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Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome. Prevalence of metabolic risk factors including diabetes mellitus, obesity, etc. is rapidly increasing in India putting this population at risk for NAFLD. Patients with NAFLD are at increased risk for liver-related morbidity and mortality and also cardiovascular disease risk and increased incidence of diabetes mellitus on long-term follow-up. Management of patients with NAFLD may require a multi-disciplinary approach involving not only the hepatologists but also the internists, cardiologists, and endocrinologists. This position paper which is a combined effort of the Indian National Association for Study of the Liver (INASL), Endocrine Society of India (ESI), Indian College of Cardiology (ICC) and the Indian Society of Gastroenterology (ISG) defines the spectrum of NAFLD and the association of NAFLD with insulin resistance and metabolic syndrome besides suggesting preferred approaches for the diagnosis and management of patients with NAFLD in the Indian context. [ABSTRACT FROM AUTHOR]

Various identified and unidentified plant species are used by different communities in the state for the treatment of a number of diseases. However, the ethnomedicinal practices of the Ahom community of the state are hardly known. Therefore, an attempt was made to study the ethnomedicinal practices of these communities. The Ahoms are one of the major Mongoloid population groups in Assam. In this paper, I have tried to describe the vegetables, how they are used in their daily life and how they cure diseases. [ABSTRACT FROM AUTHOR]

This paper critiques the category of possession-form dissociative identity disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) published in 2013 by the American Psychiatric Association (APA). The DSM as an index of psychiatry pathologises possession by categorising it as a form of dissociative identity disorder. Drawing upon ethnographic fieldwork, this paper argues that such a pathologisation medicalises possession, which is understood as a non-pathological condition in other contexts such as by those individuals who manifest possession at a temple in Kerala, South India. Through medicalising and further by creating distinctions between acceptable and pathological possession, the DSM converts a form of distress into a disease. This has both conceptual and pragmatic implications. The temple therefore becomes reduced to a culturally acceptable site for the manifestation of a mental illness in a form that is culturally available and possession is explained solely through a biomedical framework, denying alternative conceptualisations and theories which inform possession. By focussing on the DSM-5 classification of possession and the limitations of such a classification, this paper seeks to posit an alternative conceptualisation of possession by engaging with three primary areas which are significant in the DSM categorisation of possession: the DSM's conceptualisation of self in the singular, the distinction between pathological and non-pathological forms of possession, and the limitations of the DSM's equation of the condition of possession with the manifestation of possession. Finally, the paper briefly highlights alternative conceptualisations of possession, which emerged from the perspective of those seeking to heal possession at the Chottanikkara temple. [ABSTRACT FROM AUTHOR]

The advantages and uses of folklore herbs have been acclaimed and executed from ancient times in India. The use of these Folklore remedial herbs for therapeutic applications is contributing to maintenance of human health. The ancient literature, i.e., Ayurveda and Unani, also describes the global usage of herbal medicine for treatment, and its formulation's concoction for prevention of various diseases. Ehretia laevis is a conventional therapeutic herb from ancient times, frequently designated as Khandu Chakka by local people in Maharashtra. E. laevis leaves are used in the treatment of skin infections, fungal infections, mouth blisters, eczema, cuts and wounds, diabetes, asthma, fever and joint pain etc. The leaf of this plant contains abundant therapeutically beneficial secondary metabolites besides primary metabolites. This paper describes antimicrobial sensitivity of E. laevis leaf (fresh and dried) acetone and ethyl alcohol (95%) soxhlet extract and dried leaf dimethyl sulphoxide (DMSO) extract (prepared after from evaporation of acetone in dried leaf acetone extract) against isolated oral microbial flora i.e., Streptococcus spp, Staphylococcus aureus and Candida spp. Amoxicillin in dimethyl sulphoxide was also tested for antimicrobial sensitivity. The result revealed that E. laevis fresh leaf ethyl alcohol and acetone extract and dried leaf acetone and DMSO extract was efficacious against isolated oral microbial flora. The extracts showed positive results for flavonoids and tannins. The results showed the antibacterial and antifungal potential of this folklore plant, particularly against S. aureus and Candida spp., which are microorganisms that are becoming resistant against most therapeutic drugs. This use of this folklore herb requires further study on pharmacological drug formulations. And it can also be used in herbal products i.e., toothpastes, mouthwash etc. [ABSTRACT FROM AUTHOR]

The traditional system of medicine is so ingrained in our culture that, about 75% of the Indian population depends on this indigenous system for relief. With such a huge section of an ever increasing population relying on herbal remedies, it is imperative that the plant products which have been in use for such a long time be scientifically supported for their efficacy. Diabetes a metabolic disorders is most frequent occurring disease in India. The present paper deals with the investigation of standardization parameters of Eugenia jambolana (Bark), Phyllanthus niruri (Whole plant), Momordica charantia Linn. (Seeds) and Nyctanthes arbor-tristis (Leaves). In these study physicochemical parameters, extraction and preliminary photochemical screening was reported. [ABSTRACT FROM AUTHOR]

The purpose of the study was to determine the effecctiveness of STRATEGY TRAINING VS PNF TECHNIQUES TO IMPROVE BALANCE IN SUBJECTS WITH PARKINSON'S DISEASE 30 patients according to the inclusion and exclusion criteria were selected and were assigned into 2 groups by random allocation. Group-A(strategy training) Group-B (pnf technique exercises) consists of 15 patients in each group. Prior to the starting of the intervention program pre assessment was done by using outcome measures of berg balance scale, time up and go test, unified parkinson disease rating scale for both the groups Intervention program for 4 weeks. After the 4 weeks intervention post test assessment was taken by using outcome measures of berg balance scale, time up and go test, unified parkinson disease rating scale. Statistical analysis of the data showed Both the groups A and B showed significant difference from pre to post intervention. But on comparing mean values of Group A & B, Group A showed more improvement than GroupB This findings suggest that strategy training combined with conventional training program is more effective in improving balance dysfunction in parkinson's patients. [ABSTRACT FROM AUTHOR]

Chronic eustachian tube dysfunction is a condition that affects a large number of adults every year. While many cases can be managed pharmacologically, there is a significant portion that does not respond to medical treatment alone. Invasive methods from the aural side like grommet or tympanic tube insertion have complications associated with it and often cannot address the underlying condition of the nasopharyngeal side of the eustachian tube. Balloon eustachian tuboplasty (BET) is a minimally invasive intervention that has been used successfully in countries like Germany and USA in the past decade. This paper presents the experience of a new clinical user of BET in India by retrospectively looking at the outcomes of the first 10 patients on which the procedure was performed. A marketed product EustaCare was used for the cases. There was a 90% procedural success rate within 4 weeks with one patient showing no improvement in symptoms even after 8 weeks. There were no adverse events associated with the procedure nor technical issues with the product. The product is easy to learn and use. Further study is needed to draw any conclusions on long term safety and efficacy, though historical records and preliminary results for this procedure described in this paper seem promising. [ABSTRACT FROM AUTHOR]

