Accuracy of probing attachment levels using a new computerized cemento-enamel junction probe

BACKGROUND AND OBJECTIVES

The assessment of clinical attachment level (CAL) represents the gold standard for diagnosing and monitoring periodontal disease. The aim of the present study was to evaluate the performance of the newly introduced cemento-enamel junction (CEJ) probe in detecting CAL, using CEJ as a fixed reference point, and to compare the CEJ probe with the Florida stent probe (FSP) as well as with a standard manual probe, University of North Carolina-15 (UNC-15).

MATERIALS AND METHODS

Three examiners recorded the probing attachment level in 384 sites in case group (chronic periodontitis), and in 176 sites, in control group (healthy periodontal status), using the three probes. Subjects included both the sexes and ranged from 35 to 45 years. The experimental design was structured to balance the intra- and inter-examiner consistency at the same site during the two visits.

RESULTS

CEJ probe showed higher intra-and inter-examiner consistency over both FSP and UNC-15 in both the case and control groups. Frequency distribution of differences of various magnitudes of repeated measurements ≤1 mm was in the higher range of 86.8% to 87.5% for CEJ probe. The FSP was more reproducible than UNC-15 in detecting relative attachment level (RAL).

INTERPRETATION AND CONCLUSION

CEJ automated probe was found to have greatest potential for accuracy and consistency in detecting CAL than FSP and UNC-15. The automated probes appeared to be more reproducible than manual probes.

Complement-dependent lymphocytotoxicity crossmatch in deceased donor renal transplant: a single institutional experience

Complement-dependent lymphocytotoxicity crossmatches (n=217) between 47 deceased donors and 150 potential renal recipients were retrospectively studied. A negative cross match was reported in 48 (22.1%), doubtful positive in 126 (58.1%), weakly positive in 32 (14.7%) and positive in 11 (5.1%). No autoantibodies were detected. Renal transplantation was performed in 35.5% of the potential recipients. There was no incidence of hyperacute rejection. The graft survival rate was 88% at 15 months of follow up. The study concludes that a negative pretransplant lympocytotoxicity crossmatch using the basic National Institute of Health technique eliminates hyperacute rejection, but carries drawbacks, which require modification and supplementation with more sensitive and specific assays.

Association of leukocyte count and hsCRP with metabolic abnormalities in subjects with normal glucose tolerance (CURES - 64)

OBJECTIVE

The aim of the present study was to assess the association of leukocyte count and high sensitivity C-Reactive protein (hsCRP) with metabolic abnormalities in subjects with normal glucose tolerance.

METHODS

Subjects with Normal Glucose Tolerance (NGT) (n = 865) were recruited from the Chennai Urban Rural Epidemiology Study [CURES]. Standard methods were used for assessing hsCRP [Nephelometry, in a subset] and leukocytes [Flowcytometry, Sysmex SF-3000]. Insulin resistance was calculated using the Homeostasis Assessment model (HOMA-IR).

RESULTS

Body mass index, waist circumference, systolic and diastolic blood pressure, fasting plasma glucose, HbA1c, serum cholesterol, LDL cholesterol, HOMA IR and hsCRP increased significantly with increasing tertiles of leukocyte count [p for trend < 0.001]. Both leukocyte count and hsCRP showed a positive correlation with cardiovascular risk factors. Leukocyte count showed a positive correlation with hsCRP [p = 0.008]. Both mean leukocyte count [p < 0.001] and hsCRP [p = 0.04] were higher in subjects with Metabolic Syndrome (MS), which increased with increase in number of metabolic abnormalities [p for trend < 0.001]. Regression models showed leukocyte count [p < 0.001] and hsCRP [p = 0.03] to be associated with MS, even after adjusting for age and gender.

CONCLUSION

A significant association exists between systemic inflammation [leukocyte count and hsCRP] and MS/cardiovascular risk factors in Asian Indians even among non-diabetic subjects.

