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Biomedical subjects

C S Pandav

Publications and source records attributed to C S Pandav.

At least 19 recordsLinked to original sources
PubMed2000

Simple microplate method for determination of urinary iodine.

BACKGROUND: Urinary iodine is a good biochemical marker for control of iodine deficiency disorders. Our aim was to develop and validate a simple, rapid, and quantitative method based on the Sandell-Kolthoff reaction, incorporating both the reaction and the digestion process into a microplate format. METHODS: Using a specially designed sealing cassette to prevent loss of vapor and cross-contamination among wells, ammonium persulfate digestion was performed in a microplate in an oven at 110 degrees C for 60 min. After the digestion mixture was transferred to a transparent microplate and the Sandell-Kolthoff reaction was performed at 25 degrees C for 30 min, urinary iodine was measured by a microplate reader at 405 nm. RESULTS: The mean recovery of iodine added to urine was 98% (range, 89-109%). The theoretical detection limit, defined as 2 SD from the zero calibrator, was 0.11 micromol/L (14 microg/L iodine). The mean intra- and interassay CVs for samples with iodine concentrations of 0.30-3.15 micromol/L were < or = 10%. The new method agreed well with the conventional chloric acid digestion method (n = 70; r = 0.991; y = 0.944x + 0.04; S(y|x) = 0.10) and with the inductively coupled plasma mass spectrometry method (n = 61; r = 0.979; y = 0.962x + 0.03; S(y|x) = 0.20). The agreement was confirmed by difference plots. The distributions of iodine concentrations for samples from endemic areas of iodine deficiency diseases showed similar patterns among the above three methods. CONCLUSIONS: Our new method, incorporating the whole process into a microplate format, is readily applicable and allows rapid monitoring of urinary iodine.

Adult↗
PubMed2000

Validation of spot-testing kits to determine iodine content in salt.

Iodine deficiency disorders are a major public health problem, and salt iodization is the most widely practised intervention for their elimination. For the intervention to be successful and sustainable, it is vital to monitor the iodine content of salt regularly. Iodometric titration, the traditional method for measuring iodine content, has problems related to accessibility and cost. The newer spot-testing kits are inexpensive, require minimal training, and provide immediate results. Using data from surveys to assess the availability of iodized salt in two states in India, Madhya Pradesh and the National Capital Territory of Delhi, we tested the suitability of such a kit in field situations. Salt samples from Delhi were collected from 30 schools, chosen using the Expanded Programme on Immunization (EPI) cluster sampling technique. A single observer made the measurement for iodine content using the kit. Salt samples from Madhya Pradesh were from 30 rural and 30 urban clusters, identified by using census data and the EPI cluster sampling technique. In each cluster, salt samples were collected from 10 randomly selected households and all retailers. The 15 investigators performing the survey estimated the iodine content of salt samples in the field using the kit. All the samples were brought to the central laboratory in Delhi, where iodine content was estimated using iodometric titration as a reference method. The agreement between the kit and titration values decreased as the number of observers increased. Although sensitivity was not much affected by the increase in the number of observers (93.3% for a single observer and 93.9% for multiple observers), specificity decreased sharply (90.4% for a single observer and 40.4% for multiple observers). Due to the low specificity and resulting high numbers of false-positives for the kit when used by multiple observers ("real-life situations"), kits were likely to consistently overestimate the availability of iodized salt. This overestimation could result in complacency. Therefore, we conclude that until a valid alternative is available, the titration method should be used for monitoring the iodine content of salt at all levels, from producer to consumer, to ensure effectiveness of the programme.

Confidence Intervals↗
PubMed1999

Impact of HIV/AIDS on the national economy of India.

BACKGROUND INFORMATION: Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is a major public health problem in India. In general, it affects mainly young people who are at their most productive part of life. Despite initial fears that AIDS will be disastrous for the economy, recent experience and estimations have shown that there is a need for reappraisal of its economic impact on society. RESEARCH QUESTION: From the viewpoint of the society of India, what is the total cost and equivalent annual cost of HIV infections for the period 1986-1995 (10 years) in India? METHODS: Type of analysis: Cost-descriptive based on predictive modelling cohort analysis using human capital approach. A discount rate of 5% was used. The cost of HIV infections include (i) loss of productivity among HIV patients due to sickness and death, (ii) productivity loss due to caregivers of AIDS patients, and (iii) cost of management of AIDS patients. To estimate the loss of productivity due to premature death attributable to AIDS, a life table approach using two cohorts, one with and one without HIV/AIDS infection at assumed rates was used. The demographic data of 1991 census were used. The difference in the person-years lived in the two scenarios gave the person-years lost due to HIV/AIDS. This was calculated separately for rural and urban areas. To convert this to monetary terms, national per capita income for 1992-93 of Rs. 5529 was used. The data on the days of inpatient care and the cost of management of AIDS patients were based on currently available data and 'expert opinion'. We analysed, using three different sets of assumptions for determination, the low, medium and high estimates of the impact of HIV/AIDS in India. Some of the costs were not included in the present analysis: (i) use of antiviral AZT, (ii) cost of retraining of new workforce, (iii) cost of strengthening of health care system, (iv) cost of research and development, (v) cost of communication activities, (vi) cost of prevention of vertical transmission, and (vii) the intangible cost of pain and suffering to the patients and their families. RESULTS: The total cumulative number of HIV-infected persons in India until 1995 was estimated to be 1.5 million (low estimate), 2.5 million (medium estimate) and 4.5 million (high estimate). The estimated total annual cost (in billion Rupees) of HIV/AIDS in India under low, medium and high assumptions was 6.73, 20.16 and 59.19, respectively. Cost of treatment of AIDS and loss in productivity were the two major components of the cost. CONCLUSIONS: The estimated annual cost of HIV/AIDS appears to be about 1% of the GDP of India if based on high assumptions. However, as mentioned earlier, all costs of HIV have not been taken into account. Its significance has to be assessed in the context of annual growth of GDP (3.5%) and cost of other major diseases in India.

