Prevalence and Associated Risk Factors of Depression among Housewives:A Cross Sectional Study from Rural Community of Rajasthan, India

Introduction : Depression is the leading cause of disease-related disability among women in the world today. Depression is a serious condition that can impact every area of women’s life. It affects social life, family relationships, career, and one’s sense of selfworth and purpose. To determine the prevalence andObjective: associated risk factors of depression among rural housewives aged 18–59 years. A community basedMethod: cross sectional study was carried out among 414 housewives in rural field practice area of Department of Community Medicine, Jhalawar Medical College, Jhalawar, Rajasthan. Participants were selected by simple random sampling technique. A pre designed semi structured proforma was used for collecting information on socio-demographic characteristics, medical history, family problems, personal history and obstetrical and gynecological history. Assessment of depression was done by using self-reported instrument Patient Health Questionnaire-9 (PHQ-9) Out of 414 Housewives, 63 (15.2%) were found to have depression. WithResults: increasing education level, there was a declining trend toward depression. Significantly higher rates of depression were observed among housewives reporting any debilitating ailments in one or more family members (31.2%), some unusual events occurred in family in past (56.2%), presence of any addiction in family members (22.7%) and debt on family (58.8%). Marriage at early age, having first pregnancy at early age, more than two children, menstrual irregularities and suffering from unable to conceive or infertility were the biological factors significantly associated with depression. Prevalence of depression was highConclusion: among housewives in rural community. Many social and biological factors were contributing towards high rate of depression among housewives

Scrub typhus in urban areas of Wardha district in central India

Background & objectives: Scrub typhus caused by Orientia tsutsugamushi presents as acute undifferentiated fever and can be confused with other infectious causes of fever. We studied scrub typhus as part of a study on hospital-based surveillance of zoonotic and vector-borne zoonotic diseases at a tertiary care hospital located in the Wardha district, Maharashtra, India. We report here descriptive epidemiology and climatic factors affecting scrub typhus. Methods: Patients of any age and sex with fever of ?5 days were enrolled for this study. Data on sociodemographic variables were collected by personal interviews. Blood samples were tested by IgM ELISA to diagnose scrub typhus. Confirmation of scrub typhus was done by indirect immunofluorescence assay for IgM (IgM IFA). The climatic determinants were determined using time-series Poisson regression analysis. Results: It was found that 15.9 per cent of the study participants were positive for scrub typhus by IgM ELISA and IgM IFA, both. Positivity was maximum (23.0%) in 41-60 yr of age and more females were affected than males (16.6 vs. 15.5%). Farmworkers were affected more (23.6%) than non-farm workers (12.9%). The disease positivity was found to be high in monsoon and post-monsoon seasons (22.9 and 19.4%) than in summer and winter. Interpretation & conclusions: There were three hot spots of scrub typhus in urban areas of Wardha district. Rainfall and relative humidity in the previous month were the significant determinants of the disease

Study of sociodemographic factors of women undergoing caesarean section in tertiary care centre of rural area of central India

Background: Many studies have attempted to examine and evaluate the changes in population characteristics that may have contributed to the observed increase in CS rate. The aim of this study was to determine the caesarean section rate and demographic characteristics of women undergoing caesarean section in our rural tertiary health centre of central India.Methods: This prospective study was conducted in department of obstetrics and gynecology. The study instrument comprised a pre-structured data collection proforma which had various sections; social demographic characteristics, obstetric history and gestation details.Results: The overall caesarean section rate (CSR) was 36.88%. Maximum women (39.62%) who underwent Caesarean section were of age group 25-29 years. 58.05% from rural while 41.95% from urban area. CS was more in women of lower middle (22.80%) and upper lower (20.80%) class. Majority of women who had caesarean section were educated till higher school (31.87%) or were graduate (22.61%), 5.85% were illiterate. Majority of women (56.40%) were housewives. CSR was 70.83% in referred and 28.31% in booked. 52.86% women were nulliparous. Caesarean section was maximum (83%) in term, 16.92% preterm women and 0.08% post term women. 38.69% were referred from other health facilities. Maximum referrals 43.21% were from the district hospital.Conclusions: It was noted that the preference for caesarean section is more in women of 25-29 years, lower middle and upper middle class, rural women, educated upto high school and housewives at our centre. This hospital also serves as referral centre from surrounding health facilities increasing the caesarean section rate of the institute.

