North Indian Women Research Articles

Preeclampsia in North Indian women: the contribution of genetic polymorphisms

To find association of angiotensin-converting enzyme (ACE) insertion/deletion (I/D), angiotensinogen (AGT) T704C, methylenetetrahydrofolate reductase (MTHFR) C677T and factor V Leiden (FVL) G1691A polymorphisms with pre-eclampsia (PE) in North Indian women. In this prospective case-control study, genotyping of 200 pre-eclamptic women and 200 normotensive pregnant controls was performed for the ACE I/D, AGT T/C,MTHFR C/T and FVL G/A polymorphisms. Statistical analysis was carried out using SPSS and Epi Info to estimate their association with PE. The association of these polymorphisms with nonsevere PE and severe PE was separately assessed. The FVL mutation was found in 4% of women and increased the risk of PE twofold (odds ratio [OR] 2.08, P-value 0.03). The MTHFR mutant allele was found to be protective (OR 0.59, P-value 0.01). Both these polymorphisms showed similar association with nonsevere PE (OR 2.149, P-value 0.038 and OR 0.565, P-value 0.222, respectively) but not with severe PE. The ACE I/D and AGT T/C polymorphisms were not found to be associated with PE overall (OR 1.26, P-value 0.11 and OR 1.15, P-value 0.35, respectively), but ACE I/D polymorphism was found to increase the risk of severe PE (OR 1.53, P-value 0.019). FVL mutation is more common in North Indians than previously believed and it predisposes the women to PE. MTHFR mutant allele is paradoxically protective. ACE polymorphism appears to predispose to severe PE but not nonsevere PE. No significant contribution of AGT polymorphism to PE is found.

Prevalence, risk factors and virological profile of chronic hepatitis b virus infection in pregnant women in India

A large program was conducted by the Government of India to study the prevalence and profile of chronic hepatitis B virus (HBV) infection and its risk factors in pregnant women attending a tertiary care hospital in India. From September 2004 to December 2008 consecutive pregnant women attending the antenatal clinic were screened and those found positive for HBsAg were enrolled. Healthy non-pregnant women of child-bearing age, who presented for blood donation during the same period, served as controls. Women with symptoms of liver disease or those aware of their HBsAg status were excluded. Of the 20,104 pregnant women screened, 224 (1.1%) and of the 658 controls, 8 (1.2%) were HBsAg positive (P = ns). Previous blood transfusions and surgery were significant risk factors for infection with HBV. Of the women who were HBsAg positive, the ALT levels were normal in 54% of the women and HBV DNA levels were above 2,000 IU/ml in 71% of women. The median HBV DNA levels were higher in women who were HBeAg positive compared to the HBeAg negative group. The most common HBV genotype was D (84%) followed by A + D and A (8% each). In conclusion, the prevalence of HBsAg positivity among asymptomatic pregnant women in North India is 1.1% with 71% having high HBV DNA levels. These women may have a high risk of transmitting infection to their newborns.

Genetic analysis of eNOS gene polymorphisms in association with recurrent miscarriage among North Indian women

