Nutritional status and self-reported morbidity pattern of urban elderly in Hyderabad city: A preliminary study

Background: Ageing is a natural phenomenon associated with physiological and functional decline in the body, which makes elderly people vulnerable to malnutrition and age related morbidity. Hence, this study was undertaken to assess nutritional status and morbidity pattern of urban elderly. Aims & Objectives: To assess the nutritional status and the morbidity status of urban elderly. Material and methods: A community based cross-sectional study was conducted among the urban elderly in Hyderabad. A total of 261 individuals of ≥60 years were recruited for this study. Anthropometric measurements were measured to assess nutritional status. Pre-tested questionnaire was used to collect information on demographic particulars and self-reported morbidity profile. Data are presented as mean ± standard error and significance level was considered at p < 0.05. Result: The mean height and weight were 160.49 Cm ±0.55 and 66.59 Kg ± 0.68, respectively while the mean BMI was 25.83 Kg/m2 ± 0.22. The prevalence of overweight and obesity among urban elderly was 46.0% and 31.4 %, respectively. The prevalence of central and truncal obesity was 60.1% and 84.6% respectively. The prevalence of morbidities such as poor vision, hypertension, joint pains, diabetes, cataract and hyperacidity was 86.1%, 63.2%, 49.4%, 48.3%, 36% and 32.2% respectively. There was a significant (p<0.05) gender difference among BMI, central obesity, CVDs, joint pains and osteoarthritis. Conclusion: In general, the prevalence of NCDs such as obesity, hypertension and diabetes are significant public health concern among urban elderly. Therefore, primordial and primary preventive measures should be adopted during adolescence and early adulthood for the prevention and control of NCDs during the period of ageing

IRF6 rs2235375 single nucleotide polymorphism is associated with isolated non-syndromic cleft palate but not with cleft lip with or without palate in South Indian population / Polimorfismo de nucleotídeo único do gene IRF6 rs2235375 está associado com à fenda palatina isolada não sindrômica, mas não com fenda labial com ou sem fenda palatina em população do sul da Índia

Abstract Introduction Transcription factors are very diverse family of proteins involved in activating or repressing the transcription of a gene at a given time. Several studies using animal models demonstrated the role of transcription factor genes in craniofacial development. Objective We aimed to investigate the association of IRF6 intron-6 polymorphism in the non-syndromic cleft lip with or without palate in a South Indian population. Methods 173 unrelated nonsyndromic cleft lip with or without cleft palate patients and 176 controls without clefts patients were genotyped for IRF6 rs2235375 variant by allele-specific amplification using the KASPar single nucleotide polymorphism genotyping system. The association between interferon regulatory factor-6 gene intron-6 dbSNP208032210:g.G>C (rs2235375) single nucleotide polymorphism and non-syndromic cleft lip with or without palate risk was investigated by chi-square test. Results There were significant differences in genotype or allele frequencies of rs2235375 single nucleotide polymorphism between controls and cases with non-syndromic cleft lip with or without palate. IRF6 rs2235375 variant was significantly associated with increased risk of non-syndromic cleft lip with or without palate in co-dominant, dominant (OR: 1.19; 95% CI 1.03-2.51; p = 0.034) and allelic models (OR: 1.40; 95% CI 1.04-1.90; p = 0.028). When subset analysis was applied significantly increased risk was observed in cleft palate only group (OR dominant: 4.33; 95% CI 1.44-12.97; p = 0.005). Conclusion These results suggest that IRF6 rs2235375 SNP play a major role in the pathogenesis and risk of developing non-syndromic cleft lip with or without palate.

