Rural South Indian Population Research Articles

Estimation of Lifetime Ocular Ultraviolet (UV) Exposure Levels in the Rural and Urban South Indian Population using Meteorological Data from Tropospheric Emission Monitoring Internet Service

Estimation of Lifetime Ocular Ultraviolet (UV) Exposure Levels in the Rural and Urban South Indian Population using Meteorological Data from Tropospheric Emission Monitoring Internet Service

Comparison of dietary profile of a rural south Indian population with the current dietary recommendations for prevention of non-communicable diseases (CURES 147).

Background & objectives:Despite the rising prevalence of non-communicable diseases (NCDs) in rural India, data on the dietary profile of the rural Indian population in relation to the recommendations for prevention of NCDs are scarce. This study was conducted to assess the dietary intake of a rural south Indian population in relation to the current dietary recommendations for the prevention of NCDs.Methods:The dietary profiles of 6907 adults aged ≥ 20 yr, from a cluster of 42 villages in Kancheepuram district of Tamil Nadu State in southern India, were assessed using a validated food frequency questionnaire.Results:The prevalence of general obesity was 27.4 per cent and that of abdominal obesity, 14.0 per cent among this rural population. The median daily energy intake of the population was 2034 (IQR 543) kcals. More than 3/4th of the calories (78.1%) were provided by carbohydrates. Refined cereals, mainly polished rice, was the major contributor to total calories. About 45 per cent of the population did not meet WHO recommendation for protein due to low intake of pulses, flesh foods and dairy products and more than half (57.1%) exceeded the limit of salt intake; 99 per cent of the population did not meet WHO recommendations for fruits and vegetables and 100 per cent did not meet the requirement of n-3 poly unsaturated fatty acids.Interpretation & conclusions:The dietary profile of this rural south Indian population reflected unhealthy choices, with the high consumption of refined cereals in the form of polished white rice and low intake of protective foods like fruits, vegetables, n-3 poly and monounsaturated fatty acids. This could potentially contribute to the increase in prevalence of NCDs like diabetes, hypertension and cardiovascular diseases in rural areas and calls for appropriate remedial action.

Survival of Patients With Cervical Cancer in Rural India

Background: Patients’ survival after diagnosis of cervical cancer is indirectly influenced by socio-economic factors. We evaluated this survival and its socio-economic determinants in a rural population in south India. Methods: We assessed 165 women diagnosed with cervical cancer from the routine care control arm of a randomized screening trial conducted in rural south India. Kaplan-Meier curves were plotted to illustrate the observed survival of cancer patients. The effect of socio-economic factors was assessed using Cox proportional hazards regression analysis. Results: The 5-year observed survival was 32.5%, ranging from 9% for stage IV to 78% for stage I cancers. Women with poor socio-economic status (SES) had up to a 70% higher risk of death. Higher household income was significantly associated with poorer survival. However, most women in the higher income group were married women and housewives, hence with no personal income. Conclusion: Cervical cancer survival was disappointingly low in these rural populations of India and stage of disease at diagnosis was the strongest determinant. A higher household income is not always associated with women being empowered in terms of seeking healthcare. The study findings further stress the importance of strengthening prevention and screening opportunities to women in rural populations. J Clin Gynecol Obstet. 2015;4(4):290-296 doi: http://dx.doi.org/10.14740/jcgo367w