Medical tourism is a recent phenomenon to boost Indian economy. Foreigners are fascinated to get medical treatment in India especially in private hospitals due to quality medical treatment, low medical cost, modern and world-class infrastructure, best hospitality and favorable governmental policies. These reasons forced India to emerge as the preferred destination for medical treatment among the foreigners. Private hospitals are the basis for medical tourism in India. One of the main causes behind the establishment of series of private hospitals is the promotion of medical tourism in India. India is the world's second highly populated country. Most of the population is living below poverty line in rural areas. They are not able to afford costly medical treatments in private hospitals. The number of government-sponsored hospitals is very less and not well-equipped with advanced medical facilities. These reasons ultimately affect the people's right to health as granted by the Indian Constitution under Article 21. This paper aims to find out a balanced solution to promote medical tourism and also focuses on the right to health of every person in this regard. [ABSTRACT FROM AUTHOR]

Background: Hydroxyurea and blood transfusion therapies remain the main therapeutic strategies for Sickle cell disease. Preliminary data suggest substantial variation and inconsistencies in practice of these two therapeutic modalities in South Asia. In this systematic review we searched Medline, Cochrane library and Scopus for articles on usage of hydroxyurea and blood transfusion therapies for sickle cell disease in South Asia published in English between October 2005 and October 2020.Results: We selected 41 papers: 33 from India, 3 from Sri Lanka, 2 each from Pakistan and Bangladesh and one from Nepal. Only 14 prospective trials focused on hydroxyurea therapy from which majority (n = 10; 71.4%) adopted fixed low dose (10 mg/kg/day) regimen. With hydroxyurea therapy, 12 and 9 studies reported significant reductions in vaso-occlusive crises and transfusion requirement respectively. Severe anaemia (haemoglobin level < 6-7 g/dl) was the commonest indicator (n = 8) for transfusion therapy followed by vaso-occlusive crisis.Conclusions: Published data on the hydroxyurea and transfusion therapies in South Asia are limited and heterogeneous. A clear gap of knowledge exists about the nature of the sickle cell disease in the Indian subcontinent particularly from countries outside India necessitating further evidence-based assessments and interventions. [ABSTRACT FROM AUTHOR]

Pain is a mixture of noxious stimuli with sensation. It is commonly observed to be associated with toothache, migraine, inflammation, infection, increased ocular pressure, burn, wound, reduced blood supply to heart, intestinal colic, renal colic, parturition, and various diseases like renal calculi, cancer etc. Nonsteroidal anti-inflammatory drugs and opioid analgesic are normally used in the treatment of pain but can cause a lot of adverse effect. Therefore herbal drugs can be potential source to replace them. Every year a lot of plants form traditional medicinal system has been screened for their potential analgesic activity but only few of them only included in health care system after clinical research. Colocasia esculenta is important medicinal plant in India and it is used in various treatment of disease. In this paper, The analgesic activity of Hydroalcoholic extract of Colocasia esculenta was evaluated through hot plate and tail flick models. In this studythe animals were treated with Colocasia esculenta (200mg/kg & 400mg/kg), and standard Diclofenac sodium (5mg/kg). The Hydroalcoholic extract of Colocasia esculenta of 200 mg/kg and 400 mg/kg exhibited significant analgesic activity in the hot plate method (p<0.01) by increasing the pain reaction time (PAT) of the rats to sec 34.24±3.015**and 37.28±3.006** respectively at 90 min after treatment in comparison to control (40.26±5.055). In tail Flick Method Hydroalcoholic extract of Colocasia esculenta of 200 mg/kg and 400 mg/kg exhibited significant analgesic activity (p<0.001) by increasing the pain reaction time (PAT) of the rats to sec 4.30±0.025*and 6.13±0.031** respectively at 90 min after treatment in comparison to control (4.26±0.055) The results of the study concluded the Colocasia esculenta plant exhibits analgesic activity and further studies of Colocasia esculenta plant were suggested to isolate the active principles responsible for the analgesic activity. [ABSTRACT FROM AUTHOR]

Background: Leprosy is one of the oldest diseases known to mankind. Despite the advancements made by science and technology, this curable disease remains misunderstood and dreaded. India is home to the largest number of new leprosy cases globally. Tamilnadu is one among state of high level of leprosy cases in India. The country was still seen to have largest number of leprosy patients in 2018 especially female and children. Keeping this view, “The Burden Leprosy Diseases in India: A study with special reference to Tamilnadu and their Districts” was undertaken. Data and Method: The paper uses the secondary data from Report of the National Leprosy Eradication Programme, Ministry of Health and Family Welfare and other research studies and carries out the bi-variate analysis to realise its objectives. Findings and Suggestion: The Tamilnadu contribution of growth of leprosy diseases was continuously decreased because our government will take more steps to reduce the number of leprosy cases. Then only it is possible to reach less than one like Kerala and Punjab. Chennai (9.07%), Erode (9.93%) and Villupuram (9.48%) are the large number new leprosy cases deducted district in Tamilnadu. The budget allocation of Tamilnadu share was very low than the other states in India for the purpose of treatment of leprosy diseases. Government will educate the female and children to prevent from the communicable diseases like leprosy. [ABSTRACT FROM AUTHOR]

India as the second most populous country of the world where more than 60% of its population rely on Agriculture and allied occupations, healthcare has remained the matter of concern. With a weak primary health sector, lack of skilled medical professionals, inadequacy of regulation for private hospitals, low public spending on health, fragmented health information system, rising cost of medical treatment in India, medical research in India having very little application and weak governance and accountability of the sector are the matters of great concern from the perspective of service delivery. The Supreme Court of India held healthcare as the fundamental right under article 21 of the constitution, but in practice, it has not been fundamentally right in India. Though Ayusman Bharat, is a well thought out project, intending healthcare for the masses, its delivery and sustainability is questionable. The paper is an attempt to discuss the problems inherent in the India’s healthcare system. [ABSTRACT FROM AUTHOR]

