Understanding the association between intimate partner violence and sexually transmitted infections among women in India: a propensity score matching approach

BACKGROUND

Intimate partner violence (IPV) against women can significantly impact their overall health. While numerous studies in developing nations highlight the association between IPV and sexually transmitted infections (STIs), the evidence available within the Indian context remains limited. Therefore, this study aims to fill this knowledge gap by investigating the relationship between exposure to different forms of IPV and the occurrence of STIs, using a quasi-experimental approach.

METHODS

The study used a sample of 63 851 women aged 15-49 years from the latest National Family Health Survey-5. Propensity score matching (PSM) was employed to assess the 'treatment effect' from exposure to IPV (physical, emotional or sexual) in the past 12 months on STIs.

RESULTS

About 12.2% of women (95% CI: 11.7% to 12.8%) reported symptoms of STIs at the time of the survey. Approximately 31.9% (95% CI: 31.2% to 32.7%) of women reported experiencing at least one form of IPV-either physical, emotional or sexual IPV. Of all forms of IPV, physical IPV was the most prevalent, reported by 28.6%, followed by emotional IPV (13.2%) and sexual IPV (5.7%). Women who experienced any form of IPV-whether physical, sexual or emotional-reported a higher prevalence of STIs (17.8%) as compared with those who did not experience any IPV (9.5%). The findings from the PSM analysis indicated that among the three forms of IPV, the impact of sexual IPV on STIs was the most pronounced. The average treatment effect on the treated from exposure to sexual IPV on STIs was 0.15 (95% CI 0.13 to 0.17).

CONCLUSION

This study provides evidence of a significant association between IPV and STIs among women in India and underscores the urgent need for intensified efforts and interventions to address both IPV and STIs, to improve the overall health and well-being of women in India.

Prevalence and determinants of anaemia among women of reproductive age in Aspirational Districts of India: an analysis of NFHS 4 and NFHS 5 data

BACKGROUND

Over one-third of women worldwide suffer from anaemia. The prevalence of anaemia is particularly pronounced among women of reproductive age (WRA) in developing countries, such as India. No prior study has ever exclusively studied the prevalence of anaemia across the Aspirational Districts of India. Therefore, the purpose of this study was to examine the prevalence of anaemia across Aspirational Districts of India and to identify the determinants of anaemia among WRA in these districts.

METHODS

From the National Family Health Survey (NFHS)-4 (2015-16) and NFHS-5 (2019-21), data on 114,444 and 108,782 women aged 15-49 from Aspirational Districts were analyzed in our study, respectively. Bivariate statistics and multivariable binary logistic regression were used to identify the determinants of anaemia.

RESULTS

The national prevalence of anaemia among WRA has increased from 53% in NFHS-4 to 57% in NFHS-5 whereas anaemia among WRA in Aspirational Districts has increased from 58.7% in NFHS-4 to 61.1% in NFHS-5. Between 2015 and 2021, over 60% of Aspirational Districts experienced an increase in the prevalence of anaemia and one-fourth, specifically 29 out of 112, observed a rise by at least 10 percentage points (pp). Notably, there are significant variations in anaemia prevalence among districts, with Simdega and Udalgiri having the highest anaemia prevalence in NFHS-4 and NFHS-5 at 78.2% and 81.5%, respectively. During this period, Barpeta followed by Udalgiri of Assam have witnessed the maximum increase with 29.4% and 26.7% respectively. Moreover, pooled regression results show women with three to four children [AOR: 1.13, 95% CI: 1.08-1.17], women who breastfeed [AOR: 1.17, 95% CI: 1.13-1.20], Scheduled Tribe women [AOR: 1.39, 95% CI: 1.35-1.44], poorest women [AOR: 1.27, 95% CI: 1.22-1.33] and women those who consume fish occasionally [AOR: 1.14, 95% CI: 1.12-1.17] were more likely to be anaemic.

CONCLUSION

The significant increase in anaemia among WRA in Aspirational Districts of India is a matter of concern. Given the rise in anaemia among WRA, determinants-based and district-specific measures must be designed and implemented to reduce the prevalence of anaemia among Aspirational Districts of India.

