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At least 271 records · Page 15Linked to original sources
PubMed2001

Economic burden of epilepsy in India.

PURPOSE: The economic burden due to epilepsy is not adequately examined in developing countries. Cost estimates are very important in health care planning and delivery of services. We have estimated the direct and some of the indirect costs of epilepsy in India. METHODS: Epilepsy centers attached to University hospitals in six states of India participated in this study. Data on clinical characteristics, utilization of medical services, and costs were collected in a standardized format. RESULTS: There were 285 patients (mean age, 22.6 + 12.5 years) drawn from six centers in this study. The annual cost of epilepsy per patient was INR 13,755 (USD, 344). The direct cost was INR 3,725 (USD, 93), and the indirect cost was INR 10,031 (USD, 251). Direct cost included medical consultations (INR 329), laboratory services (INR 271), hospitalization charges (INR 316), and cost of travel to clinics (INR 659). The indirect cost included the cost of lost productivity due to seizures, its complications, or attendance to clinics. There are approximately 5 million people with epilepsy in India. The economic burden due to epilepsy to the nation is to the tune of INR 68.75 billion (USD, 1.7 billion). CONCLUSIONS: The annual economic burden of epilepsy in India is 88.2% of GNP per capita and 0.5% of the GNP.

Adolescent↗
PubMed2000

[Hepatitis E after travel to India--2 case reports].

We report two cases of acute hepatitis E. The first case is a 21-year-old male who had returned two weeks earlier from a three-month journey to India. He was admitted into our clinic with nausea, stomach pain, vomiting, scleral icterus and stool discoloration. After excluding other possible causes of the symptoms, we made the diagnosis by testing for antibodies by EIA. No treatment was initiated and despite a temporary increase of the icterus, the patient returned to a normal state of health. The second case is a native of India who has lived in Germany for ten years. He returned from a two-week visit to India with fever, nausea and malaise. In follow-up, he was anticteric and a temporary thrombocytopenia was detected. He was treated symptomatically, and recovered within a few days. The patient had a secondary diagnosis of sinusitis, which was resolved with antibiotics. In spite of a large spectrum of diagnostic possibilities, a part of the liver diseases cannot be etiologically clarified. Following travel to India and other endemic regions, hepatitis E should be considered in the differential diagnosis. The course of hepatitis E is usually benign, further diagnostic studies are rarely needed, and the treatment is usually symptomatic.

Adult↗
PubMed2005

The impact of HIV/AIDS on the control of tuberculosis in India.

Epidemics of HIV/AIDS have increased the tuberculosis (TB) case-load by five or more times in East Africa and southern Africa. As HIV continues to spread, warnings have been issued of disastrous AIDS and TB epidemics in "new-wave" countries, including India, which accounts for 20% of all new TB cases arising in the world each year. Here we investigate whether, in the face of the HIV epidemic, India's Revised National TB Control Program (RNTCP) could halve TB prevalence and death rates in the period 1990-2015, as specified by the United Nations Millennium Development Goals. Using a mathematical model to capture the spatial and temporal variation in TB and HIV in India, we predict that, without the RNTCP, HIV would increase TB prevalence (by 1%), incidence (by 12%), and mortality rates (by 33%) between 1990 and 2015. With the RNTCP, however, we expect substantial reductions in prevalence (by 68%), incidence (by 41%), and mortality (by 39%) between 1990 and 2015. In India, 29% of adults but 72% of HIV-positive adults live in four large states in the south where, even with the RNTCP, mortality is expected to fall by only 15% between 1990 and 2015. Nationally, the RNTCP should be able to reverse the increases in TB burden due to HIV but, to ensure that TB mortality is reduced by 50% or more by 2015, HIV-infected TB patients should be provided with antiretroviral therapy in addition to the recommended treatment for TB.

AIDS-Related Opportunistic Infections↗
PubMed2002

Nutrition transition in India.

