Semi-urban Population Research Articles

Choice of place of antenatal care among women of reproductive age in a semiurban population in northcentral Nigeria

Background: Antenatal care has an important role in identifying high‑risk pregnancies and improving the chances of safe motherhood particularly in developing countries where obstetric indicators are still poor. The objective of this study was to determine the choices women of reproductive age in Vom, a semirural town at the outskirts of Jos the capital of Plateau State Nigeria made to have antenatal care.Materials and Methods: This was a cross‑sectional study carried out between January and March 2015 in Vom, a semirural area about 30 km from Jos the capital of Plateau State among 2,641 (Two thousand six hundred and forty one) women of reproductive age.Results: Fifty‑eight percent of the respondents opted for antenatal care in government‑owned hospitals while 29% chose faith‑based institution which was in their vicinity, 11% favored private hospitals for antenatal care, while 1% chose traditional birth attendants (TBAs) and prayer houses to receive antenatal care. The majority of the respondents (32%) were females between the ages of 40 and 44 years while 22% were aged between 25 and 29 years of age. They were predominantly farmers of the Berom ethnic group and 47% of them had completed primary level of education.Conclusion: Females in the reproductive age in this rural setting in northcentral Nigeria favored government‑owned hospitals as places to receive antenatal care. Their choices were not affected by their educational status varied according to the age ranges of the respondents.Keywords: Antenatal care; reproductive age women; semiurban population

Predictors for Gingival Index in Middle-Aged Asian Indians with Type 2 Diabetes from South India: A Cross-Sectional Observational Study.

Asian Indians develop type 2 diabetes mellitus (T2DM) much earlier as compared to White Caucasians, due to unique phenotypic and genetic architecture. Periodontitis in T2DM patients is often a neglected clinical feature. This study was conducted to derive predictor variables for gingival index in middle-aged Asian Indians with T2DM in a semiurban population of Dravidian ethnicity from Tamil Nadu, India. T2DM patients (n = 232, mean age: 50.6 ± 10.4 years) with periodontitis (n = 123, mean age: 54.3 ± 2.4 years) and without periodontitis (n = 109, mean age: 55.2 ± 3.1 years) were recruited between 2014 and 2016 by purposive sampling method. Dental examinations for pocket depth (PD) and clinical attachment level (CAL) were performed and gingival index was calculated. Fasting venous blood samples were analysed for measures of glycaemia and cholesterol. Significant positive correlation (p < 0.01) was observed for gingival index with glycosylated haemoglobin (HbA1c), pocket depth, presence of T2DM, and clinical attachment level. Stepwise multiple linear regression analysis derived increased pocket depth (p < 0.01), elevated HbA1c (p < 0.01), clinical attachment level (p < 0.01), and presence of diabetes (p < 0.01) as significant predictors (r 2 value = 0.67) for increased gingival index in middle aged patients with T2DM. These variables significantly (p < 0.01) predispose middle-aged T2DM patients to increased gingival index, thus warranting appropriate intervention.

Blood-sucking ticks (Acarina, Ixodoidea) as an essential component of the urban environment

The problem of urban ticks has arisen from the increased rate of urbanization since WWII. Expansion of municipal boundaries encompasses adjacent territories, so that large areas of wilderness together with all their inhabitants get incorporated into city limits. Current strategies of biodiversity conservation include the creation of green corridors and other forms of connectivity between wilderness and urban areas as well as between green patches within cities. All this allows various mammals and birds to migrate from their native habitats into and between various parts of the cities and to establish permanent urban populations. Medium-sized and larger animals provide adult ticks with blood meal, thus creating suitable conditions for the establishment and persistence of tick populations. Independent tick populations can exist in urban forests, parks, private properties, old cemeteries, etc. Over the last decades, the tick populations that originated from those in natural habitats around the cities have become a permanent component of urban fauna. Among such ticks, the castor bean tick Ixodes ricinus is the most important species for European cities, while the deer tick I. scapularis is of great significance for the East Coast of the United States. The taiga tick I. persulcatus is the most important species for the Russian cities and towns within its range. All these and some other ticks aggressively attack humans and their pets inside cities. The tick species especially well adapted to urban life are those which can live and reproduce in buildings. The brown dog tick Rhipicephalus sanguineus (family Ixodidae), the pigeon ticks from the reflexus group of the genus Argas, and Ornithodoros ticks (family Argasidae), which form urban and semi-urban populations, are the main urban tick pests and vectors. House infestation by ticks can lead to human infection with tick-borne pathogens or severe allergic reactions. Some tick hosts, mammals as well as birds, maintain tick-transmitted pathogens and serve as competent reservoir hosts. Urban populations of these animals can participate in the circulation of some pathogens within cities. Thus, the enlargement of urban green areas followed by their population by wild mammals and birds create good opportunities for the establishment of urban populations of tick vectors with the resulting threat to the health of urban dwellers and their pets. At the same time, our understanding of the real scope and complexity of the problem of urban ticks is far from being sufficient. Finding the ways of protecting the environment without increasing the risk to human health in modern cities is a pressing and challenging problem of our time.