Sickle cell disease (SCD) affects approximately 5% of the world's population, and India has been the second highest country in the numbers of predicted SCD births. Despite the high burden in India, there is no state-led public health programme, and very few interventions dealing with the treatment and management of SCD are available. This review highlights the dearth of SCD-related interventions, and demonstrates that these interventions effectively improve patients' conditions and are feasible to implement in India. We systematically searched three databases—PubMed/Medline, Google Scholar and Web of Science—for articles from India on SCD-related interventions. The PRISMA guidelines were followed during this review. We included 22 studies, of which 19 dealt with specific therapeutic interventions, and 3 with comprehensive SCD care. Hydroxyurea therapy was the main therapy in 15 studies and is efficacious. Three studies demonstrated the feasibility of comprehensive care in resource-limited settings. The low number of SCD-related intervention studies does not match the huge burden of SCD in India. Governments of endemic countries should consider the findings of available interventions and include them in their countries' programmes. Comprehensive care is feasible in India and other low-resource settings, from screening to treatment and psychosocial support. [ABSTRACT FROM AUTHOR]

Hypertensive disorders of pregnancy (HDP), particularly pre-eclampsia and eclampsia, remain one of the leading causes of maternal mortality and are contributory in many foetal/newborn deaths. This editorial discusses a supplement of seven papers which provide the results of the first round of the CLIP (Community Level Interventions for Pre-eclampsia) Feasibility Studies. These studies report a number of enablers and barriers in each setting, which have informed the implementation of a cluster-randomized trial (cRCT) aimed at reducing pre-eclampsia-related, and all-cause, maternal and perinatal mortality and major morbidity using community-based identification and treatment of pre-eclampsia in selected geographies of Nigeria, Mozambique, Pakistan and India. This supplement unpacks the diverse community perspectives on determinants of maternal health, variant health worker knowledge and routine management of HDP, and viability of task sharing for preeclampsia identification and management in select settings. These studies demonstrate the need for strategies to improve health worker knowledge and routine management of HDP and consideration of expanding the role of community health workers to reach the most remote women and families with health education and access to health services. [ABSTRACT FROM AUTHOR]

Passiflora foeitda Linn commonly known as rakhi plant is widely used in ayurveda and folk lore India traditional medicine. The various part of the plant is extensively used in the treatment of several disease and disorders of the human. The present review highlighted the phyto-chemistry, medicinal uses and some recent research done in the plant. [ABSTRACT FROM AUTHOR]

Introduction: Necrotizing otitis externa resolves best with antimicrobial treatment. How to care for these patients and monitor their resolution remains a problem. Our protocol in Bangalore can manage these patients inexpensively and well. Materials and Methods: Patients who were referred to our patients became the subjects for this paper. They were managed through our protocol, which consists of IV ciprofloxacin and meropenem, weekly labs, weekly examinations, and photodocumention. Results: Fifty-one people presented with necrotizing otitis externa (NOE) between October 2015 and November 2017 and completed our entire protocol. Forty-six had complete resolution of their disease, while 5 had to undergo surgical removal of necrotic bone. Six of 8 patients with facial weakness had improvement in their House-Brackmann scores. Reduction of self-reported nocturnal pain, dissolution of ear canal granulations, and normalization of the erythrocyte sedimentation rate (ESR) proved to be the most accurate indicators of disease regression. Conclusion: Patients are monitored closely with review of their otalgia, examination of their canal, repeated ESRs, effective control of their diabetes, and radiological imaging. All this can be done in a resource-poor country, which in turn serves as a model for the wealthier nations. [ABSTRACT FROM AUTHOR]

Background: From time immemorial ethnic people of Purulia district of West Bengal are well acquainted with different plant resources for the treatment of various skin diseases including 'carbuncle' and others skin diseases. Carbuncle, caused by the methicillin resistant Staphylococcus aureus is of major concern in this part of India, mostly dominated by tribes like Majhi, Munda, Santal, Birhor, Ho and Rajwar etc. Hot climate, overcrowded households, improper sanitation, very poor economic background and frequent burn accidents are of major issues for spreading of these bacterial infections. Objective: Present authors are trying to summarize these ethno-medicinal knowledge of the local, conservative traditional healers by using structured questionnaires given to them and are trying to analyze these information from scientific perspective. Materials and Methods: Plant samples were collected from March 2014 to May 2016, mostly during their flowering stage and a total of 62 people, both male (84%) and female (16%) were interviewed. Informant consensus factor, fidelity level and use value were calculated. Results: Fifty-nine herbal plants belongs to 35 families were recorded for the cure of various skin diseases, among which 10 plants are used individually during medication whereas 9 polyherbal formulations were used in various combinations during treatment. Five species of the families Moraceae and Asteraceae was found to be the most common medicinal plants, among which 44.89% are herbaceous in habit. Leaves (55.55%) are the most common plant part for their use. Conclusion: Therefore, the present paper has been written to document this rapidly vanishing huge knowledge of folklore which should be digitally conserved for futuristic approach on medicinal plants in India. [ABSTRACT FROM AUTHOR]

There is paucity of evidence on cost of antiretroviral therapy (ART) delivered through the public sector in India. Moreover, the Government of India is considering changing the criteria for introduction of ART to HIV patients, which is likely to have significant economic implications. In this paper, we assess the health system cost of ART services at two levels of health care delivery. Bottom-up costing was used to collect data on capital and recurrent resources consumed over a period of one year (April 2014–March 2015). Capital costs were annualized and shared costs apportioned to calculate annual and unit costs of providing ART care. Sensitivity analysis was undertaken to measure the extent of uncertainty in input prices. The annual per capita cost of ART therapy was INR 48,975 (USD738) in the Centre of Excellence (COE) and INR 24,954 (USD376) in the ART centre. Drugs contributed around 70% and 65% of total annual cost, followed by human resource (19% each) and capital cost (7%; 12%) in COE and ART centres, respectively. These provide a comprehensive assessment of the cost of ART care in India. The study estimates could be used for planning of services, as well as undertaking further cost-effectiveness studies. [ABSTRACT FROM AUTHOR]

Alopecia, a frequently reported problem, severely impacts the quality of life of patients and is often associated with loss of confidence and low self-esteem. Several conditions such as telogen effluvium (TE), anagen effluvium, diffuse type of alopecia areata, female pattern hair loss, hair shaft abnormalities, loose anagen hair syndrome, and congenital atrichia or hypotrichosis are associated with hair loss. The actual prevalence rate of TE is not reported since most cases are subclinical in nature. Further, since women get more distressed by hair fall and promptly seek treatment, they tend to be over-represented. However, both genders can suffer from this condition if triggering factors are present. This consensus paper was developed by taking into account opinions of renowned experts in the field and is hoped to serve as an evidence-based platform for selecting efficacious and safe therapy for patients with TE. This review presents a synopsis of the key opinions of experts on all aspects of treatment and effective management of this condition. [ABSTRACT FROM AUTHOR]