Nutritional status of children under five year of age: a cross sectional study in rural area of Jhalawar, Rajasthan

Background: Adequate nutrition is essential in early childhood to ensure healthy growth and development, proper organ functions and a strong immunity. Accurate assessment of nutritional status of children is a requisite in appropriate planning and effective implementation of nutrition interventions. The objective of this study is to assess nutritional status of children under five year of age in rural area and to identify the socio-demographic factors associated with under nutrition.Methods: A cross sectional study was conducted among children aged six months to five years in rural area of Jhalawar, Rajasthan. Nutritional status of the children was assessed by measurement of mid upper arm circumference and information like birth order of children, birth weight and number of siblings was collected using a pre-coded and semi structured questionnaire.Results: Moderate under-nutrition was present in 16.8% children. Under-nutrition was present among 9.9% male and 24.2% female children. 38.1% children with birth weight less than 2.5 kg were under-nourished. Proportion of under-nutrition was 27.7% among children with number of siblings more than 2 while it was only 11.1% among those with 2 or less number of siblings.Conclusions: Gender, number of siblings and birth weight of children were significantly associated with nutrition status of children.

National Medical Commission Bill: Opportunity to end educational apartheid?

The Government has superseded the Medical Council of India (MCI) with an interim board of governors that has assumed the powers and functions of the Council, pending passage of the National Medical Commission Bill. While a systemic revamp of medical education is intended, uncertainty prevails on whether medical academia will now be more inclusive.

A comparative evaluation of effect of intravenous premedication with ondansetron versus granisetron on hemodynamics and sensory-motor blockade produced by intrathecal hyperbaric 0.5% bupivacaine

Background: Bezold Jarisch reflex is important cause of hypotension and bradycardia which occur after spinal anaesthesia. This reflex is elicited by stimulation of peripheral serotonin receptors 5- hydroxytryptamine (5- HT3 type). These receptors have antinociceptive effect, which is confirmed by many studies.The two most commonly used 5HT3 antagonist are ondansetron and granisetrone. Very few comparative studies of the two drugs on the effect after spinal anaesthesia are available.Methods: Ninety adulted patients of either sex aged 18-58 years scheduled for elective infraumbilical surgeries were randomly allocated in three groups to receive intravenous ondansetron 4mg, granisetrone 2mg or normal saline in equal volume 5mins before spinal anesthesia. Hemodynamic changes and time to sensory motor onset and regression were evaluated.Results: There was statistically significant difference in fall of systolic diastolic and mean blood pressure among the three groups. Time to two segment regression of sensory block and time to regression to S1 was faster in ondansentron (76.6±17.2mins, 176±22mins) and granisetrone group (69±17.3mins, 165±19.2mins) in comparision to control group(77.4±24.3mins, 178±21mins) which was statistically significant also p value-0.019, 0.0001 respectively.Conclusions: The prophylactic therapy with 4mg i.v. ondansetron, given five minutes before spinal anaesthesia appears to be significantly most effective and safe for attenuating haemodynamic response after spinal anaesthesia without affecting the duration of sensory block in patients undergoing infraumbilical surgeries.

A study of tobacco and alcohol consumption among the elderly population residing in field practice areas of a Tertiary Care Institute

Introduction: Tobacco and alcohol use are serious public health problems in many countries including India because of the associated health hazards. It is essential to bring down the health related risk behaviors among elderly population for promotion and prolongation of healthy life. Objective: To assess health related risk behaviors viz. smoking, alcohol and tobacco consumption among the geriatric population and making comparison of rural and urban elderly people. Material and method: A pretested, semi-structured questionnaire pertaining to sociodemographic information and three common risk behaviour practices i.e. smoking, smokeless tobacco use and alcohol consumption was used for data collection. Results: Overall, 9.6% rural and 6.8% urban elderly were current alcohol users. 19.6% rural and 12.8% urban elderly were current smokers while 20.4% rural and 14.0% urban elderly were current smokeless tobacco users. Proportions of males were significantly higher among tobacco user elderly participants in both rural and urban areas. Proportions of rural elderly were significantly higher among tobacco chewers. Conclusion: Overall prevalence of health risk behaviors was high among the study population. No significant difference found between rural and urban elderly people in relation to habit of smoking and alcohol consumption.

