RESUMEN

This paper presents the results of two proficiency testing (PT) rounds conducted by the Export Inspection Agency (EIA) Chennai laboratory in 2021 for food testing laboratories in India. The PT program was designed in accordance with ISO/TS 22117, a standard for proficiency testing in food microbiology, and targeted Listeria monocytogenes and Salmonella spp as the organisms of focus. The samples were found to be stable and recoverable during the analysis, and all PT sample packages were delivered to participant laboratories in good condition. The participant laboratories reported high sensitivity rates of 100% for PT round 061021 M and 96.49% for PT round 050721 M. The accuracy rate in PT round 061021 M was 91.89% and 92.10% in case of PT round 050721 M. However, there were some false positive and false negative results reported by some participant laboratories in both PT rounds, which may have been caused by operational errors or inconsistencies in analysis. During the PT round 061021 M, out of a total of 38 participant laboratories, five laboratories reported false positive results and one laboratory reported a false negative result. Similarly, during the PT round 050721 M, six laboratories reported false positive results which resulted in their results being deemed unsatisfactory.

RESUMEN

BACKGROUND: This systematic review evaluated the available medical literature on the prevalence and trends of waterpipe tobacco smoking among adolescents and youth in jurisdictionally representative populations. METHODS: PubMed, Embase, and Scopus were searched for relevant studies from inception until 31 December 2022 that reported the burden of waterpipe smoking among adolescents and youth (10-24 years of age). We extracted qualitative data on the demographic characteristics, burden, and correlates of waterpipe smoking (PROSPERO ID: CRD42022310982). RESULTS: A total of 2,197 articles were screened and 62 were included in the analysis. The majority (29) of the studies was from the United States of America and there were no studies from the south-east Asian region. The prevalence of ever waterpipe smoking among the 10-24 years age group was noted to be 18.16% (95% CI, 18.03-18.29). The prevalence of current (30-day) waterpipe smoking was 6.43% (95% CI, 6.34-6.50). The age of initiation of waterpipe smoking was variable. The prevalence of waterpipe smoking was higher among males, among those who belong to the high- and middle-income groups, and among university students. The common risk factors of waterpipe smoking included cigarette smoking, alcohol, and substance use. Waterpipe smoking resulted in increased susceptibility to the use of conventional forms of tobacco (e.g. smoking) among those who were never smokers. CONCLUSION: Waterpipe smoking usage was significantly high among adolescents and young adults. Developing regulatory guidelines for water-pipe smoking, surveillance of its use, intervention, and specific policy frameworks may be considered a public health priority.

Asunto(s)

Pipas de Agua , Tabaco para Pipas de Agua , Fumar en Pipa de Agua , Masculino , Adulto Joven , Humanos , Adolescente , Estados Unidos , Fumar en Pipa de Agua/epidemiología , Encuestas y Cuestionarios , Prevalencia

Asunto(s)

Nitrosaminas , Productos de Tabaco , Tabaco sin Humo , Carcinógenos/análisis , Nicotina , Nicotiana

