Hindu-Muslim differences in the prevalence of coronary heart disease and risk factors

Differences in coronary risk factors and coronary heart disease (CHD) prevalence between the Hindus and the Muslims have not been adequately studied. This study aims to determine the prevalence of certain socio-economic and biological coronary risk factors in urban communities and to compare the findings found in the Hindus and the Muslims. The study employed a cross-sectional survey design and stratified random sampling technique consisting of 1,415 males and 797 females. Among males there were 1,092 Hindus (77.2%) and 272 Muslims (19.2%) while in females there were 685 Hindus (85.9%) and 91 Muslims (11.4%). Prevalence of illiteracy and sedentary lifestyle were significantly more in Muslims (p<0.05). Smoking or tobacco use in males was similar but in females it was more in the Hindus. Self-reported diabetes was found in 1.4% Hindu males and in 1.2% Hindu females. No Muslim reported diabetes. Hindu males were significantly taller than Muslims (163.9 +/- 8.3 versus 160.9 +/- 8.9 cm; p < 0.001). In both males and females there was no significant difference in body mass index and obesity. In Hindu males the diastolic BP was significantly greater than in Muslims (81.2 +/- 9.2 versus 79.0 +/- 8.6 mm Hg; p < 0.001); prevalence of hypertension (30.5% versus 25.7%) was also significantly more (p = 0.048). In Hindu females the mean systolic BP was significantly more and there was also difference in hypertension prevalence (35.2% versus 25.3%). CHD prevalence was significantly greater in Hindu males as compared to the Muslims when determined by the presence of either ECG changes alone (4.3% versus 0.7%; p = 0.008) or ECG changes combined with clinical history (7.1% versus 1.8%; p = 0.002). A similar, though not significant, trend was seen in females (ECG changes: 8.9% versus 6.6%, clinical and ECG changes: 10.4% versus 6.6%). The prevalence of CHD is significantly more in Hindu males as compared to the Muslims and is associated with a greater prevalence of diabetes and hypertension.

Prevalence of coronary heart disease and risk factors in an urban Indian population: Jaipur Heart Watch-2

BACKGROUND

The prevalence of risk factors for coronary heart disease has been inadequately studied in India. A repeat cross-sectional survey was carried out to evaluate the changes in the major coronary risk factors in the urban population of Jaipur previously studied in the early 1990s.

METHODS AND RESULTS

Randomly selected adults > or =20 years of age were studied using stratified sampling. The target study sample was 1800 with a population proportionate gender distribution (males 960, females 840). Coronary risk factors, anthropometric variables, blood pressure, ECG, fasting blood glucose and lipids were evaluated. A total of 1123 subjects (62.4%) (males 550, females 573) were examined. Fasting blood samples were available in 523 males and 559 females. Overall coronary heart diesase prevalence, diagnosed by history or ECG changes, was found in 34 males (6.18%) and 58 females (10.12%). Risk factor prevalence showed that smoking/tobacco use was present in 201 males (36.5%) and 67 females (11.7%). Physical inactivity, either work-related or leisure time, was seen in 157 males (28.5%) and 130 females (22.7%). Hypertension (> or =140 and/or 90 mmHg) was present in 200 males (36.4%) and 215 females (37.5%). Diabetes diagnosed by history or fasting glucose > or =126 mg/dl was found in 72 males (13.1%) and 65 females (11.3%). Obesity, body mass index > or =27 kg/m2 was present in 135 males (24.5%) and 173 females (30.2%), while truncal obesity (waist:hip >0.9 males, >0.8 females) was found in 316 males (57.4%) and 392 females (68.4%). The most common dyslipidemia in both males and females was low HDL-cholesterol (<40 mg/dl: males 54.9%, females 54.2%). High total cholesterol levels of > or =200 mg/dl (males 37.4%, females 4.1%), high LDL-cholesterol levels of > or =130 mg/dl (males 37.0%, females 45.8%) and high levels of triglycerides > or = 150 mg/dl (males 32.3%, females 28.6%) were also seen in a significant number. Hypertension, obesity, truncal obesity, diabetes and dyslipidemias increased significantly with age in both males and females (Mantel-Haenzel chi2 for trend, p<0.05).

CONCLUSIONS

There is a high prevalence of standard coronary risk factors--smoking, physical inactivity, hypertension, hypercholesterolemia, diabetes and obesity--as well as factors peculiar to south Asians--truncal obesity, low HDL-cholesterol and high triglycerides--in this urban Indian population. As compared to a previous study in the early 1900s in a similar population, there is a significant increase in the number of people with obesity, diabetes and dyslipidemias.

Lipid abnormalities in coronary heart disease: a population-based case-control study

BACKGROUND

We performed a case-control study to estimate lipid-cholesterol fractions in patients with coronary heart disease and compared them with population-based controls.

