A Study on Prevalence of Trigger Factors and Associated Disorders in Tension-type Headache

Objective: To study the prevalence of trigger factors and associated disorders in tension-type headache (TTH). Trigger factors have been widely studied in the context of migraine, but very few studies have investigated trigger factors in the context of TTH. Materials and methods: A total of 400 patients above the age of 15 years fulfilling the third edition of the International Classification of Headache Disorders (ICHD 3) criteria of frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) were enrolled and evaluated using a questionnaire. Details regarding demographics, headache characteristics, triggers, and associated symptoms were obtained. Associated psychiatric disorders were also recorded. Data were analyzed using Microsoft Excel and statistical analysis was done using SPSS 22 trial version. Chi-square test and Fischer’s exact test were used for statistical analysis and subgroup comparison. Results: Out of 400 patients, 360 (90%) were found to have triggers. The mean headache intensity on visual analog scale (VAS) was 6.7. The most common trigger factor was emotional stress among both males and females. There was a statistically significant difference in the frequency of trigger factors between men and women for emotional stress, sunlight, sleep deprivation/insomnia, noise, weather change, studying, fried food, and hypersomnia. Psychiatric comorbidity was found in 29% of individuals, with sleep disorder being the most common. Conclusions: TTH has been an underrated diagnosis despite being an extremely common disorder. The trigger factors are less studied and their interactions are lesser known. The diagnostic criteria as per ICHD 3 make TTH a diagnosis of exclusion, rather than a positive diagnosis of inclusion. The trigger factors must be included in the diagnostic criteria in future versions of ICHD and associated psychiatric disorders should be sought for and treated simultaneously for better management and quality of life.

Impact of Supplementary Nutrition on Undernourished Children In An Urban Area Of Meerut- A Longitudinal Study

Background: Infants and pre-school are most susceptible to undernutrition. Integrated Child Development Services is the programme focussing undernourished children by providing them supplementary nutrition. Aim& Objective: To study prevalence of undernutrition in 0-6 year old children and to study factors associated with it. To study impact of supplementary nutrition on undernourished children. Settings and Design: A longitudinal study. Methods and Material: The present longitudinal study was conducted in randomly selected Anganwadis of urban Meerut. Children found to be suffering from under nutrition were followed up at interval of six months to see the impact of supplementary nutrition provided to them at the anganwadi centre. A detailed history of relevant underlying factors responsible for causation of under nutrition were taken from mothers of these children. Statistical analysis used: chi square test was used to find out association between risk factors and undernutrition. Risk factor found statistically significant were further analysed using step wise multiple logistic regression analysis. The impact of supplementary nutrition was assessed using paired t test. Results: Iron folic acid supplementation during pregnancy, exclusive breast feeding in children, immunization and time of initiating complementary feed were found statistically significant on both chi-square and multiple logistic regression analysis. No impact of supplementary nutrition was found on anthropometric measurements of children. Conclusions: The main focus for fighting undernutrition in children (0-6 years) should be on preventing risk factors associated with mothers in antenatal period and during child rearing practices

Re-evaluation of reading frame-shift hypothesis in Duchenne and Becker muscular dystrophy.

The reading frame hypothesis has been proposed to explain the molecular basis of two allelic forms of muscular dystrophies, Duchenne/Becker muscular dystrophy (D/BMD). To evaluate the hypothesis in Indian D/BMD patients, we analyzed deletion of dystrophin exons in 147 DMD and 19 BMD patients. Our studies showed deviation of more than 30% from the reading frame hypothesis in DMD patients (47/147). The present results implicate a need to reevaluate the reading frame hypothesis.

Fighting cancer in the information age: the role of Internet.

Cancer is a major health problem worldwide which is likely to assume alarming proportions in the next two decades. Communication and information have increasingly been considered important in helping people to cope with cancer. The arrival of Internet offers the opportunity to fundamentally reinvent medicine and health care delivery. Medical professionals can now use the Internet for continuing medical education, access latest medical information, for fast confirmation of diagnosis, exchange opinion on treatment strategies and in palliative care. Internet can provide cost-effective and timely ways to deliver a complex mix of interesting and high-quality information and expertise to cancer patients. Patients can also independently search the Internet to know about their illness and treatment options. However, of concern is the quality of information that is available in the 'Net'. Some Internet sites may contain erroneous information on cancer and can pose serious problems. There are also many good sites, which provide quality information on cancer for medical professionals, researchers and patients. This article focuses on how the Internet will aid us in fight against cancer.

Complex dynamics of toxin producing algal species and primary productivity in two water ponds of Faizabad.

