Traditional agroforestry for food security and agrobiodiversity- The Angami Naga nhalie-teizie binary system in Nagaland state of India

Traditional agroforestry practice of Angami Nagas is the integrated system of cultivating multipurpose local tree species with traditional crops varieties. Nhalie (slash and burn) and teizie (home garden) are the two major forms of traditional agroforestry which are the primary sources of food, medicine, firewood, fodder, cultural needs, livelihoods and other utilities of equal importance. The present study, which was conducted from, March 2016 to November 2019, aims to investigate the contribution of traditional agroforestry to food security among the Angami Nagas of Kohima district, Nagaland. Data collection methods included group discussion, semi-structured interview and field observations. Angami agroforestry is the main repository of agrobiodiversity. Agrobiodiversity plays important role in food security of the Angami Nagas. Agrobiodiversity avails of continuous accessibility of diverse foods all the year round. This study documented 32 species under 8 types of crops cultivated in nhalie and 71 species of food plants from teizie (homegarden). Nhalie has the potential to augment coproduction of foods and firewood to meet the increasing needs of food and energy security without negative consequences on environment. Pretty good number of wild edibles and conventional crops growing in home gardens contributes towards supplementing food during off season. Well-designed Angami granary and traditional techniques of preservation help to ensure food security by reducing unwanted post-harvest damages. Angami agroforestry not only enhances food and energy security but also infers as a tool for conservation of agrobiodiversity and sustainable development

Effectiveness of mirror therapy through functional activities and motor standards in the motor recovery in post stroke hemiplegic patients: a prospective randomized controlled trial in a tertiary care hospital in Northeast India

Background: Upper limbs are very important to motor functionality. However, in majority of stroke patients, arm functions are impaired resulting in disabilities and restrictions to function. Therefore, the objective of this study was to assess the effectiveness of mirror therapy in the motor recovery of upper extremity in the post stroke hemiplegic patient.Methods: A prospective randomized controlled trial was conducted among 72 post stroke patients aged 35-65 years having hemipa­resis attending the PMR OPD in RIMS, Manipur from 2013 to 2016. Assessment was done for FIM self care and Brunnstrom stages of motor recovery at baseline and 1 month and 6 month of post treatment. Both the study and control group participated in a stroke rehabilitation programme and study group was given mirror therapy in addition. Descriptive statistics such as mean, standard deviation and inferential statistics like Chi-square test, Student’s t test, and ANOVA were used. A p-value <0.05 was taken as statistically significant.Results: Mean age were 54.56±7.61 years (study) and 55.11±7.99 years (control). Majority of them were males (61.1%). Significant improvement was noted in the study group from baseline to 1 month and 6 months follow up. Mean score comparison of FIM self care between study and control group from baseline to 1 month was (28.28±3.11 to 34.11±2.59 vs 28.00±4.30 to 29.50±4.58) and from 1 to 6 months follow up was (34.11±2.59 to 37.83±2.04 vs 29.50±4.58 to 32.44±4.82) respectively.Conclusions: There was a significant improvement in hand function regarding both motor recovery and daily self care activities in the study group

Knowledge on Cervical Cancer and Human Papilloma Virus (HPV) Infection and Attitude towards HPV Vaccination among College Students

Background: Human papillomavirus (HPV)-associated cervical cancer is the second-most common cancer in women worldwide, and India accounts for one third of global cervical cancer deaths. (However, reduction of mortality/morbidity is due to cervical cancer’s early detection and treatment of cervical precancerous lesions.) Though youth are the prime candidates for prophylactic HPV vaccination, several studies have shown that they had very little knowledge about HPV vaccination. We could not find any documented study in Manipur regarding knowledge on cervical cancer and HPV infection. Hence this study was undertaken to determine the knowledge on cervical cancer, HPV infections, HPV vaccine among the college students and to assess their attitude towards vaccination and to determine the association between knowledge on cervical cancer and HPV infection with selected socio-demographic variables such as age, sex, etc. Methods: Cross-sectional study. Setting: colleges providing graduates between 12th Jan16th Feb 2015. Sixteen colleges were selected using convenience sampling from three districts of Manipur. A self-administered questionnaire was used for data collection among 1059 college students. Health talks were given after collecting baseline data. Data were analyzed using descriptive statistics such as mean (SD) and percentages. Chi square test and t-test were used for analysis. P-value of <0.05 was considered as statistically significant. Results: Mean age of the respondent was 20.21 ± 1.71. Only 41, 15 and 12% of the respondents have heard of cancer cervix, HPV infection and HPV vaccine respectively. One-third of the respondents have no knowledge about risk factors and preventive measures against cancer cervix. Majority of the respondents (96.7%) wanted to have HPV vaccination. However, one-fourth of them still have the opinion that it is safe to have multiple sexual partners after vaccination (P-value <0.03). Female had higher mean knowledge score of cancer cervix as compared to male (P value <0.04). Conclusions: Cervical cancer and HPV awareness among college students was found inadequate. Health education will be needed to maximize awareness among students for cervical cancer prevention

