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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)
Recently, we and others showed that the components of green tea may be useful cancer chemopreventive agents. It has been suggested that (-)-epigallocatechin-3-gallate (EGCG), the major constituent in green tea, may possess antitumor-promoting and/or anticarcinogenic effects in rodent tumor bioassay systems. During the chemical analysis of various green tea products, we found a traditionally preserved preparation of green tea used by tribes in the Himalayan region of Sikkim, India that was rich in EGCG. EGCG was isolated from this tea product, and its inhibitory effects were evaluated against the binding of topically applied 3H-labeled polycyclic aromatic hydrocarbons (PAHs) to epidermal DNA and 12-O-tetradecanoylphorbol-13-acetate (TPA) caused induction of epidermal ornithine decarboxylase (ODC) activity in Sencar mice, the short-term markers of tumor initiation and tumor promotion, respectively. Preapplication of EGCG resulted in significant inhibition (p less than 0.05) in the binding of [3H]PAH to epidermal DNA. Similarly, the topical application of EGCG resulted in significant inhibition (p less than 0.005) in TPA-caused induction of epidermal ODC activity. In further studies, we assessed the anti-skin tumor-initiating effect of EGCG in Sencar mice in an initiation-promotion protocol. The application of EGCG before challenge with 7,12-dimethylbenz[a]anthracene as tumor initiator resulted in significant reduction both in percentage of mice with tumors and number of tumors per mouse compared with a non-EGCG-pretreated group of animals. The results of the present study suggest that the green tea preparation from Sikkim may be a good source for the isolation of EGCG and that this compound may have significant potential as a cancer chemopreventive agent.
OBJECTIVES: To know the extent of gallstone disease in Sikkim and North Bengal. METHODS: 487 (14.4%) patients with gallstones were diagnosed among 3375 patients with dyspepsia in 3 years. All patients with gallstone were evaluated based on a predefined questionnaire. Abdominal sonography was performed and obesity index was calculated. Gallstones retrieved at surgery from 29 patients were subjected to infra-red spectroscopic analysis. RESULTS: The patients with gallstones included 375 women with average age of 40 years and 112 men with average age of 48.7 years. 15.7% of the women were nulliparous, 12% had one child and 23% had two children each. 73% of patients were of normal weight and 97% were non-vegetarians. Only cholesterol gallstones were found in these patients. CONCLUSIONS: Gallstones are common in Sikkim and North Bengal among dyspeptics. A majority of patients are of normal weight. The disease occurs a decade earlier in women, most of whom have only up to two children.
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.
14 population groups of Sikkim (India)--Lepchas (2), Bhutias (2), Sherpas, Tamangs, Gurungs, Mangars, Rais, Limboos/Subbas, Pradhans (Newars), Brahmans, Chhetris, Scheduled Castes--have been studied in regard of the intra- and intergroup variability of colour blindness, ear lobe attachment, mid-phalangeal hair and behavioural traits (tongue folding, hand clapsing, arm folding, leg folding, handedness). Some of these variables show a considerable distribution heterogeneity, which is discussed considering history and marriage patterns of these populations. As most of them are highly endogamous one can assume that this heterogeneity is caused by locally acting factors such as drift and/or founder effects, which could be preserved due to as good as lacking gene flow among the populations under study. Beyond that the Sikkim data are compared briefly with those reported for other Indian and Asiatic populations.
We evaluate the blood pressure profile in relation to selected biological, behavioral, and socioeconomic factors among the Lepchas, a tribal population of Asian origin inhabiting the Dzongu area of northern Sikkim. The results show that mean systolic and diastolic blood pressures of Lepcha adults (aged 19 years and older), engaged primarily in agricultural practices, are conspicuously high and that the prevalence of essential hypertension (defined in terms of WHO criteria) is remarkably high as well, irrespective of sex. Significant effects of age on blood pressure were found. None of the anthropometric variables considered was a significant correlate of blood pressure in males, whereas triceps skinfold thickness was the only significant correlate of blood pressure in females. Systolic blood pressure among males was significantly affected by alcohol intake. Mean systolic and diastolic blood pressures consistently increase with increasing intake of alcohol in both sexes.
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.
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