Can personal hygiene act as a proxy indicator of morbidity profile? A study on orphans of Uttarakhand region

Background: A healthy childhood is essential for future growth and development. It is greatly influenced by parent, family, society and environment which formulate attitude, behavior, manner and emotions. Millions of children across the world are deprived of this crucial phase of life; those are the orphans and abandoned children.Methods: This institution-based cross sectional study was carried out with the help of pre-designed semi-structured questionnaire amongst 193 orphans aged 5-14 years to assess the personal hygienic practices and morbidities among orphans and to find out the association between the morbidity with personal hygiene and other risk factors.Results: The leading morbidities observed were poor oral hygiene (57.51%) as a morbidity followed by dental caries (50.58%) and pallor (30.57%). The average morbidity per child was found to be 2. There was significant association between ages, education, personal hygienic practices with the presence of morbidity in the orphans.Conclusions: Practices related to personal hygiene was not satisfactory. There was a significant association between morbidity and personal hygiene. Despite of the fact that these children are highly vulnerable; their health needs are poorly understood and ill served.

Socio economic differentials in utilization of maternal health care services: A study in urban slums of District Dehradun.

Background: Health inequity is becoming an emerging issue all over the world. Improving maternal health is one of the UN Millennium Development goals. Pregnant women inhabiting urban slums are a “high risk” group with limited access to health facility. Objective: To study the socio economic profile of the mothers and to study the differentials in utilization of maternal health care by the beneficiaries. Study Design: Descriptive, observational cross-sectional field based study in two purposively selected urban slums of district Dehradun. Results: About 70.9% of mothers belonged to social class II and III and 66% of them belonged to nuclear families. Teenage pregnancy was seen in 8.5%. 93.8% of women received complete antenatal care, majority preferring government hospitals. 93.2% of the women received 100 IFA tablets or more but only 63.7% consumed them for 100 days. Majority of the deliveries were institutional and 79.9% were conducted by trained personnel. About 68.5 % received postnatal care. Conclusion: Although usage of ANC service was high, opportunity to deliver important health services was not fully utilized. Policy and programme to improve the quality and care of antenatal mothers, especially for the poor and under privileged are essential to improve maternal health care. Special interventions should be undertaken on priority basis so as to achieve millennium developmental goals in all population groups.

Involvement of the Early Growth Response Protein 1 in Vascular Pathophysiology: An Overview.

Hyperactivation of proliferative and growth promoting pathways underlies the progression of vessel remodeling, leading to vascular dysfunction. An upregulation of early growth response protein 1 (Egr-1), a zinc finger transcription factor has been observed in several models of vascular diseases. In the vasculature, Egr-1 expression can be induced by multiple hormonal, metabolic and external stimuli, such as growth factors, cytokines, reactive oxygen species, hyperglycaemia and stretch-induced stress. The structure of the Egr-1 promoter allows both its auto-regulation and its binding with several regulatory transcription cofactors like the serum response factor and the cAMP response element binding protein. Pharmacological and genetic studies have revealed the involvement of several signaling pathways that contribute to the expression of Egr-1. Among them, the mitogen-activated protein kinase pathway has emerged as a predominant signaling cascade that regulates Egr-1 transcription in response to various stimuli. Moreover, targeted deletion of Egr-1 by DNAzymes, antisense oligonucleotides or RNA interference has also helped in defining the importance of Egr-1 in the pathophysiology of vascular diseases. Neointimal formation and expression of genes directly linked with proinflammatory processes have been demonstrated to be enhanced by Egr-1 expression and activity. This review provides an overview on the signaling components implicated in Egr-1 expression and discusses its potential involvement in vascular pathophysiology.

Cardiovascular protection by curcumin: Molecular aspects.