RESUMEN

BACKGROUND AND AIM: The fruit of Garcinia is a rich and valuable source of bioactive compounds and is traditionally used for treating wounds and ulcers. The present study was carried out to investigate the protective effect of chromatographically standardized fruit extract of Garcinia cowa (GCE) on ethanol-induced gastric lesions in rats and its possible mechanisms. METHODS: The effect of GCE (200 and 400 mg/kg body weight) was evaluated by determining various gastric ulcer parameters like gastric wall mucus, non-protein sulfhydryls (NP-SH) content, microvascular permeability, endogenous antioxidant enzyme, and gastric histopathological study. RESULTS AND CONCLUSIONS: Oral administration of GCE at doses of 200 and 400 mg/kg exhibited significant (p < .01) dose-dependent inhibition of ulcer index by 18.94-44.02%, respectively. Pre-treatment of rats with GCE (400 mg/kg) significantly restored the depleted gastric wall mucus level by 34.09% and NP-SH content by 33.35% induced by ethanol administration. In addition, GCE (400 mg/kg) showed a significant decrease in microvascular permeability of Evans Blue by 47.43%, rationalizing its protective effect. Furthermore, a significant increase in oxidative enzyme levels with reduction in malondialdehyde level and elevation of superoxide dismutase (SOD) activity was observed in the GCE treated group as compared to the ulcer control group. The histopathological assessment also confirmed the protective nature of GCE. HPTLC analysis showed the presence of 0.27%, 0.11% w/w gallic acid, and amentoflavone, respectively in GCE. The content of α-mangostin and xanthochymol in the G. cowa extract sample quantified by HPLC-PDA method was 0.72 and 8.46%, respectively. The results obtained indicate that the protective effect of GCE against gastric ulcers in rats through multiple actions confirmed by the reduction of oxidative stress and restoration of adhered gastric mucus, NP-SH content, and histological architecture.KEY MESSAGESEthanol is the most typical ulcerogenic agent and has been shown to extend the risk of ulcer in humans.Natural products are promising alternative medication for the development of new drugs to regulate gastrointestinal diseases.Garcinia cowa protects the gastric mucosa through multiple actions that include restoration of adhered gastric mucus and inhibition of lipid peroxidation.

Asunto(s)

Antiulcerosos/farmacología , Garcinia/química , Extractos Vegetales/farmacología , Extractos Vegetales/uso terapéutico , Úlcera Gástrica/prevención & control , Animales , Antiulcerosos/uso terapéutico , Etanol/química , Frutas , Humanos , Malondialdehído/sangre , Ratas , Ratas Wistar , Úlcera Gástrica/inducido químicamente , Úlcera Gástrica/metabolismo

RESUMEN

OBJECTIVE: To study the association of educational level and risk of death from all causes, cardiovascular disease (CVD) and cancer among Asian populations. DESIGN: A pooled analysis of 15 population-based cohort studies. SETTING AND PARTICIPANTS: 694 434 Asian individuals from 15 prospective cohorts within the Asia Cohort Consortium. INTERVENTIONS: None. MAIN OUTCOME MEASURES: HRs and 95% CIs for all-cause mortality, as well as for CVD-specific mortality and cancer-specific mortality. RESULTS: A total of 694 434 participants (mean age at baseline=53.2 years) were included in the analysis. During a mean follow-up period of 12.5 years, 103 023 deaths were observed, among which 33 939 were due to cancer and 34 645 were due to CVD. Higher educational levels were significantly associated with lower risk of death from all causes compared with a low educational level (≤primary education); HRs and 95% CIs for secondary education, trade/technical education and ≥university education were 0.88 (0.85 to 0.92), 0.81 (0.73 to 0.90) and 0.71 (0.63 to 0.80), respectively (ptrend=0.002). Similarly, HRs (95% CIs) were 0.93 (0.89 to 0.97), 0.86 (0.78 to 0.94) and 0.81 (0.73 to 0.89) for cancer death, and 0.88 (0.83 to 0.93), 0.77 (0.66 to 0.91) and 0.67 (0.58 to 0.77) for CVD death with increasing levels of education (both ptrend <0.01). The pattern of the association among East Asians and South Asians was similar compared with ≤primary education; HR (95% CI) for all-cause mortality associated with ≥university education was 0.72 (0.63 to 0.81) among 539 724 East Asians (Chinese, Japanese and Korean) and 0.61 (0.54 to 0.69) among 154 710 South Asians (Indians and Bangladeshis). CONCLUSION: Higher educational level was associated with substantially lower risk of death among Asian populations.

Asunto(s)

Enfermedades Cardiovasculares/mortalidad , Causas de Muerte , Escolaridad , Neoplasias/mortalidad , Asia/epidemiología , Estudios de Cohortes , Correlación de Datos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad , Estudios Prospectivos , Factores de Riesgo

RESUMEN

BACKGROUND: Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest. METHODS AND FINDINGS: We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37-1.51) and 1.48-fold (1.38-1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%-17.2%) and 3.3% (2.6%-4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000-1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y. CONCLUSIONS: Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented. Please see later in the article for the Editors' Summary.