This study investigated the association of common polymorphisms of the endothelial nitric oxide synthase (eNOS) gene with recurrent miscarriage (RM) among North Indian women. A total of 200 patients with unexplained recurrent miscarriages and 300 controls were genotyped for six polymorphic regions of eNOS by PCR, re-sequencing and RFLP. The GG genotype of 12862A>G, the G allele of Glu298Asp and the aa genotype of intron 4VNTR increased the risk of RM by ∼1.8-fold, ∼3.5-fold and ∼2-fold, respectively (odds ratio (OR) 1.84, 95% confidence intervals (CI) 1.19–2.86, P = 0.0066; OR 3.58, 95% CI 2.12–6.03, P < 0.0001; and OR 2.23, 95% CI 1.04–4.77, P = 0.0493). Two haplotypes were found to have a significant protective effect against RM (OR 0.63, 95% CI 0.48–0.82, P = 0.0009; and OR 0.4, 95% CI 0.19–0.81, P = 0.0149) and another was found to increase the risk of RM by ∼2-fold (OR 2.12, 95% CI 1.16–3.89 P = 0.0195). In conclusion three common polymorphisms of eNOS gene, 12862A>G, Glu298Asp and intron 4VNTR increase the risk of RM in North Indian women. Risk of RM may also be modified by the presence of particular haplotypes. In many women who have had three or more miscarriages, no definite cause for the condition can be found. It was recently found that implantation depends on the receptivity of maternal endometrium which in turn is influenced by synergistic action of nitric oxide (NO). The production of NO in endothelial cells increases during pregnancy and contributes to vasodilation and vasopressor responses. NO is synthesized by a family of NO synthase (NOS) enzymes in which three isoforms have been identified: neuronal (nNOS, NOS-1), inducible (iNOS, NOS-2) and endothelial (eNOS, NOS-3). It has been shown that polymorphisms in the coding and non-coding regions of eNOS may alter eNOS expression and/or activity and thus cause a decrease in NO synthesis which may predispose patients to hypertension, vasospasm and atherosclerosis, renal failure, pre-eclampsia and recurrent miscarriages. In this study conducted in North India, we tested polymorphisms of the eNOS gene in women with and without recurrent miscarriage and tried to find if any particular polymorphism increased the probability of a woman having recurrent miscarriage. We found that at least three common polymorphisms of the eNOS gene – 12862A>G, Glu298Asp and intron4 VNTR – increase the risk of recurrent miscarriage in North Indian women.

Polymorphism of Xenobiotic-Metabolizing Genes and Breast Cancer Susceptibility in North Indian Women

NAD(P)H:quinone oxidoreductase 1 (NQO1) and cytochrome P450 1A2 (CYP1A2) are involved in the metabolism of estrogens. Genetic polymorphisms in these genes may lead to interindividual variation in breast cancer susceptibility. This study was undertaken to investigate the association of NQO1 exon 6 proline187serine (C609T) and CYP1A2 exon 2 phenylalanine21leucine (C63G) polymorphisms with breast cancer susceptibility in North Indian women. Polymorphisms were analyzed by polymerase chain reaction amplification of the desired segment of NQO1 and CYP1A2 genes followed by restriction fragment length polymorphism. NQO1 mRNA expression was analyzed by semiquantitative reverse transcription-polymerase chain reaction and its enzyme activity was estimated spectrofluorophotometrically. Odds ratios for NQO1 C609T heterozygous and homozygous variants were 0.66 (95% confidence interval: 0.39-1.13; p-value: 0.141) and 1.07 (95% confidence interval: 0.46-2.46; p-value: 0.976). All cases and controls were monomorphic for the CYP1A2 exon 2 phenylalanine21leucine (C63G) genotype. NQO1 mRNA expression and its catalytic activity among wild-type genotype, homozygous variant, and heterozygous variant were not significantly altered, except for catalytic activity of the NQO1 homozygous variant, which was observed extremely low. The results of the study suggest that NQO1 exon 6 proline187serine (C609T) and CYP1A2 exon 2 phenylalanine21leucine (C63G) polymorphisms do not play a significant role in breast cancer susceptibility in North Indian women.

Oral contraceptive pills decrease pulmonary airway resistance in healthy north Indian women

Oral contraceptive pills (OCPs) are hormonal pills used by females to prevent conception; they are a combination of estrogen and progestin. There is, however, compelling evidence that throughout the reproductive life of a woman, her airways are subject to the influence of the cyclical variations in sex hormones which occur in relation to circadian rhythms. The present study has been designed to investigate the effects of OCPs on airway resistance in terms of spirometric parameters in OCP users and nonusers. A total of 100 women (age: 20-40 years) ware selected for the present study. The subjects were provided with a one-month supply of OCPs. The constituents per tablet of MALA-N used were levonorgestrel 0.15 mg and ethinylestradiol 0.03 mg. Peak expiratory flow rate (PEFR), forced expiratory flow in expiring 25-75% air (FEF 25-75), forced expiratory volume percentage in one second (FEV1% or FEV1/FVC), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) were recorded. In our study, the FEF 25-75and PEFR increased significantly in OCP users, showing that these hormone pills decrease the resistance offered by small bronchioles.

