Descriptive analysis of sleep quality and its determinants among rural population of coastal Karnataka

Background: A good quality of sleep helps to maintain mood, memory and cognitive performance. Aim & Objective: To assess quality of sleep and its determinants among rural adults. Settings and Design: A community based cross sectional study was carried out in rural field practice area of a medical college Methods and Material: Pittsburg sleep quality index scale was used to assess quality of sleep. Semi-structured questionnaire was used to collect information from participants. Anthropometric and blood pressure measurements were taken. Statistical analysis used: Chi-square test was used to find out association between poor sleep and specific morbidities. Univariate and multivariate logistic regression was done to assess predictors of poor sleep. Results: Among the 614 study subjects, 60.3% had good sleep. Presence of morbidity was significantly associated with poor sleep [AOR=1.48; 95%CI=1.05-2.08]. Presence of a dark room, taking a bath or having milk before bed time were top reasons cited to be facilitating good sleep. Presence of mosquitoes, having young children or adolescent at home and vital events in last one year were reported to hinder good sleep. Conclusions: A sizeable proportion of rural adults have poor sleep. Presence of morbidity was a significant predictor of poor sleep.

Prevalence of goiter and its association with iodine status among the women of reproductive age group in coastal villages of Udupi Taluk, Karnataka, India

Background: Iodine deficiency is one of the most prevalent micronutrient deficiencies globally. Women in reproductive age group are vulnerable to develop iodine deficiency as there is an increase in demand for iodine, especially during pregnancy. Objectives: The objective is to assess the prevalence of goiter and its association with iodine status and salt usage practices among the women of reproductive age group. Methods: A community-based cross-sectional study was conducted from August 2015 to July 2017 among 1500 women of reproductive age group in five villages of Udupi Taluk. Stratified sampling design and proportion to population size of the reproductive age women in the study area was used to select the study participants. A pretested semi-structured questionnaire was used for data collection. Goiter was assessed clinically and graded as per the recommended criteria of the WHO. Salt samples from every household were collected for iodine estimation. Blood and urine samples were collected from subsample to estimate thyroid-stimulating hormone levels and urinary iodine excretion levels, respectively. Results: The overall prevalence of goiter was 13% with 11.5% being Grade 1 and 1.5% being Grade 2. No significant association of goiter with urinary iodine, salt iodine levels, and salt usage practices was found. Conclusions: Median urinary iodine among the women with goiter indicates iodine sufficiency and no significant difference observed in urinary iodine levels between women with and without goiter.

p53 immunoprofiling of potentially malignant oral disorders: A case series analysis.

Context: p53 tumor suppressor gene which is a frequent target for mutations in a high percentage of oral cancer is regarded as an early event in carcinogenesis. Aim: The role of p53 was assessed in potentially malignant oral disorders (PMOD) to ascertain its prognostic significance. Settings and Design: Retrospective case series analysis was carried out on 30 paraffin-embedded tissue blocks of confirmed oral leukoplakia with dysplasia. Materials and Methods: 10 cases of each of mild, moderate, and severe dysplasia were immunohistochemically analyzed for p53 expression. The intensity of staining, intracellular localization, and basal and/or suprabasal distribution were assessed. Statistics: The intensity of p53 staining and its distribution were analyzed by the Chi-square test. The intracellular localization of p53 in different grades of dysplasia was subjected to one way ANOVA. P<0.05 was considered significant. Results: 21/30 cases of epithelial dysplasia were positive for p53 immunopositivity. Intensity of p53 expression was strong in 12 cases and weak in 9 cases (P<0.05). p53 positivity was confined to basal cells in mild dysplasia, while severe dysplasia showed both basal and suprabasal staining (P<0.05). Nuclear and cytoplasmic staining between and within the groups were F=9.027 and F=6.465 respectively with high significance noted between mild dysplasia and severe dysplasia. Conclusions: Increased p53 expressivity and greater cellular localization with increase in the severity of dysplasia indicated a direct association between the degree of epithelial dysplasia and p53 accretion, which occurs as an early event in oral carcinogenesis.

Sublingual misoprostol: A better choice for cervical priming before manual vacuum aspiration.