Asunto(s)

Enfermedades Cardiovasculares/mortalidad , Neoplasias/mortalidad , Enfermedades Respiratorias/mortalidad , Fumar/mortalidad , Adulto , Asia/epidemiología , Enfermedades Cardiovasculares/economía , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Costo de Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/economía , Neoplasias/epidemiología , Neoplasias/etiología , Prevalencia , Enfermedades Respiratorias/economía , Enfermedades Respiratorias/epidemiología , Enfermedades Respiratorias/etiología , Riesgo , Factores de Riesgo , Fumar/economía , Fumar/epidemiología

RESUMEN

CONTEXT: The leaf of Careya arborea Roxb. (Lecthidaceae) has been advocated in Ayurveda for the treatment of various disorders, including ulcers, healing of wounds and several skin diseases. OBJECTIVE: The 70% ethanol (EtOH) extract of C. arborea leaves (CALE) was investigated for its gastroprotective effect in different gastric ulcer models. MATERIALS AND METHODS: CALE (100, 200, and 400 mg/kg body weight) was administered orally, twice daily for 5 d, for preventing aspirin (ASP)-, EtOH-, pylorus ligation (PL)-, and cold restraint stress (CRS)-induced ulcer in rats. The status of the antioxidant enzymes in CRS-induced ulcers, H(+)K(+)ATPase activity, gastric wall mucous in EtOH-induced ulcer, and gastric secretion parameters were estimated in the PL-induced ulcer model. RESULTS: CALE exhibited significant (p < 0.01) dose-dependent inhibition of ulcer index in ASP 12.90-51.61%, EtOH 11.97-40.35%, PL 28.63-63.92%, and CRS 38.30-66.37%, respectively. A significant (p < 0.001) decrease occurred in the level of H(+)K(+)ATPase, volume of gastric juice, and acid output. Simultaneously, the level of gastric wall mucus was increased significantly (p < 0.05). The antioxidant enzyme levels of LPO and SOD were decreased with concomitant increase in catalase activity in CRS-induced ulcers. High-performance thin-layer chromatography (HPTLC) showed the presence of quercetin, ellagic acid, and gallic acid (0.31%, 0.24%, and 0.71% w/w, respectively) in CALE. CONCLUSIONS: Our results show that C. arborea possesses significant gastro-protective activity, probably due to its free radical scavenging activity, and validate the folklore claim.

Asunto(s)

Antiulcerosos/uso terapéutico , Lecythidaceae , Extractos Vegetales/uso terapéutico , Hojas de la Planta , Úlcera Gástrica/prevención & control , Animales , Antiulcerosos/aislamiento & purificación , Aspirina/toxicidad , Femenino , Masculino , Extractos Vegetales/aislamiento & purificación , Ratas , Ratas Sprague-Dawley , Úlcera Gástrica/inducido químicamente , Úlcera Gástrica/patología , Resultado del Tratamiento

RESUMEN

Diabetes mellitus is a metabolic disorder of endocrine system. This dreadful disease is found all over the world and is becoming a serious threat to the mankind health. Alternative to synthetic agents, plants provide a potential source of hypoglycemic drugs. The aim of the present study was to evaluate the hypoglycemic effect of 70% alcoholic extract of Pentapetesphoenicea (PPE) on blood glucose level in glucose loaded, normal and experimentally induced diabetic rats. Based on the acute toxicity test, two variable doses (250, 500 mg kg(-1) b.wt.) of hydro-alcoholic extract of P. phoenicea leaves were compared with glibenclamide for the influence on fasting blood glucose in glucose loaded, normoglycemic and streptozotocin (STZ) (55 mg kg(-1), i.p.) induced hyperglycemic rats. All the statistical comparisons were made by one-way analysis of variance (ANOVA) followed by Newman-Keuls Multiple Comparison Test using Graph Pad Prism 4.01 v for windows (Graph Pad Software, San Diego, CA, USA). The difference showing a p level of 0.05 or lower was considered to be statistically significant. The administration of PPE in two doses and glibenclamide (5 mg kg(-1)) to STZ induced hyperglycemic animals significantly lowered the blood glucose levels with 18.84% (p<0.01) for PPE 250 mg kg and 38.89% (p<0.001) for PPE 500 mg kg(-1) in a dose dependant manner. Considering all the results obtained, the study concludes that the hydro-alcoholic extract of P. phoenicea leaves produced promising decrease in blood glucose levels in STZ induced hyperglycemic rats which might be related to tannins, terpenoids, sterols and flavonoid contents.