METHODS AND RESULTS

A total of 635 newly diagnosed patients with coronary heart disease (518 males and 117 females) and 632 subjects (346 males and 286 females) obtained from an ongoing urban coronary heart disease risk factor epidemiological study were evaluated. Age-specific lipid values (total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, and total:high-density lipoprotein cholesterol ratio) were compared using the t-test. Age-adjusted prevalence of dyslipidemia as defined by the US National Cholesterol Education Program was compared using the Chi-square test. In all the age groups, and in both males and females, levels of total and low-density lipoprotein cholesterol were not significantly different. In males, the high-density lipoprotein cholesterol (mg/dl) was significantly lower in patients with coronary heart disease as compared to controls in the age groups 30-39 years (35.1+/-11 v. 43.7+/-9), 40-49 years (39.0+/-10 v. 47.1+/-8), 50-59 years (38.9+/-11 v. 43.8+/-9) and 60-69 years (38.6+/-11, v. 42.8+/-7) (p<0.05). In females, high-density lipoprotein cholesterol was less in the age groups 30-39 years (30.2+/-9 v. 40.7+/-9), 50-59 years (39.7+/-12 v. 44.7+/-8) and 60-69 years (35.6+/-11 v. 42.2+/-9). The level of triglycerides was significantly higher in male patients in the age groups 40-49 years (195.3+/-96 v. 152.8+/-78), 50-59 years (176.7+/-76 v. 162.9+/-97), 60-69 years (175.5+/-93 v. 148.1+/-65) and >70 years (159.8+/-62 v. 100.0+/-22); and in female patients in the age group 30-39 years (170.8+/-20 v. 149.9+/-9) (p<0.05). The total:high-density lipoprotein cholesterol ratio was significantly higher in all age groups in male as well as female patients with coronary heart disease (p<0.05).

CONCLUSIONS

An age-adjusted case-control comparison showed that the prevalence of hypertension, diabetes, high total cholesterol (> or =200 mg/dl) (males 48.8% v. 20.2%; females 59.8% v. 33.4%) and high low-density lipoprotein cholesterol (> or =130 mg/dl) (males 42.1% v. 15.0%; females 52.1% v. 31.0%) was significantly more in cases than in controls. The prevalence of low high-density lipoprotein cholesterol (<35 mg/dl) (males 39.6% v. 6.2%; females 39.3% iv 9.5%), high total:high-density lipoprotein ratio (> or = 5.0) and high triglycerides (> or =200 mg/ dl: males 39.6%, v. 10.2%; females 17.1% v. 11.9%) was also significantly higher in cases (p<0.05).

Ketorolac tromethamine in the maintenance of intraoperative mydriasis

BACKGROUND AND OBJECTIVE

Mydriatics and antiprostaglandins are routinely applied preoperatively to facilitate the aspiration of cortical material during extracapsular cataract surgery and to prevent intraoperative miosis. Unfortunately, the ideal antiprostaglandin has yet to be introduced. This study represents the first prospective, case-controlled, randomized, masked, clinical trial comparing the efficacy of oral ketorolac tromethamine (KT) with the efficacy of topical flurbiprofen sodium (FS) and a placebo (normal saline) in maintaining intraoperative mydriasis without adrenaline in the irrigation solution.

PATIENTS AND METHODS

Sixty-three patients, undergoing extracapsular cataract extraction with posterior chamber intraocular lens implantation, were randomly divided into three equal groups. Group 1 received 20 mg of oral KT 2 hours prior to surgery, group 2 received 0.03% FS topical solution at the recommended dosage, and group 3 received topical normal saline in a regimen identical to that of group 2. Identical mydriatics were used in both groups. The patients' pupils were measured at five stages of surgery.

RESULTS

The mean pupillary diameters at each surgical stage were greater in group 1 than in group 2; however, the difference was not statistically significant. The pupils in group 3 were significantly smaller than those of group 1 or group 2 (P < .05). No systemic toxicity to KT was observed. Moreover, the need for additional postoperative analgesics was significantly greater in groups 2 and 3.

CONCLUSIONS

Oral KT is safe, convenient, and as effective as topical FS, and has the added advantage of reducing postoperative pain.

Prevalence and determinants of coronary heart disease in a rural population of India

BACKGROUND

The prevalence and determinants of coronary heart disease (CHD) have been inadequately studied in rural areas of developing countries.

