Development of perceived prenatal maternal stress scale.

BACKGROUND: Pregnancy is a state, which is often associated with extreme joy and happiness. Women undergo a number of physiological and psychological changes during pregnancy, which are often stressful if aligned with other adverse life events, compromising their health and well-being. However, there exists no comprehensive psychological instruments for measuring this stress. OBJECTIVES: The study was conducted to develop a multidimensional scale to assess prenatal maternal stress (PNMS) comprehensively. METHODS: The initial phase of the study focuses on developing items and assessing the content validity of these items. The second phase focuses on pilot-testing and field-testing the newly developed perceived PNMS scale (PPNMSS) among 356 pregnant women belonging to different parity and trimester from November 2015 to October 2016. RESULTS: The underlying factor structure of the 28-item PPNMSS had explored using exploratory factor analysis. The final scale is retained with 15 items having considerable item loading under four major factors as follows: perceived social support, pregnancy-specific concerns, intimate partner relations, and financial concerns. Reliability of each of these dimensions was assessed using Cronbach's alpha. Convergent and divergent validity of the scale was assessed by correlating the scores with perceived stress scale and the World Health Organization (five) well-being index (1998 version). CONCLUSIONS: As a comprehensive scale, PPNMSS is efficient to measure PNMS, which facilitates an early detection of stress and depression among pregnant women and timely intervention by health care professionals.

Optimization process parameters for in-situ synthesis of ammonia by catalytic hydrolysis of urea with fly ash in a batch reactor for safe feedstock in power plants.

In this study, catalytic urea hydrolysis for production of ammonia in presence of fly ash, at optimum condition, was investigated in a batch reactor. The single and combined effects of operating parameters such as initial feed concentrations, temperature, fly ash doses, times and stirring speed on the production of ammonia from urea were analyzed using response surface methodology. A 2(5) full factorial central composite experimental design was employed. Analysis of variance (ANOVA) showed a high coefficient of determination value (R(2)= 0.963) and satisfactory prediction second order regression model was derived. The optimum production conditions were determined as initial feed concentration 19.9 wt. % of urea, temperature 175°C, fly ash dose 7.5 g/L, reaction time 25 min and stirring speed 769 rpm. At optimum conversion conditions, the conversion of urea for production of ammonia was found to be 99.8 %.

Tobacco chewing and female oral cavity cancer risk in Karunagappally cohort, India.

This study examined oral cancer in a cohort of 78 140 women aged 30-84 years in Karunagappally, Kerala, India, on whom baseline information was collected on lifestyle, including tobacco chewing, and sociodemographic factors during the period 1990-1997. By the end of 2005, 92 oral cancer cases were identified by the Karunagappally Cancer Registry. Poisson regression analysis of grouped data, taking into account age and income, showed that oral cancer incidence was strongly related to daily frequency of tobacco chewing (P<0.001) and was increased 9.2-fold among women chewing tobacco 10 times or more a day. The risk increased with the duration of tobacco chewing during the first 20 years of tobacco chewing. Age at starting tobacco chewing was not significantly related to oral cancer risk. This is the first cohort study of oral cancer in relation to tobacco chewing among women.

Cancer pattern in Western Nepal: a hospital based retrospective study.

Information on cancer patterns is an important basis for determining the priorities for cancer control in different countries worldwide. There is no reliable information about the incidence or pattern of cancer in Nepal and hence an attempt was made to assess the situation based on hospital data which is the only source in the western region of Nepal. Cancer cases diagnosed by all methods or treated in Manipal Teaching Hospital, affiliated to Manipal College of Medical Sciences, Pokhara, during 1st January 2003 to 30th May 2005 were used for the present study. A total of 957 cancer cases were identified with a male to female ratio of 1.1:1. The median age of male and female patients was 63 and 60 years, respectively. The proportion of microscopically confirmed cases, both from primary and metastatic sites was 87.5% and tobacco-related cancers constituted 48% of all cancers among males and 28% among females. For males the leading cancer sites were lung (22.2%), larynx (9.8%) and stomach (9%) and that for females was lung (20%), cervix (19.7%) and breast (7.8%). Among males, 33.1% of all cancers were in the respiratory system followed by digestive organ cancers (23.2%). Among females, 28.4% cancers were related to the reproductive system, 22.8% to the respiratory system and 14.1% to digestive organs. The cancer pattern revealed by the present study provides valuable leads to cancer epidemiology in Nepal, particularly in the western region, and provides useful information for health planning and future research.

