Socio-economic & demographic determinants of hypertension & knowledge, practices & risk behaviour of tribals in India.

Background & objectives: An increase in prevalence of hypertension has been observed in all ethnic groups in India. The objective of the present study was to estimate prevalence and determinants of hypertension among tribals and their awareness, treatment practices and risk behaviours in nine States of India. Methods: A community based cross-sectional study adopting multistage random sampling procedure was carried out. About 120 Integrated Tribal Development Authority villages were selected randomly from each State. From each village, 40 households were covered randomly. All men and women ≥ 20 yr of age in the selected households were included for various investigations. Results: A total of 21141 men and 26260 women participated in the study. The prevalence of hypertension after age adjustment was 27.1 and 26.4 per cent among men and women, respectively. it was higher in the states of Odisha (50-54.4%) and Kerala (36.7-45%) and lowest in Gujarat (7-11.5%). The risk of hypertension was 6-8 times higher in elderly people and 2-3 times in 35-59 yr compared with 20-34 yr. Only <10 per cent of men and women were known hypertensives and more than half on treatment (55-68%). Men with general and abdominal obesity were at 1.69 (CI: 1.43-2.01) and 2.42 (CI: 2.01-2.91) times higher risk of hypertension, respectively, while it was 2.03 (CI=1.77-2.33) and 2.35 (CI 2.12-2.60) times higher in women. Those using tobacco and consuming alcohol were at a higher risk of hypertension compared with the non users. Interpretation & conclusions: The study revealed high prevalence of hypertension among tribals in India. Age, literacy, physical activity, consumption of tobacco, alcohol and obesity were significantly associated with hypertension. Awareness and knowledge about hypertension and health seeking behaviour were low. Appropriate intervention strategies need to be adopted to increase awareness and treatment practices of hypertension among tribals.

Diet and nutritional status of rural preschool children in Punjab.

OBJECTIVE: To assess diet and nutritional profile of rural preschool children of Punjab. STUDY DESIGN: Multistage random sampling method was adopted by following probability proportion to population size (PPS). SUBJECT: Four hundred households (HH) were covered in each district of Punjab for socio-economic and demographic information. All the available individuals from these HHs were included for anthropometry and clinical examination. Every fourth household was covered for 24-hour recall method of diet survey (individual dietary intake). RESULTS: At the state level, the intake of macro and micronutrient rich foods such as cereals, pulses and green leafy vegetables, milk and milk products and fats and oils were lower than the RDI among preschool children. Except for protein, calcium and thiamine, the mean intake of all the nutrients was lower than the recommended level. About a half of the preschool children (50.3%) were undernourished (> 2SD weight for age); 60% were stunted (> 2SD height for age) and 12% were wasted (> 2SD weight for height). The extent of undernutrition and stunting was lower than that reported for the country. There was significant variation in the prevalence of severe stunting between the districts (p < 0.001), with the highest being observed in the Rupnagar (55%) and the lowest in Hoshiarpur and Sangrur (30% each). CONCLUSION: Despite, the reported high rates of economic growth and food production in the state, a higher proportion of preschool children were consuming diets, which are inadequate with respect to energy, fat, iron, riboflavin, vitamin A and vitamin C. The prevalence of undernutrition was high as was found in other states.

Immunology of gangliosides.

This review discusses the immunology of gangliosides from the perspective of tumor, neuronal and general immunology. Antiganglioside antibodies in human sera are invariably IgM and are found in healthy individuals. Their titers decline with age. Persistent high titer of IgM is associated with several diseases, particularly neuropathies. Membrane-bound gangliosides are important tumor-associated antigens and targets for immune attack. Cells enriched with gangliosides can be used as cancer vaccines. Efficacy of these vaccines depends on the viability of whole cells, integrity of the cell membranes, adjuvants and topography of the tumor-associated antigens. The role of antiganglioside IgM is to eliminate the immunosuppressive gangliosides shed from tissues during ageing, degeneration of neural and extraneural tissues, and tumor growth and necrosis. In addition, in vitro observations with human and murine monoclonal antibodies suggest that they are capable of complement dependent cytotoxicity and apoptosis.

Impact of mid day meal program on educational and nutritional status of school children in Karnataka.

OBJECTIVE: To assess the effect of the Mid Day Meal (MDM) Program on enrollment, attendance, dropout rate and retention rate in the schools and its impact on nutritional status as well as on school performance. DESIGN: Comparison by multistage random sampling. SUBJECTS: Primary school children, who are attending the school in the MDM and non-MDM areas. RESULTS: A total of 2,694 children (MDM: 1361; Non-MDM : 1333) from 60 schools were covered in the study. Results of the study indicated better enrollment (p<0.05) and attendance (p<0.001), higher retention rate with reduced dropout rate (p<0.001) a marginally higher scholastic performance and marginally higher growth performance of MDM children. CONCLUSION: MDM program is associated with a better educational and nutritional status of school children in Karnataka.

Prediction of birth weights from body weights of newborns.

OBJECTIVE: To evaluate the accuracy of prediction of birth weights from body weights of newborns till six days after birth. DESIGN: Prospective follow-up. SETTING: Four villages near Hyderabad. METHODS: Weights of 47 newborns were recorded daily from the day of birth for seven days. The birth weights were regressed on the weights of the babies taken on the 2nd day to the 7th day. Specificity and sensitivity of the predicted birth weights to arrive at the prevalence of low birth weight (LBW) were computed. RESULTS: The co-efficient of determination (R-square) for between the days measurements decreased from 95% on the second day to 86% on seventh day with an increase in the standard error of the estimate from 84 g to 154 g. Based on the "predicted birth weights", the prevalence of LBW in the community was arrived at and compared with the actual observation. The sensitivity and specificity of these regression equations was high and ranged from 0.95 to 0.85 and 0.96 to 0.93, respectively. CONCLUSIONS: In situations where the birth weight cannot be recorded, weight of the baby taken within the first week after birth may be reliably utilized to assess the "birth weight", particularly in relation to categorization as LBW. This methodology can serve as a tool to monitor various developmental programs aimed at improving birth weights.