Resumo Introdução Fatores de transcrição constituem uma família de proteínas muito diversa envolvida na ativação ou repressão da transcrição de um gene, em um determinado momento. Vários estudos usando modelos animais demonstraram o papel dos genes do fator de transcrição no desenvolvimento craniofacial. Objetivo Nosso objetivo foi investigar a associação do polimorfismo IRF6 intron-6 na fenda labial não sindrômica com ou sem fenda palatina em uma população do sul da Índia. Método Um total de 173 pacientes com fenda labial não sindrômica com ou sem fenda palatina e 176 controles sem fendas foram genotipados para a variante IRF6 rs2235375 por amplificação alelo-específica utilizando o sistema KASPar de genotipagem de polimorfismo de nucleotídeo único. A associação entre o polimorfismo de nucleotídeo único Fator 6 Regulatório do Interferon (IRF6) intron-6 dbSNP208032210:g.G>C (rs2235375) e o risco de fenda labial não sindrômica com ou sem fenda palatina foi investigado pelo teste qui-quadrado. Resultados Houve diferenças significativas nas frequências de genótipos ou alelos do rs2235375 SNP entre controles e casos com fenda labial não sindrômica com ou sem fenda palatina. A variante IRF6 rs2235375 foi significativamente associada ao aumento do risco de fenda labial não sindrômica com ou sem fenda palatina em modelos codominantes, dominantes (OR: 1,19; IC 95%: 1,03-2,51; p = 0,034) e alélicos (OR: 1,40; IC 95%: 1,04-1,90; p = 0,028). Quando a análise do subgrupo foi realizada, um risco significativamente aumentado foi observado no grupo Fenda Palatina Isolada (OR dominante: 4,33; IC 95%: 1,44-12,97; p = 0,005). Conclusões Esses resultados sugerem que o polimorfismo de nucleotídeo único IRF6 rs2235375 desempenha um papel importante na patogênese e no risco de desenvolvimento de fenda labial não sindrômica com ou sem fenda palatina.

Influence of angiotensin converting enzyme (ACE) gene rs4362 polymorphism on the progression of kidney failure in patients with autosomal dominant polycystic kidney disease (ADPKD).

Background & objectives: Autosomal dominant polycystic kidney disease (ADPKD) is an inherited systemic disorder, characterized by the fluid filled cysts in the kidneys leading to end stage renal failure in later years of life. Hypertension is one of the major factors independently contributing to the chronic kidney disease (CKD) progression. The renin-angiotensin aldosterone system (RAAS) genes have been extensively studied as hypertension candidate genes. The aim of the present study was to investigate the role of angiotensin converting enzyme tagging - single nucleotide polymorphisms (ACE tag-SNPs) in progression of CKD in patients with ADPKD. Methods: In the present study six ACE tagSNPs (angiotensin converting enzyme tag single nucleotide polymorphisms) and insertion/deletion (I/D) in 102 ADPKD patients and 106 control subjects were investigated. The tagSNPs were genotyped using FRET-based KASPar method and ACE ID by polymerase chain reaction (PCR) and electrophoresis. Genotypes and haplotypes were compared between ADPKD patients and controls. Univariate and multivariate logistic regression analyses were performed to assess the effect of genotypes and hypertension on CKD advancement. Mantel-Haenszel (M-H) stratified analysis was performed to study the relationship between different CKD stages and hypertension and their interaction. Results: All loci were polymorphic and except rs4293 SNP the remaining loci followed Hardy-Weinberg equilibrium. Distribution of ACE genotypes and haplotypes in controls and ADPKD patients was not significant. A significant linkage disequilibrium (LD) was observed between SNPs forming two LD blocks. The univariate analysis revealed that the age, hypertension, family history of diabetes and ACE rs4362 contributed to the advancement of CKD. Interpretation & conclusions: The results suggest that the ACE genotypes are effect modifiers of the relationship between hypertension and CKD advancement among the ADPKD patients.

Diet & nutrition profile of Chenchu population - a vulnerable tribe in Telangana & Andhra Pradesh, India.

Background & objectives: Earlier studies have documented high prevalence of undernutrition, morbidity and mortality among Chenchus, a tribal population in Telangana and Andhra Pradesh, India. The present study was carried out to assess diet and nutritional status of Chenchus and cause of death. Methods: A total of 42 Chenchu villages (gudems) were covered using systematic random sampling procedure. In each gudem, all the households with at least one child under the age of five years were covered for various investigations. Weighment diet survey was carried out on a sub-sample of households. In addition, information on cause of death in the selected 42 gudems was collected for past one year using verbal autopsy method. Results: A total of 1396 subjects of all age groups were covered for various investigations. The intakes of food and nutrients were lower than the recommended levels. The prevalences of underweight, stunting and wasting among under five children were 42 per cent (CI: 37.9-46.1), 53 and 13 per cent, respectively, while 41 per cent (CI: 37.8-47.2) men and 42 per cent (34.4-47.8) women had chronic energy deficiency (BMI<18.5 kg/m2). Sixty eight deaths were reported during the past one year in 42 Chenchu gudems. The major causes of death were premature delivery, low birth weight, alcoholic cirrhosis of liver, accidents, snakebite and pulmonary tuberculosis. Interpretation & conclusions: The prevalence of undernutrition in Chenchu population was comparable with other tribal and rural counterparts in Andhra Pradesh, however, the crude death rate (11.7/1000) was higher among the Chenchus. Steps may be taken to promote consumption of balanced diet and utilization of optimal healthcare facilities to control morbidity and mortality.

