Malwa Region Of Punjab Research Articles

Changing Trends of Skin Cancer: A Tertiary Care Hospital Study in Malwa Region of Punjab.

Skin cancer constitutes a small but significant proportion of patients with cancer. Although the presence of eumelanin in dark skin is protective against the development of skin cancer, it is increasingly being diagnosed in the Indian population. To study the profile of skin cancer patients presenting to a tertiary hospital in Malwa area of Punjab, India. Retrospective study was done to analyse the profile of skin cancer patients who attended the institution over one year from 1(st) December 2013 to 30(th) November 2014. A comprehensive review of aetiology and related risk factors was done to correlate the environmental factors with high skin cancer prevalence in this region. Skin cancer constituted (3.18%) 84 out of 2638 patients registered with cancer of all types. The age of the patients was 62±14.2 years and ranged from 27 to 92 yrs. Basal cell carcinoma (BCC) was the most common histological type(46/84, 54.76%) followed by squamous cell carcinoma (SCC) (31/84, 36.91%) and malignant melanoma (MM) (7/84, 8.33%). Male: female ratio was found to be 0.79:1. BCC showed higher female preponderance (p<0.05). Head and Neck was the commonest site involved (p<0.05). Majority (88%) of patients were from rural area. 92% of patients were directly into the profession of agriculture with history of prolonged exposure to sunlight. Skin cancer constitutes a small but significant proportion of patients with cancers. This study highlights a paradoxically increasing trend of BCC and female preponderance. Head and neck is the most common site involved. Exposure to Ultra Violet B (UVB) radiation and higher levels of arsenic in drinking water has been reported to be associated with skin cancers. Limited studies show that levels of arsenic and pesticides were higher in the samples of drinking water in Malwa area of Punjab. Therefore a multipronged strategy to provide safe drinking water supply and discouraging the indiscriminate use of pesticides is recommended.

Complementary and alternative medicine usage in patients for different ailments in rural region of Malwa area of Punjab: A cross-sectional study

Background: The use of complementary and alternative medicine (CAM) has increased steadily over the past 10-15 years and has gained medical, economic, and sociological importance. The prevalence of CAM use in patients is frequently high and estimated to be from 30% to 90% as reported in the literature. However, such usage data are missing in Indian population and that too based in rural area. Aims and Objectives: Our study aims to explore prevalence, pattern of use, and predictors of CAM and patients perceptions in various chronic diseases in rural populations. Materials and Methods: A descriptive, cross-sectional, 6 months survey enrolling 350 patients was conducted at Community Health Centre, located in village Badal, in Malwa region of Punjab, for 6-month period (July-December 15). Data collection was done in two parts: (a) Demographic details and (b) conventional treatment details. A questionnaire based on the International Questionnaire to Measure Use of CAM, developed by National Research Centre in CAM of the University of Tromso, Norway, which aims to internationally assess the use of CAM. Results: Out of total of 346 patients recruited, 200 confirmed of CAM usage and 146 denied of any CAM therapy and were labeled as a nonuser group. Male predominance. Uneducated farmers below the poverty line were the dominant category who went for CAM as an ailment curing therapy, indicating education and poverty as one of the major predictors in our study. Hypertension, diabetes, arthritis, dermatology, and patients of diseases with longer duration more frequently practiced CAM. Hiding the therapies from treating physician was reported 58%. Homeopathic and ayurvedic therapies were famous in our rural population. All the results were compared in user and non-user groups. Conclusion: CAM usage to such an extent is alarming. No previous reports of CAM use in the rural population of Malwa region are documented. This increasing trends worldwide are making CAM history essential component of treatments for all common specially chronic diseases. So, our study is one of the first efforts to make CAM history an integral part of usual case history in our rural setup.

Comparing the Metal Concentration in the Nails of Healthy and Cancer Patients Living in the Malwa Region of Punjab, India with a Random European Group – A Follow up Study

The cancer prevalence in the Malwa region of Punjab (1089/million/year) is much higher than the national average cancer prevalence in India (800/million/year). In our previous study on hair metal analysis, we located a high metal burden in Punjabi cancer patients and their live-in relatives, suggesting that an excessive metal exposure is a factor in the pathogenesis of cancer. The present study focused on nail metal analysis, a biological material similar to hair. Previously, we had used

Pattern of cancer in a tertiary care hospital in malwa region of punjab, in comparison to other regions in India.

