Study of Variations in Pattern of Calcaneal Articular Facets in Human Tali in the Population of Rajasthan (India).

Talus (astragalus) is the second largest tarsal bone. It has no muscular or tendinous attachment. It takes part in the formation of various articulations in the form of talocrural , talocalcaneonavicular or subtalar joints. The prior knowledge of the anatomical set of talus and its various articulations holds significance in operating procedures. Knowing anatomy of talus not only helps in delineating underlying pathology but also helps in treatment. Three hundred dry adult tali (150- right and 150-left) were studied. Each talus was examined for the presence of various patterns of articular facets. They were classified into five groups. Type I was found in 39% cases. Type II in 43.7% cases, Type III in 6% cases, Type IV in 5.3% cases and Type V was in 6% cases; type V has two subtypes. Subtype ‘A’ was found in 5% cases & subtype ‘B’ was found in 1% cases. In the present study, highest incidence of type II tali was 43.7 % and type IV had lowest incidence of 5.3%. These variations and their incidences can be used as an anthropological marker for racial and regional differences in unidentified bones. Further, studies on various other population is indicated using larger sample size to make comparative studies more meaningful.

Age- and height-specific reference limits of blood pressure of Indian children.

BACKGROUND: Blood pressure in childhood is the most powerful predictor of hypertension in adults. Norms for blood pressure in children are based on the age- and height-specific distribution of blood pressure in a reference sample of healthy children. METHODS: We performed a cross-sectional survey of school-children in the age group 5 to 14 years in south Delhi and studied the distribution of systolic and diastolic blood pressure in 8293 children (4623 boys and 3670 girls). Blood pressure was measured in all children with a mercury column sphygmomanometer using a standardized technique. The first and the fourth Korotkoff sounds were taken as indicative of the systolic and the diastolic blood pressure, respectively. Height percentiles were computed for the study sample for every one-year sex-pooled group. Multiple linear regression was then performed for every one-year group in order to estimate the 90th and 95th percentiles of systolic and diastolic blood pressure according to percentiles of height. RESULTS: Age and height, but not gender, emerged as the principal determinants of systolic and diastolic blood pressure in multivariable linear regression analyses. Age- and height-specific 90th and 95th percentile values of systolic and diastolic blood pressure were estimated, which enabled us to categorize children into 'normal', 'high normal' and 'high' blood pressure groups. CONCLUSIONS: We present age- and height-specific reference values for blood pressure of Indian children based on a large study sample. The use of these standards should aid the identification of children with high blood pressure.

An epidemiological study of blood pressure in school children (5-14 years) in Delhi.

Distribution patterns of blood pressure were studied in a randomised sample of 10,215 school children (5,709 boys 4,506 girls) in the age group 5-14 years in Delhi. The mean values of systolic and diastolic blood pressure (SBP and DBP) increased with age in both sexes. The cut-off points for high blood pressure were based on average SBP and/or DBP values of 95th percentile or greater for each age. The values for SBP ranged from 70 mm Hg to 140 mm Hg and for DBP from 36 mm Hg to 100 mm Hg for the age group 5-9 years. In the age group 10-14 years, the values for SBP and DBP ranged from 72 mm Hg to 160 mm Hg and from 46 mm Hg to 120 mm Hg, respectively. The prevalence of hypertension (systolic, diastolic or both) was 11.9 percent in boys and 11.4 percent in girls, an insignificant difference. Anthropometric variables like height, weight and body mass index showed positive correlation with systolic as well as diastolic blood pressure but the waist-hip ratio showed negative correlation coefficient with blood pressure. Family history of hypertension in one or both the parents was present in 20.4 percent children with high blood pressure compared to 6.8 percent in normotensives. Family history or diabetes was also significantly higher in hypertensive children (5.4%) than in normotensives (3.1%).

Dietary profile of adults in an urban & a rural community.

A community based dietary survey was carried out in 906 adults (25-64 yr) from 489 families in Delhi urban population and 275 adults from 196 families in rural population of Gurgaon district (Haryana state). A combination of 24 h recall and weightment method was used to assess the individual dietary intake. Daily average intake of various nutrients was calculated. A higher intake of cereals, milk and milk products and sugar and jaggery and a lower intake of pulses, vegetables, fruits, flesh foods and oils and fats were observed in the rural population. The average total calorie intake was 1,749 kcal in the urban and 1,910 in the rural population. The average intake of carbohydrates and proteins was 257.3 g (59.0 en %) and 54.7 g (12.5 en %) in the urban population compared to 295.6 g (61.9 en %) and 63.0 g (13.2 en %) respectively in the rural group. The fat intake was the lowest in the urban low socio-economic group (45.5 g). The contribution of total fat to energy intake ranged from 24.6 en to 31.2 en per cent in different population groups. The rural group showed higher intake of calcium and iron than the urban population. Intake of retinol was higher in the high socio-economic group (urban) than other population groups. Urban/rural differences were observed in intake of retinol, thiamine, niacin, vitamin C and vitamin E. Daily dietary cholesterol intake was the highest in the urban high socio-economic group (119 mg). The fibre intake was higher in the urban than the rural population (8.0 g vs 7.4 g).