Synthesis of 3-(2-pyridyl)-2-substituted-quinazolin-4(3H)-ones as new analgesic and anti-inflammatory agents

A new series of 3-(2-pyridyl)-2-substituted-quinazolin-4(3H)-ones were synthesized by reacting the amino group of 2-hydrazino-3-(2-pyridyl)-quinazolin-4(3H)-one with a variety of aldehydes and ketones. The starting material 2-hydrazino-3-(2-pyridyl)-quinazolin-4(3H)-one was synthesized from 2-aminopyridine. The title compounds were investigated for analgesic, anti-inflammatory and ulcerogenic index activities. While the test compounds exhibited significant activity, compound 2-(1-ethylpropylidene)-hydrazino-3-(2-pyridyl)-quinazolin-4(3H)-one (AS2) showed moderate analgesic activity and compound 2-(1-methylbutylidene)-hydrazino-3-(2-pyridyl)-quinazolin-4(3H)-one (AS3) showed realistic anti-inflammatory activity when compared to the reference standard diclofenac sodium. Interestingly the test compounds showed only mild ulcerogenic side effect when compared to aspirin.

Relation between age and coronary heart disease (CHD) risk in Asian Indian patients with diabetes: A cross-sectional and prospective cohort study

OBJECTIVE

Non-migrant Asian Indians have a high prevalence of diabetes and coronary heart disease (CHD). Since the relation between age and CHD risk in this population is not known, the appropriateness of existing age threshold for patients with diabetes to be suitable for primary CHD prevention with statins is not known. We aimed to determine an age threshold above which patients develop a higher risk of CHD and would merit routine statin prescription.

DESIGN

Cross-sectional analysis of 1087 patients with diabetes from the Chennai Urban Rural Epidemiological Studies (CURES). CHD risk assessment was calculated using the United Kingdom Prospective Study (UKPDS) risk engine, externally validated by using data obtained from the 7-year follow-up cohort of the Chennai Urban Population Study (CUPS). Relation between age and CHD risk was determined and the age threshold for increased CHD risks was calculated using line of best fit.

RESULTS

UKPDS risk engine overestimates CHD event rates by 50% in this population. Age is a strong independent predictor of CHD risk. Transition from low to moderate-risk category for men and women with diabetes occurred at ages 37 and 50 years, respectively. Sensitivity for fulfilling this CHD risk criteria are 98.7% for men and 87.1% for women.

CONCLUSIONS

Statins should be routinely prescribed to all Asian Indian men and women with diabetes above the ages of 37 and 50 years, respectively. For patients below these age thresholds, decision to initiate statins should be based on patient's individual cardiovascular risk factors. This strategy may facilitate public health efforts to reduce CHD events in India.

Prevalence and risk factors for diabetic neuropathy in an urban south Indian population: the Chennai Urban Rural Epidemiology Study (CURES-55)

AIMS

This study was conducted to determine the prevalence of, and risk factors for, diabetic neuropathy (DN) in south Indian Type 2 diabetic subjects.

METHODS

Subjects were recruited from the Chennai Urban Rural Epidemiology Study, conducted on a representative cohort from Chennai city. A total of 1629 diabetic subjects were included, of whom 1291 were known to have diabetes (KD) subjects and 338 were randomly selected newly detected diabetic (NDD) subjects. Neuropathy was diagnosed if vibratory perception threshold at the great toe, measured by biothesiometry, exceeded mean + 2 sd of a healthy non-diabetic study population aged 20-45 years (cut point > or = 20 V).

RESULTS

The overall prevalence of DN was 26.1% (age-adjusted 13.1%) with no significant difference in gender. The prevalence of neuropathy was significantly higher in KD subjects compared with NDD subjects (27.8 vs. 19.5%, P = 0.002). The prevalence of diabetic retinopathy (24.1 vs. 15.3%, P < 0.0001) and hypertension (51.1 vs. 40.0%, P < 0.0001) were higher in those with neuropathy compared with those without. The odds ratio for neuropathy in subjects with duration of diabetes > 15 years compared with < or = 5 years was 5.7 (95% confidence interval: 3.52-9.08, P < 0.0001). Regression analysis showed age (P < 0.0001), glycated haemoglobin (P = 0.001) and duration of diabetes (P = 0.045) to be significantly associated with neuropathy.

