Histoid Leprosy: Are We Still Harbouring Potential Community Menace? A Case Series from North-East India

Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. Histoid leprosy is considered an uncommon multibacillary form of leprosy characterized by presence of histoid lepromas which present as erythematous round or oval shaped glistening nodules. Most commonly this form of leprosy is seen in patients on irregular therapy with MDT. In this series we report a total of three cases with their clinical, histopathological and dermoscopic findings.

Cohort profile of the largest health & demographic surveillance system (Dibrugarh-HDSS) from North-East India

Dibrugarh Health and Demographic Surveillance System (Dibrugarh-HDSS), was started in the year 2019 with the objective to create the health and demographic database of a population from a defined geographical area and a surveillance system for providing technical assistance for the implementation of programmes and formulating intervention strategies for reducing disease morbidities and mortalities in the population. Dibrugarh-HDSS adopted a panel design and covered 60 contiguous villages and 20 tea gardens. Line listing of all the households was conducted and a unique identification number detailing State, district, village/tea garden and serial number was provided along with geotagging. Detailed sociodemographic variables, anthropometric measurements (subjects ?five years) and blood pressure data (subjects ?18 yr), disease morbidity and mortality were collected. All data were collected in pre-designed and pre-tested questionnaires using a mobile application package developed for this purpose. Dibrugarh-HDSS included a total of 106,769 individuals (rural: 46,762, tea garden: 60,007) with 52,934 males (49.6%) and 53,835 females (50.4%). The number of females per thousand males were significantly higher (1042 in tea garden vs. 985 in rural populations) in the tea-garden community as compared to the village population. More than one-third (35.1%) of tea populations were illiterate compared to the rural population (17.1%). Villagers had significantly higher body mass index than the tea-garden community. The overall prevalence of hypertension (adjusted for age) was 29.4 vs. 28.2 per cent, respectively, for the village and tea-garden population. For both these communities, males (village=30.8%, tea garden=31.1%) showed a higher prevalence of hypertension (adjusted for age) than females (village=28.2%, tea garden=25.8%). The findings of the present study give an insight into the profile of the native rural and tea-garden populations that will help to identify risk factors of different health problems, review the effectiveness of different ongoing programmes, implement intervention strategies for reducing morbidity and mortality and assist the State health authorities in prioritizing their resource allocation and implementation strategies.

Predictors of smokeless tobacco use among the adult population of north-east India during 2009-2017: A decomposition analysis

Background & objectives: Contrary to overall declining trend in smokeless tobacco (SLT) use in India, an increase is observed in north-east (NE) India. This study examined the predictors of daily SLT use by gender and assessed the demographic and socio-economic characteristics that contribute to gender differences in SLT use in NE India. Methods: Data collected from 15,259 and 13,574 adults in the two rounds of Global Tobacco Adult Survey 1 and 2 for NE India during 2009-2010 and 2016-2017 were analyzed. Relative change, multivariable binary logistic regression and Blinder-Oaxaca decomposition analysis were used for analysis. Results: The findings suggest that among women in NE India, the daily SLT use significantly increased by 58 per cent between 2009-2010 to 2016-2017. Women residing in Nagaland, Manipur, Mizoram and Tripura were 3.5 and 2.5 times, respectively more likely to be daily SLT users compared to those in Assam. While age, education and wealth were the significant predictors of SLT use in both women and men, increased odds of SLT use were observed with women’s type of occupation and the State of residence. The majority of the gender differences in daily SLT use was explained by differences in work status (44%), age (26%), education (14%) and wealth status (9%) between men and women. Interpretation & conclusions: Increasing prevalence of SLT use amongst women in the NE States necessitates integration of gender-specific messages on harmful effects of SLT in the ongoing tobacco control programmes and development of culturally appropriate community-based interventions for cessation of SLT use.

Itinerários terapêuticos da população trans em um município do nordeste brasileiro / Therapeutic Itineraries of the Transgender in a Northeastern Brazilian City / Itinerarios terapéuticos de la población transexual en una ciudad del noreste de Brasil

Resumo O artigo apresenta resultados de pesquisa qualitativa sobre os itinerários terapêuticos da população trans no município de Timon - Maranhão a partir da realização de entrevistas individuais e semiestruturadas com oito pessoas trans (dois homens e seis mulheres). A análise dos dados foi realizada com base no referencial teórico da hermenêutica de Paul Ricoeur. A partir das narrativas dos participantes da pesquisa, foram reconhecidas três unidades de significado: "a construção do ser-trans", "o acesso à saúde da população trans" e, também, "itinerários terapêuticos (trans)formados". Os itinerários mencionados não apresentaram vínculos formais entre os serviços, nem tampouco garantia de acesso e continuidade do cuidado.

