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Biomedical subjects

C S Pandav

Publications and source records attributed to C S Pandav.

At least 19 recordsLinked to original sources
PubMed1995

A role for nongovernmental organizations in monitoring the iodine content of salt in northern India.

The feasibility of using nongovernmental organizations (NGOs) to monitor the iodine content of salt was studied in Uttar Pradesh, northern India, where iodine-deficiency disorders (IDDs) are endemic. Three NGOs already involved in health and development activities in the Gorakhpur, Varanasi, and Dehradun regions collected salt samples monthly from households and shops in selected villages over a 6-month period. A total of 4001 samples were analysed at regional laboratories by trained personnel using a standard protocol; 10% of the samples were sent to a central laboratory for external quality control. The iodine content lay in the range 0-95 mg/kg of salt; it was particularly low in the Gorakhpur and Varanasi regions, where over 80% of samples contained less than the minimum recommended level of 15 mg/kg; 37% of samples were in this category in the Dehradun region. Regular monitoring of the iodine content of salt at the consumer level is essential for the elimination of IDDs, and there is a need to improve awareness of this at all levels. NGOs can play a valuable role in both of these respects.

Humans↗
PubMed1995

Thyroid function in a goitre endemia.

A study was conducted to determine the thyroid function in a goitre endemia. Sadam is small village in the south district of Sikkim. Severe iodine deficiency exist in this village (prevalence of goitre 73.5%, cretinism prevalence 4%; mean urinary iodine exeretion 4.13 ng/dl - SD 3.1). Total of 72 out pf 142 households were randomly selected. All the inmates of the households above 14 years of age were examined for goitre and blood samples were collected from them for estimation of concentration of thyroid stimulating hormones (triiodothyroine T-3, thyroixe T-4) and thyroid stimulating hormone (TSH). Total of 244 subjects were examined, (137 males and 107 females). Goitre was detected in 149 (61.1%) individuals. The mean T-3, T-4 and TSH concentrations in the non-goitrous groups were (SD in parenthesis) 110.13 ng/dl (26.19), 10.12 ug/dl (2.38) and 1.01 uu/ml (0.52). The corresponding values for the goitrous group were, 132.22 ng/dl (46.25), 9.06 ug/dl (2.04) and 1.33 uu/ml (1.19). The differences in the mean concentrations between the goitrous and non-goitrous groups were statistically significant. An inverse correlation between the goitre size and T-4 on the one hand, and TSH and T-4 on the other hand was noticed. The result of the study show that functional decompensation of the thyroid occur in the majority of goitrous subjects.

Adolescent↗
PubMed1994

Toxoplasma gondii infection & its association with iodine deficiency in a residential school in a tribal area of Maharashtra.

To determine the seroprevalence and incidence of toxoplasmosis, 194 random serum samples of school students aged 10 to 18 yr (n = 178), their teachers (n = 10) and food handlers (n = 6) from a residential tribal school situated in district Dhule, Maharashtra state of western India, were tested. The samples were tested for anti-toxoplasma IgG and IgM antibodies using enzyme linked immuno sorbent assay (ELISA). Active infection was confirmed by a stage-specific direct agglutination test (DAT) using acetone fixed tachyzoites of T. gondii. A serosurveillance for rubella immunity was also simultaneously carried out. The results showed that at the age of 10 yr, all the children were immune to rubella infection and toxoplasma seroprevalence was detected in 20 per cent of the children. Toxoplasma infection was prevalent in 42.8 per cent adolescents, at the age of 18 yr. The average seroprevalence rate of toxoplasma infection was not significantly different in male and female children. The incidence rate of toxoplasma infection was inversely related to increase in age. The school staff comprising teachers and food handlers (aged 27 to 45 yr) showed a toxoplasma seroprevalence rate of 75 per cent (P < 0.001). There was also a significant difference (P < 0.05) in the prevalence of toxoplasmosis in children with grade II goitre (46.1%) and grade I or no goitre (31.8 and 26.5% respectively). The possible association between iodine deficiency and toxoplasma infection is being reported for the first time in this preliminary study.

Adolescent↗
PubMed1986

Iodine deficiency and neonatal hypothyroidism.

The incidence of neonatal hypothyroidism, as reflected in cord-blood thyroxine and thyrotropin levels, varied from 0.6% to 13.3% in iodine-deficient and normal regions of India (selected districts of Uttar Pradesh and Kerala and the city of Delhi), depending on the degree of environmental iodine deficiency. In populations with a high incidence of neonatal hypothyroidism, an increased prevalence of nerve deafness and a shift to the left in the distribution of IQ scores (towards lower scores) have been demonstrated. These indications of mild brain damage suggest that nutritional iodine deficiency can present in other ways than goitre or cretinism. Determination of the incidence of neonatal hypothyroidism using dried cord-blood spot screening appears to be the most useful and reliable method to assess the risk of brain damage in iodine-deficient areas.

Congenital Hypothyroidism↗
PubMedDate not supplied

Iodine deficiency disorders in school children of Sikkim.

