TITLE: Congenital malformations, reproductive wastage and consanguineous mating.
ABSTRACT: A study was undertaken in Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, South India, to understand the relation between congenital developmental disorders and consanguinity and also reproductive wastage and consanguinity. Four hundred children with existing congenital developmental disorders were studied with regard to their consanguineous parentage and compared with 1,000 randomly selected patients attending the paediatric outpatient department. There was a significantly higher prevalence of consanguinity in the study group (p < 0.001) and greater frequency in rural areas. The common types of consanguineous marriages were between first cousins (50.6%) and uncle and niece (42.4%). Frequency of consanguinity was not significantly related to religion and caste. The mean coefficient of inbreeding was 0.056. Consanguinity had no significant effect on average pregnancy rate and reproductive wastage. The frequency of consanguinity was significantly higher especially with autosomal recessive disorders (p < 0.001), congenital heart diseases (p < 0.001), multiple malformations (p < 0.001), neurological malformations (p < 0.005), chromosomal disorders (p < 0.01), genitourinary disorders (p < 0.02) and mental retardation-developmental disorders (p < 0.02). These observations stress the need for communicating the deleterious effects of inbreeding to the public through regular health education.
TITLE: Retinitis pigmentosa in India: a genetic and segregation analysis.
AUTHOR: Kar B; John S; Kumaramanickavel G
AFFILIATION: Department of Genetics & Molecular Biology, Vision Research Foundation, Madras, India.
SOURCE: Clin Genet 1995 Feb;47(2):75-9
ABSTRACT: Seventy-eight families with retinitis pigmentosa, presenting at the genetic clinic of Sankara Nethralaya, Madras, over a period of 6 months (from April to September 1993), were assessed to determine the different genetic types: 9% were autosomal dominant; 36%, autosomal recessive; 3%, X-linked recessive; 44%, isolated cases and 8%, undetermined genetic type. A high incidence of consanguinity was observed in autosomal recessive (57%) and isolated cases (37%). Segregation analysis showed good agreement in autosomal dominant (chi 2 = 0.864) and recessive families (p = 0.222). The high proportion of autosomal recessive and isolated cases in this study, when compared with other similar studies, is due to the high incidence of consanguineous marriages in the Indian subcontinent.
A similar result is seen in Retinitis pigmentosa genetics: a study in Indian population.. Vinchurkar MS; Sathye SM; Dikshit M Indian J Ophthalmol 1996 Jun;44(2):77-82
TITLE: A clinical study of infants presenting to a mental retardation clinic.
AUTHOR: Girimaji SR; Srinath S; Seshadri SP
AFFILIATION: Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bangalore.
SOURCE: Indian J Pediatr 1994 Jul-Aug;61(4):373-8
ABSTRACT: Early detection has a central role in the prevention and management of mental retardation. The purpose of this present study is to delinerate the characteristics of developmentally delayed infants and their families attending Mental Retardation Clinic. The sample consisted of 101 infants who were registered in Mental Retardation Clinic of NIMHANS, Bangalore in 1988 constituting 12.5% of total registrations. Data was collected from case records. Majority of subjects were males, first or second born, 7 months or older, from a consanguineous lower or middle class family. Along with developmental delay, 60% had other complaints. Medical problems were reported in about half of the subjects and most had abnormalities on physical examination. Aetiology was discernible in 77.1%. Majority had associated physical disorder such as cerebral palsy, seizures and hearing and/or visual impairment. Around 17% came for follow-up thrice or more, 43% dropped out after work-up. The main conclusions are that; (i) certain socio-demographic, personal and clinical variables influence treatment seeking, and (ii) developmental delay recognised in infancy tends to be associated with clear aetiologic factors and significant medical/neurologic problems.
ABSTRACT: The study was performed in six mohallahs (colonies) of Aligarh City (North India). All six mohallahs are predominantly inhabited by Qureshi (meat sellers, a highly endogamous group) Muslims. A total of 1721 infants and children up to the age of 6 years were examined to determine the incidence of congenital heart diseases (CHD) in relation to the degree of consanguinity of the parents. Around 43% of the subjects were the offspring of consanguineous marriages including second-cousin, first-cousin-once-removed and first-cousin. A higher percentage of CHD was found in the offspring of consanguineous marriages: about 3.37% out of 741 children as compared to 1.22% in 980 offspring of non-consanguineous marriages, whereas in the first-cousin offspring, the percentage of CHD rose to 4.41%. The differences were found to be statistically significant. The present study suggests a genetic influence and also casts doubt on the applicability of a polygenic threshold model to all forms of cardiac malformation.