OBJECTIVE: The primary objective of this review is to examine the demographic and nutrition transition in India in relation to its contribution to the emerging epidemic of chronic non-communicable diseases in this country. SETTING: India, the country as a whole and its different states with a population exceeding 1 billion in 2001. SUBJECTS: The review examines demographic changes in the population with consequent effects on the population pyramid, the rapidity and rates of urbanisation with striking variations in chronic disease patterns and the trends in obesity between rural and urban communities, attempting to relate their prevalence with the diet and lifestyle changes accompanying them. DESIGN: The review is based largely on representative large-scale surveys in the country and other reliable documented data on population characteristics. It also includes a review of the published literature. RESULTS: The results indicate that the demographic changes, rates of urbanisation and changes in dietary patterns are contributing to the changing trends in chronic disease in India. CONCLUSIONS: There is clear evidence of a demographic, epidemiological and nutrition transition in India that is fuelling the epidemic of chronic diseases and obesity, particularly in the urban areas.

Adolescent↗
PubMedDate not supplied

Body mass index of adult males in 12 populations of northeast India.

BACKGROUND: Of the anthropometric indices, body mass index (BMI) is considered to be more nutritionally than genetically related. Thus, in a country with diverse ethnic groups like India, it is more appropriate to use BMI as an indicator of the nutritional status of adult population. However, literature on BMI of adult Indians is limited to certain geographical regions or populations, and little is known about the populations in the northeast region of the Indian sub-continent. AIM: The present report deals with the BMI of adult males in 12 populations of Northeast India with a view to understanding their nutritional status. SUBJECTS AND METHODS: Anthropometric data collected by the Anthropological Survey of India on 946 adult males aged 18-62 years of 12 populations in Northeast India were used in this analysis. The populations were broadly categorized into three groups, namely, caste. Hinduized and tribal groups. The data were collected mostly from rural areas, taking into consideration the different social ranks such as castes, tribes and religious groups. RESULTS: The variation in mean BMIs between populations was highly significant, ranging between 18.3 and 20.5 kg m(-2). Despite a few exceptions, the mean values of BMI in the tribal populations were significantly higher than the caste groups. The prevalence of chronic energy deficiency (CED) was also lower in the tribal (19%) than in the Hinduized (49%) and caste (52%) populations (chi2 = 89.4, d.f. = 2, p < 0.001). Although it is difficult to explain why the tribals have higher BMI than the higher castes, the Cormic index or CI (SH/H) was significantly lower among the caste groups as compared with some tribal groups. The linear regression coefficient (b +/- standard error) of BMI on CI for all the populations, irrespective of ethnic origin, was 30.4+/-4.3 (t = 7.1, p < 0.000). and the correlation coefficient (r +/- standard error) 0.22+/-0.03. The differences in BMI across groups were, however, significant even after allowing for CI. CONCLUSION: A majority of the adult males in these populations were lean. The high proportion of individuals with grade I CED suggests the need of other information on morbidity and health status of these populations.

Adolescent↗
PubMedDate not supplied

Genetic variation observed at two tetrameric short tandem repeat loci on chromosome 12 (D12S66 and D12S67) among five distinct ethnic groups of India: detection of two new alleles.

OBJECTIVE: The present investigation reports the genetic variation observed at two tetrameric short tandem repeat (STR) loci on chromosome 12 (D12S66 and D12S67) among five anthropologically distinct population groups of India. SUBJECTS AND METHODS: A total of 277 random, normal and healthy volunteers were investigated for the D12S66 locus, and 236 for the locus D12S67, from five ethnic groups of India. Two of these belong to the state of Maharashtra in western India (Konkanastha Brahmins and Marathas) and three from the state of Kerala in South India (Nairs, Ezhavas and Muslims). DNA was extracted from peripheral blood samples, amplified by duplex polymerase chain reaction (PCR) and electrophoresed on 6% denaturing urea (7 M) gel electrophoresis. The analysis was performed on ALF Express DNA sequencer (Amersham Pharmacia Biotech) using Fragment Manager software. Statistical analysis was done by using Arlequin ver. 1.1. RESULTS: At D12S66 locus, a total of nine alleles (8-17 repeats) and 27 genotypes were detected with an observed heterozygosity ranging from 0.55 to 0.91. At the D12S67 locus, nine alleles (36-44 repeats) and 33 genotypes were observed with a heterozygosity ranging from 0.74 to 0.89. Both the loci displayed high Power of Discrimination (PD) which ranged from 0.81 to 0.91 and Polymorphic Information Content (PIC) ranging from 0.68 to 0.84. At D12S66, two alleles were detected for the first time in these population groups which were not reported earlier. The level of gene differentiation (G(ST) value, 0.02) was moderate at these two loci, indicating a close relationship among the population groups. CONCLUSIONS: From this investigation, it is concluded that both the tetrameric loci are highly polymorphic and informative, and can be used for the characterization of the Indian population groups in addition to other well-studied STR loci.