Decomposing the rural-urban gap in hygienic material use during menstruation among adolescent women in India

The use of hygienic materials (sanitary napkins, locally prepared napkins, tampons, and menstrual cups) during menstruation among adolescent women in India has improved over the years, yet a significant rural-urban gap in the usage persists at the national level. This study investigates how this rural-urabn gap varies across different states and union territories (UTs) of India and uses Fairlie decomposition to quantify the contribution of various factors to this gap. The study uses data on 114,805 adolescent women (aged 15-19 years) from the fifith round of National Family Health Survey (2019-21). The utilization of hygienic materials during menstruation among adolescent women in rural India stood at 43%, whereas in urban areas, it was 68%, indicating a significant 25 percentage point (pp) difference between the two. The rural-urban gap in the hygienic material use varied significantly across Indian states and UTs. The gap exceeded 20 pp in Madhya Pradesh (36 pp), Odisha (26 pp), Jammu and Kashmir (25 pp), Assam (25 pp), Uttar Pradesh (23 pp), Jharkhand (22 pp), Chhattisgarh (21 pp), and Rajasthan (21 pp). In contrast, the gap in Tamil Nadu, Himachal Pradesh, and Telangana was less than 10 pp. The decomposition analysis of the rural-urban gap (25 pp) revealed that the variables included in the anlaysis explained about 70% of the gap. The difference in the household wealth between rural and urban areas contributed about 69% of the explained gap. Other significant contributors to the explained gap were 'transportation to health facility' (5.6%), 'mass-media exposure' (4.9%), and 'level of education (4.4%). The findings underscore the necessity for state-specific interventions aimed at vulnerable groups, particularly individuals from economically disadvantaged backgrounds, those with lower levels of education, and limited exposure to mass media, in order to reduce the existing rural-urban disparity in hygienic material use among adolescent women.

Assessing the link between hygienic material use during menstruation and self-reported reproductive tract infections among women in India: a propensity score matching approach

Background

Reproductive tract infections (RTIs) present a substantial health concern for women, especially in developing nations such as India, where inadequate access to proper sanitation and hygiene facilities frequently results in suboptimal menstrual health and hygiene (MHH), exacerbating the risk of RTIs. In this study, we analysed the self-reported prevalence of RTIs among young women in India and evaluated the impact of hygienic menstrual material usage on these RTIs.

Methods

The study used information on 27,983 women aged 15-24 years, from the National Family Health Survey (NFHS-5) (2019-21). The prevalence of RTIs was calculated for all the states and UTs of India, and propensity score matching (PSM) technique was used to evaluate the impact of hygienic material use on RTIs among women in India.

Results

Every four out of 100 women reported RTIs in India in 2019-21. Notably, RTI prevalence displayed substantial state-level disparities. West Bengal exhibited the highest RTI prevalence at 9.3%, followed by Meghalaya, Arunachal Pradesh, and Himachal Pradesh, all surpassing 6%. In contrast, the lowest RTI rates were recorded in Puducherry at 0.9%, succeeded by Andaman and Nicobar Islands, Odisha, and Jammu & Kashmir, all registering rates below 2%. The PSM analysis revealed that women who utilized hygienic materials during menstruation exhibited a reduced prevalence of RTIs (referred to as the "treated group" with an Average Treatment Effect on the Treated (ATT) of 0.0315) compared to those who did not utilize such materials (referred to as the "control group" with an ATT of 0.0416).

Conclusions

The study underscores the critical significance of using hygienic materials during menstruation as a preventive measure against RTIs among women in India. The findings suggest the need for targeted interventions focused at promoting hygienic menstrual materials to reduce the prevalence of RTIs among women in India.

Spatiotemporal variations and determinants of overweight/obesity among women of reproductive age in urban India during 2005-2021

BACKGROUND

India has witnessed rapid urbanization in recent decades, leading to a worrisome surge in non-communicable diseases, particularly overweight/obesity, which now present a critical public health concern. Therefore, this study seeks to examine spatiotemporal variations and determinants of overweight/obesity among women of reproductive age (WRA) in urban India and its states during 2005-2021.

METHODS

The study used 44,882, 171,443, and 135,272 WRA aged 15-49 from National Family Health Survey (NFHS)-3 (2005-06), NFHS-4 (2015-16), and NFHS-5 (2019-21), respectively. The outcome variable was overweight/obesity, defined as a Body Mass Index (BMI) of ≥ 25 kg/m2. Chi-squared test and multivariable logistic regression were used to identify the determinants of overweight/obesity.