A Retrospective Analysis of Prevalence of Uropathogens and Antibiotic Sensitivity Pattern in Patients of Urinary Tract Infection in a Tertiary Care Teaching Hospital

Background: Antibiotic Resistance has now become a big threat as antibiotics are no more useful now a days, as they were previously. The objective of this study was to analyse the various bacterial isolates found in Urinary Tract Infection. Methods: This Retrospective study was conducted in the department of Microbiology in collaboration with the department of Pharmacology of Pacific Medical College and Hospital, Udaipur, Around 705 culture proven urine isolates were retrospectively studied. The samples were collected during one year from both the inpatient as well as the outpatient department of Pacific Medical College and Hospital, Udaipur. Results: Uropathogenic strains from inpatient and outpatient departments were studied for their susceptibility profiles. The various isolates were Escherichia coli, Klebseilla pneumoniae, Pseudomonas aeruginosa. Antibiotic susceptibility pattern of these isolates revealed that for outpatients, first generation Cephalosporins, nitrofurantoin, Norfloxacin/ciprofloxacin were effective for treatment of urinary tract infection but for inpatients, parenteral therapy with newer aminoglycosides and third generation Cephalosporins should be administered as the organisms for nosocomial UTI exhibit a high degree of drug resistance. Conclusion: Culture and sensitivity of the isolates from urine samples should be done as a routine before starting the antimicrobial therapy.

A Prospective Study on Drug Utilization Pattern of NSAIDs in Patients Attending Orthopaedics OPD of a Tertiary Care Hospital

Background: The objective of this study was to analyse the prescribing pattern of NSAIDs in patients attending Orthopaedics OPD and to analyse the correlation between the use of selective COX-2 inhibitors and older conventional NSAIDs in the pattern of current practice. Methods: This Prospective study was conducted on Patients visiting Orthopaedics OPD of Pacific Medical College and Hospital, Udaipur, during 6 month study period. Individual data was collected in a preformed format and was analyzed on parameters such as demographic profile and NSAID's usage pattern. Results: 180 patients were selected on the basis of inclusion and exclusion criteria. Around 417 drugs were prescribed, out of which 302 were oral, 39 were topical (Table No.2). Out of 417 drugs, total number of systemic NSAID's used were 302 [72.2%]. Of these 185 (56.2%) were used as monotherapy and 144 (43.7%) were used as fixed dose combinations (FDC). Among monotherapy 103 (55.68 %) were non-selective and 82 (44.32 %) were selective COX inhibitors. Conclusion: The result of this study suggests that the frequent use of selective COX-2 inhibitors although conventional non-selective NSAIDs topped the list of various selective and non-selective NSAIDs. Concomitant gastro protectives were also used. Fixed dose combinations were also prescribed.

Curcuma oil ameliorates insulin resistance & associated thrombotic complications in hamster & rat.

Background & objectives: Curcuma oil (C. oil) isolated from turmeric (Curcuma longa L.) has been shown to have neuro-protective, anti-cancer, antioxidant and anti-hyperlipidaemic effects in experimental animal models. However, its effect in insulin resistant animals remains unclear. The present study was carried out to investigate the disease modifying potential and underlying mechanisms of the C. oil in animal models of diet induced insulin resistance and associated thrombotic complications. Methods: Male Golden Syrian hamsters on high fructose diet (HFr) for 12 wk were treated orally with vehicle, fenofibrate (30 mg/kg) or C. oil (300 mg/kg) in the last four weeks. Wistar rats fed HFr for 12 wk were treated orally with C. oil (300 mg/kg) in the last two weeks. To examine the protective effect of C. oil, blood glucose, serum insulin, platelet aggregation, thrombosis and inflammatory markers were assessed in these animals. Results: Animals fed with HFr diet for 12 wk demonstrated hyperlipidaemia, hyperglycaemia, hyperinsulinaemia, alteration in insulin sensitivity indices, increased lipid peroxidation, inflammation, endothelial dysfunction, platelet free radical generation, tyrosine phosphorylation, aggregation, adhesion and intravascular thrombosis. Curcuma oil treatment for the last four weeks in hamsters ameliorated HFr-induced hyperlipidaemia, hyperglycaemia, insulin resistance, oxidative stress, inflammation, endothelial dysfunction, platelet activation, and thrombosis. In HFr fed hamsters, the effect of C. oil at 300 mg/kg was comparable with the standard drug fenofibrate. Curcuma oil treatment in the last two weeks in rats ameliorated HFr-induced hyperglycaemia and hyperinsulinaemia by modulating hepatic expression of sterol regulatory element binding protein 1c (SREBP-1c), peroxisome proliferator-activated receptor-gamma co-activator 1 (PGC-1)α and PGC-1β genes known to be involved in lipid and glucose metabolism. Interpretation & conclusions: High fructose feeding to rats and hamsters led to the development of insulin resistance, hyperglycaemia, endothelial dysfunction and oxidative stress. C. oil prevented development of thrombotic complications associated with insulin resistance perhaps by modulating genes involved in lipid and glucose metabolism. Further studies are required to confirm these findings.