Alleles↗
PubMed1999

Ethnic minorities and their vulnerability to AIDS in a border state of India.

To successfully stall the spread of HIV/AIDS among the ethnic minorities in India, it is imperative that we not only understand the complexity of issues in India with regard to HIV spread among ethnic groups but also comprehend that straightforward measures that might have worked in the context of other countries may not work in the Indian context. The authors present field work data and the results of interviews with 635 opinion leaders from eight 'tribal groups' from the north eastern border state of Manipur in India where a high rate of HIV infection is reported among the IDUs (intravenous drug users). The study found community support for AIDS, sex and drug education, along with an increasing perception of social vulnerability. Even though respondents perceive the threat of infection, few feel that they are personally susceptible. As HIV/AIDS prevention programmes compete with other socioeconomic conditions, the prevention blue print must be tailored to meet diverse demands in the study area and of the ethnic minorities in India.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Administrative issues involved in disaster management in India.

India as a country is vulnerable to a number of disasters, from earthquakes to floods. Poor and weaker members of the society have always been more vulnerable to various types of disasters. Disasters result in unacceptably high morbidity and mortality amongst the affected population. Damage to infrastructure and reduction in revenues from the affected region due to low yield add to the economic losses. Poor co-ordination at the local level, lack of early-warning systems, often very slow responses, paucity of trained dedicated clinicians, lack of search and rescue facilities and poor community empowerment are some of the factors, which have been contributing to poor response following disasters in the past. The first formal step towards development of policies relating to disaster care in India was the formulation of the National Disaster Response Plan (NDRP) which was formulated initially by the Government of India for managing natural disasters only. However, this was subsequently amended to include man-made disasters as well. It sets the scene for formulating state and district level plans in all states to bring cohesiveness and a degree of uniform management in dealing with disasters. A National Disaster Management Authority has been constituted which aims to provide national guidelines and is headed by the Prime Minister of India. It is the highest decision-making body for the management of disasters in the country. The authority has the responsibility for co-ordinating response and post-disaster relief and rehabilitation. Each state is required to set up Disaster Management Authorities and District Disaster Management Committees for co-ordination and close supervision of activities and efforts related to the management of disasters.

Disaster Planning↗
PubMed2004

Use of the World Health Organization (WHO) classification of non-Hodgkin's lymphoma in Mumbai, India: a review of 200 consecutive cases by a panel of five expert hematopathologists.

This study aims to answer the question whether the World Health Organization (WHO) classification of non-Hodgkin's lymphoma (NHL) can be practised to international standards at the Lymphoma Registry (LR) established at the Tata Memorial Hospital, Mumbai, India. Furthermore, the study aims to identify differences in the distribution of NHL subtypes at this LR (likely to be representative of India) as compared to the rest of the world. A panel of 5 expert hematopathologists from the NHL Classification Project reviewed 200 consecutive NHL cases at the LR in January of 2001. These cases were accrued during August and September, 2000. On all cases, hematoxylin and eosin stains and appropriate immunostains were available for review. The diagnosis made by the host pathologist at the LR (KNN) and the initial diagnosis made by each of the expert hematopathologists was compared with the consensus diagnosis. A consensus diagnosis was made by the 5 experts in 197 cases. The agreement of the host pathologist with the consensus diagnosis was 82% and the agreement of the individual experts with the consensus diagnosis varied from 76-88% (mean 82%). According to the consensus diagnosis, 80% of NHLs were of B-cell type, 18% were of T-cell type, and the immunophenotype could not be determined in the remaining 2% of cases. In conclusion, the WHO classification of NHL was properly utilized at the Lymphoma Registry, Mumbai, India, and geographic differences were noted in the distribution of NHL subtypes at the LR as compared to the rest of the world. Precursor T lymphoblastic leukemia/lymphoma was more common in India (7%) than the rest of the world (1-4%), and indolent B-cell NHLs (29%) were less common than in the West. As compared to China and Japan, peripheral T-cell lymphoma (4.6%), extranodal NK/T cell lymphoma, nasal type (0.5%) and extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-lymphoma) (2.6%) were less common, but follicular lymphoma (15%) and chronic lymphocytic leukemia/small lymphocytic lymphoma (5%) were more common. This suggests that the distribution of the B-cell and T-cell lymphomas in the Indian population, except for lymphoblastic lymphoma, lies in between the Western world (mainly Caucasian) and the Orientals.