RESULTS

Overweight/obesity prevalence among WRA in urban India has risen significantly, from 23% in 2005-06 to 33% in 2019-21. This increase is particularly pronounced among SC/ST women and women with lower educational levels. During the study period, overweight/obesity rates in different states exhibited varying increases, ranging from 3 percentage points (pp) in Rajasthan to 22 pp in Odisha. Certain southern (e.g., Tamil Nadu and Andhra Pradesh) and northeastern states saw a significant 15 pp or more increase. In contrast, several northern, central, and eastern states (e.g., Punjab, Haryana, Rajasthan, Madhya Pradesh, Chhattisgarh, Jharkhand, West Bengal) experienced relatively smaller increases ranging from 5 to 8 pp. As of 2019-21, two regions exhibited high prevalence rates of overweight/obesity, exceeding 35%: the southern region (Tamil Nadu, Andhra Pradesh, Kerala, and Karnataka) and the northern region (Punjab, Himachal Pradesh, Uttarakhand, and Haryana). In contrast, the Empowered Action Group states had relatively lower rates (25% or less) of overweight/obesity. Regression results showed that older women [AOR: 5.98, 95% CI: 5.71-6.27], those from the richest quintile [AOR: 4.23, 95% CI: 3.95-4.54], those living in south India [AOR: 1.77, 95% CI: 1.72-1.82], and those having diabetes [AOR: 1.92, 95% CI: 1.83-2.02] were more likely to be overweight/obese.

CONCLUSION

Considering the significant increase in overweight/obesity among urban WRA in India, along with substantial disparities across states and socioeconomic groups, it is imperative for the government to formulate state-specific strategies and policies based on determinants to effectively combat overweight/obesity.

Spatiotemporal change in socioeconomic inequality in hygienic menstrual product use among adolescent girls in India during 2015-2019

BACKGROUND

The use of hygienic products, such as sanitary napkins, tampons, and menstrual cups, to absorb menstrual blood is vital for the health and well-being of adolescent girls in India. However, the degree of inequity in the use of such products among this subpopulation remains inadequately explored. To fill this critical knowledge gap, this study aims to investigate the spatiotemporal dynamics of hygienic product use among adolescent girls in India from 2015 to 2020.

METHODS

In this cross-sectional study, we analyzed data from 117,749 to 114,839 adolescent girls aged 15-19, obtained from two consecutive rounds of the National Family Health Survey (NFHS) conducted in India during 2015-16 and 2019-21. Our approach involved utilizing Erreygers' Concentration Index (ECI) and Concentration Curve to quantitatively assess and visually represent socioeconomic inequality in hygienic product usage. Additionally, we investigated the spatiotemporal variation in this inequality over the study period and decomposed the ECI to identify the key contributing factors.

RESULTS

The findings reveal that hygienic product usage among adolescent girls in India has increased by 13 percentage points (PP), from 37% in 2015-16 to 50% in 2019-21. This increase is also visible across all household wealth quintiles. However, the bottom quintiles experienced a greater rise (+ 15 to 16 PP) than the top quintile (+ 8 PP). During the study period, the ECI reduced marginally, from 0.48 in 2015-16 to 0.43 in 2019-21. However, the extent of this reduction varied across different states. The greatest reduction in ECI was recorded in Punjab (-0.23 points), Telangana (-0.16 points), and West Bengal (-0.14 points). In contrast, there were a number of states with high socioeconomic inequality (ECI > 0.30) in 2015-16, where inequality reduction was minimal (< 0.05 points) over the study period. This included more developed states of Kerala, Karnataka, Maharashtra and Gujarat and relatively less developed states of Odisha, Jharkhand, Chhattisgarh, Uttar Pradesh, and Assam. Some states, such as Bihar and Madhya Pradesh, recorded an increase in socioeconomic inequality over the study period, with ECI rising to 0.31 and 0.46 (highest in the country) in 2019-21. The decomposition analysis revealed that the inequality in using hygienic products was primarily explained by place of residence, exposure to mass-media, education, and region of residence.

CONCLUSIONS

The findings suggest the need for targeted policies to reduce existing socioeconomic inequality in the usage of hygienic products among adolescent girls in India. Specifically, interventions should target regions with low use of hygienic products, economically disadvantaged groups, and poor and vulnerable populations. State-specific policies and programs are also necessary to address the disparities in socioeconomic inequality. Additionally, efforts to reduce inequality should address the underlying factors contributing to inequality.

