Epidemiologic study of trace elements and magnesium on risk of coronary artery disease in rural and urban Indian populations.

OBJECTIVE: To determine the association of trace elements and magnesium with risk of coronary artery disease (CAD) in rural and urban populations of India. DESIGN AND SETTING: Cross-sectional surveys on the randomly selected municipal streets in Moradabad city and one village in Moradabad tahsil in North India. SUBJECTS AND METHODS: There were 162 rural (86 men and 96 women) and 152 urban (80 men and 72 women) subjects between 26 to 65 years of age. Evaluations were obtained by physician- and dietitian-administered, validated questionnaires, physical examination, electrocardiogram and blood examination. RESULTS: The prevalence of CAD and coronary risk factors was 2.5 times higher in the urban population compared to rural subjects (8.6 vs. 3.0%). In rural subjects, dietary intakes and plasma levels of vitamins and minerals were comparable with those of urban subjects except for higher dietary intake of magnesium in rural subjects and higher plasma vitamin A level in urban subjects. In both rural and urban subjects, low serum zinc (80 +/- 82 vs. 110 +/- 11.0 micrograms/dl, p < 0.05) and magnesium levels (1.60 +/- 0.36 vs. 1.71 +/- 0.41 mEQ/L, p < 0.05) and lower zinc/copper ratio (0.58 +/- 0.08 vs. 1.11 +/- 0.25 p < 0.50) were inversely associated with CAD. Serum levels of copper and iron were significantly higher and plasma levels of antioxidant vitamins A, E and C and beta-carotene were significantly lower in patients with CAD compared to the rest of the subjects. In both rural (7.1 +/- 1.2 mg/day) and urban subjects (8.6 +/- 1.6 mg/day), zinc consumption was half of the recommended dietary allowances. Higher prevalence of CAD in urban compared to rural subjects was attributed to higher dietary fat intake and higher prevalence of risk factors in urban subjects. CONCLUSIONS: The findings suggest that lower serum levels of zinc and magnesium and lower zinc copper ratio were inversely associated with CAD. It is possible that urban populations with higher risk of CAD may benefit by decreasing dietary fat intake and by increasing their intake of foods rich in zinc and magnesium.

Plasmodium falciparum hepatitis during malaria epidemic.

Thirty-two patients with a smear positive for Plasmodium falciparum and with jaundice were studied prospectively. Most of the cases were in the age group of 15-44 years. Serum bilirubin (conjugated) levels ranged from 2-25 mg%. Australia antigen was negative in all. Mortality was 12.4%, due to cerebral malaria.

Problem of visual impairment in children.

PIP: Visual impairment is a global problem which is more pronounced in developing countries. There are an estimated 40-45 million blind in the world today, equivalent to a 1% prevalence of global blindness. More than 80% of global blindness is either preventable or curable by simple techniques, if done in time. Blindness in Southeast Asian countries varies from about .3% in Korea to about 2.0% in bangladesh or Myanmar and 1.5% in India. The causes of visual impairment and blindness include infections such as trachoma, injuries, malnutrition (particularly vitamin A deficiency) and refractive anomalies including muscle imbalance. Nutrition blindness is common in almost all the developing countries, but it is not problem in Sri Lanka, Myanmar, and Korea. Various control and nutritional measures undertaken by national governments have significantly reduced the prevalence of trachoma. It is a serious problem in Bangladesh and some parts of India. While socioeconomic factors contribute to its prevalence, attacks of diarrhea or acute infections add to its gravity. Eye injuries or trauma are common in developing countries. Blindness is not a public health problem alone, but low educational, socioeconomic status, unscientific cultural practices, and poor environmental status play a major role. Health education for eye care in the community and primary intervention can control causes like infections, trauma, or malnutrition, while visual aids such as spectacles have to be used for the correction of refractive anomalies. The problem of visual impairment per se and in children in particular can be overcome with concerted efforts. The countries affected have initiated control efforts to modify people's socioeconomic status. Voluntary organizations collaborating with governments have also produced good results. The education of children about eye health and training of school teachers in early detection of visual problems can be effective.^ieng