Cohort profile of the largest health & demographic surveillance system (Dibrugarh-HDSS) from North-East India

Dibrugarh Health and Demographic Surveillance System (Dibrugarh-HDSS), was started in the year 2019 with the objective to create the health and demographic database of a population from a defined geographical area and a surveillance system for providing technical assistance for the implementation of programmes and formulating intervention strategies for reducing disease morbidities and mortalities in the population. Dibrugarh-HDSS adopted a panel design and covered 60 contiguous villages and 20 tea gardens. Line listing of all the households was conducted and a unique identification number detailing State, district, village/tea garden and serial number was provided along with geotagging. Detailed sociodemographic variables, anthropometric measurements (subjects ≥five years) and blood pressure data (subjects ≥18 yr), disease morbidity and mortality were collected. All data were collected in pre-designed and pre-tested questionnaires using a mobile application package developed for this purpose. Dibrugarh-HDSS included a total of 106,769 individuals (rural: 46,762, tea garden: 60,007) with 52,934 males (49.6%) and 53,835 females (50.4%). The number of females per thousand males were significantly higher (1042 in tea garden vs. 985 in rural populations) in the tea-garden community as compared to the village population. More than one-third (35.1%) of tea populations were illiterate compared to the rural population (17.1%). Villagers had significantly higher body mass index than the tea-garden community. The overall prevalence of hypertension (adjusted for age) was 29.4 vs. 28.2 per cent, respectively, for the village and tea-garden population. For both these communities, males (village=30.8%, tea garden=31.1%) showed a higher prevalence of hypertension (adjusted for age) than females (village=28.2%, tea garden=25.8%). The findings of the present study give an insight into the profile of the native rural and tea-garden populations that will help to identify risk factors of different health problems, review the effectiveness of different ongoing programmes, implement intervention strategies for reducing morbidity and mortality and assist the State health authorities in prioritizing their resource allocation and implementation strategies.

Epidemiology of stroke: findings from a community-based survey in rural Bangladesh

OBJECTIVES

This study was designed to determine the epidemiology of stroke in a rural population of Bangladesh.

STUDY DESIGN

In a cross-sectional study, we surveyed stroke patients.

METHODS

The survey was conducted in a rural community of Bangladesh from January 2016 to June 2016. All community members 15 years and older in a surveillance system were included in this study. The Questionnaire for Verifying Stroke-Free Status was used to screen stroke cases at household level which were again examined by the neurologist for confirmatory diagnosis.

RESULTS

The prevalence of stroke was 1.96 (95% confidence interval [CI] 1.69-2.26) per 1000 population. The highest prevalence was 9.65 (95% CI 7.42-12.33) per 1000 population, identified among patients aged 65-79 years. Males had higher prevalence (2.38 per 1000 population) than females (1.55 per 1000 population). Of the 24% of patients who had radiological examination (magnetic resonance imaging and computed tomography scan) reports, 17.2% of stroke cases were ischemic, 4.8% were intracerebral, and about 1.1% were subarachnoid. The ratio of infarction to hemorrhage was 2.91. Approximately 67% of patients were diagnosed as hypertensive, and 37% of patients had elevated blood glucose level. While 15% of patients were found to be overweight or obese, 45% of patients had raised blood cholesterol level. More than 10% of patients reported that they had heart disease before the occurrence of stroke. About 40% of patients had the history of tobacco consumption.

CONCLUSIONS

The prevalence of stroke is higher among elderly and male populations. A significant proportion of patients presented with hypertension and/or diabetes.

Soil pollution at outdoor shooting ranges: Health effects, bioavailability and best management practices

The total lead (Pb) concentrations of the surface soil, sub surface soil, vegetation and surface waters of outdoor shooting ranges are extremely high and above regulatory limits. Lead is dangerous at high concentrations and can cause a variety of serious health problems. Shooters and range workers are exposed to lead dust and can even take Pb dust home to their families while some animals around the shooting range can ingest the Pb bullets. The toxicity of Pb depends on its bioavailability which has been determined to be influenced greatly by the geochemical properties of each site. The bioavailability of Pb in shooting ranges has been found to be higher than other metal contaminated soils probably because of its very low residual Pb (<1%). Despite being an immobile element in the soil, migration of Pb within shooting ranges and offsite has been reported in literature. Best management practices to reduce mobility of Pb in shooting ranges involve an integrated Pb management program which has been described in the paper. The adoption of the non-toxic "green bullet" which has been developed to replace Pb bullets may reduce or prevent environmental pollution at shooting ranges. However, the contaminated soil resulting from decades of operation of several shooting ranges still needs to be restored to its natural state.

Effects of aspirin and paracetamol on ATPases of human fetal brain: an in vitro study

In vitro effects of aspirin and paracetamol at the doses 200, 400, 600, 800 nmole/mg protein on ATPases activity were studied in the cerebrum and cerebellum of human fetus covering the age range from 10 weeks to 32 weeks of gestation. Both aspirin and paracetamol inhibit Na+K+ ATPase and Mg2+ ATPase in a dose dependent manner. The inhibition of Na+K+ ATPase and Mg2+ ATPase activity which may affect the release and uptake of biogenic amines in CNS, hinders the maturation of human fetal brain.

Biochemical studies on the in vitro effect of doxepin on Mg2+ & Na+, K+)-ATPases of human foetal & adult brain

The in vitro effect of doxepin at 10, 50 and 200 micrograms/mg protein on Mg2+ and (Na+ K+)-ATPases (EC 3.6.1.3) activities of human foetal and adult brain (crude homogenate of cerebrum and cerebellum) were studied at 10-30 wk of gestation. Both Mg2+ and (Na+, K+)-ATPases of human foetal and adult brain were found to be inhibited by doxepin in a dose dependent manner. The inhibitory effect neither varied with respect to the region (i.e., cerebrum and cerebellum) nor with the gestational ages. Inhibition of ATPases activity by doxepin may affect the release and uptake of biogenic amines in the CNS, which may hamper the maturation of brain.

In vitro effect of lorazepam on Mg2+ and (Na+,K+) ATPases of human foetal brain

Lorazepam (LZ), a benzodiazepine group of drug, inhibits Mg2+ and (Na+,K+) ATPases (EC 3.6.1.3) activity of human foetal and adult brain. The inhibitory effect neither varied with respect to the region (i.e. cerebrum and cerebellum) nor with the age of the foetus. The inhibition of ATPases activity indicates that the neuronal transmission processes, may be affected and raises the possibility of developmental disturbances.