METHODS

Entire communities were surveyed in randomly selected villages in Rajasthan, India. A physician-administered questionnaire, physical examination, and electrocardiogram (ECG) were performed on 3148 adults > or = 20 years of age (1982 males, 1166 females). Fasting blood samples for determination of lipids were obtained from 202 males and 98 females. Prevalence of coronary risk factors--smoking, hypertension, sedentary life-style, obesity, and hypercholesterolemia--was determined. CHD was diagnosed on basis of past documentation, response to WHO-Rose questionnaire, or changes in ECG. Three methods were used: (a) documentation, history, and ECG criteria, (b) ECG-Q, ST, or T changes, and (c) presence of Q waves.

RESULTS

Coronary risk factors: smoking was present in 51% males and 5% females, hypertension (> or = 140/90 mmHg) in 24% males and 17% females, hypercholesterolemia (> 200 mg/dl) in 22%, diabetes history in 0.2%, and irregular physical activity or sedentary habits in 85%. Other risk factors were lack of formal education in 44%, obesity (body-mass index > or = 27 kg/m2) in 6% and truncal obesity (waist-hip ratio > or = 0.95) in 5%. The prevalence of CHD (clinical + ECG criteria) was 3.4% in males and 3.7% in females. According to ECG criteria only, it was 2.8% in males and 3.3% in females and according to Q-waves only, it was 1.6% in males and 0.9% in females. Multivariate logistic regression analysis showed that age and smoking in males and age and systolic blood pressure in females were associated with higher prevalence of Q-wave CHD. In males, higher educational level and prayer habit were associated with lower prevalence.

CONCLUSIONS

Prevalence of CHD in this rural community is higher than in previously reported Indian studies. Smoking, hypertension, and sedentary lifestyle have high prevalence. Significant determinants of CHD are increasing age and smoking while education and prayer-habit are protective.

Hypertension epidemiology in India: meta-analysis of 50 year prevalence rates and blood pressure trends

Recent studies among Indians have shown a high prevalence of hypertension. To determine changing trends in hypertension prevalence, in mean blood pressure (BP) levels and to study urban and rural differences we performed meta-analysis of all available Indian studies. The first such study was reported by Chopra in 1942. Since then many studies (n = 33) in urban and rural areas of India have been performed. In urban populations earlier studies of Dotto (1949), Dubey (1954) and Sathe (1959) showed prevalence of hypertension of 1.24 +/- 0.2, 4.24 +/- 0.4 and 3.03 +/- 0.3% in populations of Calcutta, Kanpur and Bombay respectively. Studies since 1959 used World Health Organisation (WHO) guidelines and have shown increasing trend in hypertension prevalence. Recent studies from Ludhiana (1985) and Jaipur (1995) show that prevalence is 14.08 +/- 1.1 and 10.99 +/- 0.7% respectively. Trend analysis in studies among urban areas (n = 10) shows a significant increase in hypertension prevalence (Mantel-Haenzel chi 2 = 5.99, P = 0.014). Studies in rural areas (n = 14) also show a significant increase in hypertension prevalence (Mantel-Haenzel chi 2 = 5.93, P = 0.014) although the rise is not as sharp as in urban populations (r value, urban = 0.70, rural = 0.67). Changes in mean BP levels were analysed by using mean systolic (S) and diastolic (D) BP in urban men aged 40-49 years from 1959-1995. For SBP there was a significant increase (r = 0.95, P < 0.001) and not with DBP (r = 0.43, P > 0.2). It is concluded that in India hypertension is emerging as a major health problem more so in urban than in rural subjects. The increasing prevalence is related to a rising mean SBP.

Meta-analysis of coronary heart disease prevalence in India

This meta-analysis was performed to determine the time-trends in the prevalence of coronary heart disease in India and age-and gender-specific changes. Inter-study differences, urban-rural differences and age-and gender-specific differences were examined using the Chi-square test and Mantel-Haenzel Chi-square statistics for linear association. The prevalence of coronary heart disease increased from 1.05% in 1960 to 9.67% and 7.90% in 1995 in urban populations (X2 = 277.5, p < 0.0001; Mantel-Haenzel X2 = 5.63, p = 0.018). In rural areas, the prevalence increased from 2.03% in 1974 to 3.7% in 1995 (X2 = 90.0, p < 0.0001; Mantel-Haenzel X2 = 2.94, p = 0.086). In urban areas there was a significant increase in the prevalence of coronary heart disease in men in the age groups 20-29 and 30-39 years (p = 0.001) and in women in the age groups 20-29, 30-39 and 40-49 years (p = 0.002). In rural areas the increase in men was in the age groups 20-29 and 30-39 years (p = 0.001).