Distress, anxiety, and depression in cancer patients undergoing chemotherapy.

BACKGROUND: Chemotherapy for cancer is an intense and cyclic treatment associated with number of side-effects. The present study evaluated the effect of chemotherapy on distress, anxiety and depression. PATIENTS AND METHODS: A total of 117 patients were evaluated by using distress inventory for cancer (DIC2) and hospital anxiety and depression scale (HADS). Majority of the patients were taking chemotherapy for solid tumors (52; 44.4%). RESULTS: The mean distress score was 24, 18 (15.38%) were found to have anxiety while 19 (16.23%) had depression. High social status was the only factor found to influence distress while female gender was the only factor found to influence depression in the present study. CONCLUSION: The study highlights high psychological morbidity of cancer patients and influence of gender on depression. Construct of distress as evaluated by DIC 2 may have a possible overlap with anxiety.

Cancer in women in Kerala--a transition from a less-developed state.

An epidemiologic assessment of the problem of cancer in women in Kerala based on 3 Population Cancer Registry data and a Hospital Based data is presented. Kerala's Socio-economic and demography presents an intermediate development from a less developed to a better-developed state. As yet, the women follow a tradition-based life style. Cancer incidence rate in Kerala was only 80% of urban rates than seen in Urban Metropolis in India. The pattern of site distribution has shown that GI, Breast and Cervix cancers are the predominant cancers. Oral cavity cancers also show a high frequency. Thyroid cancer has a higher incidence rate in Kerala compared to other areas. Lung cancer among women has higher incidence rate in Karunagappally women. A high prevalence of tobacco use is reported among the men in the above area. Breast cancer incidence rate in the rural areas was only 60% of the rate seen in Urban Trivandrum. Unlike in other rural and urban areas of India Cervix cancer has a low incidence rate in Kerala women. This may be due to better education and also due to the changes in marital and other life style practices. Only 15% of cancer patients attend for medical assistance in localized stage of disease. The need for public education is highlighted and focusing on tobacco use control, self-examination and screening.

Trends of head and neck cancers in urban and rural India.

BACKGROUND: The sub-site predilection of head and neck squamous cell carcinoma (HNSCC) reflects the risk profile of a community and there are suggestions that these are changing over time. OBJECTIVE: To determine the change in head and neck cancer in rural and urban populations in India. METHODS: Cancer registry data of an urban and a rural population were reviewed over a period of 13 and 11 years, respectively. Age adjusted rates (AAR) and age specific incidence rates were used for data analysis. RESULTS: Oral cancers formed the majority of the head and neck cancers with a predilection for tongue, except in rural males, in whom the pharynx was the predominant sub-site. Overall there was a reduction in the incidence of HNSCC, which was more pronounced in urban females and rural males (p< .001). Among the sub-sites, oral cavity cancers showed a decreasing trend in urban females (p< .01) and rural males (p< .01). However, the trend was towards increase of incidence of tongue cancers. Pharyngeal cancer showed reduction in urban females (p< .01), whereas it increased in rural females. The recent increase in incidence of young adults with HNSCC reported in developed countries was not observed. CONCLUSIONS: Overall, incidence of HNSCC is reducing. This may be attributed to the decreased prevalence of tobacco use. The increase in incidence of tongue cancer may suggest factors other than tobacco and alcohol in its genesis.

Colonic polyposis syndromes--an experience from a tertiary centre in South India.

