inhibitors for the treatment of type 2 diabetes are either glucagon neutralizers or small molecular antagonists. Management of diabetes without any side effects is still a challenge to the medical system, and the search for a new and effective natural GCGR antagonist is an important area for the treatment of type 2 diabetes. In the present study, a number of natural compounds containing antidiabetic properties were selected from the literature and their binding potential against GCGR was determined using molecular docking and other in silico approaches. Among all selected natural compounds, curcumin was found to be the most effective compound against GCGR followed by amorfrutin 1 and 4-hydroxyderricin. These compounds were rescored to confirm the accuracy of binding using another scoring function (x-score). The final conclusions were drawn based on the results obtained from the GOLD and x-score. Further experiments were conducted to identify the atomic level interactions of selected compounds with GCGR.
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BACKGROUND: Dentinal hypersensitivity is a common problem and there is a growing interest in herbal based formulations for the treatment of oral diseases. This study was conducted to assess the efficacy of a commercially available novel herbal dentifrice in reduction of dentinal hypersensitivity. METHODS: A total of 73 subjects (38 males and 35 females; aged 25-60 years) were randomly divided into two groups: Group 1 - a placebo dentifrice (The Himalaya Drug Company Research and Development, Makali, Bangalore) and Group 2 - (test group), a commercially available herbal dentifrice (Hi Ora K, The Himalaya Drug Company Research and Development, Makali, Bangalore). Sensitivity scores for controlled air stimulus and cold water were recorded at baseline, 6 weeks and 12 weeks. RESULTS: The test group was found to be significantly better compared to the placebo group at the end of 6 and 12 weeks in reduction of dentinal hypersensitivity. CONCLUSIONS: The novel herbal dentifrice can be recommended for treatment of dentinal hypersensitivity.
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Dentífricos/uso terapéutico , Sensibilidad de la Dentina/tratamiento farmacológico , Nitratos/uso terapéutico , Fitoterapia/métodos , Compuestos de Potasio/uso terapéutico , Spinacia oleracea/química , Adulto , Aire , Alquenos/química , Cinnamomum zeylanicum/química , Método Doble Ciego , Femenino , Humanos , India , Masculino , Persona de Mediana Edad , Piperidinas/química , Extractos Vegetales/química , Syzygium/química , Agua , Óxido de Zinc/uso terapéuticoRESUMEN
BACKGROUND: Simvastatin (SMV) is a specific competitive inhibitor of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. Statins have recently been shown to promote bone formation. This study was designed to investigate the effectiveness of SMV 1.2% in an indigenously prepared biodegradable controlled release gel as an adjunct to scaling and root planing (SRP) in the treatment of smokers with chronic periodontitis. METHODS: Forty patients were categorized into two treatment groups: SRP plus SMV 1.2% and SRP plus placebo. Clinical parameters were recorded at baseline and at 3, 6 and 9 months; they included modified sulcus bleeding index (mSBI), probing depth (PD) and clinical attachment level (CAL). At baseline, after 6 months and 9 months, radiologic assessment of intrabony defect (IBD) fill was done using computer-aided software. RESULTS: Mean probing depth reduction and mean clinical attachment level gain was greater in the SMV group than the placebo group at all visits. Furthermore, significantly greater mean percentage of bone fill was found in the SMV group (32.37 ± 10.23%) compared to the placebo (4.18 ± 5.39%). CONCLUSIONS: There was a greater decrease in mSBI and PD and more CAL gain with significant IBD fill at sites treated with SRP plus locally delivered SMV in smokers with chronic periodontitis.