Validation of Indian Diabetic Risk Score for detecting Undiagnosed Diabetics in A Semi-Urban Population of Mangalore-South India

Background: Diabetes is considered as an "iceberg disease". According to latest WHO estimates the number of people with diabetes worldwide in 2000 is 171 million which is likely to increase to at least 366 million by 2030.Indian Diabetes Risk Score is useful for identifying undiagnosed diabetic subjects in India and includes four risk factors: Age, Abdominal obesity, Family history of diabetes and Physical activity in predicting diabetes. Objectives: To Validate the Indian Diabetic Risk score for detecting undiagnosed diabetics in a Semi urban population. Material and Methodology: The study was a validation study conducted in the field practice area of K.S. Hegde Medical Academy, Mangalore in 2015. Universal sampling was done among 80 households to obtain a minimum sample size of 160 participants. Two from each household one being the highest age and one being the middle age among the households were enrolled. Individuals aged 20 years and above were included to validate the Indian Diabetic Risk score. Informed consent was taken before introducing the participants to the study and two Random blood sugars were checked. Results: Out of 160 participants 31.9% were male and 68.1% were female. Indian diabetic risk score &gt;60 were 60%. Mean risk scores was 57.4±2x1.7. Out of 160 respondents, 86.9% were non-diabetic and 13.1% were detected diabetic. There was a significant difference in Indian diabetic risk score among diabetic and non-diabetics (p&lt;0.001). Indian diabetic risk score &gt;60 had sensitivity of 95.2% and specificity of 45.3% in predicting diabetes. Area under ROC was 0.719 (95% CI:0.62-0.81). Conclusion: Indian diabetic risk score can be used as a simple screening tool in predicting and detecting undiagnosed diabetics in the community.

A prospective study of cases with necrotising fasciitis: our experience at a tertiary care teaching hospital

Background: Necrotising fascitis is a life-threatening infection involving fascia and necrosis of subcutaneous tissue. The portal of entry usually is trivial trauma. It requires immediate diagnosis and intervention to reduce mortality. The objective of this study was to study clinical profile, predisposing risk factors and to formulate a protocol for management of necrotising fasciitis.Methods: The study was conducted at tertiary care teaching hospital in Punjab, India catering to a semi-urban and rural (agricultural based) population over a period of three years between January 2014 to January 2017. All the consecutive patients who came to the emergency department (ER) of the institute presenting early with clinical features suggestive of NF were included in the study. The study included total 50 cases. The cases were studied in detail according to study plan that included age, sex, clinical features, results of blood and wound cultures, the number of surgical interventions, total duration of hospitalization and the mortality rate.Results: The most common age group was between 40-60yrs and there were 48 males. There was history of trivial trauma or insect bite in majority of cases. Mostly patients presented with bullae formation, induration, edema. Diabetes was the commonest comorbid condition associated. All the patients were thoroughly investigated, swab cultures were taken. Debridements were done followed by grafting. In 10 patients, we could not salvage the limb and 10 patients expired after debridement.Conclusions: Necrotising fasciitis is more common in middle aged males with diabetes. Early diagnosis and aggressive treatment is required to reduce the mortality.