Is the burden of anaemia among Indian adolescent women increasing? Evidence from Indian Demographic and Health Surveys (2015-21)

Anaemia is a significant public health issue, particularly affecting women in India. However, little is known about the burden of anaemia among adolescent women in India over time. This study aimed to analyse the change in the prevalence of anaemia among adolescent women in India from 2015 to 2021 and identify the factors associated with anaemia in this population. This study used information on 116,117 and 109,400 adolescent women (aged 15-19) from the fourth and fifth round of National Family Health Survey, respectively. Bivariate statistics and multivariable logistic regression were employed to identify the statistically significant predictors of anaemia. The prevalence of anaemia among adolescent women in India increased from 54.2% (99% CI: 53.6-54.8) to 58.9% (99% CI: 58.3-59.5) over the study period (2015-16 to 2019-21). Among the 28 Indian states, 21 reported an increase in the prevalence of anaemia. However, the levels of increase varied across the states. While Assam, Chhattisgarh, and Tripura showed a substantial rise of 15 percentage points, the states of Punjab, Karnataka, Telangana, Bihar, and Madhya Pradesh recorded a marginal increase of less than 5 percentage points. Notably, Uttarakhand and Kerala exhibited a decline in anaemia prevalence during the study period. Additionally, the number of states with anaemia prevalence exceeding 60%, doubled from 5 in 2015-16 to 11 in 2019-21. Several factors were found associated with anaemia, including having more than one child (AOR: 1.33, 99% CI: 1.16-1.51), having no education (AOR: 1.25, 99% CI: 1.16-1.34), belonging to Scheduled Tribes (AOR: 1.47, 99% CI: 1.40-1.53), being in the lowest wealth quintile (AOR: 1.17, 99% CI: 1.12-1.23), year of survey (AOR: 1.26, 99% CI: 1.23-1.29), and being underweight (AOR: 1.10, 99% CI: 1.07-1.12). In conclusion, the rise in anaemia prevalence among adolescent women in India suggests the need for targeted interventions to mitigate the burden of anaemia and enhance the overall health of this population.

Intra-urban differentials in the exclusive use of hygienic methods during menstruation among young women in India

Menstrual hygiene among women is a critical public health issue in urban India, but it remains understudied and under-researched. However, to our knowledge, no national level study in India has yet examined the differentials in the exclusive use of hygienic methods among young women (aged 15-24) in urban India. This study attempts to fill this gap by analysing biodemographic, socioeconomic, and geographic differentials in the exclusive use of hygienic methods among these women. We analysed data on 54561 urban women aged 15-24 from National Family Health Survey-5, 2019-21. We used binary logistic regression to examine differentials in the exclusive use of hygienic methods. To examine spatial variation, we mapped exclusive use of hygienic methods across Indian states and districts. The study found that two-thirds of young women in urban India reported exclusive use of hygienic methods. However, there was significant geographic heterogeneity observed at both state and district levels. In states such as Mizoram and Tamil Nadu, the use of hygienic methods was over 90%, while in Uttar Pradesh, Bihar, Chhattisgarh, and Manipur, it was less than 50%. The district-level variation in exclusive use of hygienic methods was even more striking. In many states, districts with extremely low exclusive use (less than 30%) were located in close proximity to districts with high exclusive use. Being poor, uneducated, Muslim, having no mass media exposure, living in the north and central regions, not having a mobile phone, getting married before 18, and having an early experience of menarche were associated with lower exclusive use of hygienic methods. In conclusion, substantial biodemographic, socioeconomic, and geographic differentials in the exclusive use of hygienic methods suggest the need for context-specific behavioural interventions. Mass media campaigns and targeted distribution of subsidized hygienic methods could help reduce the existing inequities in the exclusive use of hygienic methods.

Spatial heterogeneity in the exclusive use of hygienic materials during menstruation among women in urban India

Background

Menstrual hygiene is essential for women to live with dignity. However, a large proportion of Indian women still suffer from unhygienic menstrual practices leading to reproductive tract infections. To understand the socioeconomic and bio-demographic determinants of menstrual hygiene practices, various national or local level studies have been conducted in India and around the world, however, no previous study has tried to understand the spatial heterogeneity across Indian districts in the use of hygienic materials among young urban women.