Sikkim is a small state in the eastern Himalayas. A survey was conducted to determine the prevalence of iodine deficiency disorders in the state. A two stage sampling procedure was adopted. In stage one, all villages in the state were listed and 249 were randomly selected for the survey. In stage two, households, were randomly selected from the selected villages using the electoral lists. The basic sampling unit was a household and all members of the households were studied. A total of 17,837 subjects were studied from 3,197 households of 249 villages. Overall prevalence of goitre and cretinism in the community as a whole, were 54.03% and 3.46% respectively. Of the population studied, 5939 were children in the age group of 5 to 16 years. There were 3,005 boys and 2,934 girls. Goitre was detected in 3,381 (56.9%). Goitre prevalence in the boys was 55.4% and in girls it was 58.5% (p = < 0.05). Grade I goitre was seen in 2,472 (73.1%), grade II in 888 (26.3%) and grade III in 21 (0.6%). Endemic cretinism was diagnosed in 175 subjects (2.9%). Cretinism prevalence in the boys was 3.1%, and in girls in was 2.8% and this difference was not significant. Neurological; cretinism was the predominant form (98.3%). Estimation of urinary iodine concentration in 167 subjects revealed the mean concentration to be 3.64 u/dl (SD 2.47). The median value was ug/dl indicating the skewed distribution of the urinary iodine concentration. The study shows the existence of severe iodine deficiency in the school-aged children of Sikkim.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Intellectual and motor functions in school children from severely iodine deficient region in Sikkim.

High prevalence of endemic goitre (54%) and endemic cretinism (3.5%) exist in Sikkim. The level of intellectual functioning and motor performance were assessed in 90 school children in the age group of 10 to 12 years selected randomly from four severely iodine-deficient villages. Bender Visual Motor Gestalt Test, Binet-Kamat Test for mental ability and Raven's Coloured Progressive Matrices were the tests used. The results show an impairment in intellectual and other neuropsychological functions in a high percentage of the children. Visuomotor coordination was poor in 62 (69%). Binet-Kamat test results showed that 19 (21%) children were intellectually subnormal (IQ < 70). Majority of the children (> 80%) had significant impairment in language, meaningful memory, non-meaningful memory, conceptual thinking, numerical reasoning and motor skills. The children did better on non-verbal reasoning and social intelligence. Goitre was detected in 82 (91.1%). Urine samples for iodine estimations was collected from every second child examined. The mean urinary iodine concentration was 4.23 micrograms/dl (SD 2.16). Urinary iodine concentration was less than 2 micro gm/dl in 26.1% (11 children) and less than 5 micro gm/dl in 84.8% (39 children) indicating severe iodine deficiency. The test results show impairment of psychomotor development in children born and brought up in iodine-deficient environment.

Child↗
PubMedDate not supplied

Cost of health services provided at a primary health centre.

BACKGROUND: Information on the cost of health services is essential for good planning and management and leads to an efficient use of resources. Very little information on this is available in India. We estimated the distribution of costs incurred on the Primary Health Centre, Chhainsa, Haryana by the type of service provided and their average unit costs. METHODS: We calculated the total costs incurred in running the primary health centre for one year using standard costing methods. This cost was apportioned under different heads on the basis of time and space utilization. The number of activities carried out, between April 1991 and March 1992, was obtained from the monthly reports of the centre maintained by the health assistant and supervised by the medical officer. RESULTS: The total cost incurred for one year was Rs 777,020 (US$ 24,250). Curative care accounted for 32% of the total costs followed by communicable disease control (17%), child care (17%), maternal care (11%) and family welfare (10%). An expenditure of Rs 24 was incurred on each outpatient. The cost of giving full primary immunization to a child was estimated at Rs 131, while Rs 127 was incurred on providing antenatal, natal and postnatal care to each pregnant woman. Tuberculosis-related activities in the community cost Rs 3 per head per year and malaria-related activities Rs 2 per head per year. The cost incurred annually on family welfare services to an eligible couple was Rs 19. CONCLUSIONS: Our findings suggest that the cost estimates from this primary health centre are comparable with the estimates from other developing countries. These cost estimates may be used to determine user fees by health agencies or for premiums for community health insurance schemes.

Capital Expenditures↗
PubMedDate not supplied

Costing of a salt iodine monitoring laboratory in India.

BACKGROUND: Iodine deficiency disorders (IDD) are an important public health problem in India and can be prevented by fortifying common salt with iodine. For the iodation programme to be effective, it is necessary to monitor the iodine content of salt. The National Iodine Deficiency Disorders Control Programme recommends that one salt iodine monitoring laboratory should be set up in each district. We calculated the cost of setting up such a laboratory in the year 1993. METHODS: We estimated that approximately 6000 samples of salt would be sent annually by health workers to the district laboratory as part of the routine report system. We calculated the capital cost of the laboratory to include land, buildings and equipment. The recurrent costs included salaries, chemicals and reagents, and maintenance assuming a uniform discount of 10%. RESULTS: A total of Rs 81,550 would be needed for one such laboratory annually, of which Rs 73,500 (89%) would be recurrent costs. This comes to Rs 13.60 per sample tested or 5 paise per head per year in a district with an average population of 1.7 million. If the building is already available and the staff in position only need to be trained, then Rs 16,040 per year (equipment, chemicals and operating costs) would be required. This comes to 1 paise per head per year. CONCLUSIONS: Setting up a salt iodine monitoring laboratory, a vital component for the salt iodation programme, has modest cost implications, especially if the building and staff already exist. This is likely to be the case in most of the districts.

Costs and Cost Analysis↗