GLOBALISASI DAN IMPAK SOSIOBUDAYA

Globalization, the ongoing process of greater interdependence among countries and their citizens, is complex and multifaceted. Many of the problems that the critics of globalization point to are real. This article on the socio-cultural impact of globalization on the semi-urban populations uses data collected in three districts in Selangor (Sepang, Kuala Selangor and Kuala Langat), Malaysia using survey and in depth interviews method. The socio-cultural impact of globalization on the semi-urban populations of Selangor can be seen from several angles. Among other things are the changes in interpersonal relationship due to changes in occupations, places of works, places of residence and different work schedules. Thus a new kind of relationship evolved i.e. between different categories of workers and the management. This create s a totally new environment whereby the management determine d certain aspects of the life of workers such as pay rise and work schedules. Their life styles are also different. With the improved economic condition more job opportunities are available for foreign workers and women. The children are now being looked after by maids or the so called transit houses which are not based on family relationship. The influx of foreign workers also expose the local populations to various infectious diseases such as tuberculosis, malaria (which had been eradicated in the country long time ago), SARS and H1N1.

GLOBALISASI DAN IMPAK SOSIOBUDAYA

Globalization, the ongoing process of greater interdependence among countries and their citizens, is complex and multifaceted. Many of the problems that the critics of globalization point to are real. This article on the socio-cultural impact of globalization on the semi-urban populations uses data collected in three districts in Selangor (Sepang, Kuala Selangor and Kuala Langat), Malaysia using survey and in depth interviews method. The socio-cultural impact of globalization on the semi-urban populations of Selangor can be seen from several angles. Among other things are the changes in interpersonal relationship due to changes in occupations, places of works, places of residence and different work schedules. Thus a new kind of relationship evolved i.e. between different categories of workers and the management. This create s a totally new environment whereby the management determine d certain aspects of the life of workers such as pay rise and work schedules. Their life styles are also different. With the improved economic condition more job opportunities are available for foreign workers and women. The children are now being looked after by maids or the so called transit houses which are not based on family relationship. The influx of foreign workers also expose the local populations to various infectious diseases such as tuberculosis, malaria (which had been eradicated in the country long time ago), SARS and H1N1.

A Study of the Behavior of Semi-Urban Youth Customers towards Online Shopping Through Online Shopping Applications

Internet, as everyone can see now, a biggest revolution on the earth that has brought changes to almost all the fields where a human can reach. The revolution which has brought the world too close that actualized virtual communicating with a person residing on earths another edge is on the finger now. The use of internet which have changed the shape and face of business is easing the customers and the sellers in a very convenient way. It has changed the traditional process of purchase by a vast. The result of such convenience is increase and speed in business activities. Online shopping has now become the lifestyle of the people. The rural population in India is also using it in a very large amount. The Indian rural and semi urban population which counts to 71% of the total population is now well connected and used to online business. Hence the scope of business in India is developed by a huge amount. The activities like agricultural marketing, purchase of raw material, etc are also being practiced by the mean now days. In this way, the increase in online commerce have now reached to the threshold of villages and creating new opportunities for business. This study aims to know the behavior of same rural and semi urban consumers

The effect of educational program based on the precede-proceed model on improving self-care behaviors in a semi-urban population with type 2 diabetes referred to health centers of Bavi, Iran

AimsSelf-care in patients with diabetes reduces the number of hospital admissions, costs and improves their quality of life so that just by training self-care to them can reduce 80 percent of diabetic complications. Therefore, this study aimed to investigate the effect of educational program based on precede-proceed model on improving self-care behaviors in patients with type 2 diabetes referred to health centers in city Bavi in 2016–2017. Materials and methodsThis quasi-experimental study, conducted on 110 patient women with type 2 diabetes referred to health centers in Bavi city in 2016–2017. The training program was designed based on Precede-Proceed Model. Data collection tools included the Precede researcher-made questionnaire and the Glasgow questionnaire. The duration of the training course was three months. After one month, the effect of this program, and the amount of improvement of the patients’ self-care behavior were evaluated. Independent t-test, paired t-test, Chi-square and Fisher's exact tests were carried was used for data analysis. ResultsAfter the intervention, the average score of predisposing factors (knowledge, attitude and self-efficacy), reinforcing factors, enabling factors and self-care behaviors, in the intervention group compared to the control group, significantly increased (P<0.05). After the training, the fasting blood sugar (FBS) and body mass index (BMI) decreased in the experimental group, but this reduction was not statistically significant (P>0.05). ConclusionThe findings of this research showed that Precede-Proceed Model would be an appropriate framework to educate patients with type 2 diabetes as well as promote self-care behaviors.