Cancer pattern varies in different regions and depends on race, lifestyle and diet. There is a lack of definitive information regarding hospital-based cancer profile in Southern Punjab, which is a cotton growing area. Excess of toxins in the macro-environment is thought to be the reason for the high incidence of cancer in this area. To generate data on the magnitude and pattern of cancer cases reporting in the medical college hospital and to plan activities for prevention of cancer in the field practice area. A five year record-based retrospective study from 1(st)January 2007 to 31(st)December 2011. All cancer cases who reported either for diagnosis or for treatment (radiotherapy/chemotherapy/surgery) were included in the study. These confirmed cases of cancer were classified according to the International classification of Disease (ICD-10) given by WHO. Descriptive statistics, percentages. Out of a total of 1328 cancer cases, females accounted for 809 (60.9%) and males for 519 (39.1%) cases. Male to female ratio was 1:1.55. The maximum number of patients were seen in 35-64 yr age group (63.5%). Top five leading sites of cancer in males were lung (9.6%), myeloid leukemia (8.3%), prostate (6.8%), mouth (6.1%) and gall bladder (6.0%); and in females were breast (35.7%), cervix (19.1%), esophagus (5.1%), myeloid leukemia (4.7%) and gall bladder (3.9%). Our figures have been compared with the national data from NCRP. Population-based epidemiological studies are required to find out the disease burden & its cause in this region.

Screening of Psychological Distress in Cancer Patients During Chemotherapy: A Cross-sectional Study.

Objective:The objective of this prospective, noninterventional, 8-months, observational study was to analyze and compare depression, anxiety, and stress (DAS) levels and their impacting factors in homogenous surviving cancer patients receiving chemotherapy as compared to normal control.Materials and Methods:A prospective and descriptive study was carried out jointly by Pharmacology and Oncology departments of a tertiary care center in Malwa region of Punjab. The data was collected by administering the validated questionnaire/response (21-item Depression Anxiety and Stress Scale (DASS-21)) after taking ethical approval and informed consent.Results:All eligible 300 subjects participated in the study and they were compared with 300 matched control. The mean age of the cases (cancer patients) and controls was 50.58 ± 13.64 and 46.1 ± 11.78 (mean (M) ± standard deviation (SD)) years. Statistical significant difference was observed in mean ‘scoring of DAS’ in cancer patients when compared with control groups. Anxiety mean scoring showed a statistical significant difference in groups (according to chemotherapy cycles given and duration of disease). Stress was more observed in breast cancer patients.Conclusion:Holistic approach in cancer management including psychological evaluation and its solution at appropriate time/stage signifies the need of time as the present study revealed that the percentage of DAS as per the DASS scale was 90, 56, and 28%, respectively. A judicious diagnosis with an apposite intercession including psychological consultation with social support at appropriate time may alleviate the extra burden of psychological disorder, rather enhance the quality of life of cancer-affected rural population.

The 2011 outbreak of dengue virus infection in Malwa region of Punjab, India-an evaluation of various diagnostic tests

ObjectiveTo compare the efficacy of rapid immunochromatographic test (ICT) and ELISA for detection of dengue specific parameters (NS1 antigen and IgM antibodies) and the association of these parameters with thrombocytopenia. MethodsA total of 1787 serum samples were obtained from the same number of clinically suspected cases of dengue during an outbreak (2011) of dengue in the Malwa region of Punjab. All the samples were subjected to rapid ICT, dengue early ELISA and dengue IgM-capture ELISA for detection of NS1 antigen and IgM antibodies. Platelet counts of all the cases positive for dengue infection and 150 cases negative for dengue parameters (control group) were recorded. ResutlsRapid ICT for NS1 antigen detection showed same specificity (100%) but lower sensitivity (85.81%) than the dengue early ELISA, while it was 100% and 94.10% respectively for IgM antibody detection. The difference in the platelet counts of cases positive and negative for dengue specific parameters was stastically insignificant (standard error of proportions=0.017, Z value=0.84, P value=0.2). ConclusionsThe confirmation of serological diagnosis of dengue should always be based on ELISA test and ICT and/or thrombocytopenia should not be used as a stand-alone test.

Comparing the metal concentration in the hair of cancer patients and healthy people living in the malwa region of punjab, India.