Methods

This study used data from 54,561 urban women aged 15-24 from the National Family Health Survey-5. Global Moran's I was applied to assess the degree of spatial autocorrelation and cluster and outlier analyses to locate hot-spots and clod-spots in the exclusive use of hygienic materials across the districts. Ordinary least square, spatial lag, and error models were used to identify determinants of exclusive use of hygienic materials.

Results

Approximately 66.8% of urban women exclusively use of hygienic materials which varied across districts. Global Moran's I of 0.46 indicated positive spatial autocorrelation in the outcome. Cluster and outlier analysis revealed cold-spots in central Indian districts and hotspots in south Indian districts. Results of spatial error model identified women's years of schooling, marital status, social group, and household wealth were major determinants of the exclusive use of hygienic materials among urban women across Indian districts.

Conclusion

Substantial spatial heterogeneity in the outcome among urban women in India suggests the need to design targeted and context-specific behavioural interventions and programs for women in urban India.

Wealth-based inequality in the exclusive use of hygienic materials during menstruation among young women in urban India

BACKGROUND

The exclusive use of hygienic materials during menstruation (sanitary napkins, locally made napkins, tampons, and menstrual cups) among urban women in India has been increasing over time. However, little is known about the wealth-based disparity in the exclusive use of hygienic materials during menstruation among these women. This study, therefore, measures wealth-based inequality in the exclusive use of hygienic materials during menstruation among urban women in India. Furthermore, the measured inequality is decomposed to unravel its contributing factors.

DATA AND METHODS

Using data from the National Family Health Survey-5 (2019-21), we calculated the Erreygers normalized concentration index (CI) for India and each of its states to measure wealth-based inequality in the exclusive use of hygienic materials during menstruation among women in urban India. Further, we decomposed the Erreygers CI to estimate the relative contribution of covariates to wealth-based inequality in the exclusive use of hygienic materials during menstruation. The analysis included 54,561 urban women aged 15-24 from 28 states and eight union territories of India.

RESULTS

The Erreygers CI value of 0.302 indicated a pro-rich inequality in the exclusive use of hygienic materials among urban women in India. While all the states and UTs showed pro-rich inequality, the CI varied considerably across the country. Among the bigger states, the inequality was highest in Madhya Pradesh (CI: 0.45), Assam (CI: 0.44), Bihar (CI: 0.41), and West Bengal (CI: 0.37) and the lowest in the south Indian states of Tamil Nadu (CI: 0.10), Andhra Pradesh (CI: 0.15), Telangana (CI: 0.15), and Kerala (CI: 0.20). Erreygers decomposition revealed that wealth-based inequality in women's education and mass media exposure contributed almost 80% of the wealth-based inequality in the exclusive use of hygienic materials during menstruation among urban women in India.

CONCLUSION

Substantial pro-rich inequality in the exclusive use of hygienic materials suggests that the policies and program initiatives should prioritize reaching out to poor women to increase the overall rate of exclusive use of hygienic materials during menstruation in urban India.

Menstrual hygiene practices among adolescent women in rural India: a cross-sectional study

Background

Exclusive use of hygienic methods (sanitary napkins, locally prepared napkins, tampons, and menstrual cups) to prevent the visibility of bloodstains during menstruation is still considerably low among adolescent women in rural India. However, no prior research has explored the prevalence and determinants of exclusive hygienic methods among rural Indian adolescent women. To address this gap, this study examines the factors affecting adolescent women’s exclusive use of hygienic methods in rural India. Additionally, this study explores state- and district-level geographical disparities in the exclusive use of hygienic methods among adolescent women in rural India.

Methods

Information on 95,551 adolescent women from rural India from the latest round of National Family Health Survey (NFHS-5) was analyzed. Bivariate statistics and multilevel logistic regression analysis were used to assess the Individual- and community-level factors associated with exclusive use of hygienic methods among adolescent women in rural India. Choropleth maps were used to discern the geographical disparities in the exclusive use of hygienic methods.

