Diabetes in rural Pondicherry, India: a population-based study of the incidence and risk factors.

Background: For India, the ‘diabetes capital’ of the world, it is essential to know the incidence of type 2 diabetes mellitus (T2DM) and its key determinants. As two thirds of Indians live in rural areas, a study was undertaken to assess the incidence and risk factors of T2DM in rural Pondicherry, India. Methods: In a population-based cohort study initiated in 2007, a sample of 1223 adults > 25 years of age from two villages of Pondicherry were selected using cluster random sampling. Data on risk factor exposure were collected using a structured questionnaire, anthropometric tests and fasting blood glucose assessment. During house visits, 1223 of 1403 invited subjects participated. Of these, 71 (5.8%) were found to have diabetes. In 2010–2011, 85% of the non-diabetics (979/1152) were followed up using the same protocol. We calculated the risk of T2DM per annum standardized by age and sex. Population estimates of the risk factors associated with T2DM were analysed using the Generalized Estimating Equation model and the Population Attributable Risk (PAR) for T2DM calculated. Results: During 2937 person-years (PY) of follow-up, 63 new cases of T2DM occurred, giving an incidence rate of 21.5/1000 PY. Almost one third (31.7%) of cases occurred in people aged below 40 years. The incidence was double among males (28.7/1000 PY; 95% confidence interval (CI): 21.0–38.7) compared with females (14.6/1000 PY; 95% CI: 9.4–21.7). Applying these rates to rural populations, it is estimated that each year 8.7 million people develop T2DM in rural India. Nearly half of the T2DM incidence was attributed to overweight/obesity and alcohol usage. Conclusion: T2DM incidence was 2% per year in adults in rural Pondicherry, India, with the rate increasing twice as fast in men. Increasing age, obesity, alcohol use and a family history of T2DM independently predicted the development of diabetes. As half of T2DM incidence was attributed to overweight/obesity and alcohol use, health promotion interventions focusing on maintaining an optimal weight and decreasing alcohol consumption may be effective in reducing the rise in T2DM cases.

Diagnostic value of biochemical predictive index in ovarian malignancy.

The aim of the study was to determine if diagnostic performance of CA-125 in ovarian malignancy can be improved by considering age of the patient. The study was a retrospective analysis of the medical records of 306 patients who underwent a CA-125 measurement in our Institute. Of the 306 patients, 31% had malignant ovarian diseases, 45% had benign ovarian diseases, 6% had non-ovarian gynaecological diseases and 18% had non-gynaecological diseases. A positive association was found between age and CA-125 levels in patients with ovarian diseases. Patients were divided into three age groups of 18–37 yrs, 38–56 yrs and 57–74 yrs and were given age scores as 1, 2 and 3 respectively. Biochemical predictive index (BPI) was calculated by multiplying age score and CA-125 value. Among the age groups ranging 38–56 yrs and 57–74 yrs, the CA-125 and BPI values were significantly higher in malignant ovarian diseases compared to benign ovarian diseases. ROC curve analysis revealed a cut-off of 86 for the BPI with the sensitivity, specificity, positive predictive value and negative predictive value as 58%, 78%, 56% and 80% respectively. BPI had better specificity and negative predictive value compared to CA-125, can be used in the screening of ovarian pathology.

Effect of lesion of nucleus septal medialis on energy homeostasis in wistar rats.

Mesolimbic areas such as nucleus accumbens, amygdala and septal nuclei are known to influence food intake and body weight. However, the reports on gender difference in the neural regulation of obesity and energy homeostasis are incomplete. Therefore, the present study was conducted to assess the effect of lesions of nucleus septal medialis (NSM) and the gender difference of lesion on food intake (FI), body weight (BW), serum lipid profile, thyroid profile, glucose and insulin levels and glucoseinsulin ratio (GIR) in Wistar albino rats. Twenty-four rats were divided equally into control and experimental groups having 6 male and 6 female rats in each group. In the experimental group, bilateral electrolytic lesion of NSM was performed by stereotaxy and post-lesion parameters were recorded. In the control group, sham-lesions of NSM were produced. Following lesion, blood glucose and serum insulin levels were decreased and GIR was increased significantly in female rats, but not in male rats. It was concluded that NSM is involved in energy homeostasis, especially in female rats.

Role of ventromedial hypothalamus on energy homeostasis in albino rats: Effect of gender.

Various brain areas like the ventromedial hypothalamus (VMH) are known to influence food intake and body weight. Though obesity is more common in females, the reports on gender difference in the neural regulation of energy homeostasis are not adequate. Therefore, the present study was conducted to assess the gender difference in the effect of VMH lesion on food intake (FI), body weight (BW), serum lipid profile, thyroid profile, glucose and insulin levels and glucose-insulin ratio (GIR) in Wistar albino rats. Twenty-four Wistar albino rats were divided equally into control and experimental groups with 6 male and 6 female rats in each. In the experimental group, bilateral electrolytic lesion of VMH was performed by stereotaxy and post-lesion parameters were recorded. In the control group, VMH sham lesion was made. Male-female difference in each parameter was determined. Following VMH lesion, FI was increased (females, P<0.01) and BW (males, P<0.05) and GIR decreased in males (P<0.001), which was significantly correlated with BW. T3 was more significantly correlated with FI and BW in females (P<0.000 and P<0.001). Following VMH lesion, male rats exhibited significant weight gain in the absence of proportionate hyperphagia indicating that weight-gain was mainly metabolic in nature. Also, the male rats developed more susceptibility to insulin resistance. The female rats developed resistance to weight-gain inspite of hyperphagia, which could be due to the higher T3 level.

Isolation and identification of aeromonas from patients with acute diarrhoea in Kolkata, India.

Isolation of diarrhoea causing Aeromonas was carried out in the division of Active Surveillance, National Institute of Cholera and Enteric Diseases (NICED), Kolkata for a period of 12 months from January 1999 to December 1999. Out of 602 stool samples collected from patients with acute diarrhoea admitted in Infectious Diseases (ID) Hospital, Kolkata, 64 (10.6%) samples were identified positive for Aeromonas as the pathogen. The different isolated and identified species from patients with acute diarrhoea were A. hydrophila (60%), A. caviae (20%), A. veronii (10%), A. schubertii (4%), A. jandaei (3%), and A. trota (3%). Most of the isolated Aeromonas strains showed resistance to commonly employed antibiotics. All the clinical isolates of Aeromonas possessed virulence genes encoding for aerolysin and cytotonic enterotoxin genes. Except A. schubertii and A. jandaei, all the other species possessed the gene for haemolysis.

Effect of cyproheptadine on glucose tolerance, serum insulin and structure of pancreatic islets in rats.

The effect of cyproheptadine (CPH) on glucose tolerance, serum immunoreactive insulin (IRI) and structure of pancreatic islets in albino rats has been studied. Hyperglycemia with glucose intolerance was observed after 10 days of administration of CPH (40 mg/kg, ip). There was insignificant change of fasting IRI after the treatment. Histological studies indicated degranulation and vacuolation of beta cells with enlargement of capillaries. Improvement in blood glucose, glucose tolerance and structure of islets with proliferation of small pancreatic ducts and cell cords were observed 10 days after the withdrawal of CPH.