BACKGROUND: Several polyposis syndromes of the gastrointestinal tract have been recognized which carry increased risk for cancer and have a genetic predisposition. There is a paucity of literature regarding the occurrence and the burden of colonic polyposis syndromes in the Indian subcontinent. This study attempts to highlight this hitherto unaddressed burden and the associated increased risk for inherited colonic cancer in this geographical location. METHODS: A retrospective study of various colonic polyposis syndromes encountered at a tertiary centre in South India over a period of 8 years (2005 to 2012) was performed. The diagnosis in each case was made histologically with clinicopathological correlation. RESULTS: Fifty cases were identified as belonging to a colonic polyposis syndrome, during the study period. There were 27 males and 23 females with a median age of 36.5 years (range 19 months to 78 years). The commonest syndrome was familial adenomatous polyposis (n = 27; 54 %) followed by Peutz-Jeghers syndrome (n = 11), attenuated familial adenomatous polyposis (n = 7), juvenile polyposis syndrome (n = 3), hyperplasic polyposis syndrome (n = 1) and Cronkhite-Canada syndrome (n = 1). Colonic malignancy was documented at first presentation in 22 patients (44 %). CONCLUSIONS: Our study highlights the various colonic polyposis syndromes encountered in a tertiary care institution in Southern India.

Metabolic studies on the possible mode of action of isoniazid tumorigenicity.

Data on tumorigenicity and mutagenicity of INH show that INH is tumorigenic in mice but not in rats. The metabolic studies on the two species denote that rats are rapid inactivators whereas mice are slow inactivators of INH. Rats are also resistant to the immediate inhibitory effect of INH on DNA biosynthesis. Using Ames test it was observed that INH is mutagenic to salmonella typhimurium strains TA 100 and 1535 and this effect is abolished in presence off 59 mixture. In vivo and in vitro studies on INH interaction with macromolecules reveal that there is a greater interaction with RNA than with DNA and the site of interaction is the cytidine and deoxycytidine, respectively. A preliminary study is undertaken to see if healed TB cases have a higher risk for cancer. It is found that cancer incidence in this group is higher as compared to noncancer patients.

Population study in the high natural background radiation area in Kerala, India.

A comprehensive survey of the population exposed to high-level natural radiation is presented. The population living in Karunagappally taluk in Kerala, India, presents a unique opportunity for studies on the health effects of chronic exposure to low-level radiation. The environmental radiation emanates largely from the thorium deposited mostly along coastal areas. In certain locations on the coast, it is as high as 70 mGy/year and on average is 7.5 times the level seen in interior areas. Using portable scintillometers, radiation levels in more than 66,306 houses were measured; outside levels were also measured in the same house compound. Of the total population of 400,000, 100,000 lived in areas with high natural radiation. Information on lifestyle, socio-demographic features, occupation, housing, residence history, and tobacco and alcohol use was obtained by house-to-house visits and enumeration of every resident individual. A population cancer registry system has been established to obtain cancer incidence rates. In this preliminary analysis, there is no evidence that cancer occurrence is consistently higher because of the levels of external gamma-radiation exposure in the area. Further dosimetry-level studies are needed along with biological studies. Studies of soil, thoron-in-breath, and the radon-thoron levels in houses are ongoing, and further case-control analyses are continuing.

Diet and stomach cancer: a case-control study in South India.

A prospective case-control study was conducted in Trivandrum, India, to evaluate the dietary risk factors for stomach cancer. One hundred and ninety-four patients with stomach cancer registered at the Regional Cancer Centre (RCC), Trivandrum, Kerala, India, during the period 1988-1991 were considered as cases. A minimum of one control (n = 305), matched for age (+/- 5 years), sex, religion and residential area was selected from the visitors to RCC during the same period. Interviews were carried out using a predetermined structured food frequency questionnaire. The information collected also included socio-demographic/economic background, tobacco chewing, tobacco smoking and alcohol habits. Data were analysed using a multiple logistic regression model. Odds ratios for all dietary variables were estimated. Increased risks were observed with higher consumption of rice (OR 3.9; 95% CI 1.6-10.0). Risk was high for those consuming spicy food (OR 2.3; 95% CI 1.1-5.0), high consumption of chilli (OR 7.4; 95% CI 4.0-13.5) and consumption of high-temperature food (OR 7.0; 95% CI 3.7-12.9). On multivariate analysis, high consumption of rice, high consumption of chilli and consumption of high-temperature food were found to be independent risk factors.