Background: Misoprostol is effective for cervical priming before manual vacuum aspiration (MVA). Aim of study was to determine whether sublingual misoprostol with a shorter interval of 2 hours before MVA would be as effective as its standard vaginal administration. Study Design: This randomized control trial included 82 women randomly assigned to receive 400 mcg of misoprostol, either sublingually or vaginally. MVA was performed 2 hours and 3 hours after in sublingual and vaginal group, respectively. Results: Cervical dilatation of 8 mm was achieved within 2 hours in sublingual group. Mean time taken for procedure (14.4 ± 5.3: sublingual group and 16.2 ± 5.7: vaginal group), and blood loss was comparable (12.2 ± 9.7 ml in sublingual group and 13.7 ± 8.5 ml in vaginal group). Conclusion: 2 hour of cervical priming with 400 mcg of sublingual misoprostol before MVA was as good as 3 hours with vaginal administration of the same dose.

Effectiveness of reproductive health education among rural adolescent girls: a school based intervention study in Udupi Taluk, Karnataka.

BACKGROUND :Adolescence is the most important and sensitive period of one's life [1] . According to the World Health Organization (WHO) Expert Committee, adolescence is defined as the period between 10 and 19 years, the second decade of life. OBJECTIVE :To determine the effectiveness of an educational intervention program on knowledge of reproductive health among adolescent girls. SETTINGS AND DESIGN :This educational intervention study was carried out over a period of one year. A total of 791 rural girls in the age group 16-19 years were randomly selected from coastal villages in Udupi District, Karnataka. MATERIALS AND METHODS :Adolescent girls were educated regarding reproductive health and their awareness levels were evaluated immediately following intervention. STATISTICAL ANALYSIS :Data was tabulated and analyzed using SPSS version 11.0 for Windows. Findings were described in terms of proportions and percentages. Chi square test was used to test the effect of the intervention. RESULTS :A significant increase in overall knowledge after the intervention (from 14.4 to 68%, P < 0.01) was observed regarding contraception. Knowledge regarding ovulation, first sign of pregnancy and fertilization improved by 37.2% (95% CI = (35.2, 39.2), P < 0.001). Knowledge regarding the importance of diet during pregnancy improved from 66 to 95% following the intervention. CONCLUSION : This study clearly showed that an educational intervention program can bring about a desirable change in knowledge among adolescent girls regarding reproductive health.

Safety and radiosensitizing efficacy of sanazole (AK 2123) in oropharyngeal cancers: randomized controlled double blind clinical trial.

Oropharynx is an important site of cancer in India. Global comparison indicates higher incidences in India. Radiotherapy remains an important treatment modality. Efforts to improve loco-regional treatment and prolong survival are areas of focus. Radiosensitizers in hypoxic tumors have shown promise. AIM: To study the safety and radiosensitizing efficacy of sanazole in oropharyngeal squamous cell carcinoma (stage T2-4, N0-3, M0) as phase-II double blind controlled trial in patients treated with conventional radiotherapy. SETTINGS AND DESIGN: Single institutional, randomized, double-blind, placebo-controlled trial. MATERIALS AND METHODS: Group 1 (control; n = 23) received normal saline infusion, group 2 (test; n = 23) received sanazole biweekly 1.25 g intravenous infusion 15 minutes before radiotherapy. Surrogate end points of efficacy were tumor and nodal size; safety parameters were mucositis, salivary and skin reactions, dysphagia, vomiting, dysgeusia and neurological deficit. Investigators blinded to the trial evaluated patients, weekly during treatment for six weeks and thereafter monthly for three months. STATISTICAL METHODS: Non-parametric, Friedman's, Chi square, Mann-Whitney U tests. RESULTS: In the test, 15 (65%) patients had complete response, five (22%) partial/no response, two (9%) died, one (4%) lost to follow up. In the control, five (22%) patients had complete response, 16 (70%) partial/no response, one (4%) died, one (4%) lost to follow up. Short-term loco-regional response was better in the test (DF = 3, 95% Confidence Interval 0.418, 0.452, P = 0.0048). In the test group significant vomiting and one case of grade 3 neurological deficit was observed. CONCLUSION: The study validates the usefulness of sanazole for initial loco-regional control in oropharyngeal cancers.

Seroprevalence of hepatitis A virus in Mumbai, and immunogenicity and safety of hepatitis A vaccine.