CONCLUSIONS

This cross-sectional population-based study shows that, among urban south Indian Type 2 diabetic subjects, the prevalence of DN is 26.1% and that DN is significantly associated with age, glycated haemoglobin and duration of diabetes.

Incidence of diabetes and pre-diabetes in a selected urban south Indian population (CUPS-19)

OBJECTIVES

Several cross-sectional studies have reported on the prevalence of diabetes in India. However, there are virtually no longitudinal population-based studies on the incidence of diabetes from India. The aim of the study was to determine the incidence of diabetes and prediabetes in an urban south Indian population.

METHODS

The Chennai Urban Population Study [CUPS], an ongoing epidemiological study in two residential colonies in Chennai [the largest city in southern India, formerly called Madras] was launched in 1996; the baseline study was completed in 1997. Follow-up examination was performed after a mean period of 8 years. At follow-up, 501 [47.0%] subjects had moved out of this colonies and were lost to follow-up. Of the remaining 564 individuals, 513 [90.9%] provided blood samples for biochemical analysis. Regression analysis was done using incident diabetes as dependant variable to identify factors associated with development of diabetes or pre-diabetes.

RESULTS

Among subjects with normal glucose tolerance (NGT) at baseline [n=476], 64 (13.4%) developed diabetes and 48 (10.1%) developed pre-diabetes (IGT or IFG). The incidence rate of diabetes was 20.2 per 1000 person years and that of pre-diabetes was 13.1 per 1000 person years among subjects with NGT. Of the 37 individuals who were pre-diabetic at baseline, 15 (40.5%) developed diabetes [incidence rate: 64.8 per 1000 person years], 16 (43.2%) remained as pre-diabetic and 6 (16.2%) reverted to normal during the follow-up period. Regression analysis revealed obesity [Odds Ratio (OR): 2.1, p=0.001], abdominal obesity [OR: 2.23, p<0.001] and hypertension [OR: 2.57, p<0.001] to be significantly associated with incident diabetes. The Indian Diabetes Risk Score (IDRS) showed the strongest association with incident diabetes [OR: 5.14, p<0.001].

CONCLUSION

The study shows that the incidence of diabetes is very high among urban south Indians. While obesity, abdominal obesity and hypertension were associated with incident diabetes, IDRS was the strongest predictor of incident of diabetes in this population.

Prevalence and significance of generalized and central body obesity in an urban Asian Indian population in Chennai, India (CURES: 47)

OBJECTIVES

To determine the prevalence of generalized and abdominal obesity in urban Asian Indians and compare the association of body mass index (BMI) and waist circumference (WC) with metabolic risk variables.

METHODS

Subjects were recruited from the Chennai Urban Rural Epidemiology Study (CURES) carried out between 2001 and 2004 and involved 2350/2600 eligible subjects (response rate 90.4%). Anthropometric measurements, lipids and oral glucose tolerance tests were carried out. Generalized obesity (BMI>or=23 kg m(-2)) and abdominal obesity (WC>or=90 cm in men and >or=80 cm in women) were defined using WHO Asia Pacific guidelines.

RESULTS

The age standardized prevalence of generalized obesity was 45.9% (95% CI: 43.9-47.9%), (women: 47.4%; men: 43.2%, P=0.210), while that of abdominal obesity was 46.6% (95% CI: 44.6-48.6%), (women: 56.2%> men: 35.1%, P<0.001). Area under the curve for identifying subjects with any three metabolic risk factors using BMI was 0.66, 95% CI: 0.63-0.69, P<0.001, while, for WC, it was 0.70, 95% CI: 0.66-0.74, P<0.001 for men, and 0.69, 95% CI: 0.65-0.74, P<0.001 for women. Isolated generalized obesity (normal WC, increased BMI) was present in 12.7% of men and 6.1% of women. Isolated abdominal obesity (increased WC, normal BMI) was present in 4.7% of men and 14% of women. Combined obesity was present in 32.6% of men and 43.3% of women.