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Pérdida de Hueso Alveolar/prevención & control , Conservadores de la Densidad Ósea/administración & dosificación , Periodontitis Crónica/terapia , Raspado Dental , Índice Periodontal , Simvastatina/administración & dosificación , Fumar/efectos adversos , Adulto , Quimioterapia Adyuvante , Preparaciones de Acción Retardada , Geles , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Masculino , Persona de Mediana Edad , Aplanamiento de la RaízRESUMEN
BACKGROUND: Along with conventional periodontal surgical therapy, local delivery of antibiotics may provide more effective treatment in smokers by targeting tissue-invasive bacteria. The aim of this randomized, placebo-controlled, double-masked clinical trial was to evaluate the adjunctive effects of subgingivally delivered 0.5% azithromycin (AZM) as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis in smokers. METHODS: Fifty-four patients were randomized and categorized into two treatment groups: Group 1 - 26 subjects who received (SRP) plus placebo gel and Group 2 - 28 subjects who received (SRP) plus 0.5% azithromycin. Clinical parameters were recorded at baseline, 3, 6 and 9 months. They included Plaque Index (PI), modified Sulcus Bleeding Index (mSBI), probing depth (PD) and clinical attachment level (CAL). RESULTS: Azithromycin resulted in significant improvements. A single application of AZM resulted in attachment gain at 9 months of 2.44 ± 0.64 mm as compared to 0.18 ± 0.68 mm for the placebo. Similarly, pocket depth and PI were significantly reduced but no change in the mSBI was noted. CONCLUSIONS: When compared to the placebo, the adjunctive use of 0.5% AZM resulted in significant improvement in clinical outcome in the treatment of chronic periodontitis among smokers.
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Antibacterianos/administración & dosificación , Azitromicina/administración & dosificación , Periodontitis Crónica/terapia , Fumar , Administración Oral , Quimioterapia Adyuvante/métodos , Raspado Dental/métodos , Método Doble Ciego , Femenino , Estudios de Seguimiento , Geles , Humanos , Masculino , Índice Periodontal , Aplanamiento de la Raíz/métodos , Resultado del TratamientoRESUMEN
AIM: The primary aim was to study the effect of naturopathy and yoga interventions in treatment of mild to moderate hypertension. DESIGN: The variables of interest were measured at the beginning and end of the intervention using a pre-post design. SETTING: The study was conducted by INYS medical research society in Jindal Nature Cure Institute, Bangalore. SUBJECTS: A total of 104 subjects, already diagnosed with mild to moderate hypertension and on treatment with antihypertensive medicines were included in study. INTERVENTIONS: The intervention consisted of various inpatient administration of different naturopathy treatments, yoga therapies, low calorie and low sodium diet for 21 days. Antihypertensive medicines were withdrawn for some patients in one week based upon response to the treatment. OUTCOME MEASURES: The outcome measures were values of diastolic and systolic blood pressure and body weight. Subjects were followed for a period of one year after every 3 months. RESULTS: After starting nonpharmacological approach of naturopathy and yoga, Systolic blood pressure came down from mean of 139.6 to 129.6 where as it came down from 91.2 to 86.1 for diastolic blood pressure. At the same time favorable effect was also seen in other variables like lipid profile and body weight. At the end of one year out of 57 patients who came for follow-up, 14 cases were found to have blood pressure within normal ranges without any medication over the previous 12 months. CONCLUSION: Naturopathy and yoga therapy can be considered as a valuable nonpharmacological approach in treatment of hypertension.
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Presión Sanguínea , Hipertensión/terapia , Lípidos/sangre , Naturopatía , Yoga , Antihipertensivos/uso terapéutico , Peso Corporal , Restricción Calórica , Dieta Hiposódica , Humanos , Hipertensión/sangre , Hipertensión/fisiopatología , Estilo de Vida , Resultado del TratamientoRESUMEN
A novel three-layer microfluidic polydimethylsiloxane (PDMS) device was constructed with two fluid chambers that holds a brain slice in place with microposts while maintaining laminar perfusate flow above and below the slice. Our fabrication technique permits rapid production of PDMS layers that can be applied to brain slices of different shapes and sizes. In this study, the device was designed to fit the shape and thickness (530-700 microm) of a medullary brain slice taken from P0-P4 neonatal rats. Medullary slices in this chamber spontaneously produced rhythmic, respiratory-related motor output for up to 3 h, thereby demonstrating that brain slice viability was maintained for prolonged periods. This design is unique in that it achieves independent control of fluids through multiple channels in two separate fluid chambers. The laminar flow exhibited by the microfluidic chamber allows controlled solutions to target specific areas of the brain slice based on the input flow rates. To demonstrate this capability, a stream of Na(+)-free solution was focused on one half of a medullary slice to abolish spontaneous neural activity in only that half of the brain slice, while the other half remained active. We also demonstrated that flow of different solutions can be focused over the midline of the brain slice. The multilayer brain slice chamber design can integrate several traditional types of electrophysiology tools that are commonly used to measure neurophysiological properties of brain slices. Thus, this new microfluidic chamber is advantageous for experiments that involve controlled drug or solution delivery at high spatiotemporal resolution.