The eye and the kidney: twin targets in diabetes

Diabetes mellitus is both defined by and is a dreaded condition because of microvascular involvement of the eye and the kidneys. The level of glucose at which retinopathy occurs forms the basis for diagnosing diabetes. Despite non-invasive methods being available for its diagnosis, retinopathy is often underdiagnosed and untreated. Eventually it leads to visual loss often in working-age populations. There appears to be ethnic variation in susceptibility to diabetic retinopathy (DR), with prevalence of DR, sightthreatening DR and macular edema being higher in people from South Asia, Africa, Latin America and indigenous tribal populations [1]. The variations are ascribed to differential susceptibility to known risk factors, as well as differences in lifestyle, access to health care and genetic and epigenetic phenomenon. A number of prevalence studies were reported from different parts of India. In a hospital-based report from Kashmir (n, 500 with diabetes), DR was identified in 27 % (n, 135) [2]. Increasing age was a risk factor, and milder forms accounted for the most cases, suggesting that early screening and treatment is necessary [3]. Prevalence studies from rural India are fewer [4]. In a population-based Central India Eye and Medical Study involving more than 4500 subjects, DR was diagnosed by fundus photography utilizing criteria of Early Treatment of Diabetic Retinopathy Study. DR was identified in 15 subjects (0.33 %) of the entire cohort. In subjects with diabetes, DR was present in 9.6 % [5]. Risk factors were increasing age and higher glucose concentrations. All eyes showed only nonsevere forms of DR. There was no significant association with other conventional risk factors or with ocular parameters. In the SN-DREAMS III report no 2 (Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study III), population-based cross-sectional screening was carried out in a rural population of south India (n, 13,079) [6]. DRwas identified using 45° four-field stereoscopic digital photography, along with 30° seven-field stereo digital pairs in those with DR. Among those with diabetes, DRwas identified in 10.3 %, with greater risk in men, insulin users, those with longer duration of diabetes, systolic hypertension and poor glycemic control [6]. In urban Chennai, the CURES Eye Study I, a populationbased screening for diabetes, was carried out in adults aged 20 years and above (n, 26,001). Among 1382 known subjects with diabetes who agreed to undergo four-field stereo colour photography, and 354 newly diagnosed subjects with diabetes, DR was present in 17.6 % [7]. The prevalence of DR was higher in men and those with proteinuria. Another population-based study in South Kerala assessed the prevalence of diabetes and DR in a community-based screening programme. One hundred and sixty camps were held in five southern districts of Kerala (Project Trinetra) [8]. In a pilot hospital-based screening for DR from western India (n, 168) using ETDRS classification, prevalence of DR was 33.9 %; non-proliferative DR was 25.5 % and proliferative DR 8.33 % [9]. The current issue of the Journal reports on the risk factors for DR in sub-Saharan Africa, prevalence in a rural south Indian population, and on biomarkers for DR and screening methods. * G. R. Sridhar sridharvizag@gmail.com

Pattern and severity of left ventricular diastolic dysfunction in early and end stage renal disease patients with or without dialysis in rural population in South India

Background: The chronic kidney disease (CKD) is a major risk factor for coronary artery disease (CAD) and left ventricle systolic dysfunction. Left ventricular (LV) diastolic dysfunction in CKD patients frequently leads to the development of congestive heart failure. The interaction between diastolic dysfunction (DD) and renal function in subjects with preserved systolic function is not well defined. Objective: Our aim was to investigate whether renal insufficiency (RI) is associated with DD among patients with left ventricular ejection fraction (LVEF) > 50%, and to investigate whether there is a correlation between CKD and DD severity. Methods: Eighty four CKD patients, aged 35-79 were examined by standard echocardiography. Subjects were divided into 4 groups depending on their estimated glomerular filtration rate (eGFR: ml/min/BSA) as follows: group 1 (60—89 ml/min/BSA), group 2 (30—59 ml/min/BSA), group 3 (15—29 ml/min/BSA) and group 4 (less than 15 ml/min/BSA), between 1/2/2014 and 30/4/2015. Glomerular filtration rate (GFR) was estimated using the MDRD formula. Patients with impaired relaxation (grade I) were compared to those with pseudonormal (grade II) or restrictive (grade III-IV) DD. Results: Among 84 patients, 23 had GFR 60-89 ml/min/BSA; 16 had GFR 30-59 ml/min/BSA; and 19 had GFR 15-30 ml/min/BSA and 26 had GFR <15 ml/min/BSA. There was a significant correlation between worsening GFR and degree of diastolic dysfunction (DD) assessed by echo. Overall, 40.4% of the participants were female, 22 (26.1 %) had grade I, & 10 (11.9 %) had grade II, 16 (19%) had grade III and 36 (42.8%) had grade IV diastolic dysfunction. Almost all patients had some degree of diastolic dysfunction. With worsening of renal function, there was worsening of diastolic dysfunction seen. In patients with end stage renal disease many had grade IV diastolic dysfunction as compared to patients with early CKD. Grade I and II DD was commonly seen in group 1 and 2. But grade III and IV DD was commonly seen in group 3 and 4. Conclusion: Worsening renal function was associated with greater degree of diastolic dysfunction and adverse clinical outcomes. Our Study indicated a clear and independent association between RI and DD. The severity of RI also tends to correlate with the severity of DD. And that LV diastolic dysfunction was observed even in patients with early stages of chronic kidney dysfunction.