CONCLUSIONS

In Asian Indians, the prevalence of combined obesity is high among both sexes, while isolated generalized obesity is more common in men and isolated abdominal obesity more common in women. However, these prevalence rates vary markedly depending on cut points used. WC is a better marker of obesity-related metabolic risk than BMI in women compared to men in this population.

Gene-Environment Interactions and the Diabetes Epidemic in India

The prevalence of diabetes is rising rapidly in all developing countries and India already has the largest number of people with diabetes. Evidence for the rising prevalence of diabetes in India comes from recent population-based studies such as the Chennai Urban Population Study (n = 1,262) and the Chennai Urban Rural Epidemiology Study (n = 26,001). These two studies revealed that the current age-standardized prevalence of diabetes in Chennai in adults >/=20 years of age is 14.3%, which is 70% higher than that seen in the year 1989 (8.3%). In the Chennai Urban Population Study, we observed that the higher-income group who consumed excess fat and calorie-rich food had an increased prevalence of diabetes compared to the lowerincome group. There was also a linear increase in the prevalence of diabetes with an increase in visible fat consumption. In addition, we observed that visible fat consumption and physical inactivity showed a cumulative effect on increasing the prevalence of diabetes. We carried out gene-diet interaction studies, which revealed that the adiponectin gene polymorphism (+10211T - G) contributed to insulin resistance and diabetes and this was exaggerated in those consuming diets with higher glycemic loads. These subjects also had an increased risk for hypoadiponectinemia. Similarly, the Ala54Thr polymorphism of the fatty acid-binding protein 2 gene showed a synergistic effect with a high glycemic load increasing the risk for hypertriglyceridemia. These studies indicate that gene-diet interactions could play a major role in increasing the risk for diabetes. However, given the imprecision in measuring dietary intake, very large sample sizes would be needed for meaningful conclusions to be drawn.

Prevalence, awareness and control of hypertension in Chennai--The Chennai Urban Rural Epidemiology Study (CURES-52)

OBJECTIVE

To study the prevalence, awareness and control of hypertension in Chennai representing Urban South India.

METHODS

The Chennai Urban Rural Epidemiology Study (CURES) is one of the largest epidemiological studies on diabetes carried out in India, where 26,001 individuals aged > or = 20 years were screened using systematic random sampling method. Every tenth subject recruited in Phase 1 of CURES was requested to participate in Phase 3 of CURES and the response rate was 2,350/26,001 or 90.4%. An oral glucose tolerance test was performed in all individuals except self-reported diabetic subjects. Anthropometric measurements and lipid estimations were done in all subjects. Hypertension was diagnosed in all subjects who were on drug treatment for hypertension or if the blood pressure > or = 140/90 mmHg.

RESULTS

Hypertension was present in 20% [men:23.2% vs. women:17.1%, p<0.001] of the study population. Isolated systolic hypertension (Systolic BP > or = 140 and Diastolic BP<90 mmHg) was present in 6.6% while isolated diastolic hypertension (DBP > or = 90 and SBP<140 mmHg) was present in 4.2% of the population. Among the elderly population (aged > or = 60 years), 25.2% had isolated systolic hypertension. Age, body mass index, smoking, serum cholesterol and triglycerides were found to be strongly associated with hypertension. Among the total hypertensive subjects, only 32.8% were aware of their blood pressure, of these, 70.8% were under treatment and 45.9% had their blood pressure under control.

CONCLUSION

Hypertension was present in one-fifth of this urban south Indian population and isolated systolic hypertension was more common among elderly population. Majority of hypertensive subjects still remain undetected and the control of hypertension is also inadequate. This calls for urgent prevention and control measures for hypertension.

A diabetes risk score helps identify metabolic syndrome and cardiovascular risk in Indians - the Chennai Urban Rural Epidemiology Study (CURES-38)

AIMS

The aims of the study were to compare the recently evolved Indian Diabetes Risk Score (IDRS), in subjects with different grades of glucose intolerance and to evaluate its usefulness as an indicator of cardiovascular risk in Asian Indians, a high risk group for diabetes and coronary artery disease (CAD).