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Encéfalo/patología , Dimetilpolisiloxanos/química , Técnicas Analíticas Microfluídicas/instrumentación , Microfluídica , Siliconas/química , Animales , Simulación por Computador , Electrodos , Electrofisiología , Modelos Teóricos , Perfusión , Ratas , Ratas Sprague-Dawley , Factores de TiempoRESUMEN
OBJECTIVE: Human rabies has been endemic in India since time immemorial, and the true incidence of the disease and nationwide epidemiological factors have never been studied. The main objectives of the present study were to estimate the annual incidence of human rabies in India based on a community survey and to describe its salient epidemiological features. METHODS: The Association for Prevention and Control of Rabies in India (APCRI) conducted a national multi-center survey with the help of 21 medical schools during the period February-August 2003. This community-based survey covered a representative population of 10.8 million in mainland India. Hospital-based data were also obtained from the 22 infectious diseases hospitals. A separate survey of the islands of Andaman, Nicobar, and Lakshadweep, reported to be free from rabies, was also undertaken. RESULTS: The annual incidence of human rabies was estimated to be 17,137 (95% CI 14,109-20,165). Based on expert group advice, an additional 20% was added to this to include paralytic/atypical forms of rabies, providing an estimate of 20,565 or about 2 per 100000 population. The majority of the victims were male, adult, from rural areas, and unvaccinated. The main animals responsible for bites were dogs (96.2%), most of which were stray. The most common bite sites were the extremities. The disease incubation period ranged from two weeks to six months. Hydrophobia was the predominant clinical feature. Many of the victims had resorted to indigenous forms of treatment following animal bite, and only about half of them had sought hospital attention. Approximately 10% of these patients had taken a partial course of either Semple or a cell culture vaccine. The islands of Andaman, Nicobar, and Lakshadweep were found to be free of rabies. CONCLUSION: Human rabies continues to be endemic in India except for the islands of Andaman, Nicobar, and Lakshadweep. Dogs continue to be the principal reservoir. The disease is taking its toll on adult men and children, the majority from rural areas, due to lack of awareness about proper post-exposure immunization. The keys to success in the further reduction of rabies in India lies in improved coverage with modern rabies vaccines, canine rabies control, and intensifying public education about the disease.
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Rabia/epidemiología , Adolescente , Adulto , Recolección de Datos/métodos , Enfermedades Endémicas , Femenino , Humanos , Incidencia , India/epidemiología , Masculino , Población Rural , Población UrbanaRESUMEN
This was a WHO sponsored national multi-centric rabies survey and one of its objectives was to find out the incidence of animal bites, anti-rabies treatment practices, Pet dog population and their care. Twenty-one medical colleges chosen with geoscatter representation conducted the survey during February-August, 2003. The survey was conducted in 18 states, covering a population of 52,731 chosen randomly from 8500 households. The annual incidence of animal bites was high, 1.7% and it was more in rural areas (1.8%), children (2.6%) and poor/low income group (75%). The main biting animal was dog (91.5%), mostly stray (63%), followed by cat (4.7%). A high proportion of bite victims did not wash their wounds with soap and water (39.5%), preferred Government hospitals (59.9%) and nerve tissue vaccine (46.9%). The use of rabies immunoglobulin was low (2.1%). A single animal bite episode led to a loss of 2.2 man-days and the cost of medicines including anti-rabies vaccine was Rs.252 (US$6). The recourse to indigenous treatment (45.3%) and local application to wound (36.8%/) was quite prevalent. About 17% of households reported having a pet/domesticated dog and the pet dog: man ratio was 1: 36. Pet dog care/management practices were not satisfactory with a low veterinary consultation (35.5%) and vaccination (32.9%). The situation was slightly better in urban areas. The people also reported the presence (83%) and menace (22.8%) of stray dogs. It is recommended to initiate appropriate community awareness and dog vaccination campaigns and effective stray dog control measures.