TLD reader with photon counting and dc techniques for wide range radiation dose measurement.

A TLD reader incorporating the techniques of photon counting and dc methods has been developed for radiation dose measurements in the range of 10(-6) Gy (10(-2) Gy = 1 rad) to 100 Gy for varied applications in radiation protection and for dosimetry in medical physics. It utilizes state-of-the-art technology and is provided with reproducible heating programmer, glow curve output, digital dose display, check light source and data processing facilities. The reader has been designed for easy operation and maintenance. The precision of the reader is about +/- 6% (1 sigma) for 10(-5) Gy and better than +/- 2% (1 sigma) for doses greater than or equal to 0.5 cGy. Further improvements are being effected to measure doses down to 10(-7) Gy.

A portable versatile x- and gamma-ray dosemeter with ditigal display for medical use.

A multipurpose dosemeter based on analogue-to-digita (A-d) conversion has been developed using solid state devices, micropower integrated circuits and displays. The A-D converter combines the features of a MOSFET electrometer, a voltage-to-frequency converter, the automatic Townsend balance, LED(LCD) display for exposure, analogue output and has a voltage-measuring accuracy of +/- 0.1% FS +/- 1 digit. The dosemeter, which is designed to measure a wide range of x- and gamma-ray exposure rates (1 mR h-1 to 1000 R min-1) and exposures (1 mR to 1000 R) with a variety of air-equivalent ionisation chambers, is compact, rugged and battery or AC mains powered. It is designed to provide trouble-free performance, easy operation and maintenance and to be independent of climatic conditions. Combining the features of a survey meter, dosemeter and a radioisotope calibrator, it can be fabricated using the facilities locally available in hospitals or universities.

Portable transfer digital dosemeter for beam output measurements with X and gamma rays, electrons and neutrons.

This instrument was developed in response to a requirement for an accurate, stable and portable transfer dosemeter for calibration, at therapy dose levels, of equipment used for generating X and gamma rays, electrons and neutrons. The detector is a 0.5 cm3 ionization chamber capable of fitting various wall materials reproducibly at the end of the chamber stem. The measuring system uniquely combines the features of a MOSFET electrometer and an automatic Townsend balance. When used for X, gamma and neutron radiations, the instrument measures the tissue kerma in free air on two ranges: 0.001 - 1.999 Gy (0.1 - 199.9 rad) and 0.01 - 19.99 Gy (1 - 1999 rad) or their exposure equivalents, with autoranging feature when the first range is exceeded. The polarizing voltage (180 V) can be reversed for electron and neutron dosimetry. The dosemeter has a measuring accuracy of +/- 0.2% FS +/- 1 digit and operates on four 1.5 V torchlight cells or on AC mains (200-250 V, 50 - 60 Hz). It utilizes solid state devices, CMOS integrated circuits and displays, and is not affected by RF fields. The instrument is enclosed in a brief-case for portability and is easy to operate and maintain in a hospital.

