Multicentric study on prevalence and risk factors for hypertension and diabetes in tribal communities in Western and Northern Maharashtra.

BACKGROUND AND OBJECTIVES: Although a number of studies have been conducted on the prevalence of hypertension (HTN) and diabetes on tribal populations in different parts of India, comparative tribe-specific information is very meager. The main objective of this study is to generate tribe-specific information on the noncommunicable disorders (NCDs) and associated risk factors in scheduled tribes (STs) in Coastal and Western Maharashtra. METHODS: The study was conducted on 1864 (females 960) adults (≥18 years) of both sexes in four dominant tribes in the region, namely, Bhils (748), Katkaris (560), Kokana (352), and Thakars (204), using the protocols approved by the Institutional Review Board. The study areas were geographically separated by large distances (250-500 km apart). Prevalence of overweight, diabetes, HTN, and hypercholesterolemia was measured using standard field-based techniques described in our earlier publication. RESULTS: All STs in this study are grossly underweight; the Katkaris are worst affected. The prevalence of obesity (body mass index ≥30 kg/m2), HTN (blood pressure ≥140 mmHg), diabetes (capillary blood glucose >126 mg/dl), and hypercholesterolemia (cholesterol ≥200 mg/dl) was 0.9%, 11.7%, 6.7%, and 0.6% respectively. There are no statistically significant inter-tribal differences in the prevalence of these parameters. Age and obesity appeared to be the most dominant risk factors for HTN. However, there is no clear-cut picture about the influence of risk factors on diabetes or hypercholesterolemia. INTERPRETATION AND CONCLUSION: The prevalence of NCDs is still very low in STs, probably due to near absence of the risk factors such as obesity, sedentary lifestyle, and hyperlipidemia. STs are highly endogamous, and the study areas are separated by large distances ruling out intermingling of tribes. Yet, there is no consistent inter-tribal prevalence pattern for NCDs. Although the sample size is small, the results support the view that environmental factors are likely to be more important than host genetics in the causation of NCDs.

Prevalence and risk factors of hypertension and diabetes in the Katkari tribe of coastal Maharashtra.

BACKGROUND AND OBJECTIVES: Urban and rural India are both going through health epidemiological transition and will soon face huge burden of noncommunicable diseases (NCDs). Information on the status of NCDs in tribals is limited. Although the prevalence of hypertension in scheduled tribes (STs) has been studied in several states by the National Nutrition Monitoring Bureau, tribe-specific data are very scanty. The objective of this study was to generate data on the status of hypertension and diabetes, the two objectively measurable NCDs in Katkaris, the dominant ST in the Raigad district of coastal Maharashtra. METHODS: The study was conducted in 410 adult Katkaris (women 219) of both sexes of ≥18 years of age in three adjoining tehsils of the district. Using the Institution Review Board approved protocol; information was obtained on sociodemographic parameters, educational level, dietary pattern, and substance abuse. Prevalence of overweight, hypertension, and diabetes was measured using standard field-based procedures and techniques. RESULTS: Katkaris, who are mostly landless manual laborers, subsist on a protein-poor, imbalanced diet. About half of women and one-third of men have body mass index (BMI) <18.5 kg/m2, an indication of undernutrition. On the other hand, about 2% of participants were obese (BMI ≥30 kg/m2). The overall prevalence of hypertension and diabetes was 16.8% and 7.3%, respectively. Hypercholesterolemia was recorded in about 3% of the participants. INTERPRETATION AND CONCLUSIONS: Prevalence of diabetes and hypertension in Katkaris is still lower than that of urban and rural populations, closer to the latter. This may be due to the absence of known risk factors such as obesity, sedentary lifestyle, and hyperlipidemia in this community. Fast acculturation of the STs suggests that NCDs will soon become a major health issue in them too. It is time to launch a multicentric national study to gather baseline information on the status of NCDs in STs.

Microbial colonization of Provox voice prosthesis in the Indian scenario.