Abstract A qualitative research was carried out on the therapeutic itineraries followed by the trans population in the municipality of Timon - Maranhão, through individual and semistructured interviews with eight trans people (two men and six women). Data analysis was performed based on the theoretical framework of Paul Ricoeur's hermeneutics. From the narratives of the research participants, three units of meaning were recognized: "the construction of the being-trans", "the access to health of the trans population" and, also, "therapeutic (trans) formed itineraries". The mentioned itineraries did not present formal links between the services, nor guarantee access and continuity of care.

Resumen Se realizó una investigación cualitativa sobre los itinerarios terapéuticos de la población trans en el municipio de Timón - Maranhão, a través de entrevistas individuales y semiestructuradas a ocho personas trans (dos hombres y seis mujeres). El análisis de los datos se realizó con base en el marco teórico de la hermenéutica de Paul Ricoeur. A partir de las narrativas de los participantes de la investigación, se reconocieron tres unidades de significado: "la construcción del ser-trans", "el acceso a la salud de la población trans" y, también, "itinerarios terapéuticos (trans) formados". Los itinerarios mencionados no presentaban vínculos formales entre los servicios, ni garantizaban el acceso y la continuidad de la atención.

Clinico-Aetiological Scenario and Microbiological Profile in Corneal Ulcer Cases in a Tertiary Eye Care Centre in Southern Assam

Corneal ulcer is a global burden which is an ocular emergency. The outcome of corneal ulcer depends on its management. Aetiology, microbiological flora and antibiotic sensitivity vary from region to region. We wanted to analyse the epidemiology of corneal ulcer in Barak valley region of Assam.METHODSThis is a cross-sectional study conducted from May 2017 to June 2018 at Silchar Medical College, Silchar, Assam, India. Cases of corneal ulcer in the study period were included. Corneal scrapping was done, and the sample was sent for Gram stain, KOH mount stain and culture-sensitivity testing.RESULTSA total of 122 patients were examined and 70 cases had positive microbiological findings. Pure bacterial isolates were found in 37 (52.8%) of the 70 cultures and pure fungal isolates in 23 (32.8%) of the cultures. Staphylococcus aureus was the most commonly isolated bacterial organism (42.5%). Out of fungal isolate, Aspergillus spp. (46.7%), was the commonest. Farmers were the most commonly affected work group.CONCLUSIONSAlthough the major aetiological agents in our study were bacterial, fungal ulcers were also seen in a significant proportion of patients. Staphylococcus was the major bacterial isolate and Aspergillus was the major fungal isolate.

Head Injury in Road Traffic Accidents - A Study from North East India.

Introduction: India is undergoing major economic anddemographic transition with increased urbanization,industrialization, construction projects and motorization. Headinjury is the result of variety of mechanisms including motorvehicle and motor cycle accidents, pedestrians being struckby motor vehicles, falls from heights, occupational hazards,assaults, riots and bomb blasts. India has second highestreported mortality rate of 29.2 per 100000 people from roadtraffic injuries. Injuries are reported to be the seventh leadingcause of death (11% of all deaths) in India, with road trafficinjuries making up to 78% of them (WHO, 1999). Currentresearch aimed to study pattern of Head Injury in Road TrafficAccidents from North East India.Material and Methods: This study was conducted on medicolegal cases coming for autopsy in Department of ForensicMedicine, Guwahati Medical College and Hospital, Guwahatiduring the period of 1st August, 2009 to 31st July 2010. Duringthis period a total 2474 autopsies were performed in ourdepartment with 815 cases had head injuries. After obtainingthe necessary and relevant information about the victim, athorough and complete autopsy was performed on the deadbody, recording the findings on the proforma.Result: Our findings are similar to above studies and also tothe studies of Sevitt S (1973), Chandra J et al (1979), TyagiAK (1986), Motto L (1988) and Basu R et al (1992), Dandonaand Mishra (2004), Menon A and Nagesh KR (2005). Mostcommon cause of head injury is Road side accident (21.26%),most commonly occurring during office hours (6-9am)(25.45%) with 4 wheelers being most common offendingvehicle(49.39%).Conclusion: Road are like arteries of country. Vehicles mustrun for development of country and necessities of life. Injurieson head and other parts of body due to road traffic incidentsare unavoidable but with scientific data, we can minimize theloss of life and misery due to death and injury. We shoulddesign our interventions based on these data and studies.