A study to estimate prevalence and risk factors of Obstructive Sleep Apnoea Syndrome in a semi-urban Indian population.

Obstructive Sleep Apnea Syndrome (OSAS) has been recognised as a major cause of morbidity and mortality in developing countries like India. There is still a paucity of Indian studies regarding the prevalence of OSAS. The current single centre prospective cross-sectional study was undertaken to know prevalence estimates for key symptoms and features that can indicate the presence of OSAS in an Indian population. A survey was conducted on subjects with age groups ≥ 25 years at King George's Medical University, Lucknow, Uttar Pradesh, India from August 2009 to July 2011. Data was recorded during the interview on the basis of Berlin Questionnaire (BQ). Risk factors for OSAS were also evaluated. Risk group categorization for OSAS was done with the help of a questionnaire and overnight polysomnography was performed in each group to measure apnea and hypopnea index (AHI). Out of 1816 subjects, 1512 (response rate 83.3%) finally participated in the survey with mean age 42.6±11.2 years, males 67.9% and females 32.1%. Of them 6.2% were found to be at high-risk OSAS; 12.2% were obese (Body Mass Index ≥30 kg/m2) and 33.5% of the obese population were at high-risk OSAS. Among high-risk patients with OSAS, 62.4% had hypertension. Statistically significant and independent risk factors found for OSAS were obesity, large neck size, alcoholism and use of sedatives/tranquillizers. High-risk category predicted an AHI ≥5 with a sensitivity of 86.3% (95% CI 73.1-93.8), specificity of 93.1% (95% CI 89.1-95.7), positive and negative predictive values of 70.9% (95% CI 57.9-81.4) and 97.2% (95% CI 94.1-98.8) respectively. It can be concluded that BQ questionnaire can still be used as a pre-assessment tool for predicting persons at risk for OSAS in clinical practice. Further studies on estimation of prevalence of OSAS by applying BQ are warranted in near future from other regions of India.

Financial Inclusion or Financial Destruction: A Case Study of Microfinance Institutions

Microfinance sector, in India has played an significant role in the progress of the Indian rural as well as urban economy. A large number of Micro Finance Institutions (MFIs) in India are serving to the financing needs of rural and semi-urban Indian population. For achieving the target of financial inclusion in India this sector cannot be ignored. Generally daily wage earners, marginal farmers, women working from homes are the clients of MFIs. Such clients work only cash basis. Collection of loan is generally done by MFIs on weekly or fortnightly basis. The objective of the paper is to analyze the short and medium term positive and negative effects of many government decisions including demonetization on MFIs in India. This study will give more insights about the impact of the demonetization and other government policy framework on MFIs in India.

Prevalence of coronary artery disease in a semi urban population in Southern Sri Lanka

Prevalence of coronary artery disease (CAD) is on the rise in Sri Lanka resulting in high hospital mortality rates. Because of paucity of community based data on CAD we carried out this study to assess prevalence of CAD and associated factors in a suburban population in Southern Sri Lanka. A cross sectional descriptive study was carried out among community living adults aged 30 years or more in Bope-Poddala Medical Officer of Health (MOH) area. Total of 1000 eligible individuals were recruited using cluster sampling. Cardiovascular Questionnaire of London School of Hygiene was administered to each participant by trained data collectors. CAD was diagnosed using criteria by Epstein and colleagues and electrocardiograms were classified according to the Minnesota code by a Cardiologist blinded to participant details Total of 579 (57.9%) females and 421 (42.1%) males were studied. Mean age of the group was 53 years. Among the participants 32% had cardiovascular risk related non communicable diseases (NCDs) and 22.2% had a family history of the same. Prevalence of CAD was 6.9% (95% CI: 5.33 - 0.47) and silent ischaemia was 2.2% (95% CI: 1.29 - 3.11). Only gender and past history of cardiovascular risk related NCDs emerged as predictors of CAD CAD was more prevalent among males and those with past history of cardiovascular risk related NCDs. Community based preventive programmes should be implemented to minimize the adverse impact of CAD.