Treatable cancers are on the rise due to improved early diagnosis and more innovative treatments, and preventative strategies against cancer are becoming a global concern. With the rapidly increasing complexity of cancer treatment, a clear definition of what constitutes ethical cancer care has become a matter of great debate. This situation is more complex in a developing country where healthcare resources are limited. Doctors, nurses and public health professionals engaged in the prevention, screening, diagnosis, treatment and research of cancers are often posed with ethical dilemmas while making complex choices. With a special focus on low- and middle-income countries, this paper is intended to highlight these real-world ethical concerns facing those involved in the management of cancer patients. While taking a neutral view, this paper has adopted a theme-wise approach to discuss barriers in cancer care. [ABSTRACT FROM AUTHOR]

Objective This study was conducted to investigate medication-related problems after implementation of clinical pharmacy services at a speciality oncology care setting. Methods It was a prospective interventional study conducted for a period of three years at a private academic oncology care setting. Paper-based medical records and medication orders were reviewed and patients and care givers were interviewed to understand the treatment plan. All the medication-related problems were identified by clinical pharmacists by performing drug therapy review. Patients were also followed up at ambulatory care and in-patient units to ensure appropriate administration of anti-cancer drugs by nurses. All the medication-related problems were discussed with the concerned clinicians and then were resolved with the interventions of clinical pharmacists. Clinical significance of these interventions were assessed and classified as "Major", "Moderate "and "Minor". Educational, clinical and system-based interventions were developed and implemented to minimize medication-related problems at the study site. Results A total of 1359 medication-related problems were identified from 2120 medication orders reviewed of 1362 patients followed during the study period. The most common medication-related problems were lack of suboptimal supportive care (17.95%), inappropriate administration of medications (14.56%), untreated indication (14.20%), wrong dosing calculations (12.21%), drug–drug interactions (11.62%) and sub-therapeutic dose (11.11%). Clinical pharmacy interventions were made to resolve all the medication-related problems. Clinical significance of majority (n = 504, 37.08%) of medication-related problems was "Moderate" followed by "Major" (n = 434, 31.93%) and "Minor" (n = 421, 30.97%). Conclusion The study has demonstrated the importance of clinical pharmacy services in improving quality and safe use of medicines in oncology practice. Positive feedback of clinicians on clinical pharmacy services was a reflection of acceptance of clinical pharmacy interventions by clinicians. [ABSTRACT FROM AUTHOR]

Technologically advanced solutions for treatment of diseases, scientific rigor & research has seen tremendous growth in therapeutic usage of medical devices [1]. The role of 'Make in India' initiative becomes of utmost importance as a driving force for technological advancement of medical devices industry [2]. However, challenges exists & need to be addressed in providing affordable healthcare by producing medical devices that are cost competitive and effective to increased access [2]. Asian Countries like Japan, China and South Korea are foremost in the Medical devices sector [3]. This paper probes the sustainability of 'Make in India' policy with the growth trajectory of Asian countries in medical devices discusses; ways of overcoming challenges through regulations, policies and other stakeholders contribution. [ABSTRACT FROM AUTHOR]

Background Malaria is a serious public health problem in India, accounting for sizeable morbidity, mortality and economic loss1,2. A Revised National Drug Policy on Malaria adopted and the guidelines have been prepared for healthcare personnel including clinicians involved in the treatment of malaria ². Aim: 1) To study adherence to the protocol in diagnosis & management of malaria cases by private medical practitioners and Urban Health Centres (UHC) of Ahmedabad Municipal Corporation (AMC). Methodology- This was a qualitative study in which 29 UHCs and 97 private practitioners of three zones of Ahmedabad Municipal Corporation were visited. Case papers of last 2 months and all malaria related registers maintained at UHCs were evaluated and home visit of 115 malaria cases was carried out. Observation & Discussion- 93.7% of patient with confirmed vivax malaria were prescribed Chloroquine and 99.1% patient with confirmed malaria prescribed Primaquine with correct dose as per age & schedule. Only 78.8% private practitioner was following the guideline dose. 20.2% of private practitioner were not prescribing Primaquine at all. Conclusion & Recommendation There was lack of sensitization in some M.O. of U.H.C & private practitioners (other than M.D. Medicine) regarding prescribing treatment as per National Drug Policy for treatment of Malaria especially primaquine. Sensitization & involvement of private doctors for rational prescription through the Indian / Ahmedabad Medical Association must be carried out. [ABSTRACT FROM AUTHOR]

We aimed to review the contributions by Indian researchers to the subspecialty of skeletal dysplasias (SDs). Literature search using specific keywords in PubMed was performed to retrieve all the published literature on SDs as on July 6, 2017. All published literature on SDs wherein at least one author was from an Indian institute was included. Publications were grouped into different categories based on the major emphasis of the research paper. Five hundred and forty publications in English language were retrieved and categorized into five different groups. The publications were categorized as reports based on: (i) phenotypes (n = 437), (ii) mutations (n = 51), (iii) novel genes (n = 9), (iv) therapeutic interventions (n = 31), and (v) reviews (n = 12). Most of the publications were single-patient case reports describing the clinical and radiological features of the patients affected with SDs (n = 352). We enlisted all the significant Indian contributions. We have also highlighted the reports in which Indians have contributed to discovery of new genes and phenotypes. This review highlights the substantial Indian contributions to SD research, which is poised to reach even greater heights given the size and structure of our population, technological advances, and expanding national and international collaborations. [ABSTRACT FROM AUTHOR]

Objectives: Hand function impairment causes limitations in activities of daily living among stroke survivors. Dexteria app therapy is a game-based therapy with the use of a touchscreen gadget that involves various hand movements. This study evaluates the effect of Dexteria app therapy on hand function in sub-acute stroke survivors. Methods: This study included 26 subacute stroke survivors, randomly allocated into 2 groups as follows: Group A (n=13) received conventional hand therapy while group B (n=13) received Dexteria app therapy. Both groups received 21 sixty-min therapy sessions. Gross hand function and fine manipulative hand function were assessed using the Brunnstrom hand recovery voluntary control grades and the Jebsen hand function test, respectively. Results: Inter-group comparison using the Wilcoxon rank sum test of the mean difference between groups A and B showed a significant difference in the Brunnstrom hand recovery voluntary control grades Z value which equaled -3.272 with P=0.001 and Jebsen hand function test Z=-3.0 and P=0.002. Discussion: Dexteria app therapy showed significant improvement in gross motor function and fine motor hand function than conventional therapy in sub-acute stroke survivors. [ABSTRACT FROM AUTHOR]

