Morbidity profile of truck drivers: a South Indian cross-sectional study

Background: Recent studies have shown that workers on the transport industry are more predisposed to cardiovascular morbidity and other health morbidities due to their improper diet and sedentary lifestyle. This study was aimed at assessing the common morbidity profile among the truck drivers and associated demographic and clinical parameters considered relevant to the development of cardiovascular disease.Methods: This was a cross sectional study conducted among 175 truck drivers aged 18-60 years at the Walayar check post, Coimbatore, southern India. After getting informed consent, a detailed physical examination was conducted. Socio demographic information was also elicited.Results: It was observed that 50% of the truck drivers were overweight and obese. Hypertensives were 41.1% and diabetics were 12%. About 27.4% had raised systolic blood pressure (BP) and 29.1% had raised diastolic BP. Low back pain was observed in 34.3%, hip pain in 24.6%, knee pain in 9.7%, shoulder pain in 5.4%, diminished vision in 4.6%, giddiness in 2.3% and hearing defects in 1.1% of the truck drivers.56.6% were current smokers and 66.3% were taking alcohol consumption more than 4 times a month. Older age was found to be a significant independent predictor [odds ratio OR 1.04 (95% CI 1.03-1.05)] for the total number of cardio vascular disease morbidities.Conclusions: We observed a higher morbidity among the truck drivers and observed that periodic health appraisals are needed

Enzymatic hydrolysis of microwave assisted acid pretreated chili postharvest residue for production of value added products

Agricultural crop residues serve as a renewable source for production of bioethanol and other value added chemicals. Optimization of enzymatic saccharification may ensure cost-effective production of bioethanol and other industrially important products. Here, we attempted optimization of various process variables affecting enzymatic hydrolysis of microwave-assisted acid pretreated chili post-harvest residue was evaluated by adopting statistical design experiments. The optimum conditions of enzymatic hydrolysis were solid loading of 15% (w/w), cellulase loading of 20 FPU per gram of pretreated biomass and incubation time of 12 h. The high solid loading, low cellulase loading and low incubation time may lead to better process economics. Maximum reducing sugar yield of 0.205 g/g was observed. Fermentation inhibitors, such as furfural and 5-hydroxymethylfurfural were absent in the hydrolysate obtained after enzymatic saccharification of pretreated biomass and were found suitable for the production of various value added products like xylanases, bioethanol and biopolymer (poly-3-hydroxybutyrate).

Prevalence and correlates of malnutrition among elderly in an urban area in Coimbatore.

Background: Different studies in India have shown that more than 50% of elderly population of India are suffering from malnutrition and more than 90% have less than recommended intake. Objectives: The aim of this study is to estimate the prevalence and correlates of malnutrition among elderly aged 60 years and above in an urban area in Coimbatore using Mini Nutritional Assessment (MNA). Methods: A cross-sectional study was conducted on 154 households and 190 elderly were interviewed. Nutritional status was assessed using the MNA questionnaire. Results: Mean (standard deviation) age of the total population (n = 190) was 71.09 (7.93) years and 30% was male. In this population, 37 (19.47%) was malnourished (MNA <17.0) and 47 (24.73%) were at risk for malnutrition (MNA 17.0-23.5). No significant association was observed between smoking, current alcohol consumption, higher medication use, higher comorbidity, and use of walk aid with malnutrition. Among the social factors studied, lower socioeconomic status compared to higher socioeconomic status (adjusted odds ratio [OR] =5.031, P < 0.001), single/widowed/divorced compared to married (adjusted OR = 3.323, P < 0.05), and no pension compared to those having pension (adjusted OR = 3.239, P < 0.05) were significantly associated with malnutrition. Conclusion: The prevalence of malnutrition observed in the aged people is unacceptably high. The increasing total number of lifestyle, somatic, functional, and social factors was associated with lower MNA scores. The findings of the present study clearly indicate that malnutrition is a multifactorial condition associated with sociodemographic, somatic, and functional status. Hence, we recommend that the treatment of malnutrition should be multifactorial, and the treatment team should be multidisciplinary. Further research is needed to develop appropriate guidelines for nutritional screening and interventional programs among geriatric population.