AUTHOR: Bundey S; Alam H
AFFILIATION: Sub-Department of Clinical Genetics, University of Birmingham, UK.
SOURCE: Eur J Hum Genet 1993;1(3):206-19
ABSTRACT: A 5-year prospective study of 4,934 children of different ethnic groups has demonstrated a 3-fold increase of postneonatal mortality and childhood morbidity in the offspring of consanguineous Pakistani parents. Most of these families contained more than one consanguineous union, resulting in a mean inbreeding coefficient for their children of 0.0686. It is estimated that 60% of the mortality and severe morbidity of this group of children could be eliminated if inbreeding ceased. However consanguinity is much favoured in this minority group, and health education will have to be carefully and sensitively handled.
TITLE: Consanguinity and its trend in a Mendelian population of Andhra Pradesh, India.
AUTHOR: Chandrasekar A; Jayraj JS; Rao PS
AFFILIATION: Department of Physical Anthropology, Sri Venkateswara University, Tirupati, India.
SOURCE: Soc Biol 1993 Fall-Winter;40(3-4):244-7
ABSTRACT: Consanguineous marriages have decreased significantly (p < 0.01) among the Kamma of Andhra Pradesh over the past forty years. The decline in uncle-niece marriages has contributed heavily to the decline in consanguinity, which may be due to shifting from agriculture to other occupations like government service and the rapid growth of industrialization. More recently, the tendency toward a lower consanguinity rate has been strengthened by reduction in number of children per marriage which reduces the number of eligible cousins. Marriages beyond first cousin have remained more or less constant.
TITLE: An epidemiological study of congenital malformations in newborn.
AUTHOR: Chaturvedi P; Banerjee KS
AFFILIATION: Department of Pediatrics, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha.
SOURCE: Indian J Pediatr 1993 Sep-Oct;60(5):645-53
ABSTRACT: In a prospective study of 3000 consecutive deliveries (14 twin deliveries), the rate of congenital malformation was reported to be 27.20 per 1000 births (82 out of 3014). No significant difference was observed in the frequency of congenital malformation in urban rural status, in different religion and caste, and in male female babies. An increase in frequency was seen in advanced maternal age and in primi and fourth gravida mothers. A number of environmental factors studied, such as use of different tooth powders, type of drinking water, different cooking vessels, associated vitamin deficiencies did not seem to influence the prevalence of birth defects significantly. The factors which significantly increased the rate of congenital malformation were consanguinity in parents, heredofamilial history of malformations, presence of hydramnios, maternal febrile illness in first trimester, past history of abortion and history of progesterone intake during pregnancy.
ABSTRACT: Analysis of data on 106,848 marriages in the cities of Bangalore and Mysore, South India, between 1980 and 1989 showed that levels of consanguineous marriage varied between cities through time and by religion. The average coefficient of inbreeding was higher in Bangalore (F = 0.0339) than in Mysore (F = 0.0203), principally reflecting large-scale, post-Independence rural migration into Bangalore. Although there was some evidence of a decline in consanguineous marriages in Mysore, there was no convincing support in either city for earlier projections of a rapid reduction in the popularity of unions between close biological relatives.
TITLE: Growth pattern of the Indian fetus.
AUTHOR: Mathai M; Thomas S; Peedicayil A; Regi A; Jasper P; Joseph R
ABSTRACT: OBJECTIVES: To determine the pattern of intrauterine growth and the gestation at birth of Indian fetuses. METHOD: One hundred twenty consecutive women who had reliable menstrual histories, low-risk pregnancies and who were booked for delivery at the Christian Medical College Hospital, Vellore, before 20 weeks' gestation were recruited to the study. Ultrasound fetal biometry was carried out at 4-weekly intervals from 20 weeks and at weekly intervals after 36 weeks until delivery. RESULTS: Growth patterns of fetal biparietal diameter and femur length were comparable to those reported in Western populations. However there was a lag in growth of abdominal circumference (AC) after 28 weeks in comparison with that reported in Western populations. The median gestation at delivery following spontaneous labor was 39 weeks. No association was observed between rate of growth of AC and gestation at birth. CONCLUSION: Slowing of growth of the fetal AC after 28 weeks and a shorter length of gestation result in the birth of smaller babies in this ethnic group. The implications of these findings are discussed.
