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Hydroxycitric acid made the genus Garcinia economically important. Genetic and chemical diversity has been studied in Garcinia species using molecular markers, HCA and antioxidant activity. Nine species were collected and screened for molecular diversity and six were subjected to analyse antioxidant and HCA content and its interspecies variability. A total of 129, 125 and 89 bands with polymorphism of 78.74%, 78.4% and 93.36% were obtained using ISSR, RAPD and EST-SSR, respectively. The average PIC value obtained with ISSR, RAPD and EST-SSR markers was 0.9161, 0.9440 and 0.8903, respectively. Determined HCA content by HILIC-HPLC system using 0.1% orthophosphoric acid and acetonitrile (30:70) as mobile phase in fruit powder of various Garcinia species was found to be significantly different. G. gummi-gutta, G. indica and G. xanthochymus are rich of HCA containing 12.44±1.04%, 7.92±0.83% and 6.3±0.286%, respectively. G. morella, G. talbotii and G. celebica contained very negligible amount of HCA, 0.023±0.012%, 0.083±0.034% and 0.34±0.013%, correspondingly. G. talbotii showed high antioxidant capacity (95.40±0.720). Below that G. indica and G. xanthochymus were showing significant amount of total phenols (1.23±0.015 and 1.07±0.008), flavonoids (11.17±0.075 and 12.35±0.219) and antioxidant activity (90.73±0.976 and 91.37±0.854). Correlation analysis found significant association between molecular and chemical variation indicating influence of genetic background on the observed HCA and antioxidant profiles. The conducted analysis showed the most distinct species at the genetic and chemical levels were G. gummi-gutta, G. indica and G. xanthochymus. This study signifies the utility of molecular and chemical fingerprints for commercial exploitation of HCA from Garcinia species. [ABSTRACT FROM AUTHOR]

Total 360 soil samples were collected from nine talukas of Patan district to analyze the soil reaction (pH), electric conductivity (EC) and organic carbon available major nutrients (N, P and K) by multistage random sampling during April 2016. Soils of Patan district are neutral to moderately alkaline in reaction (pH range 7.00 to 9.25; mean 8.14), soluble salt content (EC - range 0.05 to 9.10 dS/m; mean 1.01 dS/m) and low in organic carbon content (OC - range 0.03 to 1.38%; mean 0.33%) indicating poor fertile soil. The nutrient index for available nitrogen, phosphorus and potassium varied from 1.13 to 1.68, 1.83 to 2.48 and 2.2.0 to 2.90, respectively. This represented that the soils of Patan district were low in available nitrogen (232.28 kg/ha), adequate in available phosphorus (49.35 kg/ha) and very high in available potassium (413.46 kg/ha). Soil available nitrogen and phosphorus showed positive correlation with organic carbon and potassium, respectively. [ABSTRACT FROM AUTHOR]

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Patent ductus arteriosus (PDA) is recognised more often with increasing survival of preterm babies. The pharmacological closure of ductus by indomethacin has changed the management of PDA. Twenty neonates admitted over a period of 21 months to Neonatal Intensive Care Unit (NICU) of M.S. Ramaiah Medical College hospital, Bangalore, who were diagnosed to have PDA, were analyzed. The objectives of this retrospective analysis were to study the clinical profile, the efficacy of oral indomethacin and the outcome of PDA. 2-D and Doppler echocardiaography were used to confirm the clinically suspected PDA. These neonates were treated with 3 doses of oral indomethacin (0.2-0.25 mg/kg/dose 12 hourly) along with fluid restriction and oxygen. Echocardiography was repeated to demonstrate the closure of PDA. The incidence of PDA was 2.3% of total NICU admissions. Seventy percent of this cohort were < 32 weeks of gestation, 55% had birth weight of < 1500 gms. Seventy percent (14) neonates had onset of PDA after 48 hrs of life. 81.25% of neonates responded to indomethacin and overall survival rate in treated group was 67%. Drug related complications were noted in 2 newborns. This study illustrates the utility of echocardiography in diagnosing and monitoring PDA in preterm and low birth weight babies with high index of suspicion of this common congenital heart disease. Pharmacological intervention with indomethacin is rewarding with acceptable results. [ABSTRACT FROM AUTHOR]

The article presents a study on the examination of indoor vulnerability to polycyclic qromatic hydrocarbons in urban poor in Ahmedabad, India through several kinds of cooking fuels. The study compared the effects of biomass fuels such as cattle dung and wood and fossil fuels such as coal, kerosene from liquid petroleum gas (LPG) as cooking fuels in 60 Indian households. The study suggests that usage of biomass fuels as cooking fuels should be avoided to reduce environmental hazards.

The article presents a study on the residuals of polycyclic aromatic hydrocarbons (PAH) and organochlorine pesticides (OCP) of drinking water in Ahmedabad City, India. The study aims to determine the rate of OCP and PAH content in the water resources of industrial and residential areas in the city. The study indicates that there is no difference detected in the degrees of OCP and PAH in municipal or well water samples that were found from industrial or residential locations.

2Formerly with Space Applications Centre, Indian Space Research Organisation, Ahmedabad 380 015, India The launch of Radar Imaging Satellite (RISAT-1) marked a new chapter in the remote sensing programme of Indian Space Research Organisation (ISRO). RISAT-1, carrying a multi-mode Synthetic Aperture Radar (SAR) system, will provide complementary imaging capability in microwave along with optical images, being obtained from the well-established IRS class of satellites. RISAT-1 supports a variety of resolution and swath requirements. Both conventional stripmap and scanSAR modes are supported, with dual