Traditional agroforestry of Angami Nagas of Nagaland state, India- a quantitative assessment of socio-cultural values and agrobiodiversity

Nhalie (shifting cultivation) and teizie (home garden) are the major forms of traditional agroforestry practices of Angami Nagas in Kohima district of Nagaland. They are characterized by high socio-cultural significance and prevalence of high degree of agrobiodiversity. The present study aims to assess agrobiodiversity and socio-cultural values of nhalie agroforestry of Angami Nagas in Kohima district of Nagaland, India. This study collected primary data from 60 households across five Angami villages by using methods of group discussion and participatory interview. Teizie and nhalie had higher average cultural ecosystem service values of 7.5 and 7.1, respectively. In term of economic ecosystem services, nhalie cultivation was perceived to be an important agroforestry practice with social use value (SUV) of 52.21. A total of 136 landraces of traditional crops belonging to 36 species were recorded. Two scented rice landraces (kethselha and rüluoo) and one sticky landrace (nhalenya) were reported. High overall Simpson’s Diversity Index value of 0.72 revealed high level of crop species diversity in nhalie agroforestry of Angami Nagas. Rice was the most common crop with the highest genetic diversity (22 landraces) followed by pumpkin, squash, taro, cucumber and maize. Nhalie agroforestry could serve as the major reservoir of traditional crop species and contribute to the conservation of these valuable traditional crop species on-farm. Further, the existing agrobiodiversity managed with the traditional wisdom of Angami Nagas in nhalie agroforestry systems is required to be preserved and disseminated for sustainable use of bioresources

Study of maternal serum lipid profile and apolipoprotein a levels and its correlation with fetal growth restriction

Background: This study was aimed to estimate maternal serum lipid profile and apolipoprotein A levels in pregnancies complicated with FGR and to compare the levels with the levels in normal pregnancies.Methods: A prospective observational study was conducted in Lady Hardinge Medical College, New Delhi, in a study group consisting of 30 pregnant women at gestation 32-34 weeks with ultrasound diagnosed FGR and control group consisting of 30 age and gestation matched uncomplicated pregnant women. Maternal serum lipid profile and apolipoprotein A levels were measured and compared between the two groups.Results: Total serum cholesterol, triglyceride, LDL-cholesterol, VLDL-cholesterol and Apolipoprotein A were significantly lower in FGR group compared to normal controls. Mean±SD of total cholesterol was found to be 199.17±49.06 mg/dl in cases and 244.10±53.17 mg/dl in controls. Mean±SD of triglyceride was 200.53±60.25 mg/dl in cases compared to 304.13±69.12 mg/dl in controls. Mean±SD of LDL-Cholesterol was 98.19±37.91 mg/dl in cases and 127.07±47.84 mg/dl in controls. Mean±SD of VLDL-cholesterol was 40.11±12.05 mg/dl in cases and 60.83±13.82 mg/dl in controls. Mean±SD of Apolipoprotein A was 147.71±16.40 mg/dl in cases compared to 163.30±16.07 mg/dl in controls. HDL-cholesterol did not change significantly as its mean±SD was 60.87±15.18 mg/dl in FGR group and 56.20±16.07 mg/dl in control group.Conclusions: The decreased levels of total cholesterol, triglyceride, LDL-cholesterol, VLDL-cholesterol and apolipoprotein A levels may be used as biochemical marker for detection of FGR