AIDS Serodiagnosis↗
PubMed1995

A role for nongovernmental organizations in monitoring the iodine content of salt in northern India.

The feasibility of using nongovernmental organizations (NGOs) to monitor the iodine content of salt was studied in Uttar Pradesh, northern India, where iodine-deficiency disorders (IDDs) are endemic. Three NGOs already involved in health and development activities in the Gorakhpur, Varanasi, and Dehradun regions collected salt samples monthly from households and shops in selected villages over a 6-month period. A total of 4001 samples were analysed at regional laboratories by trained personnel using a standard protocol; 10% of the samples were sent to a central laboratory for external quality control. The iodine content lay in the range 0-95 mg/kg of salt; it was particularly low in the Gorakhpur and Varanasi regions, where over 80% of samples contained less than the minimum recommended level of 15 mg/kg; 37% of samples were in this category in the Dehradun region. Regular monitoring of the iodine content of salt at the consumer level is essential for the elimination of IDDs, and there is a need to improve awareness of this at all levels. NGOs can play a valuable role in both of these respects.

Humans↗
PubMed1995

Thyroid function in a goitre endemia.

A study was conducted to determine the thyroid function in a goitre endemia. Sadam is small village in the south district of Sikkim. Severe iodine deficiency exist in this village (prevalence of goitre 73.5%, cretinism prevalence 4%; mean urinary iodine exeretion 4.13 ng/dl - SD 3.1). Total of 72 out pf 142 households were randomly selected. All the inmates of the households above 14 years of age were examined for goitre and blood samples were collected from them for estimation of concentration of thyroid stimulating hormones (triiodothyroine T-3, thyroixe T-4) and thyroid stimulating hormone (TSH). Total of 244 subjects were examined, (137 males and 107 females). Goitre was detected in 149 (61.1%) individuals. The mean T-3, T-4 and TSH concentrations in the non-goitrous groups were (SD in parenthesis) 110.13 ng/dl (26.19), 10.12 ug/dl (2.38) and 1.01 uu/ml (0.52). The corresponding values for the goitrous group were, 132.22 ng/dl (46.25), 9.06 ug/dl (2.04) and 1.33 uu/ml (1.19). The differences in the mean concentrations between the goitrous and non-goitrous groups were statistically significant. An inverse correlation between the goitre size and T-4 on the one hand, and TSH and T-4 on the other hand was noticed. The result of the study show that functional decompensation of the thyroid occur in the majority of goitrous subjects.

Adolescent↗
PubMed1994

Toxoplasma gondii infection & its association with iodine deficiency in a residential school in a tribal area of Maharashtra.

To determine the seroprevalence and incidence of toxoplasmosis, 194 random serum samples of school students aged 10 to 18 yr (n = 178), their teachers (n = 10) and food handlers (n = 6) from a residential tribal school situated in district Dhule, Maharashtra state of western India, were tested. The samples were tested for anti-toxoplasma IgG and IgM antibodies using enzyme linked immuno sorbent assay (ELISA). Active infection was confirmed by a stage-specific direct agglutination test (DAT) using acetone fixed tachyzoites of T. gondii. A serosurveillance for rubella immunity was also simultaneously carried out. The results showed that at the age of 10 yr, all the children were immune to rubella infection and toxoplasma seroprevalence was detected in 20 per cent of the children. Toxoplasma infection was prevalent in 42.8 per cent adolescents, at the age of 18 yr. The average seroprevalence rate of toxoplasma infection was not significantly different in male and female children. The incidence rate of toxoplasma infection was inversely related to increase in age. The school staff comprising teachers and food handlers (aged 27 to 45 yr) showed a toxoplasma seroprevalence rate of 75 per cent (P < 0.001). There was also a significant difference (P < 0.05) in the prevalence of toxoplasmosis in children with grade II goitre (46.1%) and grade I or no goitre (31.8 and 26.5% respectively). The possible association between iodine deficiency and toxoplasma infection is being reported for the first time in this preliminary study.