Ocular biometry characteristics and corneal astigmatisms in cataract surgery candidates at a tertiary care center in North-East India

Purpose: The purpose of this study is to determine the ocular biometry characteristics and corneal astigmatisms using partial coherence laser interferometry in patients aged 40 years or above undergoing cataract surgery in a medical college in North-East India. Methods: In a hospital-based cross-sectional study, ocular biometry characteristics such as axial length (AL), anterior chamber depth (ACD), white-to-white (WTW) diameter, corneal power (K), and corneal astigmatisms (D) of consecutive eligible cataract patients in a medical college in North-East India between January 2015 and December 2017 were determined using the intraocular lens (IOL) master. Height and weight were also measured. Results: A cross-sectional study evaluated ocular biometry characteristics of 641 eyes in 641 eligible patients. The mean age was 64.04 ± 10.81 years. The mean AL, ACD, WTW, corneal power, IOL power, and body mass index (BMI) were 23.34 ± 1.12 mm, 3.12 ± 0.39 mm, 11.92 ± 0.54 mm, 44.41 ± 1.50 diopter (D), 20.53 ± 2.79 D, and 26.12 ± 4.32, respectively. Against-the-rule, with-the-rule, and oblique astigmatisms were 48.4%, 33.2%, and 18.4%, respectively. Corneal astigmatism of ?1 D was found in 292 eyes (45.55%) and >1.5 D in 182 eyes (28.39%). AL had statistically significant correlation with ACD, WTW, K, IOL power, height and weight but not with age. By multivariate analysis, AL was found to be associated with ACD, WTW, K and IOL power (P ? 0.05). The mean AL was negatively correlated with the mean K (R-square 0.138). Conclusion: This study is likely to provide the initial normative data for ocular biometry values in Indian adults 40 years or above, because such data is lacking in Indians using the IOL master. This will also help ophthalmologists in planning and improving the quality of surgical outcomes in phacoemulsification and phacorefractive surgeries by choosing the appropriate IOL and incision location.

Tuberculosis in North-East India: patient profile and treatment outcome of patient attending RNTCP

Background: Tuberculosis is a disease of global concern. India with its high burden of Tuberculosis, HIV and HIV-TB co-infection, this disease continue to have tremendous impact on its denizens especially the north-eastern states of the country because of its problem of HIV. It is imperative to understand every aspects of the disease for effective prevention and control.Methods: A retrospective record study of tuberculosis units was conducted.Results: The proportion of males was more as compared to females, with more cases seen with increasing age. Pulmonary TB was seen more among males, whereas extra-pulmonary TB was seen more among females. Favorable treatment outcome was seen in 84.7% of the population. HIV-TB Co-infection was seen 6.5% of the patients, with 46.3% having extra-pulmonary TB. Favorable treatment outcome was seen among them too.Conclusions: More common in males, showing increasing number of patients in older age group with favourable outcomes on treatment in all categories including HIV-TB co-infection patients.

Ultrasound guided fine needle aspiration cytology of gall bladder mass and mural thickening: a radio-pathological correlation

Background: Carcinoma of the gall bladder (GB) is the commonest malignancy of the biliary tract. Ultrasound (US) guided Fine Needle Aspiration Cytology (FNAC) plays a major role in early detection of malignancy in a suspicious GB lesion. The aim of this study was to evaluate the safety and diagnostic accuracy of US guided FNAC in detection of GB malignancy, to find the association of gall stones with GB malignancy, to study the ultrasound pattern of GB malignant mass and demographic profile of the disease in North eastern India.Methods: The study was conducted retrospectively in Dr. B. Borooah Cancer Institute, Guwahati from January 2016 to December 2017. A total number of 173 patients suspected to have GB malignancy were subjected to US guided FNAC.Results: Total 161 patients were positive for malignancy with significant female majority. There were 124 female (77.02%) and 37 males (22.98%) in the range of 29 to 82 years. Male female ratio was 1:3.5. One was diagnosed as xanthogranulomatous cholecystitis and another was chronic cholecystitis. FNAC remained inconclusive in 2 patients. There was no major procedure related complication. Adenocarcinoma was the most common malignancy found in 146 patients (98.68%). Cholelithiasis was associated in 88.19% of malignant lesions.Conclusions: US-guided FNAC is a safe, highly accurate and reliable procedure for early detection of GB malignancy.

