Prevalence and demographic profile of patients with adult congenital cardiac disease in the state of Uttrakhand – A recently created North Indian state

Background: The current burden of adult congenital cardiac disease is on the rise. Although there have been advances in their management and patient care, there is still dearth of establishing clinical preventive strategies and risk stratification in these patients. Aims and Objectives: The primary objective was to study the prevalence and pattern of adult congenital cardiac disease presenting to a tertiary care center in the state of Uttarakhand, a predominantly hilly state with sparse health-care facilities. The secondary objective was to assess the demographic, metabolic parameters and risk factors of patients with adult congenital cardiac disease. Materials and Methods: All adult patients of >16 years of age presenting at outpatient and inpatient department of internal medicine over a period of 5 years from July 2008 to June 2013 were thoroughly examined. The suspected patients of congenital cardiac disease were screened using electrocardiogram (ECG), echocardiography, and chest X-ray. Detailed demographic and metabolic parameters were compiled of each patient suffering from adult congenital cardiac disease. Psychiatric assessment of each patient was done to rule out generalized anxiety disorders. Results: A total of 2,194,000 participants attended Medicine Department over a period of 5 years from July 2008 to June 2013. Two hundred and forty patients were diagnosed to have of adult congenital cardiac disease, of these 98 (40.8%) were males and 142 (59.1%) were females. The most common defect was atrial septal defect seen in 97 (40.4%) patients of adult congenital cardiac disease. Metabolic syndrome was more common in patients with complex adult congenital cardiac disease. Generalized anxiety disorders were found to be significantly associated with these patients. Conclusions: There are sparse data available on the prevalence of adult congenital cardiac disease, especially from the state of Uttarakhand. Such a study would be useful in formulating clinical services for early diagnosis as well as in assessing risk factors for the prevention for morbidity and mortality in these patients. This study reiterates the fact that early screening and detection of congenital cardiac disease in these patients can help in planning early medical and surgical correction of the disease

Quality of life in elderly cancer patients: A hospital based study

Background - There are over 200 different known cancers that afflict humans. Increasing age is a major risk factor for developing cancer. India is witnessing a demographic transformation from a younger society to a mature one. There has been a growing call to understand the medical and psychological challenges that elderly patients confront. Moreover when these elderly people, already an under privileged class, suffer from a devastating illness like cancer, puts a lot of psychological and financial stress on the patient and the caregiver, thus affecting their quality of life.Aims – The present study was undertaken to assess the quality of life in this socially and economically under privileged class of population suffering from malignancies. The study also aimed at finding the pattern of malignancies in this group of population and factors affecting the Quality of Life (QoL) in them.Methods - Subjects were recruited from patients above 60 years of age presenting in medicine or oncology OPD and / or IPD, of Himalayan Institute of Medical Sciences, Doiwala, Dehradun with a primary diagnosis of cancer. SF -36 questionnaire was used to generate data.Statistical analysis - Data was analyzed by descriptive statistics.Results–Gastrointestinal malignancies were the most common malignancies in the elderly population, to be followed by lung and head and neck malignancies. Most of them present in advanced stages of disease. The Quality of Life (QoL) of these patients was negatively affected by the type of malignancy and its staging. Socio-demographic patterns like age, sex, education, financial status and life style also play a key role in QoL.Conclusion- The incidence of cancer is increasing in elderly and it has a negative impact on the QoL in this under privileged class of population. Therefore, it is important to identify the various malignancies at an early stage and other factors predicting quality of life in this age group so as to build up a comprehensive and multidimensional approach in their treatment

Ecological risk assessment of metals in roadside agricultural soils: A modified approach

<p>The threat of metal contamination of roadside agricultural soils poses severe ecological risks throughout the globe due to dual contamination by intensive agriculture and traffic-related activities. Therefore, the present study was conducted to assess ecological risks posed by metals (Cd, Co, Cr, Cu, Fe, Mn, Pb, and Zn) in intensively cultivated roadside agricultural soils of Punjab, India. The results of the contamination assessment factors <i>i.e.</i> Contamination Factor (CF) and Enrichment Factor (EF) indicated that the studied soils were moderately to highly contaminated with metals. It was observed that the Modified Risk Index (MRI), which is based upon EF, indicated the ecological risks of metals more efficiently than the traditional Ecological Risk Index (RI), which is based upon CF in the present study. The MRI values indicated that the metals posed considerable to high risk in 67.86% samples as compared to only 7.14% samples based upon RI values. Thus, MRI can be considered as a more efficient risk indicator in comparison to RI. Spatial distribution maps of MRI indicated to higher metal contamination in inner urban parts of study area due to higher traffic and industrial activities.</p