Design and implementation of intelligent patient in-house monitoring system based on efficient XGBoost-CNN approach.

Because of the scarcity of caregivers and the high cost of medical devices, it is difficult to keep track of the aging population and provide assistance. To avoid deterioration of health issues, continuous monitoring of personal health should be done prior to the intervention. If a problem is discovered, the IoT platform collects and presents the caretaker with graphical data. The death rates of older patients are reduced when projections are made ahead of time. Patients can die as a result of minor abnormalities in their ECG. The cardiac dysrhythmia/irregular heart rate is classified with several multilayer parameters using a deep convolutional neural network (CNN) approach in this paper. The key benefit of utilizing this CNN approach is that it can handle databases that have been purposefully oversampled. Using the XGBoost approach, these are oversampled to deal with difficulties like minority class and imbalance. XGBoost is a decision tree-based ensemble learning algorithm that uses a gradient boosting framework. It uses an artificial neural network and predicts the unstructured data in a structured manner. This CNN-based supervised learning model is tested and simulated on a real-time elderly heart patient IoT dataset. The proposed methodology has a recall value of 100%, an F1-Score of 94.8%, a precision of 98%, and an accuracy of 98%, which is higher than existing approaches like decision trees, random forests, and Support Vector Machine. The results reveal that the proposed model outperforms state-of-the-art methodologies and improves elderly heart disease patient monitoring with a low error rate.

Effective Evaluation of Medical Images Using Artificial Intelligence Techniques.

This work is implemented for the management of patients with epilepsy, and methods based on electroencephalography (EEG) analysis have been proposed for the timely prediction of its occurrence. The proposed system is used for crisis detection and prediction system; it is useful for both patients and medical staff to know their status easily and more accurately. In the treatment of Parkinson's disease, the affected patients with Parkinson's disease can assess the prognostic risk factors, and the symptoms are evaluated to predict rapid progression in the early stages after diagnosis. The presented seizure prediction system introduces deep learning algorithms into EEG score analysis. This proposed work long short-term memory (LSTM) network model is mainly implemented for the identification and classification of qualitative patterns in the EEG of patients. While compared with other techniques like deep learning models such as convolutional neural networks (CNNs) and traditional machine learning algorithms, the proposed LSTM model plays a significant role in predicting impending crises over 4 different qualifying intervals from 10 minutes to 1.5 hours with very few wrong predictions.

Applications of Intelligent Model to Analyze the Green Finance for Environmental Development in the Context of Artificial Intelligence.

Green finance can be referred to as financial investments made on sustainable projects and policies that focus on a sustainable economy. The procedures include promoting renewable energy sources, energy efficiency, water sanitation, industrial pollution control, transportation pollution control, reduction of deforestation, and carbon emissions, etc. Mainly, these green finance initiatives are carried out by private and public agents like business organizations, banks, international organizations, government organizations, etc. Green finance provides a financial solution to create a positive impact on society and leads to environmental development. In the age of artificial intelligence, all industries adopt AI technologies. In this research, we see the applications of the intelligent model to examine the green finance for ecological advancement with regard to artificial intelligence. Feasible transportation and energy proficiency and power transmission are two significant fields to be advanced and focused on minimizing the carbon impression in these industries. Renewable sources like solar energies for power generation and electric vehicles are to be researched and developed. This R&D requires a considerable fund supply, thus comes the green finance. Globally, green finance plays a vital role in creating a sustainable environment. In this research, for performing the green finance analysis, financial maximally filtered graph (FMFG) algorithm is implemented in different domains. The proposed algorithm is compared with the neural model and observed that the proposed model has obtained 98.85% of accuracy which is higher than the neural model.

Wireless IoT and Cyber-Physical System for Health Monitoring Using Honey Badger Optimized Least-Squares Support-Vector Machine.