Trends Of Antibiotic Resistance Pattern Among Common Bacterial Isolates In A Tertiary Heath Care Centre Of Tripura: A Hospital Based Study

Introduction: Resistance to antibiotics is an extremely common phenomenon in bacteria isolated from clinical material. However there is scarcity of data on antibiotic resistance from North Eastern part of India. In this Study, we aimed to generate data to find out the trend of Antibiotic resistance among the clinical isolates. Methods: Involving both indoor and outdoor patients attending this hospital are included in this study. Culture & Microbial sensitivity were performed by ‘Kirby Bauer‘ method and an according to current CLSI guidelines. Drug resistance pattern were analyzed among the Common clinical isolates. Results: Majority of isolated organisms were klebsiella sp and Staphylococcus sp . Cephalosporins resistance (99%) was more in Gram negative bacilli as compare to Fluroquinolones among Gram positive cocci (85%). Conclusion: This pilot study from a Medical College of North East has demonstrated very high levels of resistance to commonly used antibiotics and generated data can be used to formulate antibiotic use protocols in the state.

Violence against Women - An Emerging Health Issue in North East India.

Background: Violence against women is an extensively recognised public health problem but grossly underreported. The study plans to assess the magnitude as well as factors associated with domestic violence among ever married women. Methods: This cross sectional study was conducted among ever married women attending a tertiary care health centre using a semi structured questionnaire adapted from the WHO Multi-country Study on Women’s Health and Life Experiences. Descriptive statistics along with univariate and multivariate logistic regression analysis were performed to see for associations. A P- value of <0.05 was taken as significant. Results: The mean (SD) age of the respondents was 32.0±7.9 year. More than half of the respondents 278(53.6%) have faced some form of violence during their marital life. Verbal form of violence 218(78.4%) was the commonest followed by physical violence 134(48.2%). The risk of ever having faced violence was significantly associated with increasing number of children, husband being a smoker and husband being an alcohol user (P < 0.05). Conclusion: The prevalence of violence was relatively high as equated to other evidence from across the country. A primary prevention activity by raising public awareness and changing the gender-related attitudes towards women at a societal as well individual level is needed.

Isolation and characterization of Lepidoptera specific Bacillus thuringiensis strains predominantly from north-eastern states of India.

Both, the tobacco caterpillar Spodoptera litura (Fabricius) and the cotton bollworm Helicoverpa armigera (Hübner), are serious polyphagous pests causing considerable loss to crops. Indiscriminate use of chemical pesticides for controlling them has rather resulted in their resistance development. Microbial pesticides, Bacillus thuringiensis in particular, play an important role in pest management. Here, we isolated Bacillus thuringiensis-like bacteria from the soil samples primarily collected from North East region of India along with some states viz., Haryana, Punjab, Maharashtra, West Bengal and Uttarakhand and studied their toxicity against the above two insect pests at 10 µg/g along with standard strain B. thuringiensis subsp. kurstaki HD-1 and at 1 µg/g Pseudomonas fluorescens based MVPII expressing Cry1Ac toxin and AUG-5. Isolates AUG-5 and GTG-7 proved toxic to more than 75% larvae on the 4th as well as 7th day of the treatment of the neonates of H. armigera. The AUG-5 isolate was also effective against S. litura. Ten effective isolates (AUG-5, GTG-4, GTG-7, GTG-9, GTG-42, GTG-64, GTG-70, GTG-3S, GTG-4S and GTG-6S) were characterized using biochemical and 16S rDNA analysis. Nearly, all the isolates tested positive for utilizing monosaccharides. All selected B. thuringiensis isolates showed resistance to ampicillin and co-trimoxazole except AUG-5 to co-trimoxazole. AUG-5 and GTG-7 were highly toxic to both insects, and possessed cry1, cry1A and cry2 genes. These isolates AUG-5 and GTG-7 also contained high Cry1Ac (104.8 and 88.32 ng/mg) and Cry2Ab (3792 and 1305.9 ng/mg), respectively in their spore-crystal complex. Both, AUG-5 and GTG-7 isolates, could be considered for further development as bioinsecticides. The present study has established the diversity and richness of B. thuringiensis-like isolates in soils collected from north-eastern region of India.