Results

In rural India, only 42% of adolescent women exclusively used hygienic methods, with substantial geographic disparities at the state and district levels. At the state level, the exclusive use of hygienic methods varied from 23% in Uttar Pradesh to 85% in Tamil Nadu. Even greater variation was observed at the district level. There was a clear north-south divide in the exclusive use of hygienic methods among adolescent women in rural India. The results of multilevel logistic regression indicated a considerable amount of variation in the exclusive use of hygienic methods at community level which further reduced when controlled for individual and community-level factors. Rural Indian adolescent women with higher education (AOR:3.20, 95% CI: 2.81–3.64), from general category (AOR: 1.14, 95% CI: 1.07–1.21), with medium mass media exposure (AOR: 1.43, 95% CI: 1.35–1.51), and from richest wealth quintile (AOR: 3.98, 95% CI: 3.69–4.30) were more likely to use hygienic methods exclusively.

Conclusion

Wide differential across biodemographic and socioeconomic groups, and substantial geographic disparities at state- and district-level in the exclusive use of hygienic methods suggests a need to adopt context-specific interventions for adolescent women in rural India. Distribution of subsidized or free menstrual hygiene methods to disadvantaged adolescent women, and in the low-prevalence districts may increase the level of exclusive use of hygienic methods remarkably.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14622-7.

Decomposing the gap in intimate partner violence between Scheduled Caste and general category women in India: An analysis of NFHS-5 data

Scheduled Caste (SC) women, one of India's most oppressed and neglected population groups, are the most vulnerable to intimate partner violence (IPV). IPV, on the other hand, is less common among women in the General category. No study has been conducted to measure the gap in IPV between these two groups. This study is an attempt to fill this gap. This study aims to comprehensively explore the factors that underlie and explain the gap in IPV between SC and General women. Information on 10,168 ever-married SC and 9695 ever-married General women aged 15–49 from the fifth round of the National Family Health Survey was analyzed. The Fairlie decomposition (Blinder–Oaxaca decomposition modified for binary outcomes) was used in this study to explain the gap in ever experience of IPV prevalence between SC and General women. About 37.3% and 24.4% of ever-married SC and General women in India suffered either physical or mental or sexual violence from their husbands. The large part of the gap in IPV between SC and General women was due to differences in husbands' alcohol consumption (26.33% gap), wealth index (24.48% gap), controlling behavior by husband (24%) and parental IPV (15.87% gap). With the introduction of appropriate interventions and programs, these gaps can be reduced. Interventions aimed at reducing alcoholism should be emphasized.

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Intimate Partner Violence (IPV) was more prevalent in Scheduled Caste (SC) women than in General category women.

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Wealth, parental IPV, husband’s alcohol consumption and controlling behavior explained 90% of the SC-General gap in IPV.

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Group differences in husband’s alcohol consumption explained about one-fourth of the SC-General gap in IPV.

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Wealth index and husband’s controlling behavior explained about 24.5% and 24.0% of the gap in IPV, respectively.

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In short run, interventions aimed at reducing alcoholism should be emphasized.

Surgical resection of primary tumour improves aerobic performance in colorectal cancer

BACKGROUND

Colorectal cancer is the third most common cancer in the UK, with patients suffering declines in muscle mass and aerobic function. We hypothesised that tumour removal in non-metastatic colorectal cancer would lead to a restoration of lean muscle mass and increases in objective and subjective measures of aerobic performance.

METHODS

We recruited two groups: patients with colorectal cancer (n = 30, 65.3 (51-77) y, body mass index 27.67 (4.83) kg m(-2)) and matched controls (n = 30, 64.6 (42-77) y, BMI 27.14 (3.51) kg m(-2)). Controls underwent a single study while colorectal cancer patients were studied before and 10 months after tumour resection. Aerobic performance was assessed via cardiopulmonary exercise testing and activity questionnaires. Lean muscle mass was measured via dual-energy X-ray absorptiometry.

RESULTS

Lean muscle mass was not different between groups (control: 47.82 (8.23); pre-resection: 52.41 (10.59); post-resection: 52.38 (10.52), kg). Anaerobic threshold was lower in pre-operative patients compared to controls (14.40 (3.23) vs. 19.67 (5.81) ml kg(-1) min(-1), p < 0.0001), increasing significantly post-resection (17.00 (3.56) ml kg(-1) min(-1)p < 0.0001). Self reported maximal physical activity was lower after resection compared to preoperatively (pre-resection 6.0 (6.5-5 IQR), post-resection 3.75 (4-3 IQR), p < 0.0001).