Genetic distance and heterosis in Indian mustard: developmental isozymes as indicators of genetic relationships

The use of isozymes as indicators of genetic diversity and as markers for the selection of agronomic traits has been proposed in different crop species. The present investigation was conducted to study the use of isozyme-derived genetic distance between parents in predicting the F1 heterosis in Indian mustard. In addition, the interaction of isozyme-based diversity with quantitative trait and pedigree-based diversity measures, and its role in predicting hybrid heterosis has also been examined. Sixteen Indian mustard lines and their 48 crosses (12 × 4, line x tester crossing) were evaluated over two environments for isozyme and quantitative morphological characters. The results from this study suggest that the heterotic response to isozymic changes is more responsive in crosses derived from morphologically and pedigree-wise related parents in comparison to crosses derived from unrelated parents. It was possible to improve heterosis predictions by partitioning the isozyme-based genetic distance into general genetic distance and specific genetic distance and correlating the latter with the specific combining ability of morphological traits. The possible reasons for these observations are discussed.

Prevalence and determinants of hypertension in the urban population of Jaipur in western India

OBJECTIVES

To determine age-specific blood pressure levels and prevalence of hypertension in an urban Indian population.

DESIGN AND SETTING

A cross-sectional survey in six randomly selected municipal blocks in Jaipur city, India.

SUBJECTS AND METHODS

There were 2122 subjects (1415 male, 797 female) aged 20 years or more. Evaluation was by physician-administered questionnaire, physical examination and electrocardiography. Diagnosis of hypertension used World Health Organization (WHO) and USA Fifth Joint National Committee (JNC-V) guidelines. Hypertension was subclassified according to the Framingham Study criteria.

RESULTS

The mean +/- SD blood pressures (mmHg) were 125 +/- 19 systolic and 81 +/- 24 diastolic in men and 126 +/- 20 systolic and 81 +/- 12 diastolic in women. A significant correlation of blood pressure with increasing age groups was seen. The prevalence of hypertension according to the JNC-V criteria was 30% in men and 33% in women; by WHO criteria it was 11% in men and 12% in women and increased with age in all subjects. In the JNC-V hypertensive group borderline isolated systolic hypertension was present in 13% of men and 17% of women, definite isolated systolic hypertension was present in 7% of men and 2% of women, isolated diastolic hypertension was present in 65% of men and 57% of women and definite hypertension was present in 16% of men and 24% of women. Multivariate analysis revealed that age, smoking and higher body mass index were independently associated with higher prevalence of hypertension both in men and in women.

CONCLUSIONS

A high prevalence of JNC-V-defined hypertension was found in an Indian urban population. Isolated diastolic hypertension was the commonest subtype. Significant determinants of hypertension were age, smoking and body mass index.

Criteria for performing multiple dosimetry

When radiation fields vary spatially as a result of job- or location-specific conditions, the use of more than one dosimeter may be necessary for a variety of radiation protection purposes. This paper contains a methodology for when and how to use multiple dosimeters under conditions incident to routine activities in the presence of ionizing radiation. It also describes a methodology for determining the effective dose equivalent when the use of multiple dosimeters has been deemed necessary by radiation protection professionals. The methodology is based upon application of compartments and compartment factors. Included herein are examples demonstrating when multiple dosimeters should be used and how effective dose equivalent should be calculated using the compartment factors.

Prevalence of coronary heart disease and coronary risk factors in an urban population of Rajasthan

To determine the prevalence of coronary heart disease (CHD) and coronary risk factors in an urban Indian population, we studied a random sample of population of Jaipur. A physician-administered questionnaire, physical examination and a 12-lead electrocardiogram was performed on 2,212 adults of > or = 20 years of age (males 1,415, females 797). CHD was diagnosed on the basis of past documentation, response to WHO-Rose questionnaire or changes in the electrocardiogram. The overall prevalence of CHD was 7.6 percent (168 cases). The prevalence rate was 6.0 percent (84) in males and 10.4 percent (84) in females with an age-related increase in prevalence ('p' for trend < 0.001). When diagnosed on the basis of electrocardiographic changes alone (Q, ST or T wave), the prevalence was 5.2 percent (116), with 3.5 percent in males and 8.4 percent in females. CHD was silent in 57 percent males and 79 percent females. Coronary risk factors were observed in a significant proportion: smoking in 32 percent (males 39 percent, females 19 percent), hypertension (> or = 140/90 mm Hg) in 31 percent (males 30 percent, females 34 percent-JNC-V) and > or = 160/95 mm Hg in 11 percent (males 10 percent, females 12 percent; WHO classification), diabetes in 1 percent and sedentary habits in 71 percent. Additional risk factors were generalised obesity (body-mass index > or = 27 Kg/m2) in 11 percent and truncal obesity (waist-hip ratio > 0.95) in 17 percent males and 13 percent females. Significant association of CHD prevalence were seen with age, sedentary habits and presence of hypertension in both males and females, and in addition with smoking in males.

