Joint Families and Cancer Diagnosis in Rural India

Background: Each year, there are over a million new cases of cancer in India, which causes many untimely deathsand increases the economic burden to households. By focusing on preventative measures and finding socioeconomicand behavioral contributors to cancer, steps can be taken to help alleviate this burden. This study aims to find the effectliving in a joint family can have on being diagnosed with cancer in rural India. Methods: The study estimates theeffect living in a joint family, along with other demographic information, has on being diagnosed with cancer usinga logit estimation model. The data for the study was collected from a survey was conducted on the households of theHandiganur village (N=251) comprising of several demographic, social, and medical questions. Results: The studyfound that living in a joint family lowers the odds of having cancer. The results indicate that living in a joint familyreduces the probability of being diagnosed by 7.23 percentage points and is significant at a 5% level. Furthermore,among the other tested variables, eating habit is negatively significant at 5% level, suggesting that if a person eats 3 to4 times a day his or her likelihood of suffering from cancer will be lowered by 6.55 percentage points. Access to publicwells and drinking alcohol both increase the likelihood of being diagnosed with cancer by 7.90 (p<0.1) percentagepoints and 11.90 (p<0.05) percentage points respectively. Conclusions: The negative effect of joint family could bedue to two possible reasons. The first is that there is in fact a biological reason. The second reason for this result couldbe a false negative, as it could be because people in joint families are not getting the necessary check-ups required todiagnose cancer.     

Percutaneous transluminal mitral valvuloplasty in post Mitral valve repair and Aortic valve replacement patient

MV repair in the rheumatic population is feasible with acceptable long-term results. Incidence of mitral stenosis (MS) following mitral valve (MV) repair for severe rheumatic mitral regurgitation (MR) and usefulness of percutaneous transluminal mitral valvuloplasty in these patients is not described in literature. We report a case of successful PTMC in severe MS following MV repair for severe rheumatic MR.     

Knowledge, attitudes, and practices about kala-azar and its sandfly vector in rural communities of Nepal.

Reported are the results of a study of the knowledge, attitudes and practices (KAP) about kala-azar of the inhabitants of two villages (Titaria and Haraincha) situated in terai (plain) areas of Nepal. The villagers had poor knowledge about the transmission of kala-azar, with most villagers perceiving that mosquitos, instead of sandflies, were responsible for transmission of the infection. Most also failed to recognize the common symptoms of kala-azar. The majority of the respondents, 78.9% in Titaria and 48.4% in Haraincha, were aware that the condition can be treated, while fewer than 2% believed that it cannot be treated at all. More than 58% of villagers in Titaria and 36.8% in Haraincha used bednets. The residents of both villages were highly responsive to a programme to spray houses with insecticides. Fewer than 5% of respondents slept outdoors in farm outhouses and these individuals did not take any personal vector control measures. The results of this study show the importance of understanding the beliefs and practices of communities in the successful planning and implementation of kala-azar control activities in Nepal.     

Krait bite requiring high dose antivenom: a case report

Anti snake venom (ASV) is the most specific therapy available for treatment of snakebite envenomation. The ASV available in Nepal are polyvalent ASV produced in India and are effective against envenomation by cobra and krait, the two most common species found in Eastern Nepal. Neurotoxic signs respond slowly and unconvincingly and continuous absorption of venom may cause recurrent neurotoxicity. Therefore, close observation and continuous administration of ASV is essential to save the victim. We report a case of neurotoxic envenomation due to bite by common krait (Bangarus caeruleus). The victim required very high dose of polyvalent ASV for reversal of neurological manifestations.     

Clinico-epidemiological features of snakebite: a study from Eastern Nepal

We studied 604 suspected snakebite cases seen at the peripheral snakebite treatment centre, Damak, Eastern Nepal from January to December 2000 using pre-designed proforma. Seventy-five per cent of the patients were in the age group 11-40 years. The common victims were farmers (44.2%) and housewives (31.7%). The bite was commonly encountered during farming (29.4%), working in the field (16.2%), walking (13.7%) and feeding cattle (9.2%). Sixty-five per cent were bitten during outdoor and agriculture related activities. Bite during sleep was recorded in 7%: 62% had sustained bite in lower limb. Forty-two per cent of the victims arrived at the treatment centre within 2 hours of being bitten. Fourteen patients arrived 7 hours after being bitten and six were dead on arrival. A common local practice (seen in 56.7%) was to eat chillies to confirm envenomation. Application of a tourniquet, often multiple, was the common (90%) first aid measure. Neurotoxicity was present in 11% (n=66) of the victims. Five had local features of envenomation. No case of coagulopathy was recorded. Reaction to anti-snake venom was noticed in 28.16% (n=20). Two patients died during treatment. Mortality among patients with features of neurotoxicity was 3%.     

Ocular morbidity in schoolchildren in Kathmandu

BACKGROUND/AIMS: Any information on eye diseases in schoolchildren in Nepal is rare and sketchy. A programme to provide basic eye screening to schoolchildren with an aim to provide services as well as gather information on ocular morbidity has been started. METHODS: All the children in the schools visited are included in the study. This programme is targeted at poor government schools, which are unable to afford this service. A complete eye examination is given to all the children including slit lamp examination, fundus evaluation and retinoscopy, and subjective refraction. RESULTS: A total of 1100 children from three schools are included in this report. 11% of our schoolchildren have ocular morbidity, 97% (117 out of 121) of which is preventable or treatable. Refractive error is the commonest type of ocular morbidity (8.1%). Myopia is the commonest type of refractive error (4.3%) as opposed to hypermetropia (1.3%). 12.4% of children with refractive error have already developed amblyopia. Strabismus is the second commonest type of ocular disability (1.6%). Alternate divergent squint is the commonest type of strabismus (1.4%). Traumatic eye injuries (0.54%), xerophthalmia (0.36%), and congenital abnormalities (0.36%) are much less common. CONCLUSION: A school eye screening cum intervention programme with periodic evaluation seems to be appropriate for countries like Nepal as most of the eye diseases found are preventable or treatable.     

Influence of hormonal status on behavioral responses to an acute ethanol challenge during ethanol withdrawal in male and female rats

We previously reported significant sex differences in ethanol withdrawal (EW) recovery as well as in sensitivity to GABA_A receptor modulators during EW. The aim of the present study was to determine if hormonal status moderated behavioral responses to an acute ethanol challenge in EW animals comparing two different behaviors. An initial set of experiments explored motor-incoordinating effects of the acute ethanol injection during EW at either 1 day or 3 days of withdrawal. EW male, but not female, rats showed a decrease in coordination compared to controls that persisted through 3 days EW. Female rats displayed tolerance to the motor-incoordinating actions of the acute ethanol challenge at 1 day EW whereas tolerance was more evident in EW male rats at 3 days. In contrast, EW animals generally remained responsive to the anticonvulsant actions of ethanol, irrespective of hormonal status. While EW by itself did not significantly alter seizure latency, duration or severity, it increased seizure-induced mortality especially at 3 days EW. There was some evidence of tolerance to the anticonvulsant effect of the acute ethanol challenge at the lowest dose employed (0.62 g/kg), which varied by sex condition and time of EW. All sex conditions displayed marked sensitivity to the anticonvulsant effects of the ethanol challenge at the two higher doses studied. Overall, ovariectomized females showed the greatest response to the acute ethanol administration. These findings provide additional evidence of a divergence in behavioral responses during EW and suggest that multiple neuroadaptations moderate various responses to ethanol during EW, with minor contributions of hormonal status.