OBJECTIVES: Since epidemiologic trends of hepatitis A are changing worldwide, we studied its seroprevalence in Mumbai, which is thought to be a high-endemicity area. The immunogenicity and safety of a hepatitis A vaccine were also studied. METHODS: Six hundred and seventy subjects (456 men; age range 6 mo-60 y) answered a questionnaire on social and medical history. Qualitative analysis of total anti-HAV was performed in all subjects by ELISA. One hundred and seven of 147 anti-HAV negative subjects received hepatitis A vaccine at months 0, 1 and 6. Subjects were followed up (months 1, 2, 6, 7) to look for side-effects and seroconversion. RESULTS: The seroprevalence of HAV was 523/670 (78%); 38% of children < 5 years were anti-HAV negative. Seroprevalence rates of 80% were reached by 15 years. Prevalence was lower in the higher socio-economic group (151/234; 64.5%) compared with the lower socio-economic group (372/436; 85%) (p < 0.001). One month after doses 1, 2 and 3 of the hepatitis A vaccine, seropositivity was 92%, 99% and 100%, respectively. Minor self-limited side-effects occurred in 19.5% of subjects; there were no major side-effects. CONCLUSIONS: The seroprevalence of anti-HAV is high in Mumbai. Seroprevalence is lower in the higher socio-economic groups. The hepatitis A vaccine is safe and immunogenic.

Distribution of malarial parasites: effect of gender of construction workers.

The city of Mangalore in South India was having increasing number of malaria cases from 1990. Concerned over the import of cases through migrant construction workers, a screening was done among them using clinical and parasitological methods. This demonstrated 6.28% slide positivity rate with statistically insignificant difference in prevalence of infection between males and females. There were many asymptomatic individuals reporting positive only on peripheral smear examination. Yet, clinical symptoms like fever were found to have good predictive value on logistic regression. It was more so with the P. falciparum which is a relatively new entrant to Mangalore.

Exponential model for weight using 'RJ index'.

We screened a sample of 204 children between the age of 3 months to 5 years and 3 months were during a general health survey conducted by the Department of Community Medicine, Kasturba Medical College, Mangalore from March 1992 to December 1993 at Kumpala village under PHC Ullal about 10 kms from Mangalore City. We developed a new index RJ as RJ = Mid upper Arm Circumference x (Height)2 x 10(-4) and tested the correlation of RJ index and weight for age. We found the correlation coefficient (r = 0.8) to be very significant (P < 0.001). Thus we propose the model as Weight = A x exp (RJ x B). We found that the available data fit in this model. We hope that this study will be a new step in looking at arm circumference as a tool in estimating weight of pre-school children.

Evaluation of anthropometric indices of malnutrition in under five children.

Anthropometric indices in the assessment of malnutrition in under five children are being indiscriminately used especially when a community based survey is conducted and so the estimated prevalence of malnutrition varies in different methods. In this study a comparison of these common anthropometric measurements is done in order to find out the best method suitable for individual assessment of malnutrition. The evaluation technique discussed in this paper consists of comparison of the efficiency of various anthropometric measurements in detecting malnutrition and was judged in terms of specificity, sensitivity and predictive value. The test is most efficient when the sensitivity and specificity attain unity. In this study it is shown that weight for age and Body Mass Index (BMI) attain higher value of delta [delta = 1-(alpha + beta)], where - alpha is false positive value and beta is false negative value) and low value of delta standard error of which proves that the best method of assessing malnutrition using various anthropometric measurements is weight for age as against body mass index.

Angiomyolipoma of kidney: a case report.

Renal angiomyolipomas are relatively uncommon renal tumors which grossly resemble renal cell carcinoma. In view of the paucity of renal angiomyolipoma in the Indian literature, we are reporting one case in a 28 year old female without tuberous sclerosis.

Granular cell tumor: a clinicopathological study.

Granular cell tumor is a relatively uncommon tumor of doubtful histogenesis. Nineteen cases of granular cell tumor reported in the department of Pathology, Kasturba Medical College, Mangalore, were analysed. Majority of tumors were seen in third to fifth decade mainly in females. The occurrence in rarer sites like caecum, of which only two cases have been so far reported tempted us to publish this study.

Chorioangioma of placenta: report of 3 cases.

Chorioangiomas are commonest benign tumors of placenta, but those measuring more than 5 cms are rare. We present three cases of large chorioangiomas. Of the three, two cases were associated with hydramnios and premature labour.