Health monitoring is a prominent factor in a person's daily life. Healthcare for the elderly is becoming increasingly important as the population ages and grows. The health of an Elderly patient needs frequent examination because the health deteriorates with an increasing age profile. IoT is utilized everywhere in the health industry to identify and communicate with the patients by the professional. A cyber-physical system (CPS) is used to combine physical processes with communication and computation. CPS and IoT are both wirelessly connected via information and communication technologies. The novelty of the research lies in the Honey Badger (HB) algorithm optimized Least-squares Support-Vector Machine (LS-SVM) architecture proposed in this paper for monitoring multi parameters to categorize and determine the abnormal patient details present in the dataset. Since the performance of the LS-SVM is highly dependent on the width coefficient and regularization factor, the HB algorithm is employed in this study to optimize both parameters. The HB algorithm is capable of solving the medical problem that has a complex search space and it also improves the convergence performance of the LS-SVM classifier by achieving a tradeoff between the exploration and exploitation phases. The HB optimized LS-SVM classifier predicts the patients with deteriorating health conditions and evaluates the accuracy of the results obtained. In the end, the statistical data is provided to the caretaker via a smartphone application as a monthly statistical report. The proposed model offers a Positive Predictive Value (PPV), Negative Predictive Value (NPV), and an Area Under the Curve (AUC) score of 0.9478, 0.9587, and 0.9617 respectively which is relatively higher than the conventional techniques such as Decision tree, Random Forest, and Support Vector Machine (SVM) classifier. The simulation results demonstrate that the proposed model efficiently models the sensor parameters and offers timely support to elderly patients.

Phenotypes of isolates of Pseudomonas aeruginosa in a diabetes care center.

BACKGROUND: Pseudomonas aeruginosa is an invasive organism that frequently causes severe tissue damage in diabetic foot ulcers. A major problem in P. aeruginosa infection may be that this pathogen exhibits a high degree of resistance to a broad spectrum of antibiotics. Some researchers feel that P. aeruginosa is a homogeneous species, whereas others have suggested that they are panmictic. Here we characterized P. aeruginosa populations isolated from diabetic foot ulcer and from hospital environment specimens, both from a tertiary diabetes care center in Chennai, India. METHODS: Phenotypic methods like antibiotic susceptibility determinations using Kirby-Bauer's disc diffusion test and minimum inhibitory concentration (MIC) as well as outer membrane protein SDS-PAGE analysis of P. aeruginosa were performed. RESULTS: Twenty three isolates (29.8%) of P. aeruginosa from 77 diabetic foot ulcers and two environmental isolates (13.3%) from 15 different hospital fomites were detected. Both environmental isolates were sensitive to antibiotics than those isolated from clinical specimens by Kirby-Bauer's disk-diffusion method, which correlated the resistance levels by MIC determination. Outer membrane proteins (OMP) corresponding to 21, 23, 43, 46, 50, and 70 kDa were detected. CONCLUSIONS: The study is captivative as the resistance in P. aeruginosa from diabetic foot ulcers seems very common and because all the isolates were resistant to at least one or more antibiotics tested. Disk-diffusion and MIC results shows that piperacillin, amikacin and imipenem retain high levels of antipseudomonal activities and amikacin two times more active than the aforementioned antibiotics to enable itself as a potent antipseudomonal agent in diabetic foot infections. The OMP profile has revealed that clinical isolates were different from hospital environment isolates, which suggests that the origin of infections by P. aeruginosa is mainly due to growth of bacterial strains acquired by patients prior to hospital admission.

Bacterial etiology of diabetic foot infections in South India.