INTRODUCTION: Tracheoesophageal speech using the voice prosthesis is considered to be the "gold standard" with success rates as high as 90%. Despite significant developments, majority eventually develop dysfunction due to microbial deterioration. We did a pilot study of 58 laryngectomy patients who developed prosthesis dysfunction. MATERIALS AND METHODS: A total of 58 laryngectomy patients who had their dysfunctional prosthesis removed were included in this study. Dysfunctional prostheses were removed and examined. Esophageal and tracheal flanges were examined separately. After obtaining pure fungal and bacterial cultures, the yeast strains were identified. Bacteria were identified with the light microscope and gram staining. We analyzed prosthesis lifespan and probable factors affecting it. RESULTS: Central leak was found in 43% cases while in 57% peri-prosthetic leakage was the most common reason for prosthesis replacement. Microbial analysis revealed a combination of yeast and bacteria in approximately 55% culture samples. Out of these, almost 90% had the presence of single yeast species with bacteria. Pure fungal culture was identified in rest of the 45% cultures while none detected pure bacterial forms. Candida tropicalis was the solitary yeast in 81% while Candida albicans was seen in 10% as the solitary yeast. Bacterial isolates revealed Klebsiella pneumonia in 19%, Escherichia coli in 8% while Staphylococcus aureus was grown in 1% cultures. The consumption of curd (P = 0.036, 95% confidence intervals [CI]: 2.292-64.285) to have a significant correlation of the mean prosthesis lifespan. Consumption of curd (P = 0.001, 95% CI: 0.564-2.008) and history of prior radiotherapy (P = 0.015, 95% CI: 0.104-0.909) had a significant bearing on the Provox prosthesis lifespan. CONCLUSIONS: Candida is the most common organism grown on voice prosthesis in Indian scenario. Consumption of curd and history of prior radiotherapy significantly affect Provox prosthesis lifespan.

Comparative study of outcome of type I tympanoplasty in dry and wet ear.

Chronic suppurative otitis media is a common condition seen in patients attending the otolaryngology clinic. The discharging ear presents the otologist with the dilemma of operating on it or not. This due to the widespread belief that the success rate while doing tympanoplasty on wet ears is decidedly inferior. To evaluate this fact we conducted a study to compare outcomes of type 1 tympanoplasty in dry and wet ears. Wet ear meant that the patient had a mild mucoid discharge which was negative on culture. Type 1 tympanoplasty was done in all patients under local anesthesia using temporalis fascia graft and by underlay technique. We conclude that the presence of discharge in the ear at the time of operation does not interfere with the results of tympanoplasty, but it should be mucoid and scanty.

Effect of some new insect growth regulators on metamorphosis & reproduction of Aedes aegypti.

Fourth instar larvae and pupae of Ae. aegypti were treated with four most active insect growth regulators from a new series of mixed alkyl and aryl diethers based on geraniol. Considerable reduction in fecundity and fertility of adults was obtained. Treatment of pupae or pharate adults did not affect adult emergence. Topical treatment of adult females caused great reduction in fertility and fecundity in older as compared to younger females. In addition to the effects on reproduction, adult survival was also reduced in the treated younger females.

Action of some new insect growth regulators on mosquito vectors. Part II: Geraniol based diethers.

Biological activity of saturated diethers viz. 1-benzyloxy/phenoxy-8-alkoxy and 1-alkoxy-8-benzyloxy-3,7-dimethyl-1, 8-octanes (IIa-IIq) prepared from Geraniol, were studied on three mosquito species and the bug Dysdercus koenigii. These diethers exhibited oviposition deterrent and developmental inhibition activities of greater magnitudes than the compounds based on citronellol reported in Part I of this paper. Some of these new compounds inhibit development of mosquitoes at 0.05 ppm and deter oviposition at 0.05 per cent doses. Tests were extended to field simulated conditions in selected cases.

Action of some insect growth regulators on mosquito vectors: Part I--Citronellol based diethers.

New series of compounds starting from common terpenoids (Geraniol, citronellol) have been examined for biological activity on mosquito larvae. Many of these exhibited development disruption on eggs as well larvae. Some also affected adult oviposition behaviour. Developmental disturbances were classified as JH type by inducing typical metamorphosis inhibition in Dysdercus koenigii in the standard Hemipteran JH bioassay. Where indicated simulated field trials were also undertaken. This report describes results of bioevaluation of the citronellol based compounds. The results indicate that these show multifarious activity against mosquitoes but at relatively high doses, suggesting that exploration of further structural variety is needed before truly promising analogues can be obtained.