Adolescent↗
PubMed2006

Road traffic injuries in India: a review of the literature.

AIMS: India is the largest country in the South Asian region with all the problems faced by rapidly developing nations, especially increasing motorization. In spite of such developments, there are limited data in the literature addressing the problem of road traffic injuries. This article is an attempt to estimate the magnitude of the problem through published literature. METHODS: This article is a systematic review of the literature on road traffic injuries in India, conducted using three electronic databases and hand-searching of the selected articles. Final analyses were conducted with 22 studies. RESULTS: Road traffic injuries are a significant burden on the health care system in India. The most commonly affected group is young males. Pedestrians constitute a large majority of the victims and there is high early mortality in most cases. CONCLUSIONS: There is lack of population-based data on road traffic injuries in India and there is large heterogeneity in the published data. This is an important research agenda for the country. Immediate steps are required to curb this problem to limit the loss of life and resources.

Abbreviated Injury Scale↗
PubMed2004

Partner violence as a risk factor for mental health among women from communities in the Philippines, Egypt, Chile, and India.

Although studies have documented the associations between Intimate Partner Violence (IPV) and mental health, few have been done in developing countries. In this study, the association between IPV and mental health in women from different developing countries was established. Women, 15 to 49 years old with at least one child 18 years old or younger, were randomly selected from communities in Chile, Egypt, India, and the Philippines (N = 3974). The Self Report questionnaire (SRQ) was used to assess mental health. Women with a score on the SRQ of 8 or more, or who reported ever attempting suicide, were classified as having poor mental health. Physical IPV was defined as being slapped, hit, kicked, beaten or threatened by a male partner during the past year. Psychological violence included being insulted or belittled, threatened or abandoned. Between 22.5% (in Egypt) to 41% (in Chile) of participating women reported a score of eight or more on the SRQ. High score on the SRQ were significantly associated with current physical and psychological IPV in the samples from all participating countries except Chile. Twelve percent of women in Chile, 2.6%, in Egypt, 7.5% in India and 1.6% in the Philippines reported attempting suicide. Suicide attempts were also associated with current physical IPV in the Philippines, Egypt, and India, and with psychological violence in Egypt and India. IPV is significant risk factor for poor mental health in these developing countries. Efforts to reduce IPV should be considered as part of a mental health program.

Adolescent↗
PubMed2005

Development of candidate rotavirus vaccines derived from neonatal strains in India.

The need for a rotavirus vaccine in India is based on the enormous burden associated with the >100,000 deaths due to rotavirus diarrhea that occur annually among Indian children. Two rotavirus strains identified during nosocomial outbreaks of rotavirus infection in New Delhi and Bangalore, India, more than a decade ago are being developed as live oral vaccines. Infected newborns had no symptoms, shed virus for up to 2 weeks after infection, mounted a robust immune response, and demonstrated protection against severe rotavirus diarrhea after reinfection. The 2 strains are naturally occurring bovine-human reassortants. The New Delhi strain, 116E, is characterized as having a P[11],G9 genotype, and the Bangalore strain, I321, is characterized as having a P[11],G10 genotype. The strains have been prepared as pilot lots for clinical trials to be conducted in New Delhi. This unique project, which is developing a new rotavirus vaccine in India with the use of Indian strains, an Indian manufacturer, and an Indian clinical development program, aims to expedite introduction of rotavirus vaccines in India.

Administration, Oral↗
PubMed2004

Diet and risk of ischemic heart disease in India.