Estimation of the cardiovascular risk using World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts in a rural population of South India.

World Health Organization/International Society of Hypertension (WHO/ISH) charts have been employed to predict the risk of cardiovascular outcome in heterogeneous settings. The aim of this research is to assess the prevalence of Cardiovascular Disease (CVD) risk factors and to estimate the cardiovascular risk among adults aged >40 years, utilizing the risk charts alone, and by the addition of other parameters. A cross-sectional study was performed in two of the villages availing health services of a medical college. Overall 570 subjects completed the assessment. The desired information was obtained using a pre-tested questionnaire and participants were also subjected to anthropometric measurements and laboratory investigations. The WHO/ISH risk prediction charts for the South-East Asian region was used to assess the cardiovascular risk among the study participants. The study covered 570 adults aged above 40 years. The mean age of the subjects was 54.2 (±11.1) years and 53.3% subjects were women. Seventeen percent of the participants had moderate to high risk for the occurrence of cardiovascular events by using WHO/ISH risk prediction charts. In addition, CVD risk factors like smoking, alcohol, low High-Density Lipoprotein (HDL) cholesterol were found in 32%, 53%, 56.3%, and 61.5% study participants, respectively. Categorizing people as low (<10%)/moderate (10%-20%)/high (>20%) risk is one of the crucial steps to mitigate the magnitude of cardiovascular fatal/non-fatal outcome. This cross-sectional study indicates that there is a high burden of CVD risk in the rural Pondicherry as assessed by WHO/ISH risk prediction charts. Use of WHO/ISH charts is easy and inexpensive screening tool in predicting the cardiovascular event.

Prevalence and risk factors of diabetic retinopathy in a rural population of South India

The purpose of this study is to study the prevalence and associated risk factors of diabetic retinopathy (DR) in type 2 diabetics in a rural setup by means of outreach screening camps. A total of 1270 diabetic patients were enrolled into the study from outreach screening camps conducted in rural areas of Kolar district by Sri Devaraj Urs Medical College attached to Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka. Detailed history with reference to age, duration of diabetes, hypertension, smoking and alcohol consumption was taken. Detailed ocular examination was done. Prevalence and associated risk factors were noted. Among the 1270 diabetic patients who were screened, 235 (18.5 %) patients had evidence of diabetic retinopathy. This included 167 (71.1 %) patients with mild to moderate non-proliferative diabetic retinopathy (NPDR), 41 (17.4 %) patients with severe NPDR, 19 (8.1 %) patients with proliferative diabetic retinopathy (PDR) and 60 (4.7 %) patients with maculopathy. The independent risk factors of DR which were statistically significant were older age (76.6 %), longer duration of diabetes (54.5 %), alcohol consumption (6.4 %), family history of diabetes (43 %) and insulin intake (27.7 %). Diabetes and its related complications are no longer restricted to the urban and the rich, with studies proving that prevalence rates are almost equivalent to urban population; strategies for prevention, early diagnosis and treatment need to be planned and implemented at the earliest if the burden of diabetic blindness is to be tackled effectively.