Oil Pulling and Oral Health: A Review.

Oil pulling is extensively used as a traditional Indian folk remedy without the scientific proof for many years to prevent decay, bleeding gums, oral malodor, dryness of throat, cracked lips and for strengthening teeth, gums, and jaws. This paper reviewed the literature on oil pulling based on the scientific articles available under the following subheadings: (1) Introduction (2) history (3) procedure (4) mechanism (5) benefits (6) discussion (7) summary (8) conclusion. Oil pulling or oil swishing is the ayurvedic way of maintaining oral health and improving overall immune system. Oil also pulling acts as an excellent detoxifying agent in healing the body inside. Oil pulling is a procedure in which the practitioners rinse their mouth with approximately one tablespoon of an ordinary cooking oil for 3-20 min, then spits it out. This procedure is typically performed daily. In this narrative review, authors try to illustrate different types of oil used for oil pulling and their oral benefits and general benefits on the health. Various oils used for swishing (pulling) the oral cavity-coconut oil, palm oil, corn oil, rice bran oil, sesame oil, sunflower oil, soybean oil, etc. Though oil pulling is effective, none of the studies considered it as a replacement for the tooth brushing, but can definitely be a supplemental oral hygiene aid.

Demographic and clinical profile of vernal keratoconjunctivitis at a tertiary eye care center in India.

Purpose: To study the demographic and clinical profile of patients with vernal keratoconjunctivitis (VKC) at a tertiary eye care center in India. Materials and Methods: Retrospective chart analysis of 468 patients of VKC seen from January 2006 to December 2006. Results: Mean age at presentation was 12 years. Majority of the patients had mixed pattern disease (72%). Chronic perennial disease was seen in 36% patients. Personal or family history of allergies was noted in 5% patients. Severe disease based on clinical grading was present in 37% patients. Moderate to severe vision loss was seen in 12% of total population. Persistent disease beyond 20 years of age was found in 12% patients. VKC‑related complications such as corneal scarring (11%), shield ulcer (3%), keratoconus (6%), and limbal stem cell deficiency (1.2%) were seen. Treatment‑related complications like corticosteroid‑induced cataract and glaucoma were seen in 6% and 4% of patients, respectively. Conclusion: Clinical pattern of VKC seen in the tropical climate of India is essentially similar to that seen in other tropical countries. Few distinct features that we noted represent chronic perennial disease, low association with atopy, and higher propensity for disease and treatment‑related complications.

Fluorescence in situ hybridization (FISH) using non-commercial probes in the diagnosis of clinically suspected microdeletion syndromes.

Background & objectives: Microdeletion syndromes are characterized by small (<5 Mb) chromosomal deletions in which one or more genes are involved. These are frequently associated with multiple congenital anomalies. The phenotype is the result of haploinsufficiency of genes in the critical interval. Fluorescence in situ hybridization (FISH) technique is commonly used for precise genetic diagnosis of microdeletion syndromes. This study was conducted to assess the role of FISH in the diagnosis of suspected microdeletion syndrome. Methods: FISH was carried out on 301 clinically suspected microdeletion syndrome cases for the confirmation of clinical diagnosis using non-commercial probes. Of these, 177 cases were referred for 22q11.2 microdeletion, 42 cases were referred for William syndrome, 38 cases were referred for Prader Willi/Angelman and 44 cases were referred for other suspected microdeletion syndromes. Results: FISH was confirmatory in 23 cases only (7.6%). There were 17 cases of 22q11.2 microdeletion, four cases of Prader Willi syndrome and two cases of William syndrome. Interpretation & conclusion: We conclude that FISH should not be the method of choice for clinically suspected microdeletion syndromes. We propose to follow strict clinical criteria for FISH testing or preferably to follow better methods (genotype first approach). Whole genome screening may be used as first line of test and FISH may be used for confirmation of screening result, screening of family members and prenatal diagnosis.

