Risk factors and protective factors of pelvic inflammatory disease: a case-control study.

Risk factors and some protective factors for pelvic inflammatory disease (PID) in women were assessed in a case control study. Use of intrauterine device (OR = 3.98, p < 0.0001), sexual activity with multiple partners and younger age (ORs = 3.97, 1.9 and p = 0.0003, 0.0034, respectively), history of previous PID (OR = 4.08, p = 0.004) and history of minor gynecologic operation (OR = 3.07, p = 0.0158) were significant risk factors for PID. Pregnancy was a significant protective factor (OR = 0.25, p = .0074). Sterilisation had a significant protective effect (OR = 0.37, p = 0.0443) on multivariate analysis but not significant on univariate analysis. The results indicated that, almost half of the PID load on the population can be reduced by proper handling of four risk factors namely, use of IUD, sexual activity with multiple partners, history of previous PID and history of minor gynecologic operation (PARP = 0.2146, 0.1101, 0.0824 and 0.0794, respectively).

Sequential pattern of non-medical drug use in the drug career of opiate dependents in Nagpur, India.

A study was carried out in a group of opiate addicts who reported to various centers in Nagpur city, India, to know the sequential pattern of nonmedical drug use in the drug career of opiate dependents in Nagpur. The mean age of the study group was 28.2 years, the majority were males, educated up to 10th standard, employed in various occupations like petty business, vehicle driving, etc, with an average monthly income of Rs. 316. The average number of drugs ever used per person was 3.7 +/- 1.2, those recently used was 2.6 +/- 0.9 and currently used was 2.2 +/- 0.6. The study group experienced 13 drug types in their addict careers. Beedi¿cigarette was the first drug abused by the majority. Drug careers starting with beedi¿cigarette, progressing to alcohol and then to canabis and finally to heroin were observed in a majority of subjects. There appeared to be a shift from multidrug use to the singular combination of heroin and beedi¿cigarette currently. Use of all other drugs declined in favor of heroin as the career progressed. The study indicates that preventive programs should be directed at reducing the use of initial drugs like beedi¿cigarette and alcohol and also reducing the social acceptability of these drugs as measure for preventing progression to hard drugs like heroin.

A risk scoring system for prediction of coronary heart disease based on multivariate analysis: development and validation.

Considering the multifactorial disposition and the need of primordial prevention of coronary heart disease (CHD), a risk scoring system for the prediction of CHD was devised at Govt Medical College, Nagpur, India. In this pair-matched case-control study of 154 cases and 154 age and sex matched controls, socioeconomic status, physical inactivity, family history of CHD, type A personality characteristic, cigarette smoking, alcohol consumption, body mass index, diabetes mellitus, hypertension, total serum cholesterol and oral contraceptive use (in women) were studied for association with CHD. The additive risk scoring system based on the results of conditional multiple logistic regression identified five factors, namely, socioeconomic status, physical inactivity, diabetes mellitus, hypertension and toal serum cholesterol with statistical weights of 3,5,2,4 and 5 respectively. On back-validation using receiver operating characteristic (ROC) curve, a total score of 12 was found to be the cut off point above which there was increased risk of CHD. The overall predictive accuracy of this system-equivalent to the area under the ROC curve-was 0.7962 (95% Confidence Interval 0.7468-0.8455). On prospective validation using a separate group of 140 cases and 140 controls, the predictive accuracy was found to be 0.6964 (95% Confidence Interval 0.6341-0.7587). Future studies need to assess the risk scoring system in population based studies.