Some data from this paper are reproduced below for your interest.
|Abdominal circumference in mm|
|Week of gestation||Indian fetuses||Western fetuses|
TITLE: Further observations on ghee as a risk factor for neonatal tetanus.
AUTHOR: Bennett J; Azhar N; Rahim F; Kamil S; Traverso H; Killgore G; Boring J
AFFILIATION: Task Force for Child Survival and Development, Carter Center, Atlanta, GA 30307, USA.
SOURCE: Int J Epidemiol 1995 Jun;24(3):643-7
ABSTRACT: BACKGROUND. Previous case-control studies of neonatal tetanus (NNT) in the North West Frontier Province of Pakistan indicated that clarified butter (ghee) applied to the umbilical wound of newborns was a significant risk factor for NNT. However, the mechanisms underlying the risk remained undisclosed. METHODS. A hospital-based case-control study was undertaken to evaluate further ghee and other factors possibly associated with risk of NNT. Mothers of several recent ghee-associated cases were visited in their homes, asked to simulate the procedures used in preparing the ghee, and samples of ghee were collected for culture. RESULTS. Topical application of ghee to the umbilical wound was again shown to pose a significant risk for NNT. In-use contamination of ghee was documented as mothers repeatedly heated and manipulated samples of ghee set aside in special containers for this purpose. Ghee was usually applied to the umbilical wound of the baby several times each day for the first few days of life. Mothers of cases were again confirmed to be substantially more likely to report prior NNT cases than mothers of controls. CONCLUSIONS. Educational interventions to reduce umbilical ghee use or to wash hands before each manipulation might reduce the risk of NNT in babies exposed to ghee who are born to non-immunized mothers. Increased efforts to immunize women of childbearing age with tetanus toxoid are also needed, with special priority for mothers known to have been associated with a previous NNT case. Topical antibiotics should be further evaluated for protective effects in non-immunized mothers.
TITLE: Mother surrogate and nutritional status of preschool children.
AUTHOR: Jain S; Choudhry M
AFFILIATION: Department of Foods and Nutrition, College of Home Sciences, Udaipur.
SOURCE: Indian J Pediatr 1993 May-Jun;60(3):429-33
ABSTRACT: The study was conducted on 200 preschool children to find out the effect of mother surrogate on the nutritional status. The nutritional status of children was found to be affected by the time devoted by mother on child care activities, working status of mother and type of family independently and jointly. The children cared by mother had better nutritional status than those children who were cared by servants and any other family member in the absence of mother. It shows that no one can substitute the care provided by the mother.
ABSTRACT: The primary objective of the present study was to assess the impact of out-of-home employment on anxiety levels of mothers. A study group of working mothers resident in Calcutta (India) was compared with a socioeconomically similar group of non-working mothers with respect to their anxiety level, measured by the Anxiety Scale Questionnaire, in terms of the total anxiety score and its various personality components. The possible relationships between anxiety score and age of these mothers as well as their children were studied. Non-working mothers showed higher anxiety levels than their working counterparts with respect to the total anxiety score as well as its components, although the differences were statistically non-significant. The anxiety scores of non-working mothers showed increasing values with increasing age of children. This trend was absent among the working mothers. The age of these mothers was not related to their anxiety level.
TITLE: Dietary cravings and aversions during pregnancy.
AUTHOR: Wijewardene K; Fonseka P; Goonaratne C
AFFILIATION Department of Community Medicine, Faculty of Medicine, Colombo.