BACKGROUND: Ischemic heart disease (IHD) is a leading cause of death in India. Dietary changes could reduce risk, but few studies have addressed the association between diet and IHD risk in India. OBJECTIVE: The goal was to address the association between diet and IHD risk among Indians in New Delhi (northern India) and Bangalore (southern India). DESIGN: We collected data from 350 cases of acute myocardial infarction and 700 controls matched on the basis of age, sex, and hospital as part of a hospital-based case-control study in 8 hospitals. Long-term dietary intake was assessed by using food-frequency questionnaires developed for New Delhi and Bangalore. We used conditional logistic regression to control for the matching factors and other predictors of risk. RESULTS: We observed a significant and dose-dependent inverse association between vegetable intake and IHD risk. The inverse association was stronger for green leafy vegetables; in multivariate analysis, persons consuming a median of 3.5 servings/wk had a 67% lower relative risk (RR: 0.33; 95% CI: 0.17, 0.64; P for trend = 0.0001) than did those consuming 0.5 servings/wk. Controlling for other dietary covariates did not alter the association. Cereal intake was also associated with a lower risk. Use of mustard oil, which is rich in alpha-linolenic acid, was associated with a lower risk than was use of sunflower oil [for use in cooking: RR: 0.49 (95% CI: 0.24, 0.99); for use in frying, RR: 0.29 (95% CI: 0.13, 0.64)]. CONCLUSION: Diets rich in vegetables and use of mustard oil could contribute to the lower risk of IHD among Indians.

Adult↗
PubMedDate not supplied

Measles in India.

Measles is an important cause of morbidity and mortality among the children of India. In spite of this it is not considered a serious problem by the health authorities. Practically no cases are reported, and only those children with significant complications are hospitalized. Thus hospital records do not reflect the magnitude of the problem. In recent years attention has been focused on the evaluation of the morbidity and mortality due to measles in India. In the absence of reliable estimates, it is presumed that almost everyone in India suffers from measles before the age of 10 years. Hospital-based studies have found that 20%-70% of children with measles develop minor and major complications. On the basis of the few hospital-based studies and community surveys, it appears that the mortality rate due to measles is 3%-15%, depending on the health-care system in the community. All available data point to the necessity of immunization programs against measles, but logistical and economic constraints have prevented introduction of measles immunization in the Expanded Programme on Immunization. A limited experience with measles vaccine in India has shown that practically no cases occur among immunized children and that seroconversion rates are excellent. It is urgent to create awareness among health authorities, physicians, and health workers of the problem of measles.

Child↗
PubMed2006

Exploring the relationship between development and road traffic injuries: a case study from India.

BACKGROUND: Road traffic injuries (RTI) are a major cause of mortality and disability in the world. Only after significant losses have communities in developed nations taken necessary steps to prevent crashes and their consequences. Increase in road safety is related to increasing socio-economic development. We aim to study the trends in injury and death rates in a developing country, India, define sub-national variations, and analyse these trends in relation to economic and population growth. METHODS: Public sector data from India were used to develop a standardized database on traffic injuries and indicator of economic development. The data were analysed using linear regression models to test the a priori hypothesis of a positive relationship between net domestic product (NDP), and injury and death rates from road crashes across states. RESULTS: The absolute burden of RTI in India has been consistently rising over the past three decades. The reported rates are lower than those estimated by global health agencies and may reflect under-reporting. Population-based rates provide a better assessment of the public health burden of RTI than vehicle-based rates. There is an inverted U-shaped relationship between NDP and injury and death rates. Even with the limited data, Kuznets phenomenon is evident for within-country level comparisons. CONCLUSIONS: India and other developing countries could learn from the experience of highly motorized nations to avoid the expected rise in RTI and deaths with economic development, by currently investing in road safety and prevention measures.

Accidents, Traffic↗
PubMed2002

Weaning initiation patterns and subsequent linear growth progression among children aged 2-4 years in India.