A 5-year follow-up study of hypertension in a rural community.

A follow-up study of hypertension was carried out among adults, in the age group between 25 to 64 years, in a rural population of Gurgaon district, Haryana, five years after an initial community based epidemiological survey of the same population. The progress of 77 out of 98 hypertensives detected at the initial survey could be reassessed. The treatment and severity of hypertension found at the initial survey has been compared with that observed on follow-up. The percentage of cases with blood pressure (BP) controlled on treatment increased from 2.6 percent to 45.4 percent on follow-up. An electrocardiogram could be obtained in 66 out of 77 subjects reexamined and was abnormal in 21 cases (31.8%). The electrocardiographic abnormalities found were: myocardial infarction in one, left ventricular hypertrophy in 5, left ventricular hypertrophy with ischaemic ST-T changes in 6, isolated ST-T abnormalities in 5 and conduction defects or arrhythmias in 4 cases. In a cohort of 1,334 subjects who were normotensive at the initial survey, 19 new cases were detected to have hypertension. The overall annual incidence of hypertension was 2.8/1000 (male: 3.8/1000 and female: 2.4/1000). In these hypertensives, a family history of hypertension was present in 10.5 percent and obesity in 42.1 percent.

An epidemiological study of coronary heart disease in different ethnic groups in Delhi urban population.

A community based epidemiologival survey of coronary heart disease (CHD) was carried out on a random urban sample of 13,560 adults of different ethnic groups in Delhi. CHD was diagnosed either on the basis of clinical history, supported by documentary evidence of treatment in hospital/home or on the ECG evidence in accordance with Minnesota Code. The prevalence rate of CHD on clinical basis per 1000 adults was the highest in Sikhs (47.3), lowest in Muslims (22.8) and identical in Hindus (31.8) and Christians (31.2). The prevalence rate/1000 of silent CHD on the basis of ECG was high in Muslims (89.5) and Sikhs (87.3), low in Christians (25.0) and intermediate in Hindus (60.0). The Sikhs showed the highest prevalence rate of myocardial infarct (MI) (15.5) and angina (AP) (31.8) compared to other communities. The prevalence rate of CHD on clinical basis was higher in males than females in all communities. The prevalence of silent CHD was higher in females in Hindus and Sikhs but in Muslims it was higher in men (94.8) than in women (85.2). The wide variations in prevalence rates of CHD in different ethnic groups cannot be explained satisfactorily on the basis of conventional risk factors and support the multifactorial etiological character of CHD.

What is 'desirable' lipid profile.

The lipid profile of subjects with and without coronary heart disease (CHD) was studied in two epidemiological studies conducted in an urban and rural population. The prevalence of CHD was 96.7/1000 in the urban area and 27.1/1000 in the rural area. The lipid levels of the rural population, with an entirely different life style, was significantly lower compared to the urban normal population. The data suggest that if the prevalence of CHD is to be reduced in the urban population, the desirable levels of lipids should be those obtained in the rural normal population rather than the urban, CHD free, population.

An epidemiological study of obesity in adults in the urban population of Delhi.

The prevalence of obesity and its associations were assessed during a community based epidemiological survey of coronary heart disease on a randomised sample of 13,414 adults in the age group 25-64 years living in urban Delhi. Body Mass Index (BMI) > 25 was considered to be the cut off point for defining obesity. By this criterion, the overall prevalence rate of obesity was 27.8%. Obesity was found to be more common in female subjects (Male--21.3%, Female--33.4%, p < 0.001). Obesity was more frequent in male subjects with lower physical activity compared to those doing heavier physical activity (29.3 vs 17.5%, p < 0.001). Physical activity did not influence the prevalence of obesity in females. Hypertension (24.8 vs 8.2%, p < 0.001) coronary heart disease (5.3 vs 2.4%, p < 0.001) and diabetes mellitus (3.2 vs 1.6%, p < 0.001) were more common in the obese than in the non-obese subjects. Hypercholesterolaemia (65.5 vs 53%, p < 0.001) and hypertriglyceridaemia (73.3 vs 61.1%, p < 0.001) were found to be associated with obesity.

Epidemiological study of hypertension in young (15-24 yr) Delhi urban population.

A community based epidemiological study of hypertension was carried out on a random urban sample of young persons (15-24 yr) of Delhi. Hypertension was defined as systolic blood pressure greater than 140 mmHg and/or a diastolic blood pressure greater than 85 mm Hg or a history of current antihypertensive therapy. Of the 6543 subjects examined, 202 were found to be hypertensive. The overall prevalence rate was 30.9/1000 (male 41.2/1000, female 21.7/1000). Secondary hypertension was present in 4 of the 202 patients. Only 16 patients were aware of the presence of hypertension; of these 6 were on medication. Family history of hypertension was present in 87 subjects (43.1%). Of the 202 hypertensives, 67 were obese and 16 were smokers. The degree of physical activity was identical in the hypertensive and non-hypertensive subjects. Blood samples of 129 of the 202 patients were analysed for lipid levels. High values of total cholesterol were observed in nine.