Development of perceived prenatal maternal stress scale

Background: Pregnancy is a state, which is often associated with extreme joy and happiness. Women undergo a number of physiological and psychological changes during pregnancy, which are often stressful if aligned with other adverse life events, compromising their health and well-being. However, there exists no comprehensive psychological instruments for measuring this stress. Objectives: The study was conducted to develop a multidimensional scale to assess prenatal maternal stress (PNMS) comprehensively. Methods: The initial phase of the study focuses on developing items and assessing the content validity of these items. The second phase focuses on pilot-testing and field-testing the newly developed perceived PNMS scale (PPNMSS) among 356 pregnant women belonging to different parity and trimester from November 2015 to October 2016. Results: The underlying factor structure of the 28-item PPNMSS had explored using exploratory factor analysis. The final scale is retained with 15 items having considerable item loading under four major factors as follows: perceived social support, pregnancy-specific concerns, intimate partner relations, and financial concerns. Reliability of each of these dimensions was assessed using Cronbach's alpha. Convergent and divergent validity of the scale was assessed by correlating the scores with perceived stress scale and the World Health Organization (five) well-being index (1998 version). Conclusions: As a comprehensive scale, PPNMSS is efficient to measure PNMS, which facilitates an early detection of stress and depression among pregnant women and timely intervention by health care professionals.

Clinicopathological profile of head and neck cancers in the Western development region, Nepal: a 4-year snapshot.

Regional cancer epidemiology is an important basis for determining the priorities for cancer control in different countries worldwide. There is no reliable information about the pattern of head and neck cancer in western Nepal and hence an attempt was here made to evaluate the situation based on hospital data, which provide the only source in the western region of Nepal. A clinicopathological analysis of head and neck cancers treated between 2003 and 2006 in Manipal Teaching Hospital affiliated to Manipal College of Medical Sciences, Pokhara, Western Development Region, Nepal was performed. A total of 105 head and neck cancer cases were identified with a male to female ratio of 1.8:1. The median ages of male and female patients were 62 and 64 years, respectively. Ninety-seven (92.4%) of the cancer patients were suffering from carcinoma, three (2.9%) had blastoma, three (2.9%) had sarcoma, and two (1.9%) had lymphoma. The majority (61.9%) of carcinoma cases were squamous cell carcinoma followed by anaplastic carcinoma (7.2%). Of the carcinoma cases, the most common site of primary lesion was larynx (19.6%), followed by the thyroid (14.4%), the tongue and hypopharynx with 10.3% cases each. Comparative analysis among males and females did not reveal any sex difference in type of head and neck cancers. The head and neck cancer pattern revealed by the present study provides valuable leads to cancer epidemiology in western Nepal and useful information for health planning and cancer control, and future research in western Nepal.

Cancer survival in Karunagappally, India, 1991-1997.

The rural cancer registry of Karunagappally was established in 1990 to study cancer occurrence due to high natural background radiation in the coastal area of Kerala state. Cancer registration was done by active methods. The registry contributed data on survival for 22 cancer sites or types registered during 1991-1997. Follow-up has been carried out predominantly by active methods, with median follow-up time ranging between 3-57 months for various cancers. The proportion of histologically verified diagnosis for different cancers ranged between 39-100%; death certificates only (DCOs) comprised 0-25%; 75-100% of total registered cases were included for survival analysis. The 5-year age-standardized relative survival rates for common cancers were lung (6%), breast (45%), cervix (55%), mouth (42%), oesophagus (14%) and tongue (31%). Five-year relative survival by age group showed no distinct pattern or trend for most cancers. A majority of cases are diagnosed with a regional spread of disease among cancers of the tongue (48%), oral cavity (66%), hypopharynx (54%), larynx (46%), cervix (61%) and breast (53%); survival decreases with increasing extent of disease.

Gastric cancer in kashmir.

Gastric cancer has been reported to be a highly prevalent malignancy in Kashmir, where together with esophageal cancer it accounts for more than 60% of all cancers, much higher than in other parts of the region. Particular life style habits like consumption of salted tea and tobacco smoking by hukkah, as well as Helicobacter pylori infection, are often mentioned in the context of risk factors. However, the majority of the population does not consume alcohol and the prevalence of H. pylori does not appear to explain the high incidence of gastric cancer in the population. Other prevalent habits of gastric cancer patients are presented here along with demographic and tumor details. In future, well designed studies of incidence rates (population based) are essential along with investigations of reported and suspected risk factors.