SOURCE: Indian J Public Health 1994 Jul-Sep;38(3):95-8
ABSTRACT: Although nausea and vomiting in early pregnancy has been studied in detail, there is little information available regarding dietary aversions and some cravings during pregnancy. To study the prevalence and factors associated with dietary aversions and cravings during pregnancy, a survey was carried out on 1000 randomly selected pregnant women attending antenatal clinics in a district in southern Sri Lanka. In this group 473 (47.3%) had pregnancy cravings for wide variety of foods: sour food 65%, unripe fruits 40%, meat and fish 47%, ripe fruits 30%, food from alms giving 26% and jam and bread fruit 22%. Ninety nine per cent of those who had pregnancy cravings had made special attempt to obtain the food of their choice and all of them had their cravings satisfied by eating the food of their choice. Pregnancy cravings was significantly higher in women who married after a love affair's than in those who had on 'arranged' marriage (p < 0.05), in women who were superstitious (believed in devil dancing and gods) than in those who were not (p < 0.05), and in women with a family income of less than Rs. 2,500 than in those with an income of more than Rs. 2,500 (p < 0.05).
TITLE: Worldwide trends in suicide mortality, 1955-1989.
AUTHOR: La Vecchia C; Lucchini F; Levi F
AFFILIATION Institut universitaire de medecine sociale et preventive, Lausanne, Switzerland.
SOURCE: Acta Psychiatr Scand 1994 Jul;90(1):53-64
ABSTRACT: Patterns and trends in suicide mortality for the period 1955-89 for 57 countries (28 from Europe, the former Soviet Union, Canada, the United States, 14 Latin American countries, 8 from Asia and 2 from Africa, Australia and Oceania) were analyzed on the basis of official death certification data included in the World Health Organization mortality database. Over the most recent calendar quinquennium (1985-1989), Hungary had the highest rate for men (52.1 per 100,000, all ages, world standard), followed by Sri Lanka (49.6), Finland (37.2) and a number of central European countries. North American, Japan, Australia and New Zealand and several European countries had intermediate suicide rates (between 15 and 25 per 100,000), whereas overall mortality from suicide was low in the United Kingdom, southern Europe, Latin America and reporting countries and areas from Africa and Asia, except Japan, Singapore and Hong Kong. The pattern for women was similar, although the absolute values were considerably lower. The highest values were in Sri Lanka (19.0 per 100,000), followed by Hungary (17.6) and several other central European countries, with rates between 9 and 15 per 100,000. Female suicide rates were comparatively elevated in Japan, Hong Kong, Singapore and Cuba. With respect to trends over time, the figures were relatively favourable in less developed areas of the world, including Latin America and several countries from Asia, with the major exception of Sri Lanka. Of concern are, in contrast, the upward trends, particularly for elderly men in Canada, the United States, Australia and New Zealand and, mostly, the substantial rises over most recent decades of suicide rates in young cohorts of males in Japan and several European countries, Australia and New Zealand. These trends were often in contrast with more favourable patterns in women, and can be discussed in terms of ethnic, cultural and socioeconomic factors, aspects of psychiatric care or availability of instruments and methods of suicide.
ABSTRACT: A comparison of sex differential mortality rates indicates that women are at increased risk in several countries of Asia, in part due to less access to a variety of services and lower priority for food than their male siblings. Poorer nutritional status becomes apparent during adolescence, with a delay in maturation which may have repercussions for subsequent ability of the biologically immature woman to carry through a normal pregnancy. There is a dearth of information on girls during this vulnerable period of life which is recently being corrected by studies in Nepal, India and the Philippines where the magnitude of dietary risk is being compared with its impact on nutritional status and the sociocultural factors that may be responsible.
TITLE: Fetal size and growth in Bangladeshi pregnancies.
AUTHOR: Spencer JA; Chang TC; Robson SC; Gallivan S
AFFILIATION Department of Obstetrics and Gynaecology, University College London Medical School, UK.
SOURCE: Ultrasound Obstet Gynecol 1995 May;5(5):313-7
ABSTRACT: A longitudinal study of 20 uncomplicated pregnancies in Bangladeshi women was undertaken. Fetal growth was investigated by serial ultrasound scans performed between 26 and 38 weeks of pregnancy. Repeated measurements of abdominal circumference and estimates of fetal weight were best described by a log quadratic equation. The coefficients were not significantly different from those obtained from a previously reported study of fetal growth in 67 uncomplicated pregnancies with healthy outcomes in white Anglo-Saxon women. Further comparison between the two groups showed that the mean abdominal circumference and estimates of fetal weight of the Bangladeshi fetuses were smaller at 28, 32 and 36 weeks' gestation. These results suggest that, although Bangladeshi fetuses appear to be smaller than Anglo-Saxon fetuses, they grow at a similar rate during the third trimester.