Awareness about health insurance in rural population of South India

Background: In India, despite improvements in access to health care, social inequalities are gross in both rural and urban areas. Many middle and lower socio economic class families are crushed under debts at the time of hospitalization due to lack of health insurance. Health financing is an important part of broader efforts to ensure social protection in health. However “health insurance” is still an unknown word for most rural people. So this study was undertaken with the objective to assess the awareness about Health Insurance in rural areas and to describe the sociodemographic characteristic of respondents. Methods: A cross sectional community based study was done with sample size of 290 households estimated by using 25% national coverage according to Public Health Foundation of India. The study was conducted between July 2014 to August 2014. 290 families were covered from two Primary Health Centres which come under field practice area of our medical college. A pretested semi structured questionnaire was used to collect data. Data was entered in excel sheet and analysed using SPSS version 17 software. Results: Among 290 respondents 72.5% were in age group of 26-45 years, 69.4% were female, 82.1% belonged to below poverty line, 72.4% were from nuclear family and about 81% of respondents were aware of Health Insurance. Conclusions: Awareness about Health Insurance among rural population was satisfactory. Attention for implementation of health insurance policies has to be paid more importance than only awareness.

An epidemiological study of sexual disorders in south Indian rural population.

Background:Sexuality is an important aspect of the personality of an individual and influences psychological, physical and social well-being of both men and women. It is a paradox, that in the country where ‘kamasutra’ (by Vatsyayana) took birth, there is a lack of research publications and sexuality related literature; hence the current study was conducted, to estimate the prevalence and association of sexual disorders with various socio-demographic variables, in the selected rural population.Materials and Methods:Subjects who were sexually active and fulfilled the study criteria were administered Arizona Sexual Experience Scale as screening tool for the presence of sexual problems. Those who were found to be having sexual problems were interviewed further using appropriate questionnaires.Results:21.15% of the male subjects were diagnosed to have one (or more) sexual disorder. Prevalence of erectile dysfunction was found to be 15.77%, male hypoactive sexual desire disorder (HSDD) 2.56%; premature ejaculation was found to be prevalent in 8.76% of the male subjects. Around 14% of the female subjects were diagnosed to have female sexual disorders. Prevalence of female arousal dysfunction was found to be 6.65%, female HSDD 8.87%, female anorgasmia 5.67%, female dyspareunia 2.34% and female sexual aversion disorder was found to be prevalent in 0.37% of the female subjects.Conclusion:This study concluded that one in five males and one in seven females were suffering from one (or more) sexual disorder. Improving the training of undergraduate medical and nursing students in sexuality related issues, increasing trained individuals in sexual medicine by starting new courses, providing sex education to the general population using media and merging sexual health care with primary care, are likely to play a significant role in addressing the increasing sexual health morbidity.

Sexual disorders among elderly: An epidemiological study in south Indian rural population.

Background:Realizing a dearth of data on this topic, especially in the Indian context, an epidemiological study was conducted in a south Indian rural population to identify the sexual activity patterns and sexual problems among the population above 60 years of age.Objectives:(1) Assessment of sexual activity patterns among individuals above 60 years. (2) Assessment of the prevalence of sexual disorders among individuals above 60 years.Materials and Methods:The study sample consisted of 259 participants, which included both males and females above 60 years of age. Subjects who were sexually active and fulfilled the study criteria were administered Arizona Sexual Experience Scale as a screening tool, for the presence of sexual problems. Those who were found to have sexual problems were interviewed further using appropriate questionnaires.Results:Only 27.4% of the individuals above 60 years were sexually active, and it progressively dropped as age advanced and none were sexually active after 75 years of age. Among the sexually active males, erectile dysfunction (ED) was prevalent in 43.5%, premature ejaculation in 10.9%, hypoactive sexual desire disorder (HSSD) in 0.77% and anorgasmia in 0.38% of the subjects. Among females, arousal disorder was prevalent in 28%, HSSD in 16%, anorgasmia in 20% and dyspareunia in 8% of the subjects.Conclusion:The study gives us an insight into the sexual problems of the elderly and brings home the point that sexual problems are very much common among both men and women in the older population. Among elderly males, ED is the most common sexual disorder whereas in elderly females, arousal disorder is the most prevalent female sexual dysfunction, implicating biology plays an important role in men, whereas psychology plays an important role in women sexual functioning.