BACKGROUND: Foot infections are a frequent complication of patients with diabetes mellitus, accounting for up to 20% of diabetes-related hospital admissions. Infectious agents are associated with the worst outcomes, which may ultimately lead to amputation of the infected foot unless prompt treatment strategies are ensued. The present study sought to reveal the bacterial etiology of diabetic foot ulcers in South India, the diabetic capital of India. METHODS: A 10-month-long descriptive study was carried out to analyse the aerobic and anaerobic bacterial isolates of all patients admitted with diabetic foot infections presenting with Wagner grade 2-5 ulcers. Bacteriological diagnosis and antibiotic sensitivity profiles were carried out and analysed using standard procedures. RESULTS: Diabetic polyneuropathy was found to be common (56.8%) and gram-negative bacteria (57.6%) were isolated more often than gram-positive ones (42.3%) in the patients screened. The most frequent bacterial isolates were Pseudomonas aeruginosa, Staphylococcus aureus, coagulase-negative staphylococci (CONS), and Enterobacteriaceaes. Forty-nine cultures (68%) showed polymicrobial involvement. About 44% of P. aeruginosa were multi-drug-resistant, and MRSA was recovered on eight occasions (10.3%). Bacteroides spp. and Peptostreptococcus spp. were the major anaerobic isolates. CONCLUSIONS: Our study supports the viewpoint put forth by previous South Indian authors that the distribution of gram-negative bacteria (57.6%) is more common than that of gram-positive ones (42.3%) and it is contrary to the viewpoint that diabetic foot infections are frequently monomicrobial. Furthermore, recovery of multi-drug-resistant P. aeruginosa isolates is of serious concern, as almost no one has reported the same from the South Indian milieu.

Association of C-reactive protein with body fat, diabetes and coronary artery disease in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES-6).

OBJECTIVE: The aim of the study was to determine the association of high sensitivity C-reactive protein (hs-CRP) with body fat, diabetes and coronary artery disease (CAD) in an urban south Indian population. DESIGN: The study was conducted on 150 subjects selected from the Chennai Urban Rural Epidemiology Study (CURES), an ongoing population-based study on a representative population of Chennai (formerly Madras). Group 1 comprised of non-diabetic subjects without CAD (n = 50). Type 2 diabetic subjects without CAD formed Group 2 (n = 50); Group 3 comprised of Type 2 diabetic subjects with CAD (n = 50). CAD was diagnosed based on electrocardiographic (ECG) changes suggestive of ST segment depression and/or Q wave changes using appropriate Minnesota codes. All study subjects were non-smokers, and had no infectious or inflammatory diseases. The plasma levels of hs-CRP were measured using a highly sensitive nephelometric assay. Body fat was calculated using Siri's formula using skin fold measurements. RESULTS: Diabetic subjects with (2.89 mg/l) and without (2.25 mg/l) CAD had significantly higher hs-CRP levels compared with non-diabetic subjects without CAD (0.99 mg/l, P < 0.001). hs-CRP values increased with increases in tertiles of body fat (ANOVAP < 0.001) and HbA1c (ANOVAP < 0.001). Multiple logistic regression analysis revealed hs-CRP to be strongly associated with CAD (OR: 1.649, P = 0.040) and diabetes (OR: 2.264, P = 0.008) even after adjusting for age and gender. Regression analysis also revealed body fat to be strongly associated with diabetes and CAD even after adjusting for age and gender (P < 0.001). hs-CRP influenced this association for diabetes but not for CAD. CONCLUSION: hs-CRP showed a strong association with CAD and diabetes, even after adjusting for age and gender. The association of body fat with diabetes seems to be mediated through hs-CRP. However, hs-CRP does not appear to mediate the relationship between body fat and CAD.

The EIF2AK3 gene region and type I diabetes in subjects from South India.

Mutations in the EIF2AK3 gene underlie susceptibility to the Wolcott-Rallison syndrome, which is a monogenic disease associated with insulin-deficient neonatal diabetes. Furthermore, suggestive evidence of linkage between type 1 diabetes (T1DM) and the EIF2KA3 chromosomal region has been reported in Scandinavian families. We have investigated the hypothesis that polymorphic variants in and around the EIF2AK3 gene might partially account for susceptibility to T1DM in South Indian subjects. Excess transmission of the common alleles of two polymorphic markers (D2S1786 and 15INDEL, located within the gene) downstream of EIF2AK3, either singly (D2S1786, P = 0.01) and 15INDEL (P = 0.02) or as a combination (P < 0.001), were found in 234 families with a T1DM proband. There was also a clear paternal effect for the 15INDEL marker (P = 0.005) on disease susceptibility. The presence of the common allele of both markers was found in decreased frequency in the subjects with normal glucose tolerance compared to probands with T1DM (both P

Tropical chronic pancreatitis.