Comparison of and limits of accuracy for statistical analyses of vibrational and electronic circular dichroism spectra in terms of correlations to and predictions of protein secondary structure

This work provides a systematic comparison of vibrational CD (VCD) and electronic CD (ECD) methods for spectral prediction of secondary structure. The VCD and ECD data are simplified to a small set of spectral parameters using the principal component method of factor analysis (PC/FA). Regression fits of these parameters are made to the X-ray-determined fractional components (FC) of secondary structure. Predictive capability is determined by computing structures for proteins sequentially left out of the regression. All possible combinations of PC/FA spectral parameters (coefficients) were used to form a full set of restricted multiple regressions with the FC values, both independently for each spectral data set as well as for the two VCD sets and all the data grouped together. The complete search over all possible combinations of spectral parameters for different types of spectral data is a new feature of this study, and the focus on prediction is the strength of this approach. The PC/FA method was found to be stable in detail to expansion of the training set. Coupling amide II to amide I' parameters reduced the standard deviations of the VCD regression relationships, and combining VCD and ECD data led to the best fits. Prediction results had a minimum error when dependent on relatively few spectral coefficients. Such a limited dependence on spectral variation is the key finding of this work, which has ramifications for previous studies as well as suggests future directions for spectral analysis of structure. The best ECD prediction for helix and sheet uses only one parameter, the coefficient of the first subspectrum. With VCD, the best predictions sample coefficients of both the amide I' and II bands, but error is optimized using only a few coefficients. In this respect, ECD is more accurate than VCD for alpha-helix, and the combined VCD (amide I' + II) predicts the beta-sheet component better than does ECD. Combining VCD and ECD data sets yields exceptionally good predictions by utilizing the strengths of each. However, the residual error, its distribution, and, most importantly, the lack of dependence of the method on many of the significant components derived from the spectra leads to the conclusion that the heterogeneity of protein structure is a fundamental limitation to the use of such spectral analysis methods. The underutilization of these data for prediction of secondary structure suggests spectral data could predict a more detailed descriptor.

Smoking and alcohol intake in a rural Indian population and correlation with hypertension and coronary heart disease prevalence

3148 persons (1982 males and 1166 females) aged more than 20 years in a cluster of three villages were examined. The overall prevalence of smoking was 51% in males (n = 1006) and 5% in females (n = 54). Among male smokers there were 26% light smokers (< or = 5 bidis/day), 51% moderate smokers (6-20/day) and 17% heavy smokers (> 20 day) and in females there were 54% light smokers, 41% moderate smokers and 5% heavy smokers. Smokers were less educated and had higher prevalence of work-related physical activity and alcohol intake. There was a higher prevalence of hypertension and of ECG Q-waves in male smokers. Regular alcohol intake was seen in 19% males (n = 377) and in 2% females (n = 26). Among males there were 43% light drinkers (< or = 28 gm ethanol/day), 32% moderate drinkers (28-56 gm ethanol/day) and 5% heavy drinkers (> 56 gm ethanol/day). Although this group had a higher prevalence of hypertension there was an insignificant difference in CHD prevalence and a significantly lower prevalence of ECG Q-waves. Subgroup analysis has also been performed taking non-smoker-non-alcohol consuming group as controls. It was found that group which comprised of smokers-non-alcohol consumers had a significantly higher prevalence of hypertension and of ECG Q-waves. Alcohol intake-smoker group had a significantly higher prevalence of hypertension. The habits of smoking and alcohol consumption are widely prevalent among males in this rural community. Smoking and alcohol-intake, both individually and collectively, are related to higher prevalence of hypertension as well as CHD. While the prevalence of hypertension is more among the alcohol consumers, smokers have a higher prevalence of CHD.

Educational status, coronary heart disease, and coronary risk factor prevalence in a rural population of India

OBJECTIVE

To define the association between educational level and prevalence of coronary heart disease and coronary risk factors in India.

DESIGN

Total community cross sectional survey with a doctor administered questionnaire, physical examination, and electrocardiography.

SETTING

A cluster of three villages in rural Rajasthan, western India.

SUBJECTS

3148 residents aged over 20 (1982 men, 1166 women) divided into various groups according to years of formal schooling.

RESULTS

Illiteracy and low educational levels were associated with less prestigious occupations (agricultural and farm labouring) and inferior housing. There was an inverse correlation of educational level with age (rank correlation: mean -0.45, women -0.49). The prevalence of coronary heart disease (diagnosed by electrocardiography) was significantly higher among uneducated and less educated people and showed an inverse relation with education in both sexes. Among uneducated and less educated people there was a higher prevalence of the coronary risk factors smoking and hypertension. Educational level showed a significant inverse correlation with systolic and diastolic blood pressure. Logistic regression analysis with adjustment for age showed that educational level had an inverse relation with prevalence of electrocardiographically diagnosed coronary heart disease (odds ratio: men 0.82, women 0.53), hypertension (men 0.88, women 0.56), and smoking (men 0.73, women 0.65) but not with hypercholesterolaemia and obesity. The inverse relation of coronary heart disease with educational level abated after adjustment for smoking, physical activity, body mass index, and blood pressure (odds ratio: men 0.98, women 0.78).