Consent for audio-video recording of informed consent process in rural South India.

Introduction and Objectives:In recent times, audio-video (A-V) recording of consent process for all the study subjects entering a clinical trial has been made mandatory. A-V recording of informed consent process is a big challenge due to confidentiality and the sociocultural environment in India. It is important to find out the acceptability for A-V recording of the consent process and reasons for refusal, if any to address this new challenge.Materials and Methods:A descriptive survey was done among 150 residents of a rural community of South India. Acceptability for A-V recording of consent process was assessed among those who had given the informed written consent for participation in the study. An attempt to find the factors determining the refusal was also made.Results:More than one-third (34%) of the study subjects refused to give consent for A-V recording of consent process. Not interested in recording or don’t like to be recorded (39%) were the most common reasons to refuse for A-V recording of consent process. The refusal was higher among female and younger age-group adult subjects. Socioeconomic status was not found to be significantly associated with refusal to consent for A-V recording.Conclusion:Refusal for A-V recording of consent process is high in the South Indian rural population. Before any major clinical trial, particularly a field trial, an assessment of consent for A-V recording would be helpful in recruitment of study subjects.

High calcium and iron deficiencies in an elderly rural south Indian population

High calcium and iron deficiencies in an elderly rural south Indian population

Geospatial Technology in Disease Mapping, E- Surveillance and Health Care for Rural Population in South India

Abstract. Providing Healthcare to rural population has been a challenge to the medical service providers especially in developing countries. For this to be effective, scalable and sustainable, certain strategic decisions have to be taken during the planning phase. Also, there is a big gap between the services available and the availability of doctors and medical resources in rural areas. Use of Information Technology can aid this deficiency to a good extent. In this paper, a mobile application has been developed to gather data from the field. A cloud based interface has been developed to store the data in the cloud for effective usage and management of the data. A decision tree based solution developed in this paper helps in diagnosing a patient based on his health parameters. Interactive geospatial maps have been developed to provide effective data visualization facility. This will help both the user community as well as decision makers to carry out long term strategy planning.

Prevalence of Non Communicable Diseases (NCDs) in a Rural Population of South India

Globally, the burden of non-communicable diseases (NCDs), which also bear the greatest morbidity and mortality, is rising in developing countries. Demographic and epidemiological transitions taking place in the developing countries of Asia is shifting the disease burden from communicable towards non-communicable disease. India's poor are at heightened risk of acquiring NCDs owing to high rate of smoking and tobacco use. So this paper analyses the links between socioeconomic status and non communicable diseases in rural area.

Burden of cardiovascular risk factors of a rural population in South India using the WHO multivariable risk prediction algorithm

Background: Cardiovascular diseases (CVD) account for almost half of all non-communicable disease related deaths and are now the leading cause of death in low- and middle-income countries including India. There is no published data on multivariable risk prediction for cardiovascular disease from rural India. Aims & Objective: Determine the cardiovascular risk profile and the 10 year risk of fatal and non-fatal cardiovascular event in a rural population. Materials and Methods: A community based cross sectional study was done in 47 villages of Karnataka over a period of 3 years. A total of 3780 adults were screened for CVD risk factors. Various risk stratification criteria including the WHO 10 year risk of fatal/ non-fatal CVD event were used to study the magnitude of individual and aggregated risk factors for CVD. Results: The study reveals a high prevalence of CVD risk factors despite using three different risk stratification methods. The prevalence of at least one modifiable CVD risk factor in the population was 98.5%. An alarming 15.2% of the population had a high risk (>30%) of getting fatal or non-fatal MI or stroke in 10 years. Older age, lack of education, physical inactivity and family history of MI/ stroke were associated with high risk for CVD. Conclusion: The prevalence of CVD risk factors as well as the probability of a fatal or non-fatal cardiovascular event is very high in this rural population. This warrants strategies that would improve awareness and promote healthy life-styles to reduce the risk of cardiovascular disease in this population.