Tropical chronic pancreatitis (TCP) is a juvenile form of chronic calcific non-alcoholic pancreatitis, seen almost exclusively in the developing countries of the tropical world. The classical triad of TCP consists of abdominal pain, steatorrhoea, and diabetes. When diabetes is present, the condition is called fibrocalculous pancreatic diabetes (FCPD) which is thus a later stage of TCP. Some of the distinctive features of TCP are younger age at onset, presence of large intraductal calculi, more aggressive course of the disease, and a high susceptibility to pancreatic cancer. Pancreatic calculi are the hallmark for the diagnosis of TCP and in non-calcific cases ductal dilation on endoscopic retrograde cholangiopancreatography, computed tomography, or ultrasound helps to identify the disease. Diabetes is usually quite severe and of the insulin requiring type, but ketosis is rare. Microvascular complications of diabetes occur as frequently as in type 2 diabetes but macrovascular complications are uncommon. Pancreatic enzyme supplements are used for relief of abdominal pain and reducing the symptoms related to steatorrhoea. Early diagnosis and better control of the endocrine and exocrine dysfunction could help to ensure better survival and improve the prognosis and quality of life of TCP patients.

Prevalence and risk factors of hypertension in a selected South Indian population--the Chennai Urban Population Study.

OBJECTIVE: Hypertension is a major public health problem in developing countries. There is however very little population based data particularly in South India. The aim of this study is to determine the prevalence of hypertension and its associated risk factors in an urban South Indian population at Chennai. METHODS: The Chennai Urban Population Study (CUPS) is an epidemiological study involving two residential areas in Chennai in South India. Of the total of 1399 eligible subjects (age > or = 20 years), 1262 (90.2%) participated in the study. All the study subjects underwent a glucose tolerance test (GTT) and were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT) or diabetes mellitus (DM). Subjects were classified as hypertensive using the criteria, systolic blood pressure (SBP) > or = 140 mm Hg, and/or diastolic blood pressure (DBP) > or = 90 mm Hg and/or treatment with anti-hypertensive drugs. Twelve-lead resting electrocardiography (ECG) was performed in 1175 individuals and peripheral Doppler studies were done in 50% of the individuals (n=631). RESULTS: The overall crude prevalence of hypertension (HTN) in this population is 21.1% (n=266) while the age standardized prevalence is 17.0%. Body mass index (BMI) and waist-hip ratio (WHR) were significantly higher (p < 0.001) in the HTN group compared to the non-hypertensive individuals. The prevalence of diabetes (p < 0.001), obesity (p < 0.001), CAD (p = 0.001) and PVD (p = 0.0055) was higher among the hypertensive compared to normotensive group. Multiple logistic regression analysis revealed HTN to be significantly associated with age (p < 0.001), body mass index (p < 0.001) and glucose intolerance (p = 0.005). CONCLUSION: The prevalence of hypertension appears to be high in this urban South Indian population and this calls for urgent steps for its prevention and control.

Tropical chronic pancreatitis: an update.

Tropical chronic pancreatitis represents a juvenile nonalcoholic form of chronic pancreatitis prevalent in many tropical developing countries. Tropical chronic pancreatitis differs from temperate zone pancreatitis in its younger age of onset, more accelerated course, higher prevalence of pancreatic calculi and diabetes, and greater propensity to pancreatic malignancy. The diabetic stage of the disease is referred to as fibrocalculous pancreatic diabetes. The diabetes is severe and insulin requiring although ketosis resistant. Diabetic complications occur in fibrocalculous pancreatic diabetes just like in other primary forms of diabetes. The etiology of tropical chronic pancreatitis remains unclear, although malnutrition along with dietary cyanogen toxicity, antioxidant deficiency, and a genetic predisposition have been proposed. In the last few decades, the prognosis has markedly improved as a result of better management of diabetes. Yet a better understanding of the pathogenesis of tropical chronic pancreatitis could further improve treatment options and offer an opportunity for prevention of this disorder, which leads to severe morbidity in a large proportion of affected patients.