BACKGROUND: Reliance on full breastfeeding alone for a longer time could have deleterious nutritional and health implications at later stages of children's lives. About 47% of children are weaned at age >or=6 months and more than 50% of children in India under 4 years are stunted. We investigated the association between timing of weaning and stunting of children in India, using the data from National Family Health Survey, 1992-1993. METHODS: Logistic analyses were employed on pooled data comprising one state each from six regions of India (N = 6285) with height status of children aged 2-4 years as the dependent variable. Timing of weaning was considered as the main control variable in the regression models. RESULTS: Children weaned at age 6 months (odds ratio [OR] = 1.57) and after 6 months (OR = 1.88) were more likely to be stunted at later age compared with those weaned before 6 months (P < 0.001). Stunting appeared to be considerably lower for children weaned at age 3 months and showed an upward trend thereafter. The effect of age at weaning on stunting attenuated but persisted with statistical significance after controlling for important demographic, health, social and region variables. The likelihood of stunting was 77% for children weaned at age >6 months who had not received full immunization in the first year and had lived in poor conditions. CONCLUSIONS: Timing of weaning is significantly associated with stunting among children in India. The underlying causal associations between weaning behaviour and growth retardation need to be further examined by using longitudinal data.

Child, Preschool↗
PubMed2006

High HIV prevalence among a high-risk subgroup of women attending sexually transmitted infection clinics in Pune, India.

OBJECTIVE: To investigate changes over a decade in prevalence and correlates of HIV among high-risk women attending sexually transmitted infection (STI) clinics in Pune, India, who deny a history of commercial sex work (CSW). DESIGN: Cross-sectional. METHODS: From 1993 to 2002, 2376 women attending 3 STI clinics in Pune were offered HIV screening. Women who denied CSW were included (n = 1020). RESULTS: Of 1020 women, 21% were HIV infected. The annual HIV prevalence increased from 14% in 1993 to 29% in 2001-2002 (P < 0.001). The change in HIV prevalence over time was paralleled by changes in clinic visitor characteristics; in later periods, women were older, more often employed, less likely to be currently married, and more likely to report condom use. In multivariate analysis, factors independently associated with HIV were calendar period (adjusted odds ratio [AOR], 1.9 for 1997-1999 vs. 1993-1996; 95% CI, 1.2-3.0; AOR, 2.3 for 2000-2002 vs. 1993-1996; 95% CI, 1.5-3.6), lack of formal education (AOR, 2.0; 95% CI, 1.4-2.9), having been widowed (AOR, 3.1; 95% CI, 1.6-6.1), current employment (AOR, 1.8; 95% CI, 1.2-2.6), and genital ulcer disease on examination (AOR, 1.8; 95% CI, 1.2-2.7). CONCLUSIONS: Women attending STI clinics in India who deny a history of CSW represent a small, hidden subgroup, likely put at risk for HIV because of high-risk behavior of their male partners, generally their husbands. Educational and awareness efforts that have targeted other subgroups in India (men and CSWs) should also focus on these hard-to-reach women. Risk reduction in this subgroup of Indian women would also be expected to reduce perinatal infections in India.

Adolescent↗
PubMed1993

Sequence analysis of human T cell lymphotropic virus type I strains from southern India: gene amplification and direct sequencing from whole blood blotted onto filter paper.

Human T cell lymphotropic virus type I (HTLV-I) infection in India has been found to be associated with adult T cell leukaemia/lymphoma (ATLL) and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) among life-long residents of southern India. To examine the heterogeneity of HTLV-I strains from southern India and to determine their relationship with the sequence variants of HTLV-I from Melanesia, 1149 nucleotides spanning selected regions of the HTLV-I gag, pol, env and pX genes were amplified and directly sequenced from DNA extracted from whole blood blotted onto filter paper and from peripheral blood mononuclear cells, obtained from one patient with HAM/TSP, two with ATLL and eight asymptomatic carriers from Andhra Pradesh, Kerala and Tamil Nadu. Sequence alignments and comparisons indicated that the 11 HTLV-I strains from southern India were 99.2% to 100% identical among themselves and 98.7% to 100% identical to the Japanese prototype HTLV-I ATK. The majority of base substitutions were transitions and silent. No frameshifts, insertions, deletions or possibly disease-specific base changes were found in the regions sequenced. The observed clustering of the Indian HTLV-I strains with those from Japan, as determined by the maximum parsimony method, suggested a common source of HTLV-I infection with subsequent parallel evolution. Amplification of DNA from blood specimens collected on filter paper may be useful for the study of other blood-borne pathogens.

Adolescent↗