Suttur study: An epidemiological study of psychiatric disorders in south Indian rural population.

Background:Based on review of literature World Health Organization (WHO) Global Burden of Disease Study has estimated that psychiatric disorders are among the most burdensome, around the globe and has suggested general population surveys for future research. This study aims to estimate the prevalence of psychiatric disorders and study their association with various socioeconomic variables.Materials and Methods:This was an exploratory study where a door-to-door survey of the entire population residing in a South Indian village was done (n = 3033). Mini international neuropsychiatric interview kid (MINI) or MINI plus were administered to all the subjects according to the age group.Results:It was found that 24.40% of the subjects were suffering from one or more diagnosable psychiatric disorder. Prevalence of depressive disorders was found to be 14.82% and of anxiety disorders was 4%. Alcohol dependence syndrome was diagnosed in 3.95% of the population. Prevalence of dementia in subjects above 60 years was found to be 10%.Conclusion:Our study is among the very few epidemiological studies with respect to methodological design which does not use screening questionnaires and evaluates each subject with detailed administration of MINI. It concluded that one among four were suffering from a psychiatric disorder. Improving the training of undergraduate medical and nursing students is likely to play a significant role in addressing the increasing psychiatric morbidities.

Effectiveness of low vision services in improving patient quality of life at Aravind Eye Hospital.

Context:In India, where the heavy burden of visual impairment exists, low vision services are scarce and under-utilized.Aims:Our study was designed to survey the effectiveness of low vision exams and visual aids in improving patient quality of life in southern rural India.Subjects and Methods:The low vision quality of life (LVQOL) questionnaire measures vision-related quality of life through 25 questions on a Likert scale of 0–5 that pertain to (1) mobility, distance vision, and lighting; (2) psychological adjustment; (3) reading and fine work; and (4) activities of daily living. This tool was translated into Tamil and verbally administered to 55 new low vision referral patients before their first visit at the low vision clinic at Aravind Eye Hospital. Low vision aids (LVAs) were prescribed at the discretion of the low vision specialist. 1-month later, the same questionnaire was administered over the phone.Results:About 44 of 55 low vision patients completed baseline and follow-up LVQOL surveys, and 30 normal vision controls matched for age, gender, and education were also surveyed (average 117.34 points). After the low vision clinic visit, the low vision group demonstrated a 4.55-point improvement in quality of life (from 77.77 to 82.33 points, P = 0.001). Adjusting for age, gender, and education, the low vision patients who also received LVAs (n = 24) experienced an even larger increase than those who did not (n = 20) (8.89 points, P < 0.001).Conclusion:Low vision services and visual aids can improve the quality of life in South Indian rural population regardless of age, gender, and education level. Thus, all low vision patients who meet the criteria should be referred for evaluation.