Prevalence of insulin resistance syndrome in a selected south Indian population--the Chennai urban population study-7 [CUPS-7].

BACKGROUND & OBJECTIVES: Although earlier studies had shown socio-economic factors to be strongly associated with the insulin resistance syndrome (IRS) and its components, there is still a paucity of data on Indians who have increased insulin resistance. In this study, we assessed the prevalence of IRS in two socio-economic groups in an urban south Indian population. METHODS: The Chennai Urban Population Study (CUPS) is an epidemiological study involving two residential areas in Chennal in south India. Of the 1262 eligible subjects (age > or = 20 yr) who participated in the study, 1070 (76.5%) subjects who had a complete set of data were recruited for this study. Insulin resistance was calculated using the homeostasis assessment (HOMA) model. Insulin resistance syndrome was defined as the presence of insulin resistance in combination with at least 2 of the following conditions: hyperglycaemia, hypertension, dyslipidemia or central body obesity. RESULTS: The overall prevalence of IRS was 11.2 per cent (95% confidence interval: 9.4-13.3). The prevalence of the IRS in the middle-income group (18.7%) was significantly higher compared to the low income group (6.5%; P < 0.001). Multiple logistic regression analysis revealed age (P < 0.001), body mass index (P < 0.05) and socio-economic status (P = 0.014) to be associated with IRS. INTERPRETATION & CONCLUSION: The overall prevalence rate of IRS was 11.2 per cent. Age and higher socio-economic status were the risk factors for insulin resistance in this selected urban south Indian study population.

Prevalence of non-diabetic renal disease in type 2 diabetic patients in a diabetes centre in Southern India.

OBJECTIVE: The Aim of Study is to determine the prevalence of non-diabetic renal disease among South Indian type 2 diabetic subjects based on renal biopsy. METHODS: Three thousand five hundred and ninety subjects with complete records were included for the study. One hundred and forty subjects who had proteinuria but no evidence of retinopathy undertook a 24 hour proteinuric estimation. Of these 140 subjects, 28 subjects had proteinuria > 1,000 mg/day and were subjected to renal imaging. Seven subjects were excluded due to renal calculi, cysts or contracted kidneys. Of the remaining 21 diabetic subjects, one subject was excluded as he had a mild diabetic retinopathy on fundus fluorescein angiography. Of the 20 subjects included 18 participated in the renal biopsy study (response rate--90%). Renal pathology of these subjects were studied. RESULTS: Of the 18 renal biopsies, two were excluded due to different reasons. Out of 16 patients, eight (50%) had pathological changes suggestive of diabetic etiology, five (33.3%) had classical membranous nephropathy, one (6.2%) had tubulo-interstitial disease and two (12.5%) were categorized as others with minimal changes. The subjects with non-diabetic renal disease had significantly higher creatinine clearance (p = 0.024), serum cholesterol (p = 0.036), triglyceride levels (p = 0.045) and LDL cholesterol (p = 0.048) compared to subjects with diabetic nephropathy. CONCLUSION: This study suggests that even in subjects clinically suspected to have non-diabetic renal disease many may turn out to have diabetic nephropathy on renal biopsy.

Comparison of colour duplex ultrasound and ankle-brachial pressure index measurements in peripheral vascular disease in type 2 diabetic patients with foot infections.

