Normative data for paediatric lymphocyte subsets: A pilot study from western India.

Background & objectives: Accurate diagnosis of immunodeficiencies requires a critical comparison of values with age-matched controls. In India, the existing reference values for rare lymphocyte subsets are currently not available and we rely on the data originating from other countries for the interpretation of the results. Furthermore, there is limited information on normal variation for these rare-subset parameters in Indian children. So, this study aimed to establish normative values for clinically important lymphocyte subsets in Indian children at different age groups. Methods: 148 children aged ≥16 yr were enrolled in this study. The study population included 61 per cent males and 39 per cent females and was divided into the following groups: cord blood (n=18), 0-6 months (n=9), 6-12 months (n=13), 1-2 yr (n=19), 2-5 yr (n=27), 5-10 yr (n=25) and 10-16 yr (n=37). The absolute and relative percentage of lymphocytes, T, B, natural killer cell, along with activated, naïve and memory subsets, was determined by flow cytometry. Results: Median values and the 10th and 90th percentiles were obtained for 34 lymphocyte sub-populations. The T and B naïve compartments showed a decreasing trend, whereas memory cells showed an increase with age. The activated T cell subset shows an increasing pattern up to one year and then declines gradually. Double negative T cells are relatively stable. TCRgd+T cell percentage increases with age. Interpretation & conclusions: This single-centre pilot study provides preliminary data that justifies the need for future large-scale multi centric studies to generate a reference range for interpreting extended immunophenotyping profiles in the paediatric age group, making it possible for clinicians to assess the immunological status in inborn errors of immunity, infectious and autoimmune diseases.

Tobacco use in Northern India-Part 1: The detailed habit.

BACKGROUND: The finite details of tobacco consumption practices in north Indian population are hitherto not well described. This study depicts the modes of tobacco use, their relative frequency, demographic and psychosocial determinants. MATERIALS AND METHODS: Random stratified sampling from the list of blocks, villages and urban localities was done. The study was community-based house-to-house survey using interview schedule. RESULTS: There were 1607 tobacco users: 1399 male and 208 female; 1195 urban and 412 rural. Single mode of tobacco use was reported by 769 (47.85%). Chewing tobacco was prevalent in 511 (31.80%), smoking in 258 (16.55%) subjects and majority 838 (52.15%) had consistent multiple habit of smoking and chewing. Of the 10 preparations of tobacco use, the 'top 5' ranked as tobacco-betel, gutka, cigarette, bidi and khaini. Gutka consumption was significantly higher between age group of 25 years and 55 years (χ(2) = 17.2; P<0.000). Majority of users, 576 (35.84%), started tobacco before 25 years of age and about a fifth, 439 (27.32%) before 18 years. Men significantly used tobacco more than women (χ(2) = 73.2; P<0.000). Women (χ(2) = 73.2; P<0.000) preferred smokeless tobacco and perceived social barrier for smoking. CONCLUSION: Multiple or overlapping tobacco practices and other substances abuse were documented in Lucknow, the capital city of the most populous state Uttar Pradesh where chewing tobacco was the commonest as opposed to smoking.

Tobacco habit in northern India.

To study tobacco consumption practices in north-Indian population, a community-based, stratified sampling survey using validated interview schedule was performed in rural/urban areas of Lucknow, Uttar Pradesh. There were 432 tobacco users (385 men, 47 women; 276 urban, 156 rural) taken as subjects. Tobacco use practices ie, chewing/smoking/rubbing/snuffing, frequency, starting age, supply, place/context of use, quid habit, affect, facilitating conditions/barriers, tobacco users' opinion on control measures were all taken into consideration. Single mode of tobacco use was reported by 277 subjects (64.1%) and the rest had a plethora of tobacco practices. Chewing was prevalent in 322(74.5%), smoking in 256(59.3%), rubbing in 32(7.4%) and snuffing in 4 subjects (0.9%). Of the 10 preparations in the questionnaire, the "top 5" preferences ranked as tobacco-betel, gutka, cigarette, bidi and khaini that remained unchanged between sexes, rural/urban people and age groups. Women significantly (p<0.00001) preferred smokeless tobacco and perceived social barrier for smoking. Gutka consumption was significantly higher in youngsters (<25 yeans; p<0.0001). Most subjects (235; 54.3%) used tobacco 7-24 times/day. Majority (259; 60%) users started consuming tobacco before 21 years of age and about a fifth 95(22%) before 15 years. Majority users (232; 53.6%) did not procure tobacco from a fixed shop. The commonest context of tobacco use was with any refreshment (337; 78.0%). Of the 322 tobacco chewers, about half the subjects (178; 52.2%) rotated the quid in their mouth, 313(97.2%) later spat it out, 9(2.1%) swallowed it and 15(4.7%) admitted to sleep with the quid in mouth. Tobacco along with alcohol was consumed by 82(19%) and with opium by 33 subjects (7.6%). Social barrier to tobacco use was perceived by 231 subjects (53.5%), especially by smokers. Majority users (355; 82.2%) did not have negative feelings or embarrassment in using tobacco. Most users (351; 81.4%) said they would welcome legislative control on tobacco use.