Quantification of human polyomavirus JC virus load in urine and blood samples of healthy tribal populations of North‑Eastern part of West Bengal, India.

Background: Human polyomavirus JC (JCV) is a widespread human virus with profound pathogenic potential. A study was undertaken to quantify JCV load in urine and peripheral blood samples of immunocompetent, apparently healthy tribal individuals of North‑Eastern part of West Bengal, India for the first time. Materials and Methods: One hundred and thirteen samples of urine or blood were collected from different tribal groups of this region. For the quantitative estimation of the viral load in each sample, real‑time polymerase chain reaction method using the SYBR Green dye was employed. Results: The viral load estimated was found in the range between 3.5 × 102 and 2.12 × 106 copies/ml of samples having a mean and median viral copy numbers of 8.67 × 105 and 9.19 × 105 copies/ml of sample respectively. Conclusion: The mean viral DNA load in urine samples of the studied immunocompetent population was found to be higher than that found in a study conducted in the USA, but lower than similar groups of Italy and healthy adult women in the USA. However when compared with median values of viral DNA loads in urine samples of immunocompetent human subjects of Kuwait, Portugal, and Switzerland the observed viral DNA load was found to be substantially higher.

Prevalence and clinical manifestation of lymphomas in North Eastern Nigeria.

BACKGROUND: Lymphomas are one of the commonest childhood malignancies. Due to varied clinical features many patients are misdiagnosed and treated for other diseases. It is imperative to keep health workers informed about the current trend of lymphomas in northeastern Nigeria to facilitate prompt diagnosis and treatment. OBJECTIVE: To evaluate the extent of lymphomas at presentation and to define the pattern of presentation in relation to gender and site. MATERIALS AND METHODS: Retrospective analysis of cases of lymphomas over a 15 year period was conducted. Structured questionnaires were used to document demographic characteristics and clinical features. The non‑Hodgkin’s lymphoma (NHL) and Hodgkin’s lymphoma (HL) cases were categorized using standard classification schemes. Data were analyzed using the Statistical Package for Social Sciences (SPSS) software version 16, Illinois, Chicago, USA. Spearman’s correlation and Student’s t‑test were applied where appropriate. A P value < 0.05 was considered significant. RESULTS: Fifty cases of lymphoma, 10 (20%) belong to HL and 40 (80%) belong to NHL. Lymphoma is common in male, though the male to female preponderance was not significant in both the cases (P = 0.107 and 0.320, respectively). Maxilla was the commonest site of primary malignancy (36%) and late presentation of patients were observed. New trend was noticed, the NHL patients present commonly with severe symptoms than HL (P = 0.038). HL was dominated by lymphocytic predominant type, while NHL was dominated by the small non cleaved cells (Burkitt’s) lymphoma (70%). CONCLUSION: Childhood lymphoma in northeastern Nigeria has a slight shift in varied clinical presentation in favor of NHL. Patients in this study had late presentation.

Distribution of blood pressure & correlates of hypertension in school children aged 5-14 years from North East India.