CONCLUSION

In colorectal cancer, anaerobic threshold is reached more rapidly than in matched controls, returning toward normal with tumour resection. Self-reported measures of activity do not mirror this objective change, cardiopulmonary exercise testing may therefore allow for a more accurate evaluation of pre and postoperative performance capability. The variance between objective and subjective measures of exercise capacity may be important in determining return to normal activities.

Induction of antioxidative enzyme by the ayurvedic herb Desmotrichum fimbriatum Bl. in mice

The herb Desmotrichum fimbriatum Bl. (family: Orchidaceae), sold as Jibanti in West Bengal, is used in 'Rasayana therapy' in Ayurveda. Its effect on the modulation of the two antioxidant enzymes peroxidase and catalase has been studied in mice liver during 'cold water swim' (CWS) stress using appropriate controls. The drug, i.e. the aqueous ethanolic extract of the herb (whole plant) was found to increase peroxidase titre in the hepatic cells of normal mice. But in the stressed group, the drug displayed no effect on the peroxidase content, while it elicited an elevation of the catalase content. infinity-Tocoferol was used as the standard drug. These data suggested that the drug can ameliorate the peroxidative damage caused in mice by CWS stress.

Gender difference in health status and health care facilities in some social groups and subgroups of southern West Bengal, India

In recent years, social scientists are concerned with individual well-being and also in identifying the high-risk groups. In South Asia, gender is an important determinant of variation in resource allocation. Three contrasting social groups of southern West Bengal, India have been studied to find out whether there is any gender discrimination in allocation of health facilities and also to assess the health status of these groups. In general, a tendency towards favouring the males appears to exist in respect of allocation of health facilities. Also, females are more affected with the ailments associated with hard work.

Carbazole alkaloids from Murraya koenigii

Two new alkaloids, 9-carbethoxy-3-methylcarbazole and 9-formyl-3-methylcarbazole, and a known metabolite, 3-methyl-carbazole were isolated from the roots of Murraya koenigii. All three compounds were identified by detailed spectral analyses including 2D NMR studies and their structures confirmed by synthesis. Of the two new metabolites, the 9-formyl compound displayed weak cytotoxicity against both mouse melanoma B16 and adriamycin-resistant P388 mouse leukemia cell lines.

Gender difference in cereal intake: possible impacts of social group affiliation and season

Food may not be equitably distributed within the household. The distribution depends on some factors, one of which is availability of food. The generalised proposition of gender bias against women in the distribution of food in South Asia has been examined here in three culturally contrasting population groups in two seasons, viz. lean and peak. The result shows that in all the three groups, in all household membership categories, the intake of cereal is higher than the recommended intake, but the male-female differences in net intakes are higher in peak season than in lean season.

Alpha-fetoprotein: a sensitive avidine-biotin assay

A conventional enzyme-linked immunosorbent assay (ELISA) for alpha-fetoprotein was modified to incorporate the avidine-biotin complex, in order to enhance sensitivity. Five modifications of this assay were compared, of which the 2-step noncompetitive avidine-biotin assay (NABA) was found to be the most rapid and sensitive (detection limit 0.05 ng/ml). Levels of AFP in human cord serum measured by the 2-step NABA method showed good correlation (r = 0.965) with measurements by radio-immuno assay, and the assay can be performed within one hour. The simplicity and sensitivity of this assay should make it a reliable method of choice for determination of alpha-fetoprotein.

Determination of circulating DNA levels in patients with benign or malignant gastrointestinal disease

Previous studies showed that patients with neoplasms of various types and origins have abnormally high concentration of DNA in their serum. The current work compares circulating DNA levels in patients with benign or malignant disease of the gastrointestinal tract and determines the diagnostic value of such measurements. DNA was quantitated by radioimmunoassay capable of detecting 25 ng/ml, and as a simple and noninvasive test, it could be a useful addition to other diagnostic procedures. The GI tract was chosen because it affords a comparison of benign, precancerous, and malignant lesions of the same organ. Of the 386 patients studied prospectively, 48% had benign disease and mean DNA levels (+/- SE) of 118 +/- 14 ng/ml, whereas 52% had malignant disease and 412 +/- 63 ng DNA/ml. The difference was statistically significant (P less than 0.001). The DNA assay showed the highest sensitivity for pancreas carcinoma: 90% of the patients had DNA levels above 100 ng/ml, chosen as the upper normal limit. Simultaneous measurements of both DNA and carcinoembryonic antigen (CEA) resulted in increased sensitivity and specificity, even when either marker alone had low sensitivity (gastric carcinoma). The results indicate that serum DNA concentration is markedly elevated in malignancy, and moderately elevated in benign disease, as compared with normal controls. These findings may have diagnostic and prognostic value.