Nature is a valuable resource, supplying remedies for the treatment of all diseases. Plant kingdom stands for a plethora of natural compounds that are well known for their utilization in therapeutic applications. They may pave the way for the development of new mediators with appropriate efficacy in many pathological disorders in the future. In India and throughout the world, herbs have become a principle and popular medicine. Recognized green medicines are better than synthetic ones and have fewer side effects. Since ancient times, plants have been intended for their medicinal properties for treating various diseases owing to their fewer side effects, availability of the agent, cost-efficiency, and potential effectiveness. The medicinal value of plants stems from various vegetative parts of the plant, including flowers, fruit, bark, roots, leaves, seeds, and its modified parts. The Indian forests are the major repository of remedial and aromatic medicinal plants, which can be used for the production of a plethora of remedies against various diseases. Butea monosperma is one of the traditional Ayurvedic medicinal plants considered a rich source of ingredients that can be used in drug development as home remedies to treat various diseases, such as diarrhea, constipation, hypertension, dehydration, bronchial asthma, leucorrhea, cancer, infection, as well as liver and stomach disorders. The seed powder is known for its notable medicinal, pharmaceutical, and insecticidal activities. This study highlights the traditional Ayurvedic importance of an eminent medicinal plant, B. monosperma, with its active chemical constituents, as well as pharmacological, environmental, ecological, economical, and agricultural significance. This plant can be planted everywhere to take advantage of its versatile applications. [ABSTRACT FROM AUTHOR]

Background: Despite the availability of effective interventions and public recognition of the severity of the problem, rabies continues to suffer neglect by programme planners in India and other low and middle income countries. We investigate whether this state of 'policy impasse' is due to, at least in part, the research community not catering to the information needs of the policy makers. Methods & Findings: Our objective was to review the research output on rabies from India and examine its alignment with national policy priorities. A systematic literature review of all rabies research articles published from India between 2001 and 2011 was conducted. The distribution of conducted research was compared to the findings of an earlier research prioritization exercise. It was found that a total of 93 research articles were published from India since 2001, out of which 61% consisted of laboratory based studies focussing on rabies virus. Animals were the least studied group, comprising only 8% of the research output. One third of the articles were published in three journals focussing on vaccines and infectious disease epidemiology and the top 4 institutions (2 each from the animal and human health sectors) collectively produced 49% of the national research output. Biomedical research related to development of new interventions dominated the total output as opposed to the identified priority domains of socio-politic-economic research, basic epidemiological research and research to improve existing interventions. Conclusion: The paper highlights the gaps between rabies research and policy needs, and makes the case for developing a strategic research agenda that focusses on rabies control as an expected outcome. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to analyse attitudes, understanding of gambling and gambling related harm among Asians in New Zealand using secondary data from the New Zealand 2006/07 Gaming and Betting Attitudes Survey (GBAS). Design/methodology/approach -- This survey interviewed 1,973 nationwide randomly selected youths and adults ($18 years) using structured questionnaire. Chinese (N = 113) and Indian (N = 122) data were analysed separately to compare between them and with NZ Europeans (N = 792). Descriptive analysis was carried out and was subsequently tested for significant correlations by weighted (p < 0.01) and un-weighted (p < 0.05) variables. Findings -- A higher proportion of Chinese males (66.8 percent) represented in the survey compared to Indian (43.0 percent) and NZ European (48.9 percent) where Chinese consisted of more youthful age structure. Chinese respondents were more likely to be in the lowest income bracket (NZ$10,000) compared to others. Among the ten gambling activities "casino table gambling" and "casino electronic machines" (slot-style machine) were most popular among the Chinese where Indians preferred "gambling/casino evening". A significant proportion of Chinese were unwilling to refer family or friends to gambling help services despite believing that gambling does more harm than good. Pre-committed gambling sum was the most common harm minimising strategy suggested by participants. They believed education and consultation could deter youths from harmful gambling. Research limitations/implications -- This survey highlighted gambling behaviours and thoughts of the ethnic minority population in New Zealand. Study outcomes would be valuable in formulating ethnic specific preventative programme and may have policy implication. Originality/value -- There has been limited research on gambling behaviour of ethnic minorities in New Zealand. This paper fills some of the gaps. [ABSTRACT FROM AUTHOR]

Objectives: Pelvic fracture urethral distraction defect (PFUDD) may be associated with disabling complications, such as recurrent stricture, urinary incontinence, and erectile dysfunction. In this article we review the current concepts in the evaluation and surgical management of PFUDD, including redo urethroplasty. Materials and Methods: A PubMed™ search was performed using the keywords "pelvic fracture urethral distraction defect, anastomotic urethroplasty, pelvic fracture urethral stricture, pelvic fracture urethral injuries, and redo-urethroplasty." The search was limited to papers published from 1980 to March 2010 with special focus on those published in the last 15 years. The relevant articles were reviewed with regard to etiology, role of imaging, and the techniques of urethroplasty. Results: Pelvic fracture due to accidents was the most common etiology of PFUDD that usually involved the membranous urethra. Modern cross-sectional imaging, such as sonourethrography and magnetic resonance imaging help assess stricture pathology better, but their precise role in PFUDD management remains undefined. Surgical treatment with perineal anastomotic urethroplasty yields a success rate of more than 90% in most studies. The most important complication of surgical reconstruction is restenosis, occurring in less than 10% cases, most of which can be corrected by a redo anastomotic urethroplasty. The most common complication associated with this condition is erectile dysfunction. Urinary incontinence is a much rarer complication of this surgery in the present day. Conclusions: Anastomotic urethroplasty remains the cornerstone in the management of PFUDD, even in previously failed repairs. Newer innovations are needed to address the problem of erectile dysfunction associated with this condition. [ABSTRACT FROM AUTHOR]