The cancer prevalence in the Malwa region of Punjab (1089/million/year) is much higher than the national average cancer prevalence in India (800/million/year). The participants in the present study were 50 healthy individuals and 49 cancer patients all living in the Malwa region of Punjab, with the healthy people being selected from the same household as the cancer patients. High concentrations of several potentially toxic elements were found in hair samples from people living in Punjab. Compared to standard reference ranges, the metals in excess in both the control and patient groups were aluminium (Al), barium (Ba), manganese (Mn), strontium (Sr) and uranium (U). The most significant findings were high lead (Pb), U and Ba concentrations. The maximum values for Ba, Mn, Pb and U were found in hair from breast cancer patients. The mean concentration of U in hair from the breast cancer patients was 0.63 μg U/g, which is more than double the value found in the control group and over six times higher than the reference range of 0.1 μg U/g. Water, soil, and phosphate fertilizers all seem to play a potential role, causing an increased metal burden in Punjabi people living in the Malwa region. The present study indicates that metals, and especially U, may be a factor in the development of breast cancer among Punjabi women.

Quality of life in cancer patients undergoing chemotherapy in a tertiary care center in Malwa region of Punjab

Objective:The objective of this prospective, non-interventional, 4-month observational study was to analyze and compare patient-reported quality of life (QOL) and their physical/psychosocial symptom burden during their respective chemotherapy sessions.Materials and Methods:A prospective and descriptive study was carried out jointly by Pharmacology and Oncology Departments of a tertiary care center in Malwa region of Punjab. The data collection was performed by administering validated questionnaire/response after taking informed consent.Results:A total of 131 cancer patients were recruited with the mean age of 49.05 ± 14.35 (SD (standard deviation)) years. As per the QOL scoring of Global Health Status (GHS) and four items of symptom scale, that is, insomnia, pain, appetite loss, and constipation, and financial difficulties attained a significance difference. GHS significantly improved in group three as compared to group one, indicating that the patient's overall health/QOL improved as the chemotherapy session progressed.Conclusion:Although QOL scoring system did not show significant improvement in all areas (except insomnia, pain, appetite loss, constipation, and financial difficulties) with reference to their respective chemotherapy cycles, but a judicious diagnosis with an appropriate treatment including chemotherapy may lessen the negative perception of cancer as a deadly and fatal disease in our rural population.

Effects of Environmental Pesticides on the Health of Rural Communities in the Malwa Region of Punjab, India: A Review

ABSTRACT The Malwa region of Punjab, India, is facing an unprecedented crisis of environmental health linked to indiscriminate, excessive, and unsafe use of pesticides, fertilizers, and poor groundwater quality. The region has been described as India's “cancer capital” due to abnormally high number of cancer cases, which have increased 3-fold in the last 10 years. Studies of this region have also highlighted a sharp increase in many other pesticide-related diseases, such as mental retardation and reproductive disorders. The most affected individuals are the agricultural workers who are directly exposed to pesticides. The Malwa region of Punjab, India, is less than 15% of the total area of Punjab (only 0.5% of the total geographical area of India), but it consumes nearly 75% of the total pesticides used in Punjab. The high use of pesticides, along with environmental and social factors, is responsible for the high concentration of pesticide residues in the food chain of this region. Moreover, many banned and restricted pesticides are still in use in this region, warranting strict periodical health checkups and other interventions. The present review describes occupational, environmental, and social factors associated with pesticide use in the Malwa region of Punjab, India, and proposes some risk reduction interventions.

Disease Dynamics and Surveillance of Malaria in Malwa Region of Punjab and Evaluation of RDT Test

Aim: Malaria remains an enormous public health problem. Regular and ongoing surveillance to detect changes in its trends to initiate the control measures is the need of the hour. The present study was undertaken to provide the malaria transmission dynamics using surveillance indicators through active and passive surveillance in district Faridkot. Usefulness of rapid malaria diagnostic test was also evaluated. Methodology: This retrospective study extended over a period of two years (2010-2011). Thick and thin blood smears were prepared from suspected cases of malaria complaining of fever and headache for the last three days (i) of 2 CHC’s, 8 PHC’s and 68 sub centers as a part of active surveillance and (ii) those who visited GGS Medical College & Hospital and civil hospital Faridkot as a part of passive surveillance. Out of all the samples collected during the passive surveillance 995 samples collected at GGS Medical College and Hospital, Faridkot were also subjected to rapid diagnostic test (OptiMAL). Results: The annual blood examination rate (ABER) was 9.0 and 9.7 in 2010 and 2011 respectively. Annual parasite incidence (API) recorded was < 2 (0.5) in both the years and slide positive rate (SPR) was 0.5 and 0.05 in the two respective years of study. Significant gap in the rate of case detection of active and passive surveillance systems was observed with predominance of passive surveillance. More than 96% of cases were of P. vivax. Research Article British Microbiology Research Journal, 3(3): 339-345, 2013 340 RDT’s showed an excellent correlation with conventional microscopy. Conclusion: Malaria (P. vivax) is a persistent problem in the Malwa region with variation in its transmission dynamics with in the year. P. vivax is the main species of malarial parasite in the Faridkot district with occasional cases of falciparum malaria. Prevention strategy should be targeted towards on the spot diagnosis by using RDT and hence prompt treatment. It could help to prevent spread of drug resistance and complicated malaria.