Interleukin-6 G-174C gene polymorphism and serum resistin levels in North Indian women: Potential risk of metabolic syndrome

The present investigations were aimed to identify the possible association between genetic polymorphism in interleukin-6 (IL-6) G-174C gene, which confers susceptibility to metabolic syndrome, and serum level of resistin in North Indian women. The study population comprised 370 unrelated Indian women (192 having abdominal obesity and 178 controls). Polymorphism in genotype (CC+GC) of IL-6 G-174C gene was determined using a combination of polymerase chain reaction (PCR) and sequence-specific primer with restriction fragment length polymorphism (RFLP) technology. Insulin resistance (IR) and serum resistin level were also analyzed along with metabolic risk factors. Of 192 abdominal obese women, 147 (76.56%) were found to have mutant CC+GC (p = 0.001) genotype and allele frequency (p = 0.001), which was significantly higher 45 (23.44%) than non-obese and their respective wild type. The mutant genotype (CC+GC) of IL-6 gene was found to be associated significantly with high triglyceride (p = 0.025) and resistin level (p < 0.001), when compared with respective wild genotype (GG) in obese women. Non-obese women with no signs of metabolic risk factors were found to have significantly low level of serum resistin and IR in comparison to obese women having genetic polymorphism for IL-6 G-174C gene. Study suggests that IL-6 G-174C gene is one among the susceptibility loci for metabolic syndrome in North Indian women. Genotype for this polymorphism may prove informative for prediction of genetic risk for metabolic syndrome. Further, high level of serum resistin molecules may be targeted to correlate with metabolic syndrome risk factors and could be used as early prediction marker.

The Pious Self is a Jewel in Itself

This article historically situates Ashraf Ali Thanvi’s Bahishti Zewar ( Heavenly Ornaments) as a manual for the production of pious dispositions. Written in 1905 for Muslim women in north India, this Urdu text teaches women how to train themselves to be pious and provides an ideal picture of the well-formed woman, self-reflective of how her actions correspond to the Divine will. Brought up as a Muslim, she has already been socialised into subordination to this will. Becoming self-reflective, linked to a critical rite of passage of an individual’s life, involves more regulated, arduous and deliberate reiterative work on the self. Without advocating that women should be managed through religious idiom, the analysis presented here challenges euro-centric perceptions of modernity and tradition and proposes that we need to think through more carefully what kind of agency is actually involved in consolidating the Muslim subject who submits to Divine will in a framework of ‘ shariatic modernity’. This discussion carries immense relevance for current debates about how Muslim women may address the challenges of living in the West.

Status and recognition of sportswomen in Indian society

In the early 1900s when club life was introduced in India, sporting activities also found a serious place in female lives due to the facilities provided. Women pioneers had started...

Vascular endothelial growth factor gene polymorphisms in North Indian patients with recurrent miscarriages

The association of four common polymorphisms of vascular endothelial growth factors (VEGF) with recurrent miscarriages(RM) was evaluated in North Indian women for 200 patients with RM and 200 controls. The subjects were genotyped for the polymorphisms 2578C/A, 2549 18-bp I/D, 1154G/A and +936C/T. Association of VEGF genotypes, alleles and haplotypes with recurrent miscarriage were evaluated by Fisher’s exact test. 1154G/A and +936C/T modified the risk of RM. The 1154A allel and +936T allel significantly increased the risk of RM (OR = 1.485, P = 0.0210, 95% CI 1.072–2.057 and OR = 1.869, P = 0.0054, 95% CI 1.214–2.876 respectively). Risk was further increased when –1154A/A genotype and +936C/T genotype were considered (OR = 2.0, P = 0.0310,95% CI 1.068–3.747 and OR = 1.716, P = 0.0293, 95% CI 1.058–2.784 respectively). However, no association was found between 2578C/A or 2549 18-bp I/D and RM. Four haplotypes, AIAC, ADAC, CIAT and ADGT, were found to predispose to RM while the haplotypes CIAC, CDGT and ADGC were found to show protective effect. In conclusion, two common polymorphisms of the VEGF gene,1154G/A and +936C/T, increase the risk of RM in North Indian women. RM is also predisposed in the presence of haplotypes AIAC,ADAC, CIAT and ADGT.

