A cross-sectional study on the palmar dermatoglyphics in relation to carcinoma breast patients.

INTRODUCTION: Dermatoglyphics is a collective term for all the integumentary features (skin patterning of the fingers, toes, palms and soles) and it applies to the division of the anatomy which embraces their study. AIMS AND OBJECTIVES: The purpose of this study was to examine the predominant finger tip patterns in the patients of carcinoma breast. An attempt is also being made to devise a score to assess the risk variables. MATERIALS AND METHODS: The fingerprints of 100 carcinoma breast patients were obtained and they were compared with those of 100 females who were not suffering from any malignancy till date. The different quantitative parameters of each hand of both the cancer patients and the controls were studied. The parameters which were included were the fingertip ridge pattern, the ridge count in the individual fingers, the Total Finger Ridge Count (TFRC) and the Absolute Finger Ridge Count (AFRC). RESULTS: There was a significant increase in the arch pattern and a decrease in the radial loops in the right thumb (p<0.001), the left thumb (p<0.001), the left index finger (p<0.001) and the left middle finger (p<0.001). A comparison of all the five fingers of both the left and right hands of the cancer patients with the controls showed an arch pattern (p<0.001) with the highest frequency. The lower values of the TFRC (below 50) were associated with carcinoma breast .The lower values of the AFRC (below 100) were associated with the cancer patients. CONCLUSION: This study was able to establish a specific finger tip predominance in the Carcinoma breast patients.

Population-based cancer incidence in Sikkim, India: report on ethnic variation.

BACKGROUND: A Population-Based Cancer Registry (PBCR) was set up in Sikkim (a state in the North Eastern India) in 2003. We examined incidence rates by ethnic groups from 2003-2008. METHODS: Age-adjusted incidence rates (AARs) per 100,000 person-years were calculated by direct method using the world standard population, and analysed by ethnic group (Bhutia, Rai and other). RESULT: There were a total of 1148 male and 1063 female cases of cancer between 2003 and 2008 on the Sikkim PBCR. The overall AARs were 89.4 and 99.4 per 100,000 person-years in males and females, respectively. Incidence rates were highest amongst the Bhutia group (AAR=172.4 and 147.4 per 100,000 person-years in males and females, respectively), and the largest difference in rates were observed for stomach cancers with AARs being 12.6 and 4.7 times higher in the Bhutia group compared with other ethnic groups in males and females, respectively. CONCLUSION: These observations call for further epidemiological investigations and the introduction of screening programmes.

The magnitude of cancer breast in India: a summary.

Cancer of breast has emerged as the leading site of cancer in most urban populations of India. For the year 2007, there have been an estimated 82,000 new cases of cancer Breast in India. It is rapidly replacing cancer of cervix as the most important leading site of cancer among women. The data collected over the years from five urban population based cancer registries namely Bangalore, Bhopal, Chennai, Delhi and Mumbai, under the network of National Cancer Registry Programme (NCRP) have shown a statistical rising trend in the incidence rate of breast cancer. In hospital-based cancer registries, cancer of the breast is the leading site of cancer in Mumbai and Thiruvananthapuram, second leading site in Bangalore, Dibrugarh and Chennai. Cancer of breast constitutes 14.3 to 30.0% of all cancers in women in these HBCRs. The report on 'Development of an Atlas of Cancer in India' showed that Chandigarh (39.5), North Goa (36.8), Aizawl (36.2) and Panchkula (34.6) had the higher microscopic incidence rates of breast cancer compared to that seen in Delhi PBCR that had the highest rate among all PBCRs.

The magnitude of cancer cervix in India.

The Indian Council of Medical Research initiated a network of cancer registries under the National Cancer Registry Programme (NCRP) in 1981 and data collection commenced in these registries from January 1982. The results on incidence rates provided by the Population Based Cancer Registries (PBCRs) have shown the variation in patterns of cancer in general and that of cancer cervix in particular. Cancer of the cervix has been the most important cancer in women in India, over past two decades. All the urban Population Based Cancer Registries at Bangalore, Bhopal, Chennai, Delhi and Mumbai have shown a statistically significant decrease in incidence rates of this site of cancer. Since over 70 per cent of the Indian population resides in the rural areas, cancer cervix still constitutes the number one cancer in either sex. Based on the data of the PBCRs, the estimated number of new cancers during 2007 in India was 90.708. The relative five year survival reported some time earlier averaged 48.7 per cent.