Patterns of Semen Analysis: Experiences of a Laboratory Catering to Semi Urban Population of Delhi

Background:Infertilityis defined as failure of a couple to conceive after one year of regular sexual intercourse. It remains both prevalent and problematic among couples worldwide. The analysis of semen remains the preliminary investigation for males in the workup of infertility in couples.It is a key element in the fertility evaluation of men and permits male reproductive potential to be evaluated in association with possible risk factors.Aim: To assess and analyse the semen characteristics of all the males who presented to our hospital, irrespective of primary or secondary infertility.Material and Methods: This is an observational study conducted in the Department of Pathology, Hamdard Institute of Medical Sciences, Delhi; from Jan 2012 to Oct 2013. Semen of 139 subjects were evaluated and results analyzed.Results: The present study included 139 subjects whose age ranged from 22 years to 48 years with a mean age of 29.42 years. Patients were divided into oligospermia[17%], normospermia[16%] and azoospermia[9%]. 42.5% of the cases had sperm counts in the range of 51-80million/ml. Asthenospermia was seen in 22.1% of the cases.An age specific comparative analysis of the mean sperm counts, total motility and normal morphology revealed a decline in the aaverage values of these parameters with age.Conclusions: Routine semen analysis remains the backbone of the evaluation of the male factor infertility, but it is important to acknowledge the limitation of semen analysis with respect to collection, processing, evaluation, biological variation of the parameters and lack of information on sperm function. A normal semen analysis does not guarantee the fertilization potential of sperm.Bangladesh Journal of Medical Science Vol.16(2) 2017 p.314-319

Body mass index\u2013measured adiposity and population attributability of associated factors: a population-based study from Buea, Cameroon

BackgroundObesity is currently a global health challenge driven by a mix of behavioural, environmental and genetic factors. Up to date population-based disease burden estimates are needed to guide successful prevention and control efforts in African countries. We investigated the prevalence and population attributable fractions of overweight and obesity in Buea, the Southwest region of Cameroon.MethodsData are from a community-based cross-sectional study involving randomly selected adults conducted in 2016. Body mass index (BMI) was categorized according to the WHO classification. Multivariable logistic regressions were used to investigate factors independently associated with obesity. Corresponding population attributable fractions were estimated.ResultsAmong the 1,139 participants, age-standardized prevalence (95% CI) of overweight and obesity were; 36.5 (33.7–39.3) and 11.1 (9.3–12.9) percent respectively. Mean BMI was 25.3 ± 4.3 kg/m2; women were heavier than men (25.8 vs. 24.4 kg/m2; p <0.0001). Factors associated with obesity were; female gender [odds ratio 3.20 (95% CI: 1.93–5.59)], age > 31 years [3.21 (1.86–5.28)] and being married [2.10 (1.60–3.51)]. At the population level; older age, being married, low level of education, high monthly income and physical inactivity accounted respectively for 11.9%, 21.8%, 11.6%, 6.4% and 8.7% of overweight and obesity among the women, while older age and being married explained 9.2% and 28.3% of overweight and obesity in men.ConclusionThe prevalence of overweight and obesity in this semi-urban Cameroonian population is high, affecting over a third of individuals. Community-based interventions to control weight would need to take into account gender specificities and socio-economic status.

Community Mental Health in India: Current Scenario

Health services in India are with under resources & particularly mental health is suffering more. WHO estimates that nearly 75% of those affected by mental illnesses do not have access to quality mental health services due to various reasons. In India there are very few national importance institutes such as NIMHANS at Bangalore, and Central Institute of Psychiatry at Ranchi, these are mostly accessible by the semi urban and urban population villagers who require more mental health services are almost deprived. WHO's estimates, there are 0.301 psychiatrists per 100,000 population, 0.166 nurses, 0.047 psychologists, and 0.033 mental health social workers. In India government run only 43 under resourced mental hospitals which are serving a large population of 1.2 billion. Although availability of mental health services has been increased in India but there is still a wide gap between existing morbidity and services available.

Psychosocial factors of vegetable intake in urban and semi-urban Mexican schoolchildren

The aim of this study is to explore a predictive capacity of psychosocial factors of motivation, ability and environmental opportunity factors of vegetable intake between urban and semi-urban schoolchildren population 10 to 12 years old of six cities of the State of Chihuahua (Mexico). A validated questionnaire was administered in a representative sample of 1434 schoolchildren of Elementary School. Frequency of daily consumption of vegetables was higher in semi-urban schoolchildren (vegetables ? 2 portion/day). The regression analysis explained 33% (p<0.01) to 45% (p<0.01) of the variance in vegetable intake by potential psychosocial factors. Preferences, cognitive abilities, perceived barriers and accessibility at home were a significant related to vegetable intake in urban (B<0.18, p<0.01) and semi-urban schoolchildren (B<0.11, p<0.01). It is concluded that in designing effective intervention to increment vegetable intake between urban and semi-urban children should focus on increase the preferences and cognitive abilities. Also, decrease perceived barriers and facilitate the availability at home. Finally, implication of the findings in psychosocial factors and for more efficient future research interventions need to be applied on mediation analysis to determine the predictive capacity and strength of the factors to obtain more effective intervention. Abstract