Curcumin is the active component in turmeric — a spice that has been extensively used as a culinary agent and a home remedy to prevent and treat many diseases in India and other countries for hundreds of years. However, systematic studies to understand the molecular basis of disease preventing or therapeutic properties of curcumin began to appear in the scientific literature only during the last 40 years. As a result of these studies, substantial evidence has accumulated to suggest that curcumin can affect signaling pathways linked to cellular growth, proliferation, survival, inflammation and transcription. In addition, curcumin has also been shown to exert anti-atherosclerotic, anti-cancer, anti-diabetic, anti-inflammatory and anti-oxidative properties in animal models of various diseases and in human subjects. In this article, we highlight the cardiovascular protective role of curcumin with an emphasis on the molecular basis of this effect.

Urbanization and coronary heart disease: a study of urban-rural differences in northern India.

BACKGROUND: In the West, urbanization has been accompanied by a rise in the rate of coronary heart disease. This trend has gone hand in hand with an increased consumption of processed, energy-dense food and dependence on machines for physical work. To examine whether a similar trend is underway in northern India, the prevalence of and risk factors for coronary heart disease were compared in rural, semi-urban and urban communities. METHODS AND RESULTS: A total of 7,169 adults were interviewed and examined during 1995-2000 in cross-sectional cluster sample surveys from a rural area of Haryana (Raipur Rani block), two semi-urban areas of Punjab (Mandi Gobindgarh and Morinda), and Chandigarh city. The study, which covered people in the age-group of 35+ years, also estimated the lipid, glucose and insulin levels of a sub-sample of 186 persons who did not have coronary heart disease or hypertension. The prevalence of coronary heart disease among males in the villages, towns and city was 1.7%, 2.5% and 7.4%, respectively, and among females, 1.5%, 3.4% and 7.1%,respectively. The age- and sex-adjusted prevalence odds ratio of coronary heart disease, in comparison to the villages, was 1.9 (95% CI; 1.1-3.2) in the towns and 4.9 (95% CI: 2.9-8.2) in the city. Hypertension, diabetes, obesity and physical inactivity were significantly more common in the urban areas, while the rate of tobacco smoking was significantly higher in the rural areas ( p< 0.05). The alcohol consumption rates for the urban and rural communities were similar (p> 0.05). The quantity of the food items commonly consumed, as well as the frequency with which particular items were consumed, varied across the rural, semi-urban and urban areas ( p< 0.05). The urban population had significantly higher levels of lipids and serum insulin than did the rural population, but a lower level of plasma glucose ( p< 0.05). CONCLUSION: The urban way of living is leading to an increase in the prevalence of the well-known risk factors for, as well as the rate of, coronary heart disease. Attempts to preserve the traditional lifestyle are necessary in order to prevent an epidemic of coronary heart disease in the developing countries.

Primary cardiac tumors: surgical experience and follow-up.

BACKGROUND: Primary cardiac tumors are rare. There are only a few reports of such tumors from India. METHODS AND RESULTS: We report our experience with 34 patients with primary cardiac tumors operated on at our institute between December 1989 and October 2001. The study group comprised 16 males and 18 females with a mean age of 40.05 +/- 13.06 years (range 7-65 years). The predominant symptoms were breathlessness and congestive heart failure. In addition, 1 patient presented with peripheral embolism with impending limb ischemia that necessitated emergency embolectomy. Echocardiography was confirmatory in the diagnosis of all the benign tumors, whereas the malignant tumors were incidentally found during surgery. All the patients survived the operation. Complete resection of the tumor was possible only in benign tumors; however, malignant tumors were partly removed to relieve obstruction. All the excised benign tumors showed no recurrence on a mean follow-up of 54.78 +/- 31.30 months (range 3-108 months). Myxoma was found in 31 patients, left ventricular fibroma in 1, and leiomyosarcoma in 2. Both the patients with malignant tumors developed recurrence postoperatively, and succumbed to extensive distant metastases. CONCLUSIONS: The long-term outcome of surgery was excellent in patients with benign cardiac tumors. However, malignant tumors had an unchanged prognosis, although symptomatic relief was achieved.