Cyclooxygenase-2 Gene Polymorphisms and Risk of Cervical Cancer in a North Indian Population

Single nucleotide polymorphisms in the cyclooxygenase-2 (COX-2) might contribute to differential COX-2 expression and subsequent interindividual variability in susceptibility to cancer. This study sought to evaluate the effects of COX-2 +8473T/C (rs5275) and -765G/C (rs20417) gene polymorphisms on the risk of cervical cancer in women of Northern India. Peripheral blood samples were collected from 200 histopathologically confirmed patients with cervical cancer and 200 unrelated, healthy female controls of similar ethnicity. Questionnaire survey was conducted to comprehend the demographic data, smoking status, and cancer stage of patients. Polymerase chain reaction-based restriction fragment length polymorphism was used to detect the genotypes of the COX-2 gene. Cyclooxygenase-2 +8473CC genotype was associated with a significantly reduced risk of cervical cancer (P = 0.036; odds ratio, 0.4; 95% confidence interval, 0.1-0.9), whereas COX-2 -765G/C polymorphism demonstrated no association. In addition, no significant association with clinical stages of cervical cancer and modulation of risk due to tobacco usage was observed in our study. Cyclooxygenase-2 +8473T/C gene polymorphism demonstrated protective effect in North Indian women. Further studies evaluating the role of COX-2 gene polymorphisms in ethnically diverse populations and a larger cohort may help in understanding the etiopathogenesis of cervical cancer in women worldwide.

Endothelial nitric oxide synthase, angiotensin-converting enzyme and angiotensinogen gene polymorphisms in hypertensive disorders of pregnancy

We investigated the variations in genes encoding endothelial nitric oxide synthase (NOS3), angiotensin-converting enzyme (ACE) and angiotensinogen (AGT) in hypertensive disorders of pregnancy and the relationship between the polymorphisms and circulating nitric oxide (NO) and ACE levels in pregnant north Indian women. Frequencies of NOS3 G894T, 4b/a and T(-786) --> C, AGT T704C and ACE ins/del polymorphisms were studied in 342 subjects: 120 with preeclampsia (PE), 104 with gestational hypertension and 118 normotensive pregnant women. Variations were evaluated by polymerase chain reaction-restriction fragment length polymorphism. NO and ACE levels were determined using ELISA. There was no difference in the distribution of individual NOS3 and ACE polymorphisms in the study groups. Haplotype analysis showed a global difference in the NOS3 haplotype distribution between the PE and non-PE subjects (P=0.03). The presence of AGT 704C allele was associated with a reduced risk of developing PE (odds ratio: 0.33, 95% CI: 0.19-0.59 in recessive mode). Circulating total NO and ACE levels were similar in three groups. No relationship was found between circulating NO levels and any of the NOS3 polymorphisms, but the circulating ACE levels were higher in those with DD genotype (P<0.05). In conclusion, there was no association between individual NOS3 and the ACE gene polymorphisms and hypertensive disorders of pregnancy in north Indian women. The presence of minor alleles at all the three sites in NOS3 seemed to increase the risk of PE, and AGT 704C allele was associated with a reduced PE risk. The complexity of interaction between these genetic abnormalities requires further studies.