Rapid detection of chromosome X, Y, 13, 18, and 21 aneuploidies by primed in situ labeling/synthesis technique.

AIMS AND OBJECTIVE: Primed in situ labeling/synthesis (PRINS) technique is an alternative to fluorescent in situ hybridization for chromosome analysis. This study was designed to evaluate the application of PRINS for rapid diagnosis of common chromosomal aneuploidy. MATERIALS AND METHODS: We have carried out PRINS using centromere specific oligonucleotide primers for chromosome X, Y, 13, 18 and 21 on lymphocyte metaphase and interphase cells spread. Specific primer was annealed in situ, followed by elongation of primer by Taq DNA polymerase in presence of labeled nucleotides. Finally, reaction was stopped and visualized directly under fluorescent microscope. RESULTS: Discrete centromere specific signals were observed with each primer. CONCLUSION: PRINS seems to be a rapid and reliable method to detect common chromosome aneuploidy in peripheral blood lymphocyte metaphase and interphase cells.

Conventional septoplasty verses endoscopic septoplasty: A comparative study.

The study was carried out to compare the postoperative morbidity among patients of conventional and endoscopic septoplasty and to assess the efficacy and use of endoscopic septoplasty with other endoscopic surgeries. The present prospective study was conducted among 100 patients of deviated nasal septum, admitted in the department of Otorhinolaryngology, of Sawai Man Singh Medical College and hospital, Jaipur, Rajasthan. Patients were selected by simple random sampling procedure and were divided into group A and B, with 50 cases in each group. Group A underwent conventional septoplasty and group B underwent endoscopic septoplasty. Deviated nasal septum was commonly associated with inferior turbinate hypertrophy (75%) and concha bullosa (26%). Postoperatively, a significant relief from the symptoms of nasal obstruction (96%), nasal discharge (88%), headache (100%) and post nasal drip (67%) was observed in endoscopic septoplasty. Posterior deviations were best corrected by endoscopic septoplasty. Complication rate was higher in conventional septoplasty. The endoscopic approach to septoplasty facilitates accurate identification of the pathology. It facilitates realignment by limited and precise resection of the pathological areas.

Knowledge, attitude and practice of dental caries and periodontal disease prevention among primary school teachers in Belgaum City, India

Objective: To evaluate the knowledge, attitude and practice of dental caries and periodontal disease prevention among primary school teachers in Belgaum city and to identify teacher's level of knowledge of health Information and utilization of the services of the school teachers in promotion of dental health and prevention of dental diseases. Methods: A cross-sectional questionnaire based survey was conducted among 150 primary school teacher from 175 primary school of Belgaum city, Karnataka, India. The questionnaire comprised six questions on knowledge, six questions on practice, and three questions on attitude regarding dental caries and periodontal disease prevention. Each question was followed by four choices. Chi square test was applied by using the statistical package for the social sciences (SPSS) software (version 11.0). Results: The female subjects had better knowledge and practices as compared to their male counterparts. Also the younger subjects had better knowledge and practices as compared to the older subjects. The teachers were more aware and they knew that tooth decay was due to chocolate and carbohydrate sticky food and also they knew the tooth loss in adults was due to decayed teeth and periodontal diseases. Conclusion: They had good knowledge and preventive attitude towards prevention of dental diseases but a few but important deficiencies in the of knowledge, attitude and practice about prevention of dental diseases have been identified for which recommendations are suggested.