Determination of circulating DNA levels in patients with benign or malignant gastrointestinal disease

Previous studies showed that patients with neoplasms of various types and origins have abnormally high concentration of DNA in their serum. The current work compares circulating DNA levels in patients with benign or malignant disease of the gastrointestinal tract and determines the diagnostic value of such measurements. DNA was quantitated by radioimmunoassay capable of detecting 25 ng/ml, and as a simple and noninvasive test, it could be a useful addition to other diagnostic procedures. The GI tract was chosen because it affords a comparison of benign, precancerous, and malignant lesions of the same organ. Of the 386 patients studied prospectively, 48% had benign disease and mean DNA levels (+/- SE) of 118 +/- 14 ng/ml, whereas 52% had malignant disease and 412 +/- 63 ng DNA/ml. The difference was statistically significant (P less than 0.001). The DNA assay showed the highest sensitivity for pancreas carcinoma: 90% of the patients had DNA levels above 100 ng/ml, chosen as the upper normal limit. Simultaneous measurements of both DNA and carcinoembryonic antigen (CEA) resulted in increased sensitivity and specificity, even when either marker alone had low sensitivity (gastric carcinoma). The results indicate that serum DNA concentration is markedly elevated in malignancy, and moderately elevated in benign disease, as compared with normal controls. These findings may have diagnostic and prognostic value.

Determination of circulating DNA levels in patients with benign or malignant gastrointestinal disease

Previous studies showed that patients with neoplasms of various types and origins have abnormally high concentration of DNA in their serum. The current work compares circulating DNA levels in patients with benign or malignant disease of the gastrointestinal tract and determines the diagnostic value of such measurements. DNA was quantitated by radioimmunoassay capable of detecting 25 ng/ml, and as a simple and noninvasive test, it could be a useful addition to other diagnostic procedures. The GI tract was chosen because it affords a comparison of benign, precancerous, and malignant lesions of the same organ. Of the 386 patients studied prospectively, 48% had benign disease and mean DNA levels (+/- SE) of 118 +/- 14 ng/ml, whereas 52% had malignant disease and 412 +/- 63 ng DNA/ml. The difference was statistically significant (P less than 0.001). The DNA assay showed the highest sensitivity for pancreas carcinoma: 90% of the patients had DNA levels above 100 ng/ml, chosen as the upper normal limit. Simultaneous measurements of both DNA and carcinoembryonic antigen (CEA) resulted in increased sensitivity and specificity, even when either marker alone had low sensitivity (gastric carcinoma). The results indicate that serum DNA concentration is markedly elevated in malignancy, and moderately elevated in benign disease, as compared with normal controls. These findings may have diagnostic and prognostic value.

Activation of an endogenous mouse type C virus by ultraviolet-irradiated herpes simplex virus types 1 and 2

Infection of BALB/c mouse cells with UV-irradiated herpes simplex virus (HSV) types 1 and 2 resulted in activation of a xenotropic type C virus detected by infectious center formation in permissive rat cells. The levels of type C virus activated by HSV were related to the UV dose and the multiplicity of infection used. The ability of HSV to activate type C virus was eliminated by heat-inactivation and by neutralization with specific antiserum against HSV, but was not affected by purification or treatment with DNase and RNase. Maximum levels of type C virus in the cells and medium were observed within 1 day after HSV infection, and the levels returned to control cell values within 3-4 days. The possible significance of these findings with respect to the putative oncogenic potential of HSV is discussed.

Constituents of Pleiospermium alatum: Alatamide and N-benzoyltyramine methyl ether

Two alkamides have been isolated from the leaves of Pleiospermium alatum (Rutaceae). On the basis of spectral and chemical evidence the new alkamide, designated alatamide, has been identified as N-(E)-(p- methoxystyryl)benzamide (1). The second compound has been characterized as N-benzoyltyramine methyl ether (2) by hydrolysis experiments and synthesis.