BACKGROUND AND OBJECTIVES: Peripheral vascular disease (PVD) is a common cause of morbidity and mortality and is reported to be more common among diabetic subjects compared to non-diabetic subjects. The aim of the study was to compare the specificity and sensitivity of ankle-brachial index (ABI) measured by peripheral doppler with the colour duplex ultrasound (CDU) for diagnosis of PVD. METHODS: One hundred type 2 diabetic patients admitted to our diabetic centre with foot lesions underwent both colour duplex ultrasound and ankle-brachial index measurements. PVD was diagnosed if the individual had haemodynamically significant obstruction on CDU, or if the ABI was < 0.9. The sensitivity and specificity of ABI was determined using the CDU as 'gold standard'. RESULTS: The mean age of the study group was 59.5 +/- 10.1 years and the mean duration of diabetes was 11.7 +/- 8.1 years. Of the total 100 subjects, six subjects had calcification of peripheral vessels and they were not included while calculating for sensitivity and specificity of ABI. Twenty (21.3%) subjects diagnosed as PVD by the CDU were not classified as PVD by the ABI measurements. Conversely, only three subjects (3.2%) classified as PVD by ABI had normal arteries based on CDU scanning. Overall, ABI had low sensitivity (70.6%) but a high specificity (88.5%). The overall agreement between CDU and ABI was poor (k = 0.20). CONCLUSION: ABI is a good initial screening tool but some patients with significant stenosis in lower extremities would be missed, if ABI measurement alone is used for diagnosis of PVD.

Prevalence of coronary artery disease and its relationship to lipids in a selected population in South India: The Chennai Urban Population Study (CUPS No. 5).

OBJECTIVES: The aim of this study was to assess the prevalence and risk factors for coronary artery disease (CAD) in a native urban South Indian population. BACKGROUND: High prevalence rates of premature CAD have been reported in migrant Asian Indians. There are very few studies on CAD in native Indians living in the Indian subcontinent. METHODS: The Chennai Urban Population Study (CUPS) is an epidemiological study involving two residential areas in Chennai in South India. Of the total of 1,399 eligible subjects (age > or =20 years), 1,262 (90.2%) participated in the study. All the study subjects underwent a glucose tolerance test and were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT) or diabetes. Twelve-lead electrocardiogram (ECG) was performed in 1,175 individuals (84%). Coronary artery disease was diagnosed based on previous medical history or Minnesota coding of ECGs. RESULTS: The overall prevalence rate of CAD is 11.0% (age standardized, 9.0%). The prevalence rates of CAD were 9.1%, 14.9% and 21.4% in those with NGT, IGT and diabetes, respectively. Prevalence of CAD increased with an increase in total cholesterol (trend chi-square: 26.2, p < 0.001), low-density lipoprotein (LDL) cholesterol (trend chi-square: 24.5, p < 0.001), triglycerides (trend chi-square: 9.96, p = 0.002) and total cholesterol/high-density lipoprotein ratio (trend chi-square: 6.14, p = 0.0132). Multiple logistic regression analysis identified age (odds ratio [OR]: 1.05, p < 0.001) and LDL cholesterol (OR: 1.009, p = 0.051) as the risk factors for CAD. CONCLUSIONS: The prevalence of CAD is rising rapidly in urban India. Lifestyle changes and aggressive control of risk factors are urgently needed to reverse this trend.

Intra-urban differences in the prevalence of the metabolic syndrome in southern India -- the Chennai Urban Population Study (CUPS No. 4).

AIMS: To assess the influence of socioeconomic status on the prevalence of the metabolic syndrome in an urban south Indian population in Chennai. METHODS: The Chennai Urban Population Study is an epidemiological study involving two residential colonies in Chennai (formerly Madras) in south India representing the middle and lower income groups. All individuals > or = 20 years of age living in the colonies were invited to participate in the study. Of the total 1399 eligible subjects, 1262 individuals (479 belonging the middle income group colony and 783 from the low income group colony) participated in the study. The overall response rate was 90.2%. The main outcome measures were the prevalence rates of the various components of the metabolic syndrome. RESULTS: There were significant differences in the socioeconomic status and lifestyle of the inhabitants of the two areas. The mean monthly income of the Tirumangalam (middle income) group (Rs8075 +/- 3859) was significantly higher than the T. Nagar (low income) group (Rs1399 +/- 916). The dietary profile of the middle income group showed higher intake of calories, fat and sugar compared to low income group (P < 0.001). The age-standardized prevalence rates of the various components of the metabolic syndrome were significantly higher in the middle compared to the low income group - diabetes (12.4 vs. 6.5%), impaired glucose tolerance (7.5 vs. 2.9%), hypertension (14.9 vs. 8.4%), obesity (males 38 vs. 13.4%, females 33.1 vs. 24.2%), hypercholesterolaemia (24.2 vs. 14.2%) and hyperinsulinaemia (16.7 vs. 6.6%) P < 0.001). Although the prevalence of coronary artery disease and hypertriglyceridaemia were higher in the middle income group, the differences did not reach statistical significance. The relative odds ratio for diabetes and impaired glucose tolerance increased significantly with increase in income while hypercholesterolaemia, hypertriglyceridaemia, hypertension and coronary artery disease showed no significant changes. Logistic regression analysis revealed that geographical area (higher social class) had a strong association with the components of the metabolic syndrome even after inclusion of other risk factors like age and body mass index in the model. CONCLUSIONS: Significant differences exist in the prevalence of various components of the metabolic syndrome even within an urban environment and this appears to be influenced by socioeconomic status.