CONCLUSION

Uneducated and less educated people in rural India have a higher prevalence of coronary heart disease and of the coronary risk factors smoking and hypertension.

Circadian rhythms of renal phosphohydrolases analysed by Cosinor method

Rhythmometric analysis of hydrolytic enzymes of mouse kidney has been performed on circadian time scale using the F test. Significant rhythms were detected in glucose-6-phosphatase (G6Pase), inorganic pyrophosphatase (InPPase) and alkaline phosphatase (AlPase) on protein and fresh weight basis. Acrophase (time for peak activity) of G6Pase, InPPase and AlPase per mg protein was at 9.9 degrees (1.0 hr), 88.5 degrees (6.0 hr) and at 342.3 degrees (20 hr) respectively. ATPase, which did not show significant rhythm (mean +/- SD = 4.51 +/- 0.30), had a peak value at 32.1 degrees (2.14 hr) with an amplitude of 0.31 units on protein basis. However, G6Pase and AlPase oscillated with high amplitudes (0.18 and 0.71) across the mean value (mesor) of 0.68 +/- 0.3 and 1.43 +/- 0.46 units respectively and with a phase shift of 5 hr. Since G6Pase is a multicomponent and multifunctional enzyme having several overlapping enzyme activities (viz. InPPase), coordinated events of G6Pase, InPPase and ATPase in the regulation of daily renal functions have been mapped in the intact animals, along a physiologic time scale.

Lipoprotein lipids and the prevalence of hyperlipidaemia in rural India

BACKGROUND

The prevalence of hyperlipidaemias has been inadequately studied in rural populations of developing countries. No significant data exist on the population levels of serum cholesterol, cholesterol subclasses or triglycerides in these countries.

METHODS

We studied fasting blood samples of 300 apparently healthy adults (202 men and 98 women, age range 20-73 years) randomly selected from a larger sample of 3148 individuals during a comprehensive cardiovascular risk-factor survey in Rajasthan, India. Levels of serum total cholesterol, its subfractions [low-density-lipoprotein (LDL) cholesterol, very-low-density-lipoprotein cholesterol and high-density-lipoprotein (HDL) cholesterol] and triglycerides were measured and correlated with age and anthropometric data.

RESULTS

The mean +/- SD serum total-cholesterol levels were 4.39 +/- 1.0 mmol/l in men and 4.37 +/- 1.0 mmol/l in women, the mean LDL-cholesterol levels 2.51 +/- 1.0 mmol/l in men and 2.62 +/- 0.9 mmol/l in women, the mean HDL-cholesterol levels 1.15 +/- 0.4 mmol/l in both mean and women and the mean fasting serum triglyceride levels 1.63 +/- 0.6 mmol/l in men and 1.48 +/- 0.7 mmol/l in women. Age correlated positively with total-cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels in both men and women. Levels of the cholesterol subtypes did not differ between the sexes (P > 0.01), although triglyceride levels were significantly higher in men (P < 0.01). Lipoprotein lipids did not correlate significantly with height, weight, body-mass index or waist:hip ratio. When classified according to the recommendations of the US National Cholesterol Education Program for the determination of the prevalence of hyperlipidaemia, 43 individuals (14.3%; men 14.4% and women 14.3%) had borderline high cholesterol levels (5.20-6.18 mmol/l) and 24 (8%; men 7.9% and women 8.2%) had high cholesterol levels (> or = 6.21 mmol/l). Forty-five participants (15%) had borderline high LDL-cholesterol levels (3.36-4.11 mmol/l) and 20 (6.7%) had high LDL-cholesterol levels (> or = 4.14 mmol/l); low HDL-cholesterol levels (< 0.9 mmol/L) were found in 89 (29.7%). Eighteen participants (6%) had mild hypertriglyceridaemia (2.82-5.64 mmol/l) and two (0.7%) had severe hypertriglyceridaemia (> 5.64 mmol/l).

CONCLUSION

Total-cholesterol and LDL-cholesterol levels are low in a rural Indian population, although an atherogenic lipid profile is present in a significant proportion.