TITLE: How pervasive are sex differentials in childhood nutritional levels in south Asia?
AUTHOR: Basu AM
AFFILIATION: Institute of Economic Growth, Delhi University, India.
SOURCE: Soc Biol 1993 Spring-Summer;40(1-2):25-37 94196397
ABSTRACT: This paper considers the assumption that there are widespread sex differentials in the household allocation of food in South Asia. From primary field data and a critical review of the existing literature, it concludes that we have no reason to believe that girls in this region invariably get an unfair deal in the matter of nutrition, even in those areas where sex differentials in child mortality are the most acute. Too much of the research to support such a contention starts with the biased view that gender differences in nutritional status must exist. It is pointed out in this paper that a new look at this issue is essential if we are to use scarce resources most effectively to fight gender inequalities. By identifying more precisely the areas in which women are worst discriminated against, action to affect these areas can be focused much better than by spreading efforts into programs where the need is at best marginal.
ABSTRACT: BACKGROUND: South Asians who have settled overseas and those in urban India have an increased risk of ischaemic heart disease (IHD). Reasons for this increased risk are unclear. Most studies have been based on migrants to western nations, so their findings may not apply to most south Asians, who live in their own countries. Therefore, we assessed the relative importance of risk factors for IHD among South Asians in Bangalore, India. METHODS: We conducted a prospective hospital-based case-control study of 200 Indian patients with a first acute myocardial infarction (AMI) and 200 age and sex matched controls. We recorded prevalence of the following risk factors for IHD: diet, smoking, alcohol use, socioeconomic status, waist to hip ratio (WHR), blood glucose, serum insulin, oral glucose tolerance test, and lipid profile. FINDINGS: The most important predictor of AMI was current smoking (odds ratio [OR] 3.6, p < 0.001) of cigarettes or beedis (a local form of tobacco), with individuals who currently smoked 10 or more per day having an OR of 6.7 (p < 0.001). History of hypertension and of overt diabetes mellitus were also independent risk factors (OR 2.69 [p = 0.001] and 2.64 [p = 0.004], respectively). Among all individuals, fasting blood glucose was a strong predictor of risk over the entire range, including at values usually regarded as normal (OR adjusted for smoking, hypertension, and WHR 1.62 for 1 SD increase, p < 0.001). Abdominal obesity (as measured by WHR) was also a strong independent predictor across the entire range of measures (OR adjusted for smoking, hypertension, and blood glucose 2.24 for 1 SD increase; p < 0.001). Compared with individuals with no risk factors, individuals with multiple risk factors had greatly increased risk of AMI (eg, OR of 10.6 for the group with smoking and elevated glucose). Lipid profile was not associated with AMI. In univariate analyses, higher socioeconomic (income) status (OR 0.32, p = 0.005 highest vs lowest; OR 0.75 middle vs lowest) and vegetarianism (OR = 0.55, p = 0.006), seemed to be protective. The impact of vegetarianism was closely correlated with blood glucose and WHR. INTERPRETATION: Smoking cessation, treatment of hypertension, and reduction in blood glucose and central obesity (perhaps through dietary modification) may be important in preventing IHD in Asian Indians.
AUTHOR: Vanita; Singh JR; Singh D
SOURCE: CLINICAL GENETICS 1999, Vol 56, Iss 5, pp 389-393
ABSTRACT: Congenital cataract is a major cause of blindness in children, and there is wide variation in the few reports available on the frequencies of its different inheritance patterns. Two hundred and fifty-two families with congenital cataract belonging to 13 different states of India, were clinically and genetically investigated to study their inheritance and segregation patterns. Twenty-one percent of the cases were autosomal recessive, 15% autosomal dominant, 63% were simplex cases, and in the remaining cases the inheritance pattern was not clear. A high incidence of consanguinity (50.9%) was observed in autosomal recessive cases. Out of 340 affected individuals, 222 (65.3%) were males and 118 (34.7%) were females. Segregation analysis showed good agreement in autosomal dominant and recessive families and the data are indicative of the prevalence rate for different inheritance patterns of congenital cataract within the Indian population.