An Epidemiological Study (Cross-sectional Study) of Glaucoma in a Semiurban Population of Delhi

Aim: The purpose of this study was to study the epidemiology of glaucoma in a semi urban population of delhi. Methods: 24651 patients attending the eye OPD of Attar Sain Jain Eye and General Hospital, Govt of NCT of Delhi were screened and treated for glaucoma over a period of 6 months-from 1st July to 31st December, 2013. Results: Total of 261 cases of all types of glaucoma was identified. Out of these 43 were angle closure glaucoma and 218 were open angle glaucoma. Newer cases diagnosed were 118(78 of open angle glaucoma and 30 of angle closure glaucoma). Thus the overall incidence was 4.79 cases per 1000 population. Overall prevalence of glaucoma was 10.59 cases per 1000 population. The overall male to female distribution was 121 male cases to 140 female cases but this figure was skewed towards 30 females to 13 males in case of angle closure. Family history for glaucoma was positive in 73 percent of all cases (191 cases). Two cases required surgery and 32 cases required laser iridotomy (new and augumentation). 62 percent of the overall patients were diabetics and 32 percent were smokers. Conclusion: Glaucoma is one of the leading causes of blindness in the world and India and is a silent killer of the eye. There is a lack of glaucoma epidemiological and risk factor studies and more such studies are required with larger population base and longer duration to have an assessment of the burden of glaucoma. Initiatives to increase public awareness and comprehensive eye examinations by ophthalmologists are the key to reducing or eliminating undiagnosed glaucoma. If all ophthalmologists perform comprehensive eye examinations (that includes basic slitlamp examination, intraocular pressure (IOP) measurement, pachymetry, gonioscopy and dilated fundus examination), we can definitely minimize under-diagnosis.

Predictive Factors of Breast Feeding in Urban and Semi Urban Population of Aligarh

Predictive Factors of Breast Feeding in Urban and Semi Urban Population of Aligarh

Presbyopic spectacle coverage and barriers to near vision correction among adult population in ido local government area, Southwest Nigeria

Background: The magnitude of presbyopes with appropriate near vision correction is low globally and spectacles' correction remains cost-effective option for low- and middle-income countries. Objectives: The objective of this study was to determine presbyopia correction coverage (PCC), presbyopic met need and unmet need, willingness to pay for a pair of near vision spectacles, and barriers to usage of near vision spectacles among adults aged 40 years and above in a semiurban population of Southwest Nigeria. Materials and Methods: A cross-sectional, population-based study was carried out on 440 participants who were 40 years and above. Participants were selected using multistage sampling technique. Participants had refraction for both distance and near vision. Information on the use, barriers, and source of near vision spectacle was collected using interviewer-administered questionnaire. Data analysis was done using Statistical Package for Social Sciences software version 22 (IBM Corp., New York, USA). Results: A total of 440 participants were examined. Male to female ratio was 1:1.2 and the mean age of the participants was 51 ± 8 years. The PCC in the study was 27.3% with met need of 20.5% and unmet need of 54.5%. The major barriers to usage of near spectacles in this study were “not a priority” at 38.4% (95% confidence interval [CI] 32.3–44.5) and “not aware of the problem” at 34.7% (95% CI 28.7–40.7). Most of the participants (75.7%) were willing to pay at least 1000 naira (US$6) for a pair of near spectacles; hence, cost was not a significant barrier. Conclusion: The PCC in the area was low. Basic eye screening and refractive services should be incorporated into primary eye care for easy accessibility by the adult population in this area.

Malignant and Premalignant Lesions of the Oral Cavity: A Histopathological Study in a Rural and Semi-Urban Population of India

Malignant and Premalignant Lesions of the Oral Cavity: A Histopathological Study in a Rural and Semi-Urban Population of India