Introduction: Direct visual internal urethrotomy (DVIU) followed by intermittent self-dilatation (ISD) is the most commonly performed intervention for urethral stricture disease. The objective of this paper is to outline the current scientific evidence supporting this approach for its use in the management of anterior urethral strictures. Materials and Methods: A Pubmed database search was performed with the words "internal urethrotomy" and "internal urethrotomy self-catheterization." All papers dealing with this subject were scrutinized. Cross-references from the retrieved articles were also viewed. Only English language articles were included in the analyses. Studies were analyzed to identify predictors for success for DVIU. Results: Initial studies showed excellent outcomes with DVIU with success rates ranging from 50% to 85%. However, these studies reported only short-term results. Recent studies with longer followup have shown a poor success rate ranging from 6% to 28%. Stricture length and degree of fibrosis (luminal narrowing) were found to be predictors of response. Repeated urethrotomies were associated with poor results. Studies involving intermittent self-catheterization following DVIU have shown no role in short-term ISD with one study reporting beneficial effects if continued for more than a year. A significant number of studies have shown long-term complications with SC and high dropout rates. Conclusions: DVIU is associated with poor long-term cure rates. It remains as a treatment of first choice for bulbar urethral strictures <1 cm with minimal spongiofibrosis. There is no role for repeated urethrotomy as outcomes are uniformly poor. ISD, when used for more than a year on a weekly or biweekly basis may delay the onset of stricture recurrence. [ABSTRACT FROM AUTHOR]

Anisomeles indica L., and Anisomeles malabarica L. R. Br. Ex Sims, growing wild in India. These shrubs become gives biological effect because of chemical composition of essential oil. Now it is interesting to know available chemicals in it, which also support the claim biological activities still, by the researchers. The chemical composition and antibacterial activity of the essential oils from A. indica and A. malabarica were investigated together here for the first time. The aerial parts (Stem, leaves, flowers and fruit) of hydrodistilled essential oils were analyzed by gas chromatography-mass spectrometry (GC-MS), and antibacterial activity was individually evaluated against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Bacillus pumilus using a paper disc diffusion method. Collectively more than forty compounds were identified in A. indica and A. malabarica, representing 98.29-97.88% of the total essential oil, respectively. The major constituents of essential oils obtained from the A. indica, were linalyl acetate (15.3%), and α-thujone (11.9%). The most abundant compounds in essential oils of A. malabarica, were - α-thujone (17.6%), terpenyl acetate (16.45%) and, σ-cadinene (11.5). All tested G+ ve & G-ve were inhibited by essential oil samples. The GC-MS results of both plants indicated the essential oil is rich in monoterpenes and terpenoids, which have been implicated antibacterial activity, comparable to gentamycin, it was used as a positive probe. The current findings also help to differentiate the valuable Anisomeles species for phyto-pharmaceuticals. [ABSTRACT FROM AUTHOR]

This paper is a contribution to the growing literature on how best to design and support community health worker (CHW) programmes to maximise their positive impact. CHWs are laypeople trained to promote health among their peers. To do so they are commonly tasked with providing basic curative services, promoting the use of existing health services, facilitating cultural mediation between communities and healthcare providers and encouraging critical reflection and dialogue on social health issues. This paper presents a case study of a CHW project in rural Uttarakhand, north India, called the Accredited Social Health Activist (ASHA) programme. While the ASHA programme is not specifically targeting HIV/AIDS, CHW programmes have been flagged as a key means of addressing health resource shortages in poor countries, especially in relation to HIV/AIDS. This study of the ASHA programme provides insights into how best to support CHW programmes in general, including those focused on HIV/AIDS. The research involved 25 interviews and five focus groups with ASHAs, health professionals and community members as well as over 100 hours of non-participant observation at public health centres. The research investigated contextual features of the programme that are hindering the ASHAs' capacity to increase quantitative health outcomes and act as cultural mediators and agents of social change. Research found that ASHAs were institutionally limited by: (1) the outcome-based remuneration structure; (2) poor institutional support; (3) the rigid hierarchical structure of the health system; and (4) a dearth of participation at the community level. The conclusion suggests that progressive policy on CHW programmes must be backed up by concrete institutional support structures to enable CHWs to fulfil their role. [ABSTRACT FROM PUBLISHER]

Background: Drugs to protect the liver are frequently prescribed in some countries as part of treatment for tuberculosis. The biological rationale is not clear, they are expensive and may do harm. We conducted a systematic review to a) describe the ingredients of "liver protection drugs"; and b) compare the evidence base for the policy against international standards. Methods: We searched international medical databases (MEDLINE, EMBASE, LILACS, CINAHL, Cochrane Central Register of Controlled Trials, and the specialised register of the Cochrane Infectious Diseases Group) and Chinese language databases (CNKI, VIP and WanFang) to April 2007. Our inclusion criteria were research papers that reported evaluating any liver protection drug or drugs for preventing liver damage in people taking anti-tuberculosis treatment. Two authors independently categorised and extracted data, and appraised the stated methods of evaluating their effectiveness. Results: Eighty five research articles met our inclusion criteria, carried out in China (77), India (2), Russia (4), Ukraine (2). These articles evaluated 30 distinct types of liver protection compounds categorised as herbal preparations, manufactured herbal products, combinations of vitamins and other non-herbal substances and manufactured pharmaceutical preparations. Critical appraisal of these articles showed that all were small, poorly conducted studies, measuring intermediate outcomes. Four trials that were described as randomised controlled trials were small, had short follow up, and did not meet international standards. Conclusion: There is no reliable evidence to support prescription of drugs or herbs to prevent liver damage in people on tuberculosis treatment. [ABSTRACT FROM AUTHOR]

Hearing loss is partial or complete inability to receive and interpretation ofsound stimuli in unilateral or bilateral Ear. On the basis of its pathogenesis, Hearing loss is categorized in to Conductive, Sensorineural and mixed. Childhood hearing loss can be a debilitating condition that affects 1 to 6 per 1,000 newborns to a significant degree, physically, mentally and socially. Among them, Conductive hearing loss is most common hearing loss in children which accounts 85 to 90 percentage of childhood hearing loss in India. Such high prevalence warrants close attention because it is widely acknowledged that the first 36 months after the birth represent a critical period in cognitive and linguistic development. In the Ayurvedic classics, Shrotrendriya (one of thepancha Gyanendriya) is seat of Vayu and Aakshatatwa and is nourished by Tarpaka-Kapha. The interchangeable term of Hearing loss in Ayurveda is BADHIRYA. In Modern Medicine, there is range of medical and surgical intervention to manage the conductive hearing loss even though which has its own limitation. Ayurveda also have protocol for the management of hearing loss. So, presented case was managed with as per the protocol (Karnapoorana and as per the guidelines of Pratishyayawatchikitsa) prescribed in Badhiryachikitsa in Ayurveda. The result of this case study assessed with Pure tone audiometry and Tympanometry before and after treatment. The present paper discusses a case of conductive hearing loss and its management in Ayurveda. [ABSTRACT FROM AUTHOR]