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Mordeduras y Picaduras/epidemiología , Enfermedades de los Perros/epidemiología , Encuestas Epidemiológicas , Rabia/epidemiología , Organización Mundial de la Salud , Adulto , Animales , Animales Domésticos , Mordeduras y Picaduras/terapia , Niño , Reservorios de Enfermedades/estadística & datos numéricos , Reservorios de Enfermedades/veterinaria , Enfermedades de los Perros/prevención & control , Perros , Femenino , Humanos , Incidencia , India/epidemiología , Masculino , Rabia/prevención & control , Rabia/transmisión , Rabia/veterinaria , Vacunas Antirrábicas/administración & dosificación , VacunaciónRESUMEN
The potentiality of the masked o-benzoquinones, i.e., 6,6-dimethoxy-2,4-cyclohexadienones 5-8, to react both as dienes and dienophiles in their intermolecular reactions has been demonstrated. The masked o-benzoquinones (MOBs) 5-8 generated in situ from 2-methoxyphenols 1-4 underwent intermolecular Diels-Alder cycloadditions with acyclic 1,3-dienes 9a-e to provide bicyclo[2.2.2]octenones 10a-f-13a-f along with cis-decalin derivatives 14a-f-17a-f with regio- and stereoselectivity, except in the case of MOB 8. The formation of cis-decalins in these Diels-Alder reactions illustrates the dienophilic character of MOBs, in addition to their general behavior as dienes. The ratio of the two cycloadducts obtained in each reaction as a result of the dual character of MOBs depends on the nature and/or position of the substituents on both the cyclohexadienone moiety and the added conjugated acyclic diene. All of the cycloadducts resulted from the diene property of MOBs in intermolecular Diels-Alder reactions smoothly underwent Cope rearrangement to furnish cis-decalins as sole products in excellent to quantitative yields.
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BACKGROUND: Animal models are frequently used to generate and test hypotheses about amnesia resulting from electroconvulsive therapy (ECT). Although many predictors of ECT-induced amnesia are known, their relative effects have been inadequately researched in the context of the animal models. OBJECTIVE: We sought to determine the relative retrograde amnestic effects of electroconvulsive shock (ECS) stimulus intensity (dose) and number on strong memories in rats. We also sought to identify dose-dependent ceiling amnestic effects, if any. METHODS: Adult rats (n = 144) were overtrained in a passive avoidance task using a step down apparatus. The rats were then randomized in a factorial design to receive one, two, or three once-daily bilateral ECS at 0-mC (sham ECS), 30-mC, 60-mC, 120-mC, or 180-mC doses. Recall of the pre-ECS training was assessed 1 day after the last ECS. RESULTS: Retrograde amnesia was observed only in rats that received 3 ECS; dose-dependent amnestic effects did not emerge. Higher stimulus intensity was associated with a small (13%) but significant increase in motor seizure duration, but only at the first ECS; stimulus intensity did not influence the attenuation of seizure duration across repeated occasions of ECS. CONCLUSION: With bilateral ECS, the number of ECSs administered is a more important variable than the ECS dose in weakening a strong, recently acquired, noxious memory; this finding may have important clinical implications. Higher stimulus intensity marginally increases motor seizure duration at the first ECS but does not influence the decrease in seizure duration across repeated ECSs.