METHODS

The data for the present study were obtained from the Phase 3 (n = 2350, response rate: 90.4%) of the Chennai Urban Rural Epidemiology Study, a population-based study done in Chennai, the largest city in southern India. IDRS was developed based on multiple logistic regression analysis using four simple parameters namely age, abdominal obesity, family history of type 2 diabetes and physical activity. In all subjects, family history of diabetes was obtained, and details on physical activity were assessed using a validated questionnaire. Subjects with an IDRS of <30 was categorized as low risk, 30-50 as medium risk and those with > or =60 as high risk for diabetes. Biochemical and anthropometric measurements were done using standardized procedures. Minnesota coding was used to grade 12-lead electrocardiogram.

RESULTS

The mean IDRS increased significantly with worsening glucose intolerance [normal glucose tolerance (NGT) subjects: 48 +/- 17, impaired glucose tolerance (IGT): 57 +/- 16, newly diagnosed diabetics (NDD): 61 +/- 15 and known diabetics (KD): 68 +/- 12; p for trend <0.001]. Among NGT group, the prevalence of cardiovascular risk factors increased progressively in low-, medium- to high-risk score groups; hypertension: 9.4, 22.1 and 38.2% (p for trend: < 0.001), hypertriglyceridemia: 8.8, 19.9 and 25.3% (p for trend: < 0.001), hypercholesterolemia: 7.2, 20.3 and 34.9% (p for trend: < 0.001) and metabolic syndrome: 1.8, 14.6 and 30.3% (p for trend: < 0.001), respectively. The prevalence of CAD was also significantly higher in individuals with high risk compared with those with low risk (p = 0.030) and the medium risk (p = 0.050) in the NGT group.

CONCLUSIONS

The results suggest that in Asian Indians, (i) the diabetes risk score increases with increasing glucose intolerance, and (ii) it can serve as an effective indicator of metabolic syndrome and cardiovascular risk even among subjects with NGT.

Lack of association between serum adiponectin levels and the Pro12Ala polymorphism in Asian Indians

AIMS

The aim of the study was to investigate the association of serum adiponectin levels with the Pro12Ala polymorphism of the peroxisome proliferator activated receptor-gamma (PPARG) gene in Asian Indians.

METHODS

We selected 400 diabetic subjects, 200 with the Pro12Pro genotype (100 male and 100 female) and 200 with the Pro12Ala genotype (100 male and 100 female) and 400 age- and sex-matched normal glucose tolerance subjects with similar genotype profiles from the Chennai Urban Rural Epidemiology Study. Fasting serum adiponection levels were measured using radioimmunoassay. The Pro12Ala polymorphism was genotyped by PCR-restriction fragment length polymorphism using BstUI.

RESULTS

All clinical and biochemical parameters were similar in the subjects with the Pro12Pro and Pro12Ala genotypes. There was no significant difference in serum adiponectin values between subjects with the Pro12Pro and Pro12Ala genotypes (males 5.4 vs. 5.8 microg/ml, P = 0.546; females 6.9 vs. 7.2 microg/ml, P = 0.748). Adiponectin values did not differ among these two genotypes even when categorized based on their diabetes status (normal glucose tolerance Pro12Pro 7.9 vs. Pro12Ala 7.7 microg/ml, P = 0.994; diabetes Pro12Pro 4.7 vs. Pro12Ala 5.4 microg/ml, P = 0.622).

CONCLUSION

The Pro12Ala polymorphism of the PPARG gene is not associated with serum adiponectin levels in Asian Indians.