Background & objectives: Elevated blood pressure (BP) in the young predicts serious cardiovascular events in the adults. High prevalence of adult hypertension reported from Assam, North east (NE) India may be linked with elevated blood pressure in the childhood. The present study was an attempt to describe the distribution of BP and correlates of hypertension in children aged 5-14 yr. Methods: A total of 10,003 school children from 99 schools of Dibrugarh district, Assam, NE India, were surveyed by stratified random cluster method. Blood pressure, demographic and anthropometric information were recorded. Blood pressure was categorized in to normal, prehypertension, stage I and stage II hypertension. Results: Girls had significantly higher (104.2 ± 12.0 vs. 103.2 ± 11.6 mm Hg, p<0.001) mean systolic blood pressure (SBP) than boys. Both SBP and diastolic blood pressure (DBP) revealed significant correlation with age, height, weight and BMI in overall and in gender specific analysis. Hypertension was found in 7.6 per cent school children (Boys: 7.3%, Girls: 7.8%). In multivariable analysis older age (OR 3.3, 95% CI: 2.82-3.91), children from tea garden community (OR 1.3, 95% CI: 1.08-1.55) and other community (OR 1.4, 95% CI: 1.18-1.73) and overweight (OR 1.5, 95% CI: 1.1-2.1) were independently associated with hypertension. Interpretation & conclusions: Mean blood pressure in the young school children of 5-14 yr was high. A programme comprising screening, early detection and health promotion through school health programmes may help prevent future complications of hypertension.

Mosquito-borne diseases in Assam, north-east India: current status and key challenges.

Mosquito-borne diseases, including malaria, Japanese encephalitis (JE), lymphatic filariasis and dengue, are major public health concerns in the north-eastern state of Assam, deterring equitable socioeconomic and industrial development. Among these, malaria and JE are the predominant infections and are spread across the state. The incidence of malaria is, however, gradually receding, with a consistent decline in cases over the past few years, although entry and spread of artemisinin-resistant Plasmodium falciparum remains a real threat in the country. JE, formerly endemic in upper Assam, is currently spreading fast across the state, with confirmed cases and a high case-fatality rate affecting all ages. Lymphatic filariasisis is prevalent but its distribution is confined to a few districts and disease transmission is steadily declining. Dengue has recently invaded the state, with a large concentration of cases in Guwahati city that are spreading to suburban areas. Control of these diseases requires robust disease surveillance and integrated vector management on a sustained basis, ensuring universal coverage of evidence-based key interventions based on sound epidemiological data. This paper aims to present a comprehensive review of the status of vectorborne diseases in Assam and to address the key challenges.

Thyroid Disorders in Pregnancy- Experience from North East India.

Aims: Thyroid dysfunction is commonly encountered in pregnancy and can affect maternal and Fetal outcomes. Limited data are available from north east India on the prevalence of various thyroid disorders in pregnancy. The present study was hence conducted to evaluate the prevalence of thyroid disorders in a large government hospital in Assam. Study Design: Prospective cohort study. Place and Duration of Study: Sample: Department of endocrinology and department of obstetrics, Gauhati medical college, Guwahati between may 2011 to April 2013. Methodology: Pregnant women irrespective of gestational age attending the antenatal clinic of Gauhati medical college were screened for thyroid dysfunction by estimation of serum free t34 (FT4), TSH and thyroid peroxidase antibodies (TPOAB). Subjects with known thyroid disorders, chronic illness or on medications known to affect thyroid status were excluded from the study. Results were interpreted as per the American thyroid association (ATA) 2011 guidelines. Results: A total of 542 pregnant women were enrolled for this prospective cohort study. The mean age was 23.85±4.04 yrs. Of the 542 women screened, 69.18% were Euthyroid, 21.58% had subclinical hypothyroidism (SCH), 5.35% had overt hypothyroidism (OH), hyperthyroidism was observed in 2.39% and 1.47% had gestational Thyrotoxicosis. TPOAB were positive in 18.08% of women. Conclusion: A high prevalence of thyroid disorders specially hypothyroidism were seen in this study using the newer ATA diagnostic criteria emphasizing the need for screening of all women during pregnancy.

Profiles of gall bladder cancer reported in the hospital cancer registry of a Regional Cancer Center in the North-East India.

Background: The incidence of gall bladder cancer (GBC) is very high in this part of the world and there is little information on the descriptive epidemiology of GBC from our population. Methods: A retrospective study on the data set of hospital cancer registry was analyzed. The data set consisted of patient information registered during the period of January 2011 to December 2012. The cases included for the present study were histologically confirmed and radiologically diagnosed cases of GBC. All the cases were retrospectively analyzed for gender, age, urban-rural residences, religion of patients and their educational levels. Descriptive statistics was calculated and Chi square test was done to see the significance differences among categories. Results: A total of 837 cases of GBC were registered, F:M was 2.33, median age in females and males was 54 and 50 years respectively, majority of cases in both the genders were seen in 50-59 years of age, 81.1% patients were from rural areas and 18.8% from urban areas, Chi square on comparison with other cancers showed p<0.05, and there was no major religious and educational pattern of GBC seen in our population. Conclusion: In our population females are at high risk especially past 40 years of age and rural population with its varied environmental, lifestyles and infective agents should be investigated for possible risk factor in the causation of GBC.