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Amnesia Retrógrada/fisiopatología , Terapia Electroconvulsiva/métodos , Electroencefalografía , Convulsiones/fisiopatología , Animales , Aprendizaje por Asociación/fisiología , Reacción de Prevención/fisiología , Humanos , Masculino , Recuerdo Mental/fisiología , Sobreaprendizaje/fisiología , Ratas , Ratas Wistar , Tiempo de Reacción/fisiologíaRESUMEN
Intramolecular Diels-Alder (IMDA) reactions of masked o-benzoquinones (MOBs) 5a-d to 7a-d and 17a-d to 19a-d generated in situ from 2-methoxyphenols 2-4 and 14-16, respectively, in the presence of alkenols 1a-d, resulting in highly functionalized oxatricyclic [m.3.1.0] ring systems are described. The MOBs 5a-d to 7a-d underwent the IMDA reactions to furnish the adducts 8a-d, 10a-d, and 12a-d (direct method) in poor yields with the concomitant formation of considerable amounts of unexpected byproducts 9a-d, 11a-d, and 13a-d, respectively. To avoid the formation of byproducts and to improve the yields of the desired cycloadducts, a detour method comprising sequential bromination of 2-methoxyphenols 2-4, tandem oxidative acetalization-Diels-Alder reaction, and debromination has been developed. The oxidation of bromophenols 14-16 in the presence of alkenols 1a-d produced the corresponding MOBs 17a-d to 19a-d, which underwent cycloaddition to afford the cycloadducts 20a-d to 22a-d, respectively, as sole products in good to high yields in a highly regio- and stereoselective manner. Treatment of the bromoadducts 20a-d to 22a-d with tributylammonium formate-palladium reagent produced the corresponding debrominated products 8a-d, 10a-d, and 12a-d in high to excellent yields. In general, the latter oxatricycles were obtained in higher overall yields via the detour method than those via the direct method.
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Compuestos Bicíclicos Heterocíclicos con Puentes/síntesis química , Alcaloides/síntesis química , Benzoquinonas/química , Bromo , Fenoles/química , EstereoisomerismoRESUMEN
Intermolecular Diels-Alder reactions of masked o-benzoquinones, i.e., 6,6-dimethoxy-2,4-cyclohexadienones 5-7 and 21-24 generated from 2-methoxyphenols 1-3 and 17-20, respectively, with electron-deficient dienophiles leading to highly functionalized bicyclo[2.2.2]octenones are described. The masked o-benzoquinones (MOBs) 5-7 underwent Diels-Alder cycloadditions with methyl acrylate, methyl methacrylate, and methyl vinyl ketone to provide bicyclo[2.2.2]octenones 13a-c to 15a-c (direct method) in low to moderate yields with the concomitant formation of considerable amounts of dimers 9-11. To retard dimerization and to improve the yields of the requisite bicyclo[2.2.2]octenones, a detour method comprised of sequential bromination of 2-methoxyphenols 1-4, oxidation and Diels-Alder reaction, and debromination has been developed. The oxidation of bromophenols 17-20 produced MOBs 21-24 which are stable enough to be isolated. The MOBs 21-24 underwent cycloaddition with electron-deficient dienophiles in a very efficient manner to afford the corresponding cycloadducts 25a-c to 28a-c in good to high yields without self-dimerization. When the cycloadducts 25a-c to 28a-c were treated with either Bu(3)SnH/AIBN or tributylammonium formate-palladium reagent, the corresponding debrominated products 13a-cto 16a-c were obtained in high to excellent yields. In general, the cycloadducts 13a-c to 15a-c were obtained in 20-40% higher yields via the detour method than those via the direct method. In both routes, the Diels-Alder reactions proceeded in a highly regio- and stereoselective manner to furnish a single cycloadduct in each case.
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A rapid and high yielding method for the synthesis of precursors of synthons for DNA synthesis, N-protected 2'-deoxyribonucleosides is described, which occur under mild conditions using microwave irradiation. The desired material, N-protected nucleosides, was obtained in 93-96% yield in few minutes. The final products were then characterized by 1H-NMR and MALDI-TOF and compared with the standard samples. The method is amenable to small to moderate scale of synthesis.
