Umesh Kapil

Background : In women, cancer of the breast is one of the most common incident cancer and cause of death from cancer. Anthropometric factors of weight, height, and body mass index (BMI) have been associated with breast cancer risk. Objectives : To study the association of overweight and obesity with breast cancer in India. Materials and Methods: A hospital-based matched case-control study was conducted. Three hundred and twenty newly diagnosed breast cancer patients and three hundred and twenty normal healthy individuals constituted the study population. The subjects in the control group were matched individually with the patients for their age ±2 years and socioeconomic status. Anthropometric measurements of weight and height were recorded utilizing the standard equipments and methodology. The paired 't' test and univariate logistic regression analysis were carried out. Results: It was observed that the patients had a statistically higher mean weight, body mass index, and mid upper arm circumference as compared to the controls. It was observed that the risk of breast cancer increased with increasing levels of BMI. Overweight and obese women had Odd's redio of 1.06 and 2.27, respectively, as compared to women with normal weight. Conclusions: The results of the present study revealed a strong association of overweight and obesity with breast cancer in the Indian population.

Thirty primary schools were selected in district Kangra utilizing the population proportionate to size cluster sampling methodology in the year 2004. A total of 6939 children were included in the study. The clinical examination of the thyroid of each child was conducted. On the spot casual urine sample and salt samples were collected from a ‘sub set of’ children included in the study. The Total goiter rate (TGR) was found to be 19.8%. The median Urinary iodine excretion level was 200 μg/l and only 64% of the salt samples had the stipulated level of iodine. The findings of the present study revealed that current iodine status of population is adequate, however, TGR showed mild iodine deficiency (chronic), and there is a need of continued monitoring the quality of iodised salt provided to the beneficiaries under the Universal salt iodisation programme in order to achieve the goal of elimination of lodine deficiency disorders from district Kangra.

Background: A survey conducted by the central iodine-deficiency disorders team in Himachal Pradesh, a state in the goiter-endemic belt of India, revealed that 10 of its 12 districts have an endemic prevalence of goiter. The survey was conducted to provide health program managers data to determine whether it would be necessary to initiate intervention measures. Objective: To assess the status of urinary iodine excretion and household salt iodization levels after three decades of a complete ban on the sale of noniodized salt in this goiter-endemic state in India as measured by assessment of urinary iodine excretion levels and iodine content of salt at the household level. Methods: The guidelines recommended by WHO/UNICEF/ICCIDD for a rapid assessment of salt iodization were adopted. In each of the 12 studied districts, all senior secondary schools were enlisted and one school was selected by using a random sampling procedure. Two hundred fifty children 11 to 18 years of age were included in the study. Urine samples were collected from a minimum of 170 children and analyzed using the wet digestion method. Salt samples were also collected from a minimum of 170 children and analyzed using the spot testing kit. Results: All districts had a median urinary iodine excretion level > 200 μg/L and 82% of the families were consuming salt with an iodine content of 15 ppm or higher. Conclusions: The results of the present study highlight the successful implementation of the salt iodization program in the state of Himachal Pradesh. This positive impact may be due to the comprehensive strategy adopted by the state government to improve the quality of salt, development of an effective monitoring information system and effective information, education, and communication activities.

Background: Copper is an essential trace element that plays a pivotal role in cell physiology. Dietary intake of copper by a population of low-income groups in India has been found to be low, and hence the possibility of dietary copper deficiency exists. Objective: To determine serum copper levels among tribal populations in India, an area in which data are limited. Methods: The study was conducted among tribal populations 18 to 75 years of age residing in Sahibganj, Jharkhand. Two blocks in the district were selected (from a total of eight) for the detailed study. A semistructured pretested questionnaire was used to collect demographic and socioeconomic information about subjects. A total of 995 subjects were enrolled for the present study. Blood was drawn from the antecubital vein and collected in previously labeled polypropylene tubes. Serum copper was determined by the atomic absorption spectrophotometry method and serum samples with copper levels less than 80 μg/dL were considered to have low serum copper levels. Results: The mean serum copper concentration of the study subjects was 91.18 ± 35.48 μg/dL. Thirty-four percent of the study subjects had low serum copper levels (< 80 μg/dL). Nearly 35% of males and 34.4% of females had low serum copper levels. Conclusions: This study documented a high prevalence of low serum copper levels among the studied tribal population. Further multicenter studies with larger sample sizes are needed to assess the biological implications of copper deficiency among the tribal populations in India.

Cancer of the larynx is fourteenth most common cancer in the world. Limited data are available from India on associations with risk factors and hence the present hospital based matched case-control study was conducted. Three hundred and five laryngeal cancer patients and an equal number of healthy controls matched for their age within 2 years, sex and place of residence constituted the study population. A pre-tested, semi-structured questionnaire was administered to each individual to elicit information on their socio-demographic profile, food habits and risk factors and dietary consumption patterns. Univariate logistic regression analysis and multivariate forward stepwise conditional logistic analysis were performed. In the univariate analysis a lower consumption of roots and tubers green leaf vegetable other vegetables and fruits, and higher consumption of milk, eggs, meat, tea, alcohol , smoking, consumption of betel leaf with tobacco as well as a preference for spicy and fried foods emerged as significant positive variables. After adjusting for education, years of use of alcohol, smoking, chewing of betel leaf with tobacco in the model, low green leafy vegetables and preference for spicy foods were found to be positively related to the risk of laryngeal cancer. There was a significant difference in the dietary consumption patterns of laryngeal cancer patients and controls, indicating a role for nutritional factors in the etiology of laryngeal cancer in the Indian population.

Umesh Kapil, Supreet Kaur, Charan Singh, Shoba Suri; The Impact of a Package of Single Mega Dose of Vitamin A and Daily Supplementation of Iron, Folic Acid and

Umesh Kapil, Preeti Singh; Combating Iodine Deficiency in National Capital Territory of Delhi, India—Lessons Learnt, Journal of Tropical Pediatrics, Volume 51,

Trace element deficiencies have been documented to play an important role in determination of the fetal outcome. Pregnant women in developing countries have been reported to consume diets with a lower density of minerals and vitamins. Deficiencies of trace elements like zinc, copper and magnesium have been implicated in various reproductive events like infertility, pregnancy wastage, congenital anomalies, pregnancy induced hypertension, placental abruption, premature rupture of membranes, still births and low birth weight. The present review article highlights the important of role played by zinc, copper and magnesium during pregnancy and its outcome. The role of individual trace elements and in combination with other trace elements has not been completely documented. There is a need to undertake further studies in this field.