Prevalence of human papillomavirus infection among young women in North India

Background: The number of women infected with human papillomavirus (HPV) and the distribution of the HPV genotypes vary across populations and with age. Objective: To determine the prevalence and genotype distribution of HPV in young married women aged 16–24 years. Methods: 1300 women residing in an urban slum in Delhi donated samples of exfoliated cervical cells that were collected by the Digene ® kit and tested for the presence of HPV DNA by two techniques in parallel, i.e., PCR using PGMY consensus primers for all HPV types and the Digene HPV test (Hybrid Capture 2 (HC2) Probe B for high-risk (hr) types. Genotyping was done on all HPV positive samples using the Roche reverse line blot assay. Results: HPV infection was detected in 91/1300 (7%) samples by PCR and 110/1300 (8.4%) samples by HC2. Genotyping identified 20 high-risk and 11 low-risk types. HPV16 was the commonest high-risk type (3%) followed by HPV52 (1.2%) and HPV51 (0.8%). Among low-risk types, HPV62 was the commonest (0.8%), followed by HPV84 and HPV89 (0.5% each). Multiple infections were found in 3% of the HPV positive samples. Conclusion: A wide spectrum of HPV genotypes is seen in this young population. Knowledge about HPV types prevalent in communities in different regions of India would be useful in devising the optimum strategy for cervical cancer prevention.

Maternal indicators and obstetric outcome in the north Indian population

Understanding the effect of maternal parameters on obstetric outcome has public health importance because these indicators are associated with infant health and survival and influence development and health in later life. To determine the effects of various maternal indicators on pregnancy outcome in north-Indian women. A prospective study of all consecutive women with singleton pregnancy, who were registered in the first two months of pregnancy and delivered in the hospital. Maternal indicators such as age, height, prepregnancy weight, body mass index (BMI), hemoglobin and parity were correlated with pregnancy outcome. The women with a medical disorder or complication that developed during the course of pregnancy were excluded. A total of 2027 women were analyzed. Maternal height, weight, BMI and parity had a positive significant correlation with birth weight of the newborn (r=0.081, P value < 0.001, r=0.148, P value <0.001, r = 0.121, P value < 0.001 and r = 0.099, P value < 0.001, respectively). Maternal height, weight and period of gestation were significant indicators for low birth weight on multivariate logistic regression. The rate of preterm delivery was significantly higher in women with hemoglobin < 7 g% and women with parity >3. The chances of caesarian section increased significantly with increase in maternal height, weight and BMI. A prepregnancy weight of more than 40 kg, BMI of more than 19.8 and hemoglobin of at least 7 g% or more favor good obstetric outcome.

Sociodemographic patterning of non-communicable disease risk factors in rural India: a cross sectional study

Objectives To investigate the sociodemographic patterning of non-communicable disease risk factors in rural India.Design Cross sectional study.Setting About 1600 villages from 18 states in India. Most were from four large...

Abstract C59: Human papillomavirus genotype distribution in northern India: Implications for vaccination

Abstract Background: Cervical cancer caused by human papilloma virus (HPV), is the commonest cancer in Indian women, with an estimated 132000 new cases and 76000 deaths annually. More than 100 HPV genotypes have been identified in humans of which at least 40 HPV types are found in the genital tract. Several high-risk HPV types are known to cause the disease. There are only limited data available on the genotype distributions in this region. Methods: During the period three different cross-sectional studies were carried out: (1) a hospital-based cross-sectional study in which 106 women presenting with invasive cervical cancer; (2) a hospital-based cross-sectional study in which 524 women presenting to have an unhealthy cervix were invited to participate; (3) a community-based cross-sectional study in which 465 women also underwent HPV testing. HPV typing in these studies was done by using L1 consensus PCR followed by reverse line blot hybridization assay (Roche). Results: In the hospital-based population, among 106 invasive cervical cancers the six commonest HPV types were HPV-16, -18, -45, -59, -33 and 73. HPV-16/18, singly or in combination, were seen in 83% of cases. (2) In the hospital-based population, among the 524 symptomatic hospital subjects, the overall HPV prevalence was 15.5 % and the six commonest HPV types were as follows: HPV -16, -89, -39, -52, -33 and 18. Among the HPV positive women accounted for HPV-16/18 were associated with 34.3%, 45.4% and 65.7% of normal, low-grade and high-grade disease respectively. Among (3) the community-based women, the overall HPV prevalence was 7 % and the six commonest HPV types were as follows: HPV- 16, - 45, -52, -31, -66, and -18. Conclusions: A wide spectrum of HPV types is seen in north Indian women, with HPV-16/18 are the commonest types in all populations. However, thereafter there is considerable variation. It is estimated that the HPV -16/18 vaccine would reduce over 75% of the total cancer burden in this region. The community population is from a confined geographical area whereas the hospital population includes not only residents of Delhi and neighbouring areas but also further states of North India as well as neighboring countries of Nepal and Bangladesh. Thus more studies are required to establish the true picture of HPV type-distribution in this large and diverse region. Citation Information: Cancer Res 2009;69(23 Suppl):C59.