Knowledge, attitude and practice towards malaria in rural communities of the epidemic-prone Thar Desert, northwestern India.

In order to assess the knowledge, attitude and practice of the rural Thar Desert population about malaria and its vectors, a total of 345 heads of households, including housewives, suffering with malaria were surveyed randomly, along with the same number of healthy control subjects, in four villages of Jodhpur and Jaisalmer districts of Rajasthan, north-western India. Results showed that in the traditionally hypoendemic Thar Desert, with low levels of immunity against malaria particularly Plasmodium falciparum, a large segment of rural people were equally less aware about the dangers of the disease. About three-fourths of the studied population did not quite comprehend the purpose of the five decade-old National Anti Malaria Programme, while nearly 50% respondents were reluctant to accept the programme lacking the component of community participation but directly targetting on the control of the disease. Consequently, about 50% malaria patients and 60% healthy subjects lacked in taking initiative to resort to any anti-mosquito or anti-malaria measure to protect themselves, although 27% malaria patients and 2.9% healthy subjects acknowledge correct causes of malaria. This study, being the first of its kind in a desert community currently facing emergence of P. falciparum-dominated malaria outbreaks, is a testimony to the hitherto prevalent deep gaps in knowledge about the disease, and its results warrant sincere efforts to link up the malaria control programme with the community participation for protection against this scourage in future.

An approach to evaluate a possible bias in Indian well-to-do standard weight values and its implications for interpretations of survey results.

The results of different Nutrition surveys carried out in India during 1976-1980 by the National Nutrition Monitoring Bureau (NNMB), Hyderabad, clearly indicated that, among preschool age children, girls often fared better compared to boys with regard to body weight. In these surveys, Hyderabad well-to-do standards have been in use, but it is well documented that, generally, in India girls often have higher morbidity and mortality compared to boys. In view of the above, it is hypothesized that the values quoted for girls in Hyderabad standard weight values are possibly on the low side. A novel approach was developed and the above hypothesis was tested with the help of lower percentiles. Analysis suggests that there exists a bias and the values quoted for girls in Hyderabad well-to-do standard are certainly on the lower side. Hence, as recommended by WHO, there is a need to adopt NCHS standard values in assessment of the nutritional status of preschool children instead of local standards.

Nutritional anthropometry--validity of cut-off points.

The present communication seeks to describe an alternate approach of arriving at cut-off levels using ratio of percentiles for (i) differentiating normal children from the undernourished ones, and (ii) identifying the severely undernourished group of children in the community on the basis of body weight and height. It also examines validity of the cut-off levels presently used of weight for age (Gomez and Indian Academy of Paediatrics classification) and height for age parameters. 1. The cut-off levels are independent of the reference standard and, as such, the same cut-off levels could be used irrespective of the standards. 2. It is desirable to have separate cut-off levels for preschool and school age groups. The use of common cut-off points for both the age groups seems to result in loss of sensitivity of the order of over 5 per cent. 3. The use of the 90 per cent cut-off level in the Gomez classification misclassifies some of the normals as undernourished, thereby tending to overestimate the problem of undernutrition in communities. 4. The body weight groups based on the suggested cut-off points do bear a relationship to the prevalence of signs of PEM--the greater the weight deficit, the higher the prevalence of signs of PEM in preschool children.

Anthropometric measurements, deficiency signs and their relationship under drought conditions.