Association between Smoking and Body Mass Index among Males Aged 20 Years and Above - A Study in Rural Tamil Nadu, South India.

Objective: To investigate the relationship between smoking status and Body Mass Index (BMI) in men aged 20 years and above. Methods: A cross sectional study was conducted in the rural field practice area of Department of Community Medicine, PSG Institute of Medical Science and Research, Coimbatore during June and July 2010. A total of 459 men aged 20 years and above were included in the study. Statistical analyses were done using General Linear Model procedure of SPSS. Results: Cigarette smokers weighed (Kg) less, p<0.01 (age adjusted mean ± standard error = 58.64 ± 0.44) and were leaner, p<0.001 [age adjusted mean BMI (kg/m2) ± standard error = 21.13 ± 0.13] than ex/non-smokers (61.11 ± 0.69 and 22.19 ± 0.2 respectively). Regarding the intensity of smoking and BMI, light smokers (1 to 20 cigarettes per day) were leaner than ex/non smokers (mean ± standard error were 21.13 ± 0.13, 22.19 ± 0.208 respectively, p< 0.001). Regarding the duration of smoking and BMI, a linear diminution in BMI is observed with increasing duration of cigarettes smoking compared to ex/non smokers (mean ± standard error of BMI) for ex/non smokers 22.19 ± 0.208, 1 to 10 years of smoking 21.56 ± 0.221(p<0.05); 11 to 20 years of smoking 21.23 ± 0.256 (p<0.01); 21 to 30 years of smoking 20.30 ± 0.333 (p<0.001); 30 and above years of smoking 20.07 ± 0.501(p<0.001). Conclusion: We found significant results confirming an association between cigarette smoking and lower BMI in men.

Activated charcoal and baking soda to reduce odor associated with extensive blistering disorders.

BACKGROUND: Skin disease leading to extensive blistering and loss of skin is associated with a characteristic smell. Odor can cause physiologic disturbances such as increase in heart rate and respiratory rate. It can also cause nausea and vomiting and is disturbing to bystanders. AIMS: To test odor reducing capability of activated charcoal. METHODS: In this blinded experimental study we used putrefied amniotic membrane to produce odor and studied the effectiveness of activated charcoal and soda-bi-carbonate to reduce odor. RESULTS: Statistical analysis with Kruskal Wall's Chi Square Test and Man Whitney U test showed significant reduction of odor using activated charcoal by itself or along with soda-bi-carbonate. CONCLUSION: We recommend the usage of activated charcoal with/without soda bicarbonate as an inexpensive practical measure to reduce foul odor associated with extensive skin loss.

Study of histamine wheal suppression by dexamethasone with and without iontophoresis.

BACKGROUND: Iontophoresis increases the penetration of drugs into the skin by electric current. The ability of topical steroids to reduce the size of the histamine wheal was used to assess the efficacy of topical dexamethasone delivered with and without iontophoresis. AIM: To determine the wheal suppressing ability of dexamethasone delivered with and without iontophoresis. METHODS: A template with three squares of 3x3 cm was placed on both forearms of 20 volunteers and the edges marked. A gauze piece soaked in 2 ml of dexamethasone solution was placed on the flexor aspect of the left forearm and the electrode, an aluminum foil was placed on it and connected to the negative pole (since dexamethasone is negatively charged). An electric current was passed for 15 minutes. Similarly, on the right forearm, a dexamethasone soaked gauze piece was placed without iontophoresis. Histamine wheal suppression was assessed at the end of 30 min, 1 hr and 2 hrs, on both sides. Statistical analysis was done using an independent t-test. RESULTS: There was a statistically significant difference in wheal suppression at 30 min (p=0.006) on the left hand where iontophoresis was used. CONCLUSION: Our experiment showed that topical dexamethasone with iontophoresis has the maximum effect at the end of 30 minutes and is more effective than dexamethasone without iontophoresis.