In order to develop a method of predicting and assessing pond eutrophication, which is a serious environmental problem, and to propose effective measure of improvement of water quality. The present study was performed to measure water quality variables, primary productivity, chl-a and biomass of toxin producing algal species and fish production. High nutrient influx and toxin producing algal species have been observed during June 1999 to May 2000 in two water bodies [Girija Kund (A) and Maqubara pond (B)] of Faizabad. The maximum chl-a concentration, toxins producing algal species biomass were found to be 415.00 and 515.00 in pond A, while 451.00 microg/l and 541.22 mg/l in pond B, respectively in the case of Microcystis aeruginosa. Ecological parameters to evaluate GPP, NPP and CR were found to be 297.00, 134.000 and 182.00 mgCm3/h in summer season in pond B, respectively which is higher than pond A. A poor association existed between chl-a and GPP. Temporal variation (Photosynthetic rate) in A(max) & P(max) was also observed to evaluate the productivity of pond. Annual fish production potential of the ponds A and B has been estimated to be around 342.00 Kg and 204. 00 Kg, respectively which may be due to the presence of toxin producing algal species.

Molecular diagnosis in haemophilia A.

Haemophilia A is the commonest cause of X-linked inherited bleeding disorder. Due to inadequate medical facility for management of the disease, the DNA based genetic diagnosis has assumed great importance. Ideally, the direct detection of mutations is the most accurate and reliable approach for carrier detection and prenatal diagnosis. However, mutation detection is possible only in limited number of cases. In majority of haemophiliacs, no common mutation is easily identifiable. The limitation has been over come by the use of linkage-based analysis using polymorphic DNA markers in the factor VIII gene. Some of these markers can be identified by restriction enzymes and are called RFLP markers. Other markers are a class of short tandem repeats sequences which result in differences in the number of CA repeats in different individuals. The combined use of these markers has made it possible to identify carriers and provide prenatal diagnosis in upto 95% of families having affected individuals. Therefore, the recurrence of the disease can be prevented to a great extent in the haemophilia A affected families.

Patterns of tobacco use amongst school teachers.

Indulgence in tobacco is a known health risk. The example of school teachers in this regard is likely to have far reaching influence on their pupils and the community. A cross sectional study among 257 teachers from 30 schools revealed that as high as 51.0% teachers consumed tobacco in one form or the other. Smoking was the most popular form of tobacco use (72%). Marked gender differences were noted with 73.9%. Male teachers hooked to tobacco habit in comparison to 13.9% of female teachers. Educational qualification had paradoxical effect on tobacco habit as fewer (20.0%) graduate teachers used tobacco in comparison to non graduate teachers (55.7%). However proportion of Post graduate teachers consuming tobacco was still higher (64.2%). Initiation to tobacco habit in majority began at age 21 years and beyond. Common reasons given for tobacco consumption were curiosity (37.9%), to be social (22.0%), enjoyment (21.2%), to relieve stress (8.17%) and improving performance (5.8%). 21.9% smokers consumed more than 20 cigarettes a day. More than four fifth teachers consciously avoided tobacco use in school premises. Nearly half (45.3%) of tobacco users reported reduction in tobacco use in preceding two years. By and large teachers (92.4%) were aware of harmful consequences of tobacco on health. But only in 29.6% it was a cause for concern. 71.2% respondents intended to give up tobacco habit. 33.7% smokers were aware of hazards of passive smoking to others.

Internet resources for the human geneticist.

The Internet is a massive expanding body of information, which is likely to play a significant role for clinicians and researchers across the world. Since its inception in December 1969 the Internet has grown rapidly and is anticipated to expand 1,000% in the coming next few years. Various useful databases on human genetics are already in 'the Net' and many more are being added constantly. The future of human geneticist is in handling of information. In this review of Internet and compilation of important web site addresses we expect to stimulate and instruct human geneticists in navigating the Net. The list of web sites provided in this article is expected to facilitate their search.

Gastrointestinal leiomyomas in a developing country.

Twenty one consecutive patients with leiomyoma of the gastrointestinal tract were studied. Recurrent gastrointestinal bleeding was found in 18 (85.7%) and recurrent intestinal obstruction in 3 (14.3%) patients. The commonest site of the lesion was the stomach followed by ileum, jejunum and duodenum. Barium meal examination and gastrointestinal endoscopy were suggestive of the diagnosis in 8 and angiography in 2 patients. The remaining patients were diagnosed peroperatively. All patients underwent excision and remained asymptomatic on follow up except two patients who had a recurrence of the tumor as leiomyosarcoma.