A comprehensive health survey of 618 inhabitants from 1 to 90 years old was conducted in Kathmandu City and in a neighboring village. It included the measurements of height and weight, examinations of blood, feces, urine as well as clinical findings. It also covered the examinations of drinking water and the inquiries of the living conditions. The anthropometric measurements revealed that Nepalese children are generally small in height for age and 4.2 per cent of them were malnourished. The symptoms relating to avitaminoses, such as xerosis of the skin, angular lesions of the lips, hypotrophic papillae of the tongue were not seldom seen. Thyroid enlargements over the grade II of Shichijo's classification or grade I of Perez's were found in 9.2 per cent of males and 18.6 per cent of females. Among clinical abnormal findings, infective eye diseases were most frequent, followed by skin and respiratory diseases. Anemia and iron deficiency were found in high rates among children under 10 years, the aged over 50 years and the females in child-bearing ages. Parasite infestation rate was 92.8 per cent as a whole, trichuris trichiura (81.6 per cent) was the most prevalent, followed by ascaris lumbricoides (61.8 per cent) and hookworm (29.3 per cent). Cystes of entamoeba histolytica (5.5 per cent) and giardia lambria (12.8 per cent) were also found in apparently healthy persons. No available residual chlorine was found in the city water of Kathmandu, though chlorination was carried out in the treatment plant, suggesting some defects in transmission system. In the village, water is supplied without treatment and was found contaminated by E. coli.
Yearly changes in serum electrolytes, especially calcium (Ca), and Ca intake which may influence such changes were studied for 2 years from 1979 to 1980 in the same inhabitants of a rural area with a tendency to low Ca intake, and the following results were obtained. 1) Among different components of electrolytes, yearly changes in Ca were greater than in magnesium and inorganic phosphorus. 2) Yearly changes in serum Ca level from 9 mg/dl or lower level to higher level or vice versa were more frequent in men than in women and the number of women with not more than 9 mg/dl showed a tendency to decrease. 3) Yearly changes in serum Ca were closely correlated with Ca intake. It was supposed that serum Ca level in those who took about 400 mg/day of Ca was fluctuating above or below 9 mg/dl level in proportion to amount of intake.
A dermatitis of unknown etiology has occurred among about 60 residents working in paddy fields in a rural district of Hyogo Prefecture, located in the side of Seto inland sea (Takasago City). The dermatitis had been brought about from June, 1981 to August, 1981 after rice-planting and weeding were done, which was characterized by erytemato-papulo-vesicular eruptions with severe itching, mostly during 5 to 15 days. The chief complains and symptoms were obtained on the body parts exposed to paddy field water, especially back of hands, fingers, wrist-joints and lower parts of legs. The results of questionaries in the patients, clinical observations and seroepidemiological survey by indirect fluorescent antibody method in the use of Schistosoma mansoni cercariae as an antigen, seemed that the dermatitis was due to the invasion of cercariae of anavian schistosome. The surveillance for snail intermediate hosts has been performed in the fields where the dermatitis occurred. Up to date the cercariae causing the dermatitis has not been clarified yet. The etiological survey of cercariae from the fresh water snails is proceeding under survey.
The obesity of women in Ikawa district, Shizuoka City was investigated and the following results were obtained. 1, The incidence of obesity in women of the Ikawa district during 1970 was 13.2%. However, this percentage had approximately doubled to 23.6% by 1980, 11 years later. 2. The height and body weight of the women inhabitants except for those women who participated in a mass screening program, were measured to calculate the rate of increase or decrease in their body weight. Measurements were conducted on 431 women corresponding to 62.8% of the 686 total population. The rate of obese women was found to be 21.3%. This was almost the same rate of obesity that was seen in the women who participated in the mass screening. 3. The women were classified into 4 groups accoding to the degree of obesity. Average values were sought for in the realm of blood properties and blood pressure. A significant difference was noted in GB, Ht, Hb, SP, uric acid, T-Ch, TG, GOT, GPT, γ-GPT, and blood pressure between the obese group and the group having a normal body weight. 4. The skinfold thickness (upper arm+ abdomen) had the highest degree of correlation among the obese group (skinfold thickness and the Minowa method), in relationship to blood properties, and blood pressure. 5. The time period when women most frequently developed obesity was “after child-birth”, followed by the time period from middle age on. These indicated the characteristic causes for obesity in a woman. 6. Thirty of the 46 obese women showing a more than 20% weight gain in 1980 had already shown the same weight gain percentage in 1970. Therefore, it is inferred that the development of obesity in this district had begun a long time ago.
In order to carry out mass examination for detection of stomach ailments effectively and improve screening accuracy, the Nagano Prefectural Welfare Federation of Agricultural Cooperatives, with its mass gastric examination committee as a driving force, has made every endeavor in close collaboration with Federation-affiliated hospitals. The ratio of those receiving detailed examination to the total number of those who have undergone mass screenings, and the detection ratio of gastric cancer cases, especially those in early stages, have increased steadily over the past years. This is due in the main to untiring effort exerted by public health nurses and other persons concerned with health problems. However, the results of X-ray examination made on the basis of the diagnostic standards prepared by the Federation show that there is much need of improving examiners' ability to read mass miniature radiographs correctly.
We have carried out the mass survey for diabetes mellitus by a 50 g GTT as the first screening since 1971. Average incidences of diabetic pattern, IGT pattern, borderline pattern and normal pattern in a Glucose Tolerance Test (GTT) were 2.3±1.8%, 6.6±1.7%, 19.8±6.6% and 71.4 ±7.8%, respectively. 21 males and 6 females were found to be diabetic by this survey for 11 years. Insulinogenic indices (I. Is.) of diabetic, IGT, borderline and normal patterns were 0.13±0.07, 0.70±0.37, 0.58±0.40 and 1.05±0.30, respectively, and the values of I. I. in diabetics and borderline diabetics were significantly lower than that in the normal pattern. A I. I. in the subjects who have revealed the normal glucose tolerance every year for 11 year, 2.62±1.28, was high in the normal range. On the other hand, a I. I. in the subjects who became overtly diabetic from the IGT, borderline or normal pattern, 0.36±0.31, was significantly lower. Therefore, taking into consideration that one of the characteristics of NIDDM is low insulin response to glucose, the mass survey for diabetes mellitus should be carried out by a Glucose Tolerance Test (GTT) as the first screening with the measurement of plasma insulin concentrations. A follow-up study for the low insulin responder is considered to be one of the most preferable investigations for the detection of the early stage of diabetes mellitus.