Asunto(s)

Hiperglucemia/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Malvaceae/química , Extractos Vegetales/uso terapéutico , Animales , Glucemia/análisis , Ratas , Estreptozocina

RESUMEN

CONTEXT: Cleome viscosa Linn. (Capparidaceae) is used traditionally in the Indian system of medicine as a carminative, anthelmintic, and diuretic, and used for healing wounds, ulcers and diarrhea. OBJECTIVE: A 70% ethanol (EtOH) extract of the aerial parts of Cleome viscosa extract (CVE) was investigated for gastroprotective activity in different gastric ulcer models in order to validate ethnobotanical claims regarding the plant use in ulcers. MATERIALS AND METHODS: CVE (100, 200 and 400 mg/kg body weight) was administered orally, twice daily for 5 d, for prevention from EtOH, pylorus ligation (PL) and cold restraint stress (CRS)-induced ulcers in rats. Estimation of H(+)K(+)ATPase activity and gastric wall mucous were performed in EtOH-induced ulcer, antioxidant enzyme activities in supernatant mitochondrial fraction of CRS-induced ulcer, and gastric secretion parameters were estimated in PL-induced ulcer model. RESULTS: CVE showed significant (p < 0.01) dose-dependent inhibition of lesion index in EtOH 15.93-42.30%, PL 26.34-59.28% and CRS 22.58-54.03%, respectively. CVE prevents the oxidative damage of gastric mucosa by blocking lipid peroxidation and by a significant (p < 0.001) decrease in superoxide dismutase, and an increase in catalase activity. A significant (p < 0.01) decrease occurred in the level of H(+)K(+)ATPase, volume of gastric juice and total acidity. Simultaneously, the level of gastric wall mucus and pH were increased significantly (p < 0.05). High performance thin layer chromatography analysis showed the presence of quercetin and gallic acid (0.3% and 0.25% w/w, respectively) in CVE. CONCLUSIONS: Results of our study showed that C. viscosa possesses significant gastroprotective activity, probably due to free radical scavenging activity, and validates the folklore claim.

Asunto(s)

Antiulcerosos/farmacología , Cleome/química , Extractos Vegetales/farmacología , Úlcera Gástrica/prevención & control , Animales , Antiulcerosos/administración & dosificación , Antiulcerosos/aislamiento & purificación , Catalasa/efectos de los fármacos , Catalasa/metabolismo , Cromatografía en Capa Delgada , Relación Dosis-Respuesta a Droga , Femenino , Ácido Gálico/aislamiento & purificación , Ácido Gálico/farmacología , Mucosa Gástrica/efectos de los fármacos , Mucosa Gástrica/patología , ATPasa Intercambiadora de Hidrógeno-Potásio/metabolismo , Concentración de Iones de Hidrógeno , Peroxidación de Lípido/efectos de los fármacos , Masculino , Medicina Tradicional/métodos , Componentes Aéreos de las Plantas , Extractos Vegetales/administración & dosificación , Quercetina/aislamiento & purificación , Quercetina/farmacología , Ratas , Ratas Sprague-Dawley , Úlcera Gástrica/patología , Superóxido Dismutasa/efectos de los fármacos , Superóxido Dismutasa/metabolismo