Health & nutritional status of HIV infected children in Hyderabad, India.

Background & objectives: Information on nutritional status of HIV infected children from India is lacking and is required before taking up nutritional supplementation trials. Thus, the aim of the present study was to assess the growth and morbidity status of HIV infected children over a period of one year in a city in southern India. methods: This was an observational study carried out between July 2009 and February 2011, at two orphanages in Hyderabad, India. Seventy seven HIV-positive children aged between 1 and half and 15 years, both on and not on antiretroviral therapy (ART) were included. Nutritional status was assessed longitudinally for one year by weight gain, linear growth and body composition. Serum samples were analyzed for haemoglobin, micronutrients, CD4 and CD8 counts. Dietary intakes were assessed by institutional diet survey and morbidity data were recorded every day for 12 months. Results: Mean energy intakes were less than recommended dietary allowance (RDA) in all age groups. Iron and folate intakes were less than 50 per cent of RDA; 46 (59.7%) children were stunted, 36 (46.8%) were underweight and 15 (19.5%) had low BMI for age. Anaemia was observed in 35 (45.5%) children. Micronutrient deficiencies such as vitamin D (40/77; 51.9%), vitamin A (11/77; 14.3%), folate (37/77; 48.1%), iron (38/77; 49.3%) were widely prevalent. HIV viral load was higher in children not on ART and those with morbidity. Respiratory (36.6%) and dermatological illnesses (18.8%) were the commonest presentations. Interpretation &conclusions: Acute, chronic malnutrition and micronutrient deficiencies were common in HIV infected children, especially in those not on ART and having morbidity. With severe malnutrition being an alarming consequence of HIV, prophylactic nutritive care should be considered for integration into HIV care strategies besides initiation of ART to improve the nutritional status and quality of life of these children.

A Community-based Randomized Double Blind Controlled Trial of Lactobacillus paracasei and Bifidobacterium lactis on Reducing Risk for Diarrhea and Fever in Preschool Children in an Urban Slum in India.

Aims: The aim of the study was to determine the effect of probiotics on diarrhea and fever in preschool children in a community setting in a developing country. Study Design: Double blind randomized controlled trial. Place and Duration of Study: The study was performed in Addagutta; a slum of Hyderabad (India), from July 2010 to April 2011. Methodology: Healthy preschool children (2-5 years, n=379) in an Urban Slum in India. Three randomly allocated groups of children received either of the two probiotics (Lactobacillus paracasei Lpc-37 and Bifidobacterium lactis HN019) or the placebo for a period of 9 months and were assessed for weight gain, linear growth and incidence of diarrhea and fever. Results: Neither of the tested probiotics; L. paracasei Lpc-37 or B. lactis HN019 had any influence on weight gain or linear growth. There was no significant difference between the groups in incidence of diarrhea and fever when assessing the whole study period. However, during the wet season, in the months of August and September, incidence of diarrhea was significantly higher in placebo group (16.9%) compared to L. paracasei Lpc- 37 (11.7 %) and B. lactis HN019 groups (8.4 %). Similarly, the incidence of fever was significantly higher in the month of August in the placebo group (11.5%) compared to the L. paracasei Lpc-37 group (7%) and B. lactis HN019 group (7.3%). Probiotic supplementation had no effect on fecal calprotectin, but fecal IgA and serum interleukin 8 were decreased significantly in the B. lactis HN019 group compared to placebo. Consumption of L. paracasei Lpc-37 lead to increased levels of fecal L. paracasei. Conclusion: During the rainy season, when incidence of fever and diarrhea was highest, the administered probiotics reduced the incidence of these symptoms. Over the whole study period, the probiotics did, however, not influence incidence of diarrhea or fever.

Overview of Clinical Issue Associated With Bisphosphonates In General Dentistry And Orthodontic Speciality.