Prevalence and associated risk factors of coronary artery disease in a rural south Indian population on a governmental health insurance scheme

ObjectivesTo examine the prevalence of Coronary heart disease (CHD) and associated risk factors based on coronary angiography among a geographically well-defined rural population of south India having an access to a governmental health insurance scheme. Study designObservational cross-sectional study. MethodsThis study in rural Andhra Pradesh covers 413 rural primary health centers each catering for 30,000 people was conducted between December 2007 and November 2011. From an eligible population of 43,025 subjects screened through health camps and clinically assessed for CHD based on (1) History of angina or myocardial infarction (2) ECG changes suggestive of Ischemic heart disease, 3692 subjects were CHD-diagnosed but 3248 got admitted as inpatients for additional clinical ascertainment before 3050 in-patients were studied finally based on angiographic findings. Results8.58% were diagnosed as CHD; all the conventional risk factors were significantly associated with CHD risk except BMI. 2005 subjects (65.7%) of those with diagnosed CHD had hypertension, 1013 (33.2%) had diabetes, 1292 (42.4%) were smokers (current and former), 938(30.8%) had Dyslipidemia and 848 (28%) had BMI >25 kg/m2 (Table 1) 0.1171 (38.4%) had single vessel disease, 1452 (47.6%) had two vessel disease and 427 (14%) had triple vessel disease (Table 3). Left ventricular dysfunction was found in 1187 (38.9%) patients and renal impairment was seen in 519 (17%) patients. ConclusionsThis study shows that CHD and associated cardio-metabolic risk factors are growing concerns in rural India even in rural populations. Both community based strategies and clinic based targeted approach to high risk patients are necessary to address such a public-health problem.

Is Being Tall Cardioprotective? Correlation Between Height And Atherosclerosis. An Autopsy Study

Objectives: Ischemic heart disease (IHD) following atherosclerosis is the most common cause of cardiac deaths worldwide. Short stature has been said to be associated with an increased risk of coronary heart diease (CHD) in many Western populations but contradictory reports have emerged from Asian studies and a few Western studies. Degree of atherosclerosis being an indicator of future IHD, its association with height of the subjects was assessed in the present study. Materials and Methods: Hearts and aortas from 120 autopsies, 82 male and 38 female were assessed. Most patients had died of non-vascualar causes except for two who died of myocardial infarction. Height was measured to the nearest 0.5 cms using flexible measuring tape. Atherosclerosis was microscopically assessed using the modified American Heart Association classification based on morphological descriptions. The results were statistically analyzed using the SPSS software for Windows version 16 using Pearson\'s Chi-square. Results: The degree of atherosclerosis of the coronaries and aortas of short and tall males and only coronaries of short and tall females showed that the difference was not statistically significant (p > 0.05). However the difference in degree of atherosclerosis of aorta of tall and short females was statistically significant (p = 0.02). Conclusion: These data refute the hypothesis that stature is inversely related to risk of CHD. The hypothesis that short stature is an adverse risk factor for CHD has been studied mainly in the Western populations and it does not seem to hold true in the present study done in a rural South Indian population of Kolar. Further prospective follow up studies and autopsy studies are required to confirm and apply these findings to the Indian scenario. Keyword: Atherosclerosis, height, autopsy

Prevalence of thrombocytopenia in a diagnosed case of malaria in rural population of South India

Introduction: Malaria is a major health problem in the tropics and poses a significant burden on health expenditure. Malaria is a common disease in rural India with high mortality and morbidity. Falciparum malaria is common in rural India and presents with protean manifestations, involving multiple systems and high mortality. Compared to benign malaria, Plasmodium falciparum malaria progresses to life-threatening complications, more so in rural India. The global case-fatality rate of falciparum infection is around 2 million deaths per year. Objective: To evaluate the incidence of thrombocytopenia in malaria, its variations in falciparum and vivax; and prognosis of patients with significant thrombocytopenia.Materials and Methods: Platelet count was done on a fully automated, quantitative, hematology Coulter analyzer (Name: I Count 3, Irish Company, 2010 model) for a sample collected from peripheral smear positive for malaria patient. Results: The mean platelet count in vivax infections wasis 120454.55/ml ranging from of 36,000 to 263,000 and in falciparum infections the mean platelet count was 118,200 with a range of 13,000-667,000.Conclusions: Low platelet counts observed in the course of malaria illness are transient and do not necessarily have prognostic implications or platelet infusions more so with the relatively benign course in Plasmodium vivax malaria.