Congenital anomalies in a tertiary care hospital in North East region, India

Background: Congenital anomalies are important cause of morbidity and mortality in newborns and are defined as structural and functional abnormalities including metabolic disorders present at birth. These defects are of prenatal origin resulting from defective embryogenesis or intrinsic abnormalities in the process of development and are associated with various risk factors.Methods: Our study is a cross sectional study done at Regional Institute of Medical Sciences, Imphal over period of 3 years from January 2015 to December 2017. Aim of study was to find out incidence of congenital anomalies and proportions of different types of congenital anomalies. Outcome was studied in relation to maternal age, religion, parity, and gestational age, sex of the baby, outcome and sex of the baby.Results: Total numbers of congenital anomalies were 257 babies out of 29879 births giving the incidence of 0.86%. Most common congenital anomalies in this study are musculoskeletal followed by craniospinal, genitourinary, cardiovascular and gastrointestinal. It was more common in preterm babies and parity 1-3, more common in 21-30 years of maternal age. Consanguinity was seen in 7 out of 257 patients.Conclusions: Congenital malformations are a major cause of still births and infant mortality. Targeted scan should be done at 18-20 week to find out anomalies and reduce the prevalence. There should be widespread education in the community regarding the common congenital malformations, their outcomes and possible available mode of treatmen

Body composition and prevalence of overweight and obesity and its determinants among adolescents in Manipur, North-Eastern India: a cross-sectional study

Background: Childhood obesity is emerging as one of the serious public health problems. It has become one of the significant risk factors associated with a cluster of non-communicable diseases which causes an enormous socioeconomic and public health burden. Therefore, the objective of this study was to assess the body fat % and prevalence of overweight and obesity among adolescent in Manipur and to identify factors which may contribute to overweight.Methods: A cross-sectional study was conducted among 12,410 students studying in class VIII-XII in four districts of Manipur from 2007-2009.  A self-administered questionnaire method was used. BMI and Body composition were determined using the TANITA Body Composition Analyzer. Overweight/ obesity were classified by using WHO classification. Analysis done using SPSSv20 and mean (SD), percentages and Chi-square test were used. A p-value <0.05 was considered as statistically significant.Results: The overall mean fat % was 19.4±6.1 and girls have higher fat% than boys. Overall prevalence of overweight and obesity were 6.4% and 1.2% respectively. Obesity prevalence was more among girls than boys (1.6% vs 1.0%). Statistically significant association was found between obesity with family history of overweight, private schooling, playing games, mode of transport to school, sleeping hours, being vegetarian and watching television.Conclusions: Though the prevalence of overweight and obesity as compared to other parts of India is low, the increasing trend is a definite cause of concern. Therefore, there is a need for primary prevention targeted among children and adolescents regarding adoption of healthy life styles

Comparison between prolotherapy using 25% dextrose versus extracorporeal shock wave therapy in the management of pain and improvement of functional outcome in patients suffering from chronic lateral epicondylitis: a randomized controlled trial

Background: Lateral epicondylitis is a tendinopathy characterized by pain around the lateral aspect of the elbow occuring more frequently in nonathletes than athletes significantly affecting the patient’s life in terms of the quantity and quality of work done. In resistant cases of tennis elbow, a number of treatment options have been tried including extracorporeal shockwave therapy, autologous blood injections and surgery as last resort but none of them has proved to be superior over another. Recent studies show that 25% dextrose prolotherapy which induces an inflammatory reaction at site of administration would be a better treatment option in resistant cases.Methods: A prospective randomized controlled trial was done in Department of Physical Medicine & Rehabilitation, Regional Institute of Medical Sciences, Imphal to compare the effectiveness of 25% dextrose prolotherapy injection and extracorporeal shockwave therapy in management of pain and improvement of functional outcome in patients suffering from chronic lateral epicondylitis.Results: The outcome variables VAS for pain and Grip strength for function were measured at baseline, 1 month, 3 months and 6months. Data collected were analysed using SPSS version 21. For analytical purpose, description statistics like mean and standard deviation were used. Statistical tests like t-test, Chi square test, Fisher’s exact test were used for intra group and inter group analysis. P-value <0.05 was taken as significant. In study group 2ml of 25% dextrose mixed with 2% lignocaine (0.5ml) was given to the affected lateral epicondyle. In control group, weekly sessions of single sitting ESWT was given to the lateral epicondyle for 3 consecutive weeks. In the follow up assessment at 1 month, 3 months and 6 months, there was significant improvement in mean score of VAS and Grip Strength scores in both the groups (p<0.05). When both the groups were compared with each other, study group showed a better improvement and was found to be significantly more effective than shockwave therapy group in reducing pain and improvement of functional outcome in chronic lateral epicondylitis (p = 0.001).Conclusions: Prolotherapy may be considered as a novel alternative conservative management before opting for surgery in resistant cases of lateral epicondylitis