Assessment of Nipah virus transmission among pork sellers in Seremban, Malaysia.

Between September 1998 and May 1999, 265 cases of encephalitis were reported from among those involved in pig rearing. A few cases were also reported among abattoir workers. This raised questions of the risk of transmission among those who handled raw pork. A serosurvey was conducted among pork sellers in Seremban town, which is about 20 km from one of the pig rearing areas which had reported cases of encephalitis. It was found that out of the 28 pork sellers tested, only one tested positive for Nipah virus antibodies and that this pork seller also worked in an abattoir in the same district, removing the urinary bladders from slaughtered pigs. Based on these findings, it was concluded that the risk of transmission of the virus from handling raw pork appeared to be low.

Reproductive problems of the work force.

The number of women in the workforce in increasing. A substantial proportion are in the reproductive age which brings to attention the problem of work exposures that adversely affect reproductive outcome. These exposures include chemicals, radiation, strenuous physical activity and infections. They affect reproduction by effect on the germ cells, through hormonal distribution which in turn affects transport of germ cells or zygote, implantation and development. Some of these exposures are teratogenic. At present, some regulations and policies seem to be directed at women workers while there is evidence to show that women are not the only victims. Paternal exposures have also been reported to be associated with infertility, spontaneous abortions and other adverse outcomes. There is insufficient information about reproductive effects of work exposures and hence further research is required in this area.

Prevalence and risk factors of peripheral vascular disease in a selected South Indian population: the Chennai Urban Population Study.

OBJECTIVE: The epidemiology of peripheral vascular disease has rarely been studied in non-European populations. The purpose of this study was to determine the prevalence and risk factors of peripheral vascular disease (PVD) among South Indians. RESEARCH DESIGN AND METHODS: The Chennai Urban Population Study is an epidemiological study involving 2 residential areas in Chennai in South India. Of the 1,399 eligible subjects (> or =20 years of age), 1,262 (90.2%) participated in the study. All of the study subjects underwent an oral glucose tolerance test and were categorized as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT), or diabetes. Peripheral Doppler studies were performed on 50% of the study subjects, and PVD was defined as an ankle-brachial index (ABI) <0.9. RESULTS: The prevalence rates of PVD were 2.7, 2.9, and 6.3% in individuals with NGT, IGT, and diabetes, respectively The overall prevalence rate was 3.2%. Known diabetic subjects had a higher prevalence of PVD (7.8%) compared with newly diagnosed diabetic subjects (3.5%). PVD was uncommon until middle-age and then the prevalence rate increased dramatically. Univariate regression analysis showed age >50 years (odds ratio [OR] 6.3, 95% CI 2.1-20.6, P<0.001) and hypertension (OR 2.7, 0.9-7.3, P = 0.08) to be associated with PVD, whereas smoking and serum lipid levels showed no association. Multivariate regression analysis identified age as the most significant risk factor for PVD. Of the 90 subjects who had coronary artery disease (CAD), only 6 had PVD, and the positive predictive value of the ABI for CAD was only 30%. CONCLUSIONS: The prevalence of PVD in this urban South Indian population is considerably lower than that reported in European and U.S. studies and is in marked contrast to the high prevalence rate of CAD reported in this population.