Cutaneous manifestations in patients with chronic renal failure on hemodialysis.

BACKGROUND: Chronic renal failure (CRF) presents with an array of cutaneous manifestations. Newer changes are being described since the advent of hemodialysis, which prolongs the life expectancy, giving time for these changes to manifest. AIM: The aim of this study was to evaluate the prevalence of dermatologic problems among patients with chronic renal failure (CRF) undergoing hemodialysis. METHODS: One hundred patients with CRF on hemodialysis were examined for cutaneous changes. RESULTS: Eighty-two per cent patients complained of some skin problem. However, on examination, all patients had at least one skin lesion attributable to CRF. The most prevalent finding was xerosis (79%), followed by pallor (60%), pruritus (53%) and cutaneous pigmentation (43%). Other cutaneous manifestations included Kyrle's disease (21%); fungal (30%), bacterial (13%) and viral (12%) infections; uremic frost (3%); purpura (9%); gynecomastia (1%); and dermatitis (2%). The nail changes included half and half nail (21%), koilonychia (18%), onychomycosis (19%), subungual hyperkeratosis (12%), onycholysis (10%), splinter hemorrhages (5%), Mees' lines (7%), Muehrcke's lines (5%) and Beau's lines (2%). Hair changes included sparse body hair (30%), sparse scalp hair (11%) and brittle and lusterless hair (16%). Oral changes included macroglossia with teeth markings (35%), xerostomia (31%), ulcerative stomatitis (29%), angular cheilitis (12%) and uremic breath (8%). Some rare manifestations of CRF like uremic frost, gynecomastia and pseudo-Kaposi's sarcoma were also observed. CONCLUSIONS: CRF is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and pruritus and the early recognition of cutaneous signs can relieve suffering and decrease morbidity.

Half an hour versus three hour contact of topical steroid (clobetasol propionate).

BACKGROUND: Steroids when left on the skin for longer duration may contribute to the side effects without any additional clinical benefit. The relationship between the duration of topical steroid contact with the skin and its effectiveness has not been established. The ability of the topical steroids to inhibit the size of histamine induced wheal was used to assess their relative efficacy. AIM: To determine whether half an hour contact and three hour contact of a topical steroid, clobetasol propionate, is equally effective in inhibiting the size of the histamine induced wheal. METHODS: On 30 volunteers, 4 squares were marked on flexor aspect of both forearms using a template. One fingertip unit of clobetasol propionate 0.05% was applied on all the areas. Half an hour later all areas of left forearm and last square of right forearm were wiped. Prick testing was done with histamine and size of wheal recorded after 15 minutes. Similarly steroid was wiped from the 1st, 2nd, 3rd square after 1 hr, 2 hr and 3 hrs on right forearm and the corresponding areas prick tested on both forearms. RESULTS: There was statistically significant wheal suppression at the end of 2 hrs and 3 hrs as compared to half an hour. CONCLUSION: We conclude that half an hour application of clobetasol propionate is ineffective and that it is effective only after two hours of contact and hence short contact of half an hour will be less effective than relatively prolonged contact of 2 hours.

Sweat function in the diabetic foot.

BACKGROUND: Autonomic dysfunction, an early manifestation of diabetic neuropathy, presents with altered sweating patterns, leading to dryness and fissuring. We conducted a study to assess the sweat function in the diabetic foot and to determine the interrelation between the duration of diabetes, sensation, fissuring, and sweating. METHODS: The sweat function was assessed in 30 diabetic patients, 28 of whom had fissuring of the feet, using Ninhydrin impregnated discs. RESULTS: There was a significant association between fissuring and sensation, but not between the duration of diabetes and fissuring and between loss of sweating and fissuring. In 18 patients (60%) there was impairment or absence of sweating in the presence of normal sensation. CONCLUSION: Although fissuring increases with long-standing diabetes and sweating is reduced in diabetic patients with fissures on the foot, the correlation between these entities was not statistically significant. Since 60% patients had altered sweating in the presence of normal sensations, the sweat test can be used as an early indicator of diabetic neuropathy.