Objetivo: Avaliar o conhecimento, atitudes e práticas frente à cárie dentária e prevenção da doença periodontal entre professores da escola primária na cidade Belgaum e identificar o nível de conhecimento desse profissional sobre as informações de saúde e utilização dos serviços da escola na promoção de saúde bucal e prevenção de doenças dentárias. Método: Um inquérito transversal utilizando como instrumento um questionário foi realizada entre os 150 professores do ensino básico de 175 escolas primárias da cidade Belgaum, Karnataka, na Índia. O questionário foi composto por seis questões sobre o conhecimento, seis perguntas sobre a prática, e três perguntas sobre a atitude em relação a cárie dentária e prevenção da doença periodontal. Cada pergunta continha quatro opções. O teste do Qui-quadrado foi aplicado usando o software SPSS (versão 11.0). Resultados: As professoras tinham um melhor conhecimento e práticas, em comparação com os professores. Também os sujeitos mais jovens tiveram um melhor conhecimento e práticas, em comparação com os indivíduos mais velhos. Os professores eram mais conscientes e sabiam que a cárie dentária devia-se à ingestão de chocolate e carboidratos de consistência pegajosa e também sabiam que a perda dentária em adultos devia-se a dentes cariados e doença periodontal. Conclusão: Os professores possuíam bom conhecimento e atitudes preventivas em relação à prevenção das doenças bucais, porém poucas mas importantes deficiências no domínio do conhecimento, atitude e prática sobre a prevenção de doenças dentárias foram identificadas sendo sugeridas recomendações.

Cárie Dentária em Pré-Escolares: um Estudo em Áreas Cobertas pela Estratégia Saúde da Família do Recife, PE, Brasil / Dental Caries in Preschoolers: A Study in Areas Assisted by the Family Health Strategy of the city of Recife, PE, Brazil

Objeti vo: Analisar o padrão de distribuição da cárie dentáriaem pré-escolares residentes em áreas assisti das pela EstratégiaSaúde da Família do Recife, Pernambuco, em dois distritossanitários e, estabelecer comparações.Método: Um inquérito epidemiológico de cárie dentária foiconduzido no ano de 2006 em 2020 crianças de 18-36 meses e5 anos de idade cadastradas nas unidades de saúde da famílianos Distritos Sanitários II e IV, Recife/PE. Uti lizou-se o índiceceo-d, segundo padronizações da Organização Mundial deSaúde e do Ministério da Saúde. A amostra foi probabilísti capor conglomerados (famílias) em um estágio. Calculou-sedistribuição de freqüência, testes de comparação de médias(t-Student e ANOVA), de proporções (Qui-quadrado) comnível de signifi cância de 5,0% e fatores de ponderação pararepresentati vidade da amostra. As análises foram produzidaspor distrito e microrregiões.Resultados: Nos dois Distritos as prevalências e médias ceo-dforam elevadas, sendo de 29,7% no total de crianças de 18-36meses e 63,8% aos 5 anos. Entre os Distritos o ceo-d variou de0,99 a 1,15 (18-36 meses) e 3,01 a 3,65 (5 anos). Contudo, asrazões de prevalência não apresentaram diferenças signifi cantesentre distritos e idades. Entre microrregiões, as diferençasna prevalência e severidade ocorreram apenas na idade de 5anos.Conclusão: Os indicadores de cárie uti lizados informama existência de nichos infanti s com piores situações desaúde bucal em áreas pobres de aparente homogeneidadesocioeconômica devendo-se assim reorientar as intervençõescoleti vas e individuais em áreas/microáreas, onde esses índicessão mais elevados...

Objecti ve: To analyze comparati vely the distributi on patt ernof dental caries in preschoolers living in areas assisted by theFamily Health Strategy of the city of Recife, PE, in two sanitarydistricts.Method: An epidemiological survey of dental caries wasconducted in 2006 in 2,020 children aged 18-36 months and5 years enrolled in the Family Health Centers of the SanitaryDistricts II and IV of the city of Recife, PE. The dmft index wasused as recommended by the World Health Organizati onand the Brazilian Ministry of Health. A probabilisti c sampleby conglomerates (families) was used in one stage. It wascalculated frequency distributi on, tests for comparison of themeans (Student’s t-test and ANOVA) and proporti ons (chisquare)with 5.0% signifi cance level, and ponderati on factorsfor sample representati veness. The analyses were produced bydistrict and by microregions.Results: In both districts, the prevalence and dmft means werehigh, being 29.7% among children aged 18-36 months and63.8% among those aged 5 years. Comparing the districts, thedmft ranged from 0.99 to 1.15 (18-36 months) and from 3.01to 3.65 (5 years). However, the prevalence rati os did not showsignifi cant diff erences between districts or ages. Comparing themicroregions, the diff erences in caries prevalence and severityoccurred only at the age of 5.Conclusion: The caries indicators used in this study revealedthe existence of niches of children with worse oral healthconditi ons in poor areas with apparent socioeconomichomogeneity, suggesti ng a reorientati on of collecti ve andindividual interventi ons in areas/microareas in which higherindices are observed...