Genetic association of phase I and phase II detoxification genes with recurrent miscarriages among North Indian women

Allelic variants of the detoxification genes that have impaired biotransformation functions may increase susceptibility to reproductive toxicity leading to endometriosis, recurrent miscarriage (RM) or poor pregnancy outcome. In the present study, we have investigated CYP1A1, CYP2D6, GSTT1, GSTP1 and GSTM1, which are involved in the phase I and phase II detoxification systems, in relation to their role in the etiology of unexplained RMs. In a case-control study, we have investigated 200 females with RM and 300 age and ethnically matched healthy controls with successful reproductive history from North India. The frequencies of phase I wild-type genotypes of CYP1A1 and CYP2D6 in RM cases were 0.56 and 0.60, whereas in controls these were 0.68 and 0.65, respectively (both P < 0.05). The GSTM1 null-genotype frequencies were 0.66 and 0.84 among RM cases and controls, respectively, the GSTT1 null-genotype frequencies were 0.52 and 0.45 (P < 0.005) and the GSTP1 variant allele frequencies were 0.23 and 0.20, respectively. In conclusion, we observed significant protective effects of phase I wild-type genotypes and association of the GSTT1 null genotype with RM. Through combined analyses we have highlighted the importance of the balance of phase I/phase II detoxification systems, in the etiology of RM.

Impact of dietary intake, education, and physical activity on bone mineral density among North Indian women

The aim of the study was to determine the relationship of dietary nutrients and bone mineral density (BMD) in North Indian women. This cross-sectional study was conducted from April 2006 to March 2008. Subjects included 255 healthy women, aged 20-69 years, who were relatives of patients being admitted in the hospital. Various demographic characteristics including socioeconomic status and serum parameters in relationship to BMD were evaluated. In addition, the daily dietary intake of energy, protein, fat, and calcium and the amount of physical activity were assessed. BMD at the lumbar spine, femoral neck, and Ward's triangle was measured by dual-energy X-ray absorptiometry (DXA). Body mass index (BMI), physical activity, and educational level were positively correlated with BMD. The daily intakes of energy (1563.4 +/- 267.2 kcal) and protein (48.7 +/- 8.7 g) were below the recommended dietary allowance. Daily dietary energy, protein, and calcium intakes were correlated with BMD at the lumbar spine. Stepwise multiple linear regression analyses showed that age, BMI, and physical activity were significant predictors for BMD at all sites. In addition, energy intake was also a predictor for BMD at the lumbar spine. The protein intake was associated with BMD at the spine (P = 0.02 and beta = 0.163) even after making adjustments for energy intake. Thus, dietary pattern coupled with higher education levels and greater physical activity favored bone health.

Impact of Toll-like receptors [TLR] 2 (−196 to −174 del) and TLR 4 (Asp299Gly, Thr399Ile) in cervical cancer susceptibility in North Indian women