Nerve conduction studies in the upper limb in the malwa region-normative data.

To establish the normal electrophysiological data for the median and the ulnar nerves in normal healthy adults in the Malwa region of Punjab, India. Nerve conduction studies were performed prospectively in the upper limbs of 100 carefully screened, healthy individuals of either sex, who were between the ages of 20 and 60 years, by using a standardized technique. Motor studies: The median distal latency (DL) in men was 3.4 (0.2) ms, the amplitude (CMAPA) was 10.80 (2.8) mV, the conduction velocity (MNCV) was 55.6 (2.5) m/s and the F-wave (min latency) was 27.57±2.54(21.5-34.2). In the ulnar nerve , the motor DL was 2.34 (0.25) ms, the amplitude (CMAPA) was 9.8(2.6) mV, MNCV was 63.4 (3.0) m/s and the F-Wave(min latency) was 26.29±2.12(21.6-34.7). In the sensory studies, the median nerve DL was 2.0(0.35) ms, SNCV was 53.4±3.0 m/s and the amplitude (SNAPA)was 59.3 (16.4) μV for men and it was 68.7(28.4) μV for women. For the ulnar nerve in men, the DL was 1.85(0.25)ms, SNCV was 55.5 (4.1) m/s and the amplitude(SNAPA) was 55.5 (18.4) μV for men and it was 64.9 (16.8) μV for women. Only the gender showed a statistically significant effect on the sensory nerve action potential for the median (p < 0.04) and the ulnar nerves (p < 0.041). The normative conduction parameters of the commonly tested nerves in the upper limb were established in our EMG lab. The mean motor nerve conduction parameters for the median and the ulnar nerves correlated favourably with the existing literature data. However, for the sensory nerves, a higher value for the nerve action potential amplitude was demonstrated in this study.

Study of poisoning trends in north India – A perspective in relation to world statistics

India is an agriculture based country with Punjab as one of the leading food grain producing states. There is an ever increasing burden to feed the growing population. This has led to over-usage of pesticides which on one hand has contributed significantly to increase the crop yield while on the other hand has led to sharp increase in the poisoning cases in the region. The present study was undertaken to study the deaths related to poisoning in Malwa region of Punjab in 2010 with a view to assess the pattern, trends and incidence of poisoning in relation to age, sex, area, season and type of poison used. These constituted 17.6% of all the unnatural deaths. From the available data the mortality rate from poisoning in Patiala district comes to 60 per million; whereas for males it is 81 per million and for females it is 35 per million. The mortality rate from poisoning in urban population is 78 per million whereas in rural population it is 50 per million. The results of the present study have been compared to those from India and around the world.

In situ measurements of radon levels in water and soil and exhalation rate in areas of Malwa belt of Punjab (India)

Radon concentration levels in water and soil gas from 36 locations pertaining to some areas of Malwa region of Punjab have been measured on an in situ basis using a continuous active radon detector (AlphaGuard, Model – PQ 2000 PRO, Genitron instruments, Germany). Exhalation rate measurements have also been carried out at these places, using a closed-circuit technique. The radon concentrations in soil and water varied from 1.9 to 16.4 kBq m−3 and 5.01 to 11.6 kBq m−3, respectively. The exhalation rate (E Rn) ranged between 7.48 and 35.88 mBq m−2 s−1 with an average value of 18.17 mBq m−2 s−1. Annual dose rates have been calculated for water radon concentrations. The minimum to maximum values of dose rates were found to be 13.42–31.08 μSv y−1. The recorded values of radon concentration in water are within the safe limit of 11 Bq l−1 recommended by the US Environment Protection Agency [National Research Council, Risk Assessment of Radon in Drinking Water (Academy Press, Washington, DC, USA, 1999)]. All measurements were made in similar climatic and environmental conditions to ensure minimal variations in meteorological parameters. An intermediate correlation coefficient (0.5) was observed between radon exhalation rates and soil gas values.