Circadian rhythmometric analysis of hepatic phosphohydrolases with special reference to glucose-6-phosphatase and inorganic pyrophosphatase

Rhythmometric analysis of a group of phosphohydrolases in mouse liver has been performed along a single 24 hr time scale. The presence of the rhythm was conducted by F test. Statistically significant circadian rhythm was detected in glucose-6-phosphatase (G6Pase) and inorganic pyrophosphatase (InPPase) activity expressed on fresh weight and protein basis. Both G6Pase and InPPase oscillated with a high amplitude of 0.44 U and 1.15 U respectively across the mean value (mesor) of 0.40 +/- 0.42 U and 2.81 +/- 1.14 U per mg protein and with a phase shift of 80 degrees (5.34 hr) among them. On the other hand, alkaline phosphatase (AlPase) did not show any rhythm whereas adenosine triphosphatase (ATPase) showed rhythmic activity on protein basis and oscillated across mesor of 1.84 +/- 0.5 U with an amplitude of 0.52. Acrophase (time for peak activity/mg protein) of G6Pase, InPPase and ATPase was found at 194.2 degrees (13.34 hr), 114.1 degrees (8.0 hr) and at 306.1 degrees (20.4 hr) respectively. AlPase, though did not show significant rhythm, had peak value at 231.8 degrees. Since hepatic G6Pase is a multicomponent and multifunctional enzyme with several overlapping activities (viz. InPPase), coordinated action of G6Pase and InPPase in the regulation of hepatic cell functions has been suggested.

Immunosorbent electron microscopic studies on a tobamovirus causing brinjal necrotic mosaic

Serological relationships of brinjal necrotic mosaic virus (BNMV), a strain of tobacco mosaic virus (TMV) causing necrotic mosaic disease of brinjal in India to other TMV strains was investigated by immunosorbent electron microscopy (ISEM). The intensity of trapping and decoration revealed a close relationship of BNMV to TMV-D, TMV-U1 and TMV-WU1 strains, and a distant relationship to TMV-A1 and TMV-P11 strains. There was a negligible relationship to TMV-P14, tomato mosaic virus (ToMV) and cucumber green mottle mosaic virus (CGMMV). Therefore, BNMV is proposed to be distinct from the previously reported TMV-A1 strain of brinjal.

Dynamics of Met5- and Leu5-enkephalin and their receptor binding activity in relation to morphine

A complete normal coordinate analysis of Met5- and Leu5-enkephalins using Wilson's GF matrix method and Urey Bradley force field has been carried out to understand the dynamical behaviour of enkephalins. In addition, the charge distributions on different atoms of the two enkephalins and morphine using CNDO/2 method are also reported. The similarity in the charge distribution on the part of these two molecules is indicative of the possible interactions at the same receptor site as that of morphine and its derivatives. Apart from the topographical features and charge distribution, binding onto receptor site is not a static but a dynamic process and low frequency modes must play an important role in the recognition process. The significance of the out-of-plane amide VII band and other skeletal modes as characteristic of conformational states of Met5- and Leu5-enkephalins are discussed.

Coronary heart disease and coronary risk factor prevalence in rural Rajasthan

To determine the prevalence of coronary risk factors and coronary heart disease (CHD) in rural Rajasthan, 1150 randomly selected individuals in a cluster of villages in central Rajasthan have been studied. These included 805 men and 345 women. The prevalence of various coronary risk factors in the whole group were: Smoking 488 (42.4%); Diabetes (history): 5(0.4%); Alcohol intake: 146 (12.7%); Sedentary lifestyle: 797 (69.3%); Stressful life events: 48 (4.2%); Hypertension (BP > or = 140/90) 152 (13.2%); obesity (BMI > or = 27 Kg/M2): 194 (10.9%); and Truncal obesity (waist:hip > or = 0.93): 20.8%. The overall prevalence of CHD was 46.1/1000. Patients with CHD had a higher prevalence of male sex (67.9 vs 51.5%); educated persons (30.2 vs 28.8%); businessmen (13.2 vs 10.2%); smoking (47.2 vs 40.5%); sedentary lifestyle (75.5 vs 62.3%); stressful life events (7.5 vs 4.8%); and hypertension (26.4 vs 14.8%). On the other hand, persons without CHD had higher prevalence of alcohol intake (10.8 vs 7.5%); regular prayers (23.1 vs 22.6%); physically active lifestyle (37.7 vs 24.5%); obesity (13.6 vs 6.9%), and truncal obesity (21.0 vs 20.0%). The following risk factors emerged significant on statistical analysis (Odds ratio, 95% confidence intervals): male sex (1.99, 1.04 to 3.7); hypertension (2.04, 1.01 to 4.09); male smokers (1.80, 1.28 to 4.09); and sedentary lifestyle (1.86, 1.01 to 3.59). This study shows a low prevalence of CHD in rural population which is however more than previously reported studies from India.