Objective(s) Targeting the Toll-like receptor (TLR) signaling pathway in elucidating the cellular and molecular mechanisms of human diseases, including cervical cancer, is gaining tremendous importance. The aim of our study was to identify the role of TLR 2(−196 to −174 del) and TLR 4(Asp299Gly and Thr399Ile) gene polymorphisms in cervical cancer susceptibility in North Indian women. Methods For the study, blood samples were collected from histopathologically confirmed patients of cervical cancer ( n = 150) and unrelated, healthy female controls of similar ethnicity ( n = 150). Genomic DNA was extracted from peripheral blood leukocytes using salting-out method. TLR 2 and TLR 4 genotyping was done using Polymerase Chain Reaction and Restriction Fragment Length Polymorphism followed by 10% polyacrylamide gel electrophoresis. Results TLR 2 del allele showed significant association ( p = 0.048, OR = 1.6 [95%CI = 1.00–2.51]) with cervical cancer susceptibility, while no significant association was found with TLR 4 (Asp299Gly and Thr399Ile). However, TLR 4 Thr/Ile genotype was found to be significantly associated with early stage (Stage II) of cervical cancer ( p = 0.044, OR = 2.51 [95%CI = 1.03–6.12]). Furthermore, TLR 2 ins/del genotype showed strong association ( p = 0.015, OR = 1.95 [95%CI = 1.14–3.33]) with tobacco usage in women with cervical cancer. Conclusion(s) Our study highlighted the involvement of TLR 2 (−196 to −174 del) and TLR 4 (Thr399Ile) gene polymorphisms in cervical cancer susceptibility. The TLR gene polymorphisms, upon further evaluation, may be helpful in elucidation of immunobiological mechanisms associated with cervical cancer susceptibility.

Awareness Of Risk Factors And Aspects of Breast Cancer Among North Indian Women

Objectives: To determine the knowledge of women about breast cancer and its risk factors. Study design: Community based descriptive cross sectional analysis. Setting: Field practice and adjoining areas of urban health training center of Department of community medicine, Government medical college and hospital, Chandigarh. Study subjects: Women more than 30 yrs of age of Chandigarh, North India. Main outcome measures: Women's demographics, knowledge about breast cancer, risk factors, treatment, detection and preventive modalities. Results: All the respondents had heard of breast cancer. Awareness about breast mass/lump to be cardinal symptom of breast cancer was known to 47.2% (463) of respondents. The two main causes of breast cancer according to respondents were late initiation of breast feeding (150, 15.3%) or not practicing breast feeding (166, 16.9%).Late marriage being a risk factor was known only to 55(5.9%) respondents and relation of obesity with breast cancer was known to only 89(9.1%) subjects. The main preventive modality, breast self exam was known by only (324, 33%) subjects. Of those who knew about breast self examination correct methodology was known only to 1/4th of respondents (255, 25.9%).Conclusions: Women do have knowledge deficits about breast cancer and various factors related to it.

Human Papillomavirus-Type Distribution in Women With and Without Cervical Neoplasia in North India

Our objective was to determine the human papillomavirus (HPV)-type prevalence in cervical samples in women with and without cervical neoplasia in an opportunistic hospital-based cancer-screening program. A cross-sectional study of 524 women presenting from January 2003 through June 2005 with symptoms of persistent vaginal discharge, intermenstrual bleeding, and postcoital bleeding or detected to have an unhealthy cervix underwent HPV genotyping by consensus polymerase chain reaction and reverse line-blot hybridization assay, conventional Pap smear, and colposcopy, with directed biopsy from all lesions detected. The prevalence rates of HPV infection among women with normal, low-grade cervical neoplasia (CIN 1) and high-grade CIN (>CIN2) were found to be 7.6%, 42.3%, and 87.5%, respectively. Seventeen high-risk and 6 low-risk HPV types were identified by the reverse line-blot assay. Multiple infections were seen in 20% of women. In normal women, the 6 commonest types were HPV-16, HPV-89, HPV-39, HPV-52, HPV-62, and HPV-18, whereas in high-grade disease, these were all high-risk types HPV-16, HPV-18, HPV-33, HPV-39, HPV-35, and HPV-56. HPV-16 was the commonest type in all groups, seen in 49.4% cases overall and in 74.3% of high-grade squamous intraepithelial lesion. It was followed by HPV-18 (7.4%) and HPV-33 and HPV-39 (4.9% each). HPV-89 was the commonest low-risk type (9.9%). HPV-16/18 were associated with 34.3% of normal, 45.4% of low-grade and 65.7% of high-grade lesions. A wide spectrum of HPV types is seen in north Indian women, with the majority being HPV-16 in all grades of histology. A vaccine against HPV-16 and HPV-18 could prevent two thirds of cases of high-grade cervical neoplasia.