RESUMEN

OBJECTIVE: To study morpho-anatomical characters and physicochemical analysis of Fumaria indica (F. indica) (Hausskn.) Pugsley, (Fumariaceae), an important medicinal plant used extensively for treating a variety of ailments in various system of indigenous medicine. METHODS: Evaluation of the different parts of the plant was carried out to determine the morpho-anatomical, physicochemical, phytochemical and HPTLC fingerprinting profile of F. indica and other WHO recommended methods were performed for standardization. RESULTS: Morpho-anatomical studies showed compound and pinnatifid leaf, 4 to 6 cm in length, linear and oblong in shape and anomocytic arrangement of stomata, thin walled parenchymatous cells, scattered, sclerenchymatous, capped vascular bundles and radiating medullary rays. Physicochemical studies showed foreign matter 0.2%, loss on drying 6.8%, total ash 16.77%, alcohol and water soluble extractives 8.92% and 20.26%, respectively, sugar 17.75%, starch 22.97% and tannins 2.37%. Phytochemical evaluation revealed the presence of carbohydrate, alkaloids, flavonoids, saponins, tannins and sterol. Thin layer chromatography was carried out with different solvents and the best solvent system was chloroform and methanol in 80:20 ratio and revealed 12 spots with different Rf value under UV light 366λ. CONCLUSIONS: The results of the study can serve as a valuable source of information and provide suitable standards for identification of this plant material for future investigations and applications.

Asunto(s)

Fumaria/anatomía & histología , Fumaria/química , Fenotipo , Extractos Vegetales/química , Fumaria/citología , Fitoquímicos/química , Hojas de la Planta/química , Hojas de la Planta/citología , Raíces de Plantas/química , Raíces de Plantas/citología , Tallos de la Planta/química , Tallos de la Planta/citología

RESUMEN

OBJECTIVE: To study detailed pharmacognostic profile of leaves and stem of Careya arborea (C. arborea) Roxb. (Lecthyidaceae), an important medicinal plant in the Indian system of medicine. METHODS: Leaf and stem samples of C. arborea were studied by macroscopical, microscopical, physicochemical, phytochemical, fluorescence analysis of powder of the plant and other methods for standardization recommended by WHO. RESULTS: Macroscopically, the leaves are simple, broadly obovate in shape, acuminate apex with crenate, dentate margin, petioles (0.1-1.8 cm) long. Microscopically, the leaf showed the presence of median large size vascular bundle covered with fibrous bundle sheath, arrangement of xylem in cup shape and presence of cortical vascular bundle, patches of sclerenchyma, phloem fibers in groups and brown pigment containing cells in stem are some of the diagnostic features noted from anatomical study. Powder microscopy of leaf revealed the presence of parenchyma cells, xylem with pitted vessels and epidermis with anisocytic stomata. The investigations also included leaf surface data; quantitative leaf microscopy and fluorescence analysis. Physiochemical parameters such as loss on drying, swelling index, extractive values and ash values were also determined and results showed that total ash of the stem bark was about two times higher than leaf and water soluble extractive value of leaf and stem bark was two times higher than alcohol soluble extractive value. Preliminary phytochemical screening showed the presence of triterpenoids, saponins, tannins and flavonoids. CONCLUSIONS: The results of the study can serve as a valuable source of information and provide suitable standards for identification of this plant material in future investigations and applications.

Asunto(s)

Lecythidaceae/química , Farmacognosia , Extractos Vegetales/farmacología , Hojas de la Planta/química , Tallos de la Planta/química , Flavonoides/farmacología , Humanos , India , Medicina Tradicional , Fitoterapia/métodos , Saponinas/farmacología , Taninos/farmacología , Triterpenos/farmacología , Organización Mundial de la Salud