Congenital malformations at birth in Central India: A rural medical college hospital based data.

OBJECTIVE: To study the incidence of congenital anomalies and the associated risk factors in Department of Pediatrics at Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, a rural medical college hospital in central Maharashtra. MATERIALS AND METHODS: All the intramural deliveries between 1 January 2005 and 31 July 2007 comprised 9386 births and their 9324 mothers (62 mothers gave birth to twin babies). The newborns were examined and assessed systematically for the presence of congenital anomalies, system wise distribution of anomalies and risk factors attributable. RESULTS: Out of the total 9386 deliveries, 9194 were live births and 192 were stillbirths. The total number of babies with congenital malformations was 179 (1.91%). Out of the 9262 singleton births, 177 (1.05%) were malformed, whereas 2 of the 62 pairs of twins had birth defects. Nine of the 179 malformed babies (5.02%) were still born. Prematurity, increased maternal age, increasing birth order and low birth weight were found to have a higher risk of congenital anomalies. Cardiovascular malformations were most common in live births, followed by musculoskeletal and genitourinary anomalies. CONCLUSION: Congenital anomalies are a major cause of stillbirths and infant mortality. Evaluation of cardiovascular system to rule out congenital heart disease in high-risk mothers’ babies is the important factor to be considered.

A paired comparison among siblings of common parents about dental care with and without Down syndrome / Comparação pareada da assistência odontológica entre irmãos de mesmos pais portadores ou não de síndrome de Down

Objetivo: Comparar a assistência odontológica entre irmãos de mesmos pais portadores ou não de síndrome de Down. Método: Um estudo analítico transversal envolvendo 180 indivíduos com Síndrome de Down e 180 irmãos destes sujeitos sem Síndrome de Down, foi conduzido numa escola de ensino especial na cidade de Udaipur, Rajasthan, India. Empregando um modelo de questionário validado, os pais foram solicitados a preencher duas versões do questionário, sendo uma para o filho com Síndrome de Down e outro para o filho com idade mais próxima sem Síndrome de Down. Resultados: Muitos pais apresentaram comportamentos ou experiências diferentes com o filho portador de Síndrome de Down e o respectivo irmão sem Síndrome de Down. As maiores diferenças foram observadas quanto à consulta anual ao dentista (p<0,001), flúor terapia (p<0,001), extrações (p<0,001) e tratamento ortodôntico (p<0,001). As crianças com Síndrome de Down foram menos propensas a visitar o dentista anualmente e a receber flúor terapia e tratamento ortodôntico em comparação aos seus irmãos sem Síndrome de Down. Conclusão: Essa análise pareada sobre diferenças familiares nos comportamentos e experiências de assistência odontológica entre irmãos com e sem Síndrome de Down irmãos demonstrou que crianças com Síndrome de Down têm menor probabilidade de serem levadas ao dentista anualmente, receberem cuidados de prevenção à cárie e tratamento restaurador, e serem submetidas a extrações dentárias.

Objective: To compare dental care among siblings of common parents with and without Down syndrome. Method: A cross sectional analytical study was conducted in 180 mentally retarded subjects with Down syndrome and 180 their siblings without Down syndrome at a special need school in Udaipur city Rajasthan. Using a validated questionnaire, parents were asked to complete two versions of the questionnaire one for their child with Down syndrome and another for the siblings closest in age without Down syndrome. Results: Many respondents showed different behavior or experiences to their child with Down syndrome and a sibling without Down syndrome. The greatest differences were observed for yearly consultation to the dentist (p<0.001), fluoride therapy (p<0.001), extraction (p<0.001) and orthodontic treatment (p<0.001). Down syndrome subjects were less likely to consult a dentist yearly and less likely to receive fluoride therapy and orthodontic treatment in comparison to their siblings without Down syndrome. Conclusion: This paired analysis of within family differences in dental care behaviors and experiences for subject with Down syndrome and non Down syndrome siblings demonstrated that there are differences, subject with Down syndrome are less likely to consult a dentist yearly, less likely to receive caries-preventive and restorative care and less likely to have had a dental extraction.