This paper provides HIV estimation methodology used in India and key HIV estimates for 2010-2011. We used a modified version of the Spectrum tool that included an Estimation and Projection Package as part of its AIDS Impact Module. Inputs related to population size, age-specific pattern of fertility, gender-ratio at birth, age and gender-specific pattern of mortality, and volume and age-gender distribution of net migration were derived from census records, the Sample Registration System and large-scale demographic health surveys. Epidemiological and programmatic data were derived from HIV sentinel surveillance, large-scale epidemiological surveys and the programme management information system. Estimated adult HIV prevalence retained a declining trend in India, following its peak in 2002 at a level of 0.41% (within bounds 0.35-0.47%). By 2010 and 2011, it levelled at estimates of 0.28% (0.24-0.34%) and 0.27% (0.22-0.33%), respectively. The estimated number of people living with HIV (PLHIV) reduced by 8% between 2007 and 2011. While children accounted for approximately 6.3% of total HIV infections in 2007, this proportion increased to about 7% in 2011. With changing priorities and epidemic patterns, the programme has to customise its strategies to effectively address the emerging vulnerabilities and adapt them to suit the requirements of different geographical regions. [ABSTRACT FROM AUTHOR]

Background: Ethnomedicinal plants are rich traditional resources of Northeast India. Most of these plants are edible and are used as food by the tribal population of Northeast India. Quantitative nutritional analyses of three ethnomedicinal wild edible plant from Northeast India namely: Zanthoxylum oxyphyllum Edgew, Rotheca serrata (L.) Steane and Mabb. and Blumea lanceolaria (Roxb.) Druce were carried out to identify the occurrence and abundance of nutrients, minerals and amino acids. Methods: Proximate nutrients were estimated by standard AOAC methods. ICP-OES mineral analyzer was used to screen and quantify individual mineral elements. By performing UPLC analysis the presence and abundance of amino acids were investigated. Result: Proximate analysis revealed that the plant species contains adequate amounts of protein, fibre and ash. From nutritional perspectives, low fat and carbohydrate in these species specifies that they are desirable diet for human nutrition. In regard to mineral content, the plant species were rich in macro minerals K, Ca, Na and Mg. Heavy metals were found within the recommended dietary permissible limits for humans. All the essential and non essential amino acids excluding cysteine, methionine and histidine were present in reasonable quantities. The plant species may be exploited to provide quality diets to mitigate nutrient deficiency. Adding together its nutritional and medicinal properties it may potentially be utilized in therapeutics. The further scope of the research involves ascertaining their potentiality in food-based strategies to perk up nutritional health. [ABSTRACT FROM AUTHOR]

Purpose: VISHRAM is a community-based mental health program to address psycho-social distress and risk factors for suicide in a predominantly rural population in Central India, through targeted interventions for the prevention and management of Depression and Alcohol Use Disorders (AUD). The evaluation was designed to assess the impact of program on the contact coverage of evidence-based treatments for depression and AUD through a repeated survey design. This paper describes the baseline prevalence of depression among adults in rural community, association of various demographic and socio-economic factors with depression and estimates contact coverage and costs of care for depression.Methods: Population-based cross-sectional survey of adults in 30 villages of Amravati district in Vidarbha region of Central India. The outcome of interest was a probable diagnosis of depression which was measured using the Patient Health Questionnaire (PHQ-9). Data were analyzed using simple and multiple logistic regression.Results: The outcome of current depression (PHQ-9 ≥ 10) was observed in 14.6 % of the sample (95 % CI 12.8-16.4 %). The contact coverage for current depression was only 4.3 % (95 % CI 1.5-7.1 %). Prevalence of depression varied greatly between the two sites of the study; higher age, female gender, lower education, economic status below poverty line and indebtedness were associated with depression; and while a contact coverage with formal health care was very low, a large proportion of affected persons had consulted family members.Conclusions: Our findings clearly indicate that psycho-social distress in rural communities in Maharashtra is strongly associated with social determinants such as gender, poverty and indebtedness and affects the entire population and not just farmers. [ABSTRACT FROM AUTHOR]

Introduction: Pneumonia is the leading cause of death from infection in children worldwide. Despite global treatment recommendations that call for children with pneumonia to receive amoxicillin dispersible tablets, only one-third of children with pneumonia receive any antibiotics and many do not complete the full course of treatment. Poor adherence to antibiotics may be driven in part by a lack of user-friendly treatment instructions.Objective: In order to optimise childhood pneumonia treatment adherence at the community level, we developed a user-friendly product presentation for caregivers and a job aid for healthcare providers (HCPs). This paper aims to document the development process and offers a model for future health communication tools.Methods: We employed an iterative design process that included document review, key stakeholder interviews, engagement with a graphic designer and pre-testing design concepts among target users in India and Kenya. The consolidated criteria for reporting qualitative research were used in the description of results.Results: Though resources for pneumonia treatment are available in some countries, their content is incomplete and inconsistent with global recommendations. Document review and stakeholder interviews provided the information necessary to convey to caregivers and recommendations for how to present this information. Target users in India and Kenya confirmed the need to support better treatment adherence, recommended specific modifications to design concepts and suggested the development of a companion job aid. There was a consensus among caregivers and HCPs that these tools would be helpful and improve adherence behaviours.Conclusions: The development of user-friendly instructions for medications for use in low-resource settings is a critically important but time-intensive and resource-intensive process that should involve engagement with target audiences. [ABSTRACT FROM AUTHOR]