PIP: In October-November 1987 in India, the Desert Medicine Research Centre in Jodhpur conducted a rapid anthropometric survey of 555 preschool children in 4 districts of Rajasthan which had been severely affected by drought (Jodhpur, Jalore, Nagpur, and Barmer districts) to determine the association between anthropometric measurements and various nutritional deficiency signs and infections. Based on weight for age, 82.3% of the children were undernourished. 13.3% of all children were severely malnourished (grade III undernutrition). Anemia, protein energy malnutrition (PEM), and upper respiratory infections occurred significantly more often as one digressed from the normal nutrition grade. These 3 conditions were also closely linked to weight status. Based on height for age, 62.4% of the children were chronically undernourished. 11.9% of all children were severely so. PEM was the only deficiency sign or infection associated with height status (6.2% of children with normal nutrition had PEM vs. 15.% for grade I undernutrition and 34.8% for grade II undernutrition; p .001). Vitamin A deficiency, anemia, and PEM occurred more frequently as one went from normal nutrition to grade II undernutrition based on fat fold at triceps (FFT) measurements. PEM and upper respiratory infections were significantly associated with weight for height status. Weight correctly identified 84% of all nutritional deficiency signs and infections. The corresponding figures for height, FFT, and weight for height were 64.2%, 75.4%, and 31%. Thus, weight was the most sensitive screening measurement in identifying nutritional deficiency signs and infections. Based on weight alone, the odds ratio of undernourished children developing Vitamin b-complex deficiency, PEM, and upper respiratory infections was 1.58, 3.25, and 1.77, respectively. Weight for height was the most specific screening measurement (88.2% vs. 44.7% for height, 29.3% for FFT, and 26.1% for weight).^ieng

Lack of relationship between sorghum consumption, mycotoxin contamination and pellagra in a traditionally sorghum eating population.

Traditionally, the disease pellagra has been associated with corn consumption and niacin deficiency, and has presently been recognised as a multiple factor nutritional syndrome. In the recent past, it has been suggested that consumption of mycotoxin contaminated sorghum/corn may be involved in the development of pellagra in a sorghum/corn eating population. The present study relates to the assessment of levels of mycotoxins (aflatoxin B1 and T-2 toxin) in sorghum collected from a traditionally sorghum eating population. Despite 25% fungal contamination in the sorghum samples collected, the levels of mycotoxins were minimal (1.4%) and there was no incidence of pellagra in the survey area. The absence of pellagra in the survey areas may be attributed to the changing dietary pattern.

Anemia and physical fitness of school children of rural Hyderabad.

Physical fitness status of 119 school children was assessed by administering a simple field level 'running test' without any sophisticated equipment. Moderately anemic children had taken significantly longer time (6.25 min) to complete the 'running test' distance of 1.6 Km. Children with normal hemoglobin (Hb) values and those with higher level normal Hb values took shorter times (7.42 and 7.06 min) to complete the test distance. Deficits of weight for age, height for age and weight for height did not exert independent influence on the 'running time'. Anemic children in the sub-groups of each category of nutritional anthropometric indicator, performed poorly. Anemia proved to be a handicap either in the presence or absence of anthropometric deficits. Mild and moderate anemia imposed handicaps on physical endurance and fitness of school children irrespective of other nutritional deficits.

Better education for better health care.

PIP: In India, all national nutrition programs and activities are carried out by staff at the primary health centers under the leadership of medical officers. A study of 114 of these officers from 80 primary health centers in rural districts of Andhra Pradesh State was undertaken to assess their knowledge and performance, particularly with regard to nutrition and related matters. Scores were expressed in percentages, with under 50% considered poor, 50-75% satisfactory, and over 75% good. The highest score 67.7% was obtained on knowledge of nutrition and related areas, and the lowest, 19.7% was for the participant's awareness of their own job responsibilities. Although overall theoretical knowledge on nutrition and related matters was satisfactory, significant gaps existed. A majority were ignorant as to how many people were covered by their centers and the numbers of staff in different categories, suggesting little attention was being given to planning and implementation of various services. Only 23% were aware of their own responsibilities regarding nutrition, and only 16% mentioned teaching nutrition during their training programs. The conclusion is that the medical education system must be better coordinated with the health care delivery infrastructure. Medical undergraduates need more exposure to Practical aspects of health care in rural communities, managerial aspects of work in primary health centers, and programs with a stronger nutrition component. In addition, refresher courses must be offered, and the problem of overburdening the medical officers must be dealt with.^ieng

Mejor educación para mejorar la atención de salud / Better education for better health care

A survey of medical officers in charge of primary health centres in rural districts of Andhra Pradesh, India has revealed significant deficiencies in their knowledge and performance. The situation could be improved by creating closer links between the medical education system and the machinery for health care delivery, organizing refresher courses, and introducing educational programmes with a stronger nutrition component