Knowledge and Perception of Sexual Behaviors and Sexuality Education among Adolescents in Imphal City, Manipur- A Cross-Sectional Study

Background: The World Health Organization defines adolescents as those belonging to the age group of 10-19 years old. Nevertheless, adolescence should be considered a phase rather than a fixed age group, with physical, social, psychological and cultural dimensions. This is indeed a transition period between childhood and adulthood where special attention is required. Due to unawareness, peer pressure and misinformation they become confuse and indulge in high risk behaviors. The objective of this study is to determine the knowledge and perception of sexual behavior and sexuality education among adolescents and also to determine the association between knowledge regarding HIV/ AIDS and selected variables.Methods: A cross sectional study was conducted among 420 students of class X-XII from four schools of Imphal and undergraduate 1st year MBBS, BDS and Nursing students of RIMS, Imphal, Manipur during 3rd- 24th April 2014. Data was collected through self administered questionnaire and analyzed by SPSS version-16. Descriptive statistics like mean, percentages were used. Chi-square test was used for analysis where P-value of <0.05 was taken as significant.Results: Out of 420 undergraduate MBBS, BDS, Nursing and Class X-XII school students, 221 (52.6%) were males and mean age was 16±1.6 years. Only 23.8% of the respondents had adequate knowledge about HIV/ AIDS. There was significant increase in the knowledge with increase in age (P=0.00). Significant increase in knowledge was found among the undergraduate MBBS, BDS, Nursing students as compared to school students (P=0.00). 18 (4.3%) respondents had experienced sexual intercourse.Conclusion: More than 2/3rd of the students had inadequate knowledge about HIV/ AIDS. Higher age and education of the students were significantly associated with knowledge about HIV/ AIDS

Thyroid dysfunction in preeclampsia and related fetomaternal outcomes

Background: Changes in thyroid function in normal pregnancy are well-documented but in complicated pregnancy like preeclampsia, very little is known. Studies have shown evidences of hypothyroidism in preeclampsia necessitating thyroid function tests to be done in preeclampsia. The study was done to analyze the fetomaternal outcome of preeclampsia with coexisting thyroid dysfunction.Methods: A cross-sectional analytical study was done over 18 months on 95 preeclamptic patients admitted at the antenatal ward and fetomaternal outcomes were analyzed according to thyroid status.Results: Out of 95 patients with preeclampsia, 42 (44.2%) had thyroid dysfunction. Among these 42 patients, 37 (38.9%) patients had subclinical hypothyroidism, 4 (4.2%) had overt hypothyroidism and 1 (1%) had hyperthyroidism. Severe preeclampsia was seen in 64.3% of the patients with thyroid dysfunction compared with 39.6% in euthyroid patients. The mean thyroid stimulating hormone (TSH) level was significantly higher and means free thyroxine (fT4) level was significantly lower in severe preeclampsia compared with non-severe preeclampsia. Complications like abruption, intrauterine fetal death (IUD), intrauterine growth restriction (IUGR), oligohydramnios, preterm deliveries, postpartum hemorrhage (PPH), low birth weight babies, birth asphyxia in babies and subsequent neonatal intensive care unit (NICU) admissions were significantly higher (p <0.05) in the preeclampsia patients with thyroid dysfunction in comparison with euthyroid ones.Conclusions: Hypothyroidism may be a modifiable risk factor for preeclampsia. Thyroid screening early in pregnancy may be helpful in predicting the occurrence of preeclampsia and timely thyroid hormone administration can reduce the maternal and perinatal morbidity and mortality associated with preeclampsia