RESUMEN

Fumaria indica (Hausskn.) Pugsley (Fumariaceae), known as "Fumitory", is an annual herb found as a common weed all over the plains of India and Pakistan. The whole plant is widely used in traditional and folkloric systems of medicine. In traditional systems of medicine, the plant is reputed for its anthelmintic, diuretic, diaphoretic, laxative, cholagogue, stomachic and sedative activities and is used to purify blood and in liver obstruction in ethnopharmacology. The whole plant is ascribed to possess medicinal virtues in Ayurvedic and Unani systems of medicine and is also used in preparation of important Ayurvedic medicinal preparations and polyherbal liver formulations. The review reveals that phytochemical constituents of wide range have been separated from the plants and it possesses important pharmacological activities like smooth muscle relaxant, spasmogenic and spasmolytic, analgesic, anti-inflammatory, neuropharmacological and antibacterial activities. The separation of hepatoprotective and antifungal constituents from this plant was also reported newly. This review highlights the traditional, ethnobotanical, phytochemical, pharmacological information available on Fumaria indica, which might be helpful for scientists and researchers to find out new chemical entities responsible for its claimed traditional uses.

Asunto(s)

Fumaria/química , Fitoquímicos/farmacología , Extractos Vegetales/farmacología , Etnobotánica , Humanos , India , Pakistán , Fitoquímicos/aislamiento & purificación , Extractos Vegetales/aislamiento & purificación

RESUMEN

BACKGROUND: The occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived populations, overweight and obesity are established causes of diabetes. The shape of the association of overweight and obesity with diabetes risk and its overall impact have not been adequately studied in Asia. METHODS AND FINDINGS: A pooled cross-sectional analysis was conducted to evaluate the association between baseline body mass index (BMI, measured as weight in kg divided by the square of height in m) and self-reported diabetes status in over 900,000 individuals recruited in 18 cohorts from Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. Logistic regression models were fitted to calculate cohort-specific odds ratios (OR) of diabetes for categories of increasing BMI, after adjustment for potential confounding factors. OR were pooled across cohorts using a random-effects meta-analysis. The sex- and age-adjusted prevalence of diabetes was 4.3% in the overall population, ranging from 0.5% to 8.2% across participating cohorts. Using the category 22.5-24.9 kg/m²) as reference, the OR for diabetes spanned from 0.58 (95% confidence interval [CI] 0.31, 0.76) for BMI lower than 15.0 kg/m² to 2.23 (95% CI 1.86, 2.67) for BMI higher than 34.9 kg/m². The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline (p-value of interaction<0.001), in cohorts from India and Bangladesh (p<0.001), in individuals with low education (p-value 0.02), and in smokers (p-value 0.03); no differences were observed by gender, urban residence, or alcohol drinking. CONCLUSIONS: This study estimated the shape and the strength of the association between BMI and prevalence of diabetes in Asian populations and identified patterns of the association by age, country, and other risk factors for diabetes.

Asunto(s)

Índice de Masa Corporal , Diabetes Mellitus/epidemiología , Diabetes Mellitus/fisiopatología , Adulto , Estudios de Cohortes , Estudios Transversales , Femenino , Geografía , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia

RESUMEN

BACKGROUND: Most studies that have evaluated the association between the body-mass index (BMI) and the risks of death from any cause and from specific causes have been conducted in populations of European origin. METHODS: We performed pooled analyses to evaluate the association between BMI and the risk of death among more than 1.1 million persons recruited in 19 cohorts in Asia. The analyses included approximately 120,700 deaths that occurred during a mean follow-up period of 9.2 years. Cox regression models were used to adjust for confounding factors. RESULTS: In the cohorts of East Asians, including Chinese, Japanese, and Koreans, the lowest risk of death was seen among persons with a BMI (the weight in kilograms divided by the square of the height in meters) in the range of 22.6 to 27.5. The risk was elevated among persons with BMI levels either higher or lower than that range--by a factor of up to 1.5 among those with a BMI of more than 35.0 and by a factor of 2.8 among those with a BMI of 15.0 or less. A similar U-shaped association was seen between BMI and the risks of death from cancer, from cardiovascular diseases, and from other causes. In the cohorts comprising Indians and Bangladeshis, the risks of death from any cause and from causes other than cancer or cardiovascular disease were increased among persons with a BMI of 20.0 or less, as compared with those with a BMI of 22.6 to 25.0, whereas there was no excess risk of either death from any cause or cause-specific death associated with a high BMI. CONCLUSIONS: Underweight was associated with a substantially increased risk of death in all Asian populations. The excess risk of death associated with a high BMI, however, was seen among East Asians but not among Indians and Bangladeshis.