Adolescent↗
PubMed1986

Iodine deficiency and neonatal hypothyroidism.

The incidence of neonatal hypothyroidism, as reflected in cord-blood thyroxine and thyrotropin levels, varied from 0.6% to 13.3% in iodine-deficient and normal regions of India (selected districts of Uttar Pradesh and Kerala and the city of Delhi), depending on the degree of environmental iodine deficiency. In populations with a high incidence of neonatal hypothyroidism, an increased prevalence of nerve deafness and a shift to the left in the distribution of IQ scores (towards lower scores) have been demonstrated. These indications of mild brain damage suggest that nutritional iodine deficiency can present in other ways than goitre or cretinism. Determination of the incidence of neonatal hypothyroidism using dried cord-blood spot screening appears to be the most useful and reliable method to assess the risk of brain damage in iodine-deficient areas.

Congenital Hypothyroidism↗
PubMedDate not supplied

Iodine deficiency disorders in school children of Sikkim.

Sikkim is a small state in the eastern Himalayas. A survey was conducted to determine the prevalence of iodine deficiency disorders in the state. A two stage sampling procedure was adopted. In stage one, all villages in the state were listed and 249 were randomly selected for the survey. In stage two, households, were randomly selected from the selected villages using the electoral lists. The basic sampling unit was a household and all members of the households were studied. A total of 17,837 subjects were studied from 3,197 households of 249 villages. Overall prevalence of goitre and cretinism in the community as a whole, were 54.03% and 3.46% respectively. Of the population studied, 5939 were children in the age group of 5 to 16 years. There were 3,005 boys and 2,934 girls. Goitre was detected in 3,381 (56.9%). Goitre prevalence in the boys was 55.4% and in girls it was 58.5% (p = < 0.05). Grade I goitre was seen in 2,472 (73.1%), grade II in 888 (26.3%) and grade III in 21 (0.6%). Endemic cretinism was diagnosed in 175 subjects (2.9%). Cretinism prevalence in the boys was 3.1%, and in girls in was 2.8% and this difference was not significant. Neurological; cretinism was the predominant form (98.3%). Estimation of urinary iodine concentration in 167 subjects revealed the mean concentration to be 3.64 u/dl (SD 2.47). The median value was ug/dl indicating the skewed distribution of the urinary iodine concentration. The study shows the existence of severe iodine deficiency in the school-aged children of Sikkim.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Intellectual and motor functions in school children from severely iodine deficient region in Sikkim.

High prevalence of endemic goitre (54%) and endemic cretinism (3.5%) exist in Sikkim. The level of intellectual functioning and motor performance were assessed in 90 school children in the age group of 10 to 12 years selected randomly from four severely iodine-deficient villages. Bender Visual Motor Gestalt Test, Binet-Kamat Test for mental ability and Raven's Coloured Progressive Matrices were the tests used. The results show an impairment in intellectual and other neuropsychological functions in a high percentage of the children. Visuomotor coordination was poor in 62 (69%). Binet-Kamat test results showed that 19 (21%) children were intellectually subnormal (IQ < 70). Majority of the children (> 80%) had significant impairment in language, meaningful memory, non-meaningful memory, conceptual thinking, numerical reasoning and motor skills. The children did better on non-verbal reasoning and social intelligence. Goitre was detected in 82 (91.1%). Urine samples for iodine estimations was collected from every second child examined. The mean urinary iodine concentration was 4.23 micrograms/dl (SD 2.16). Urinary iodine concentration was less than 2 micro gm/dl in 26.1% (11 children) and less than 5 micro gm/dl in 84.8% (39 children) indicating severe iodine deficiency. The test results show impairment of psychomotor development in children born and brought up in iodine-deficient environment.

Child↗
PubMedDate not supplied

Epidemiology of endemic cretinism in Sikkim, India.

A survey was conducted in Sikkim to determine the prevalence of endemic cretinism in the state. A household was the basic sampling unit. Villages were selected randomly in the state and from these households were selected randomly using the electoral lists. All members of the households were studied. Total of 17,837 individuals from 3,197 households from 249 villages were studied. There were 8,953 males and 8,884 females. A total of 617 endemic cretins were identified: 316 males and 301 females. The overall prevalence of endemic cretinism was 3.46%: (males 3.53% and females 3.39%). Endemic cretinism was observed in 194 (77.9%) villages studied. Neurological cretinism was the predominant form (98.7%). Deaf-mutism was the most salient neurological feature seen in 472 (76.5%) subjects. Motor system examination revealed proximal spasticity and brisk reflexes, both more marked in the lower limbs. Recording of daily life activities revealed 14.1% of the cretins to be totally dependent and another 23% to be requiring considerable assistance for their daily routine activities. The overall prevalence of goitre found in this survey was 54%. Urinary iodine concentration was estimated from a representative sample of the population; mean 4 micrograms/dl (SD 2.68). This survey shows the existence of severe iodine deficiency in Sikkim.

Adolescent↗