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Desoxirribonucleósidos/síntesis química , Microondas , Desoxicitidina/farmacología , Desoxirribonucleósidos/farmacología , Hidrólisis , Cinética , Espectroscopía de Resonancia Magnética , Modelos Químicos , Espectrometría de Masa por Láser de Matriz Asistida de Ionización DesorciónRESUMEN
Kolleru Lake is the largest natural freshwater lake in the districts of East and West Godavari of Andhra Pradesh. The major population centres in the Kolleru Lake region are the 148 villages of which 50 bed villages and 98 belt villages. All bed and belt villages in lake region have at least one drinking water pond. Drinking water ponds are filled with lake water during monsoon season and directly supplied to the public throughout the year. The water samples were collected from village drinking water ponds in a year by covering three seasons and analysed for different physico-chemical parameters to assess the quality of drinking water.
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Contaminantes del Agua/análisis , Abastecimiento de Agua , Monitoreo del Ambiente , Humanos , India , Control de Calidad , Lluvia , Estaciones del Año , Agua/químicaRESUMEN
Penetrating head injuries can be difficult to manage as the extensive surgery which may be required can result in severe morbidity and mortality in some patients. A conservative surgical approach with a "pull and see" policy was adopted successfully in a described case. Extraction can be achieved by using the mechanical advantage of the lever principle. By this method while removing the object any movements of sharp edges which will cause secondary damage can be reduced to a minimum.
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Traumatismos Craneocerebrales/terapia , Cuerpos Extraños/terapia , Heridas Penetrantes/terapia , Lesiones Encefálicas/terapia , Humanos , MasculinoRESUMEN
This article presents the results of an assessment of gynecological morbidity among 385 women with young children residing in a district of Karnataka State, South India. All three main modes of assessment (clinical examination, laboratory tests, and self-reports) reveal a high burden of reproductive tract infections. The two most common conditions, identified by laboratory tests, were bacterial vaginosis and mucopurulent cervicitis. Approximately one-fourth of the women had clinical evidence of pelvic inflammatory disease, cervical ectopy, and fistula. The contribution of sexually transmitted diseases to overall gynecological morbidity appears to be relatively modest; 10 percent were so diagnosed. Associated conditions of anemia and chronic energy deficiency were common. Severe anemia was found in 17 percent of cases and severe chronic energy deficiency in 12 percent. These results indicate that radical improvements in women's health in India will require far more than the diagnosis and treatment of reproductive tract infections.
PIP: An assessment of gynecological morbidity among 385 married mothers of children 6-12 months of age from a district in South India's Karnataka State revealed a high burden of reproductive tract infections. Research methods included clinical examination, laboratory tests, and self-reports. A total of 152 women reported 226 gynecological complaints to a social worker, primarily vaginal discharge with bad odor and itching or irritation (22%), lower abdominal pain or vaginal discharge with fever (16%), and menstrual bleeding disorders or pain (15%). Under more extensive probing by a gynecologist, the proportion of women reporting menstrual problems rose to 62%. At medical examination, 36% of women had at least one clinically diagnosed reproductive tract infection, including pelvic inflammatory disease (11%), cervical ectopy (10%), and genital prolapse (3%). More than half had endogenous infections. The two most common infections, identified by laboratory tests, were bacterial vaginosis (18%) and mucopurulent cervicitis (37%). Sexually transmitted diseases, primarily trichomonal vaginalis, were diagnosed in 10%. Women residing in town, those with 6 or more years of schooling, and women with 4 or more pregnancies were significantly more likely to report menstrual problems. Laboratory-detected vaginosis was significantly higher among urban and sterilized women. There were no significant associations between demographic/socioeconomic status variables and the other reproductive health problems analyzed. Finally, severe anemia was present in 17% and chronic energy deficiency in 12%. The combination of widespread undernutrition/malnutrition and reproductive tract infections revealed in this study indicates an urgent need to take steps to implement the reproductive health strategy outlined at the 1994 Cairo Conference in South India.