Asunto(s)

Pueblo Asiatico , Índice de Masa Corporal , Mortalidad , Obesidad/etnología , Asia/epidemiología , Causas de Muerte , Estudios de Cohortes , Femenino , Humanos , Masculino , Sobrepeso/etnología , Modelos de Riesgos Proporcionales , Riesgo

RESUMEN

BACKGROUND: Maternal cigarette smoking has been causally associated with an increased risk for stillbirth. Preliminary reports suggest an increased risk for stillbirth with smokeless tobacco use during pregnancy. METHODS: We conducted a population-based prospective cohort study to investigate this association by using a house-to-house approach to recruit 1,217 women who were between 3 and 7 months' gestation. Of these, 96% were contacted after delivery to determine the pregnancy outcome. Demographic and maternal variables which were apparently associated either with stillbirth or with smokeless tobacco use (OR >or= 1.5) were included as potential confounders. Stillbirth was defined as any delivery of a dead fetus after 20 completed weeks of gestation. We used time-to-event methods to analyze the risk of stillbirth. RESULTS: Overall occurrence of stillbirth among singleton deliveries in this population was 4.1%. Smokeless tobacco use was reported by 17% of women; 8.9% of smokeless tobacco users had a stillbirth compared with 3.1% among nonusers (life-table adjusted hazard ratio = 3.1; 95% confidence interval = 1.7-5.6). After adjustment by the Cox proportional hazards procedure for age, educational and socioeconomic background, working status of mother, parity, prenatal care variables, and place of delivery, the risk for stillbirth in users was 2.6 (95% confidence interval-1.4-4.8). Most women used mishri (a pyrolyzed tobacco product often used as dentifrice), and there was a dose-response relationship between the daily frequency of use and stillbirth risk. The risk of stillbirth associated with smokeless tobacco use was greater in earlier gestational periods. CONCLUSIONS: Smokeless tobacco use during pregnancy increases stillbirth risk, with a risk at least as great as that associated with maternal cigarette smoking.

Asunto(s)

Mortinato/epidemiología , Tabaco sin Humo/efectos adversos , Adulto , Estudios de Cohortes , Femenino , Humanos , India/epidemiología , Embarazo , Factores Socioeconómicos

RESUMEN

Information on 217,174 microscopically diagnosed cancers diagnosed in 2001-2002 was collected from pathology laboratories in 68 districts across India. Data collection took place primarily via the Internet. Average annual age-adjusted incidence rates for microscopically diagnosed cases (MAAR) by gender and site were calculated for each of the 593 districts in the country. The rates were compared to those from established population based cancer registries (PBCR). In 82 districts, the MAAR for 'all cancer sites' was above a "completeness" threshold of 36.2/100,000 (based on results of a rural PBCR). The results confirmed some known features of the geography of cancer in India, and brought to light new ones. Cancers of the mouth and tongue are particularly frequent in both genders in the southern states. Very high rates of nasopharynx cancer were found in the northeastern states (Nagaland, Manipur). There was clear geographic correlation between the rates of cervical and penile cancer, and a high rate of stomach and lung cancer (in both genders) in many districts of Mizoram State. The area of high risk for gallbladder cancer seems larger than suspected previously, involving a wide band of northern India. There is a belt of high incidence of thyroid cancer in females in southwest coastal districts. Other than identifying possible existence of high-risk areas of specific cancers, our study has recognized places where PBCR could be established. The study was remarkably cost-effective and the electronic data-capture methodology provides a model for health informatics in the setting of a developing country.

Asunto(s)

Neoplasias/epidemiología , Femenino , Humanos , Incidencia , India/epidemiología , Masculino , Neoplasias/patología