Modern day general dental practice and orthodontic specialty practice is no longer limited only for healthy and younger individuals. Bisphosphonates ( Bp) have gained much popularity with regard to treatment of calcium metabolic disorders. In every part of the world currently adult patients under bisphosphonate therapy are visiting dental and orthodontic clinics to resolve their problems. So far there is no contraindication for orthodontic patients who are under bisphosphonate therapy. Even though there is no contraindication for orthodontic intervention, few general dental procedures like surgical or invasive treatments are avoided as a precautionary measure. Considerable modifications of regular dental and orthodontic procedures should be enforced in their management. This article reviews the clinical implication of the patients under bisphosphonate therapy who are in need of dental and orthodontic procedures.

Azide resistance in Rhizobium ciceri linked with superior symbiotic nitrogen fixation.

Isolated azide resistant (AzR) native R. ciceri strain 18-7 was resistant to sodium azide at 10 microg/ml. To find if nif-reiteration is responsible for azide resistance and linked to superior symbiotic nitrogen fixation, transposon (Tn5) induced azide sensitive mutants were generated. Using 4 kb nif-reiterated Sinorhizobium meliloti DNA, a clone C4 that complemented azide sensitivity was isolated by DNA hybridization from genomic library of chickpea Rhizobium strain Rcd301. EcoRI restriction mapping revealed the presence of 7 recognition sites with a total insert size of 19.17 kb. Restriction analysis of C4 clone and nif-reiterated DNA (pRK 290.7) with EcoRI and XhoI revealed similar banding pattern. Wild type strain 18-7, mutant M126 and complemented mutant M126(C4) were characterized for symbiotic properties (viz., acetylene reduction assay, total nitrogen content, nodule number and fresh and dry weight of the infected plants) and explanta nitrogenase activity. Our results suggested that azide resistance, nif-reiteration, and superior symbiotic effectiveness were interlinked with no correlation between ex-planta nitrogenase activity and azide resistance in R. ciceri.

Sinus histiocytosis with nodal and extranodal involvement--a case report.

A two and half years old male child of sinus histiocytosis with massive lymphadenopathy, paraplegia and spinal cord involvement was treated with surgery and radiotherapy for the spinal cord compression and later with chemotherapy for his nodal disease in the neck. There was a significant improvement in his neurologic status as well as in his nodal status reiterating the role of combination therapy in this disease.

Pulmonary infections after kidney transplantation.

OBJECTIVE: To retrospectively analyse the epidemiology, aetiology, temporal profile and outcome of lung infection following kidney transplantation. METHODS: Out of 142 consecutive renal transplant (RT) recipients who underwent live donor transplantation from June, 1990 to May, 1998, 43 (33%) had serious infection requiring hospitalisation of which 27 were pulmonary. All such pneumonia were included for retrospective analysis. All had a minimum follow up of six months (if alive) and were on triple drug immunosuppression. All had detailed and appropriate investigations for definitive diagnosis. RESULTS: The aetiological agents were Gram negative bacterial infection (2), Gram positive bacterial infection (1), nocardia (2), tuberculosis (10), aspergillosis (2), mixed bacterial and fungal infection (4), Pneumocystis (2) and unconfirmed (4). Four patients had pneumonia because of probable nosocomial exposure. Radiologically lobar/segmental pneumonia was observed in five, nodular lesion six, reticulonodular lesion eight, patchy consolidation five and pleural effusion three. Nodular pneumonias were due to aspergillosis or nocardiosis. Four patients developed secondary cavitation. Pulmonary infections were significantly associated with leucopenia (8/27) (p < 0.01) but not with renal dysfunction (creat > 2 mg%), diabetes, old age or additional immunosuppression (p > 0.05). There were 11 deaths. Mortality was related to failure to reach diagnosis (3) and delayed institution of therapy (6 patients). Pneumonia within first six months had a higher mortality (9/16) compared to late pneumonia (2/11). Immunomodulating virus (CMV 4, HEP B 2) was present in six patients of whom four succumbed. CONCLUSION: Pulmonary infection is a common and serious post-transplant infection requiring hospitalisation, is associated with high mortality. Patients with leucopenia are predisposed to these infections. Prophylaxis for Pneumocystis, Nocardia and tuberculosis needs strong consideration to reduce mortality of such infection. Nosocomial exposure risk needs careful consideration in outbreaks of opportunistic infection.