Conjunctival amyloidosis: is it related to trachoma?

Due to presence of trachoma in a large percentage of cases of conjunctival amyloidosis, trachoma has been blamed for causing secondary localized amyloidosis. However, there is no study to demonstrate evidence of amyloidosis in tarsoconjunctival specimens of trachomatous lids. 50 eyes of 35 patients having trachomatous eyelids with thickened tarsal plate, trichiasis and entropion had a tarsoconjunctival biopsy (3 mm x 20 mm) from the upper lid. Histopathological examination using Haematoxylin--eosin and congo red stains failed to reveal evidence of amyloid deposition in any of the biopsies. This is the first histopathological study of amyloidosis in trachomatous patients. Our study rules out the long-standing concept of trachoma having causal relationship with conjunctival amyloidosis. It is concluded that conjunctival amyloidosis occurring in trachomatous lids should be considered as primary localized amyloidosis.

Influence of cessation of smoking on long term mortality in patients with coronary heart disease

Cessation of smoking in patients with coronary artery disease (CAD) has shown variable results. The long term mortality in patients of coronary heart disease (CHD) who quit smoking following diagnosis of their disease has been variable. We have analysed the long term effects of cessation of smoking on mortality in a cohort of 173 patients with CAD and compared the mortality of this group with 299 nonsmokers and 52 current smokers. The baseline data were identical for major risk factors like age, hypertension, diabetes, cholesterol levels, and congestive heart failure among the three groups (p > 0.1). There were more patients with previous myocardial infarction in past (38.7%) and current smokers (40.4%) than among nonsmokers (25.4%). All patients were followed for a period extending upto 11 years. The mean duration of follow up was 6.81 +/- 2.95 years in non-smokers, 5.98 +/- 2.94 years in exsmokers, and 6.32 +/- 3.44 years in current smokers. Actuarial analysis shows that overall mortality was significantly more among exsmokers than nonsmokers (Logrank test = 3.72, 1p < 0.05). The exsmokers showed similar mortality as current smokers during the first three years of follow up (Logrank test = 1.10, 1p < 0.1); but afterwards the mortality was significantly less in exsmokers than in current smokers (Logrank test = 6.29, 1p < 0.025). However, the overall mortality was lowest in nonsmokers when compared to that of exsmokers and current smokers (Logrank test = 3.92, p < 0.05). The total mortality was 28.1% in nonsmokers, 32.4% in exsmokers, and 46.2% in current smokers. The incidence of sudden death was, however, similar in all the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Blepharoptosis repair by modified sutureless Fasanella-Servat Operation (F.S.O)--a large series of 50 cases

A modified technique of sutureless Fasanella-Servat Operation (F.S.O.) using special curved haemostat for the correction of mild to moderate acquired ptosis with good Levator Palpebrae Superioris (L.P.S.) action (12 m.m.) was performed in a large series of 50 eyes. Excellent correction was achieved in 94.6% eyes with mild ptosis & 61.6% eyes with moderate ptosis. No operative and post operative complications were observed. The technique was found to be very safe, quick and effective.

Vibrational CD of the amide II band in some model polypeptides and proteins

The amide II vibrational CD (VCD) spectra of poly (L-glutamic acid) and poly (L-lysine) in various conformational forms and those of several proteins in H2O have been measured. Characteristic VCD patterns have been observed in the amide II region due to helix, beta-sheet, and coil conformations in polypeptides. Based on their x-ray crystal structures, the proteins studied have been assigned to six categories. Proteins in the same category give rise to similar amide II VCD. While the protein conformational type is indicated using the amide II VCD, discrimination between types is less characteristic than with the previously studied amide I' VCD in D2O.

Comparison of alpha-lactalbumin and lysozyme using vibrational circular dichroism. Evidence for a difference in crystal and solution structures

The conformation of the milk protein alpha-lactalbumin has been studied using vibrational circular dichroism (VCD) and compared to parallel studies on lysozyme. These proteins have been shown by Acharya et al. [(1989) J. Mol. Biol. 208, 99-127] to have very similar three-dimensional crystal structures. However, their VCD spectra in D2O solution are quite different. The VCD of lysozyme in D2O more resembles that of alpha-lactalbumin in 33% propanol/D2O, under which conditions alpha-lactalbumin has conformationally transformed to a structure with increased helical fraction. These results can be seen to be consistent with UVCD and resolution-enhanced FTIR spectra of alpha-lactalbumin and lysozyme in both D2O and H2O environments. The solvent sensitivity of the alpha-lactalbumin spectra and hence of its conformation contrasted with the lack of such sensitivity for lysozyme suggest that the alpha-lactalbumin crystal structure represents a conformation different from that which is dominant in aqueous solution.