Pregnancy Outcome among Nulliparous Women at the University of Maiduguri Teaching Hospital, North Eastern Nigeria: A Retrospective Cohort Study.

Aim: To compare the pregnancy outcomes among nulliparae, with multiparae as the control. Study Design: Retrospective cohort study. Place and Duration of Study: University of Maiduguri Teaching Hospital over a period of one year (1st January 2007 to 31st December 2007). Methodology: This retrospective cohort study reviewed the pregnancy outcome of nulliparae over one year, using multiparae as control. The data were analysed using SPSS. The χ 2-test was used to compare the sociodemographic characteristics and pregnancy outcomes of the nulliparae and the multiparae. Multivariate logistic regression analysis was used to create a model for the factors that were independently associated with nullipara. A P-value of<0.05 was considered significant. Results: Nulliparae contributed 259 (13.7%) of the 1,865 babies delivered during the period of study. The age ranged from 15 years to 42 years with mean age of 27.1 years ±5.3 years. Nulliparous women were more likely to be of younger age less than 20 years (P<0.001), educated (P=0.01) and booked early (P=0.001) when compared with multiparae. Also nulliparous women were more likely to have pregnancy induced hypertension (P=0.001) and episiotomy at delivery (P<0.001) but less likely to have anaemia (P=0.002) when compared with multiparae. Multivariate logistic regression showed that Nulliparae were more likely to be of younger age group (OR 7.22, P<0.001) and have malaria (OR 2.22, P=0.02), malpresentation (OR 5.68, P=0.02), abruptio placentae (OR 6.41, P=0.02), preterm delivery (OR 7.04, P=0.01), episiotomy (OR 7.74, P<0.001) and pregnancy induced hypertension (OR 3.53, P=0.01) but less likely to have anaemia at booking and fetal macrosomia. Conclusion: Nulliparous women are at increased risk of certain adverse pregnancy outcome including malaria, preterm delivery and pregnancy induced hypertension. These adverse factors should be looked out for and excluded in order to improve maternal and fetal health in these women.

Dengue vectors in urban and suburban Assam, India: entomological observations.

Background: Dengue is rapidly becoming established in north-east India and spreading, on account of rapid urbanization and population movement, with reported morbidity and attributable death cases. This study aims to determine the seasonal abundance of Aedes (Stegomyia) albopictus and Aedes (Stegomyia) aegypti in Guwahati metropolis and suburban settlements; to characterize the breeding resources for these mosquitoes; and to ascertain the status of their susceptibility to adulticides and larvicides. Methods: Mosquito larval surveys were carried out in different localities in both Guwahati city and adjoining suburbs from January to December 2013, to determine the seasonal abundance of disease vectors and their breeding preferences. The insecticide susceptibility status of mosquito adults and larval populations of both Aedes aegypti and Aedes albopictus was ascertained, using World Health Organization standard diagnostic concentrations and test procedures. Results: The study revealed that both Aedes aegypti and Aedes albopictus are widely abundant in Guwahati city and suburbs, and breeding in a wide variety of resources. Aedes albopictus, however, was the predominant mosquito species in suburbs, breeding preferentially in flower vases, cut-bamboo stumps and leaf axils. Aedes aegypti was the most common in the city, breeding predominantly in discarded tyres, cement tanks and used battery boxes. Both Aedes aegypti and Aedes albopictus were resistant to dichlorodiphenyltrichloroethane (DDT; 4%), but susceptible to malathion (5%), and exhibited a varied response to pyrethroids. However, larval populations of both these mosquito species were susceptible to larvicides, including malathion (1.0 mg/L), temephos (0.02 mg/L) and fenthion (0.05 mg/L), at much lower dosages than diagnostic concentrations. Conclusion: Given the seasonal abundance and case incidence in city areas, it is highly probable that Aedes aegypti is the predominant mosquito vector transmitting dengue virus. The study results have direct relevance for the state dengue-control programme, for targeting interventions and averting outbreaks and spread of disease.