Background: Rates of perinatal depression (antenatal and postnatal depression) in South Asia are among the highest in the world. The delivery of effective psychological treatments for perinatal depression through existing health systems is a challenge due to a lack of human resources. This paper reports on a trial protocol that aims to evaluate the effectiveness and cost-effectiveness of the Thinking Healthy Programme delivered by peers (Thinking Healthy Programme Peer-delivered; THPP), for women with moderate to severe perinatal depression in rural and urban settings in Pakistan and India.Methods/design: THPP is evaluated with two randomised controlled trials: a cluster trial in Rawalpindi, Pakistan, and an individually randomised trial in Goa, India. Trial participants are pregnant women who are registered with the lady health workers in the study area in Pakistan and pregnant women attending outpatient antenatal clinics in India. They will be screened using the patient health questionnaire-9 (PHQ-9) for depression symptoms and will be eligible if their PHQ-9 is equal to or greater than 10 (PHQ-9 ≥ 10). The sample size will be 560 and 280 women in Pakistan and India, respectively. Women in the intervention arm (THPP) will be offered ten individual and four group sessions (Pakistan) or 6-14 individual sessions (India) delivered by a peer (defined as a mother from the same community who is trained and supervised in delivering the intervention). Women in the control arm (enhanced usual care) will receive health care as usual, enhanced by providing the gynaecologist or primary-health facilities with adapted WHO mhGAP guidelines for depression treatment, and providing the woman with her diagnosis and information on how to seek help for herself. The primary outcomes are remission and severity of depression symptoms at the 6-month postnatal follow-up. Secondary outcomes include remission and severity of depression symptoms at the 3-month postnatal follow-up, functional disability, perceived social support, breastfeeding rates, infant height and weight, and costs of health care at the 3- and 6-month postnatal follow-ups. The primary analysis will be intention-to-treat.Discussion: The trials have the potential to strengthen the evidence on the effectiveness and cost-effectiveness of an evidence-based psychological treatment recommended by the World Health Organisation and delivered by peers for perinatal depression. The trials have the unique opportunity to overcome the shortage of human resources in global mental health and may advance our understanding about the use of peers who work in partnership with the existing health systems in low-resource settings.Trial Registration: Pakistan Trial: ClinicalTrials.gov Identifier: NCT02111915 (9 April 2014) India Trial: ClinicalTrials.gov Identifier: NCT02104232 (1 April 2014). [ABSTRACT FROM AUTHOR]

Background: The incidence of hip fractures in older adults in India is likely to increase dramatically in the coming decades as a result of an aging population and increasing life expectancy. Currently, more than 600,000 adults over 60 years of age suffer a hip fracture annually in India. This paper outlines a protocol for a qualitative study investigating the care seeking behavior of older adults with hip fractures: to determine the processes in decision making, identify causes for delay in obtaining care, and identify potential barriers and facilitators to seeking appropriate care in time. Methods and design: The planned study will consider Odisha, an eastern state in India with limited health care facility, as a suitable case study. It is proposed to conduct 30 in-depth interviews in two administrative districts of Odisha. The participants will be patient and their carers in seven health facilities- four public hospitals, two private hospitals and one traditional bone-setting facility. The study relies on a purposive sampling strategy. Ethics permission will be sought from each participating institution and participants. The participants will be adults aged 50 years or older of both sexes arriving at the recruiting centers with a history of fall or injury, pain in the hip region and inability to walk and X-ray confirmed diagnosis of proximal femoral fracture and their primary carer. Trained qualitative research team will conduct these interviews. A thematic framework approach will be used to analyze the data using NVivo 9 software. The data collected from the interviews will be analysed to explore the cause of the hip fracture, events following the injury, the experiences of patients from the time of sustaining the injury, pain relief measures, decision to seek care, understanding of the urgency for treatment, causes for delay in receiving treatment, funding sources, cost liabilities for the family, financing mechanisms for out of pocket expenditure and the burden for caring. Discussion: The findings of this study will provide an increased understanding of the care seeking behaviors of older adults with hip fracture, and inform contextually appropriate changes in healthcare program and policy aimed at improving health outcomes. [ABSTRACT FROM AUTHOR]

Background Despite harmful drinking causing a significant burden on global health, there is a large treatment gap, especially in low- and middle-income countries. A major barrier to care is the lack of adequately skilled human resources to deliver contextually appropriate treatments. This paper describes the systematic process used to develop Counselling for Alcohol Problems ( CAP), a brief psychological treatment (PT) for delivery by lay counselors in routine primary care settings to men with harmful drinking in India. Methods CAP was developed using a methodology involving 3 sequential steps: (i) identifying potential treatment strategies; (ii) developing a theoretical framework for the treatment; and (iii) evaluating the acceptability and feasibility of the treatment. Results CAP is a 3-phase treatment delivered over 1 to 4 sessions based on a motivational interviewing ( MI) stance and involves the following strategies: assessment and personalized feedback, family engagement, drink refusal skills, skills to address drinking urges, problem-solving skills and handling difficult emotions, and relapse prevention and management. Data from a case series were used to inform several adaptations to enhance the acceptability of CAP to the recipients and feasibility of delivery by lay counselors of the treatment, for example expansion of the target group to include alcohol-dependent patients and the extension of the delivery settings to include home-based delivery. There was preliminary evidence of the effectiveness of CAP. Conclusions CAP is an acceptable brief PT for harmful drinking delivered by lay counselors in primary care whose effectiveness is currently being tested in a randomized controlled trial based in primary care in Goa, India. [ABSTRACT FROM AUTHOR]

Plant and animal materials have been used successfully for the treatment of human diseases since ancient times. Every country in the world has enlisted various indigenous herbal remedies according to the diseases and human requirements. Ayurveda is an original holistic system of diagnosis and treatment involving nutrition, hygiene and rejuvenation, developed and perfected in India. Terminalia chebula (Harad) is an indigenous medicinal plant used traditionally in the treatment of several human diseases. Harad is one of the major components of Triphala. The present paper enumerates the chemical profile and folk lore uses of selected plant. [ABSTRACT FROM AUTHOR]

The vital steps in any endodontic treatment are thorough mechanical shaping and chemical cleaning followed by obtaining a fluid tight impervious seal by an inert obturating material. For the past two decades, introduction and use of rotary nickel-titanium (Ni-Ti) files have changed our concepts of endodontic treatment from conventional to contemporary. They have reported good success rates, but still have many drawbacks. The Self-Adjusting File (SAF) introduces a new era in endodontics by performing the vital steps of shaping and cleaning simultaneously. The SAF is a hollow file in design that adapts itself three-dimensionally to the root canal and is a single file system, made up of Ni-Ti lattice. The case series presented in the paper report the clinical experience, while treating primary endodontic cases with the SAF system in India. [ABSTRACT FROM AUTHOR]

Death due to poisoning accounts to a large number of fatalities throughout the world and India. Irrespective of the mode of exposure of a poison, the confirmation of the cause of death is always by subjecting the viscera and blood for chemical analysis. The methods of analysis will be selected on the view of Drugs involved, Resources available and Standard of proof acceptable by the prosecution. Each laboratory would have formulated a protocol for the analysis of tissue specimens, based on the incidences of poisonings in the region. The forensic science laboratory of Bangalore has got a scheme for detection of poisons based on various studies. When certain compounds are suggested by the history or clinical findings, simple tests like colour tests may be performed. However, in the absence of clinical or other evidences to indicate the poisons involved a defined series of tests is needed. In the analysis of an unknown poison, various steps are involved and tests are performed sequentially. The importance of better communication between the analytical toxicologist, clinician, autopsy surgeon is emphasized in this paper as well. [ABSTRACT FROM AUTHOR]