Epidemiology of type 2 diabetes: Indian scenario

India leads the world with largest number of diabetic subjects earning the dubious distinction of being termed the "diabetes capital of the world". According to the Diabetes Atlas 2006 published by the International Diabetes Federation, the number of people with diabetes in India currently around 40.9 million is expected to rise to 69.9 million by 2025 unless urgent preventive steps are taken. The so called "Asian Indian Phenotype" refers to certain unique clinical and biochemical abnormalities in Indians which include increased insulin resistance, greater abdominal adiposity i.e., higher waist circumference despite lower body mass index, lower adiponectin and higher high sensitive C-reactive protein levels. This phenotype makes Asian Indians more prone to diabetes and premature coronary artery disease. At least a part of this is due to genetic factors. However, the primary driver of the epidemic of diabetes is the rapid epidemiological transition associated with changes in dietary patterns and decreased physical activity as evident from the higher prevalence of diabetes in the urban population. Even though the prevalence of microvascular complications of diabetes like retinopathy and nephropathy are comparatively lower in Indians, the prevalence of premature coronary artery disease is much higher in Indians compared to other ethnic groups. The most disturbing trend is the shift in age of onset of diabetes to a younger age in the recent years. This could have long lasting adverse effects on nation's health and economy. Early identification of at-risk individuals using simple screening tools like the Indian Diabetes Risk Score (IDRS) and appropriate lifestyle intervention would greatly help in preventing or postponing the onset of diabetes and thus reducing the burden on the community and the nation as a whole.

Prevalence of metabolic syndrome using WHO, ATPIII and IDF definitions in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES-34)

AIM

To compare the prevalence of metabolic syndrome (MS) using the World Health Organisation (WHO), Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria of MS in an urban south Indian population, and their ability to identify coronary artery disease (CAD) in males and females.

METHODS

Chennai Urban Rural Epidemiology Study (CURES) is one of the largest epidemiological studies on diabetes carried out in India, in which 26 001 individuals aged >or=20 years were screened using systematic random sampling method. Every tenth subject recruited in Phase 1 of CURES was requested to participate in Phase 3, and the response rate was 90.4%. An oral glucose tolerance test (OGTT) was performed in all individuals except self-reported diabetic subjects. Anthropometric measurements and lipid estimations were done in all subjects and the prevalence of MS estimated using the three criteria. Diagnosis of CAD, made by resting 12 lead ECG, was compared by the three criteria of MS.

RESULTS

MS was identified in 546 subjects (23.2%) by WHO criteria, 430 subjects (18.3%) by ATPIII criteria and 607 subjects (25.8%) by IDF criteria. Only 224 of these subjects were identified by all the three criteria. There was an increased risk of probable CAD in MS subjects diagnosed by WHO criteria (odds ratio (OR) 3.86, 95% Confidence Interval (CI), 2.37-6.29, p < 0.001), compared to ATPIII criteria (OR 2.19, 95% CI 1.30-3.67, p < 0.05) and IDF criteria (OR 1.90, 95% CI 1.16-3.12, p < 0.05). The WHO criteria marked out a much higher population for CAD risk compared to ATPIII and IDF criteria in males, but not in females.

CONCLUSION

In Asian Indians, the WHO, ATPIII and IDF criteria of MS identify different individuals. The WHO criteria identify a greater number of CAD subjects in males, but not in females.

Structure of the extended diarrhea-inducing domain of rotavirus enterotoxigenic protein NSP4

Rotavirus nonstructural protein 4 (NSP4) is a multidomainal and multifunctional protein and is recognized as the first virus-encoded enterotoxin. Extensive efforts to crystallize the complete cytoplasmic tail (CT), which exhibits all the known biological functions, have been unsuccessful, and to date, the structure of only a synthetic peptide corresponding to amino acids (aa) 95-137 has been reported. Recent studies indicate that the interspecies-variable domain (ISVD) from aa 135 to 141 as well as the extreme C-terminus are critical determinants of virus virulence and the diarrhea-inducing ability of the protein. Among the five NSP4 genotypes identified, those belonging to genotypes A1, B and C possess either a proline at position 138 or a glycine at 140, while those of A2, D and E lack these residues in the ISVD, suggesting conformational differences in this region among different NSP4s. Here, we examined the crystallization properties of several deletion mutants and report the structure of a recombinant mutant, NSP4:95-146, lacking the N-terminal 94 and C-terminal 29 aa, from SA11 (A1) and I321 (A2) at 1.67 and 2.7 A, respectively. In spite of the high resolution of one of the structures, electron density for the C-terminal 9 residues could not be seen for either of the mutants, and the crystal packing resulted in the creation of a clear empty space for this region. Extension of the unstructured C-terminus beyond aa 146 hindered crystallization under the experimental conditions. The present structure revealed significant differences from that of the synthetic peptide in the conformation of amino acids at the end of the helix as well as the crystal packing owing to the additional space required to accommodate the un structured virulence-determining region. The crystal structure and secondary structure prediction of the NSP4:95-146 mutants from different genotypes suggest that the region C-terminal to aa 137 in all the NSP4 proteins is likely to be unstructured, and this might be of structural and biological functional significance.

Diversity in Indian equine rotaviruses: identification of genotype G10,P6[1] and G1 strains and a new VP7 genotype (G16) strain in specimens from diarrheic foals in India

Rotaviruses causing severe diarrhea in foals in two organized farms in northern India, during the period from 2003 to 2005, were characterized by electropherotyping, serotyping, and sequence analysis of the genes encoding the outer capsid proteins. Of 137 specimens, 47 (34.31%) were positive for rotavirus and exhibited at least five different electropherotypes (E), E1 to E5. Strains belonging to different electropherotypes exhibited either a different serotype/genotype specificity or a lack of reactivity to typing monoclonal antibodies (MAbs) used in this study. Strains belonging to E1, E2, and E5 exhibited genotype G10,P6[1], G3, and G1 specificities and accounted for 19.0, 42.9, and 9.5% of the isolates, respectively. Though they possessed G10-type VP7, the E1 strains exhibited high reactivity with the G6-specific MAb, suggesting that the uncommon combination of the outer capsid proteins altered the specificity of the conformation-dependent antigenic epitopes on VP7. E3 and E4 strains accounted for 28.6% of the isolates and were untypeable. Sequence analysis of VP7 from E4 strains (Erv92 and Erv99) revealed that they represent a new VP7 genotype, G16. The detection of unexpected bovine rotavirus-derived G10,P6[1] reassortants, G1 serotype strains, and a new genotype (G16) strain in two distant farms reveals an interesting epidemiological situation and diversity of equine rotaviruses in India.

Community empowerment--a successful model for prevention of non-communicable diseases in India--the Chennai Urban Population Study (CUPS-17)

BACKGROUND AND OBJECTIVE

Randomized clinical trials have documented that lifestyle changes through physical activity can prevent diabetes. However there is no data whether such strategies are applicable at community level, that is, in a real life setting. This study demonstrates the first attempt in India, to our knowledge, of increasing physical activity through community empowerment in an attempt at primary prevention of non communicable diseases.

METHODS

The Chennai Urban Population Study [CUPS] was conducted in the year 1996 in two residential areas: a middle income group the Asiad colony at Tirumangalam, and a low income group at Bharathi Nagar in T. Nagar. The Asiad colony was selected for this study. Of the 524 eligible individuals available at baseline in 1998 [age > or =20 years], 479 individuals consented for the study (response rate: 91.4%). After seven years, in 2004, the number of eligible individuals increased to 712 of whom 705 consented for the study (response rate:99%). Education regarding the benefits of physical activity was provided by mass awareness programmes like public lectures and video clippings. Both at baseline and during follow-up, details about the physical activity were collected using a validated questionnaire, which included job related and leisure time activities, and specific questions on exercise. Study individuals were then graded as having light, moderate and heavy physical activity using a scoring system.

RESULTS

In response to the awareness programmes given by our research team, the colony residents constructed a unique public park with their own funds. Though the occupation grades did not change, there was a significant change in the pattern of physical activity. At baseline, only 14.2% of the residents did some form of exercise. more than three times a week, which presently increased to 58.7% [p < 0.001]. The number of subjects who walked more than three times a week increased from 13.8% at baseline to 52.1% during follow-up [p < 0.001].

CONCLUSION

This study is a demonstration of how community empowerment with increased physical activity could possibly lead to prevention of diabetes and other non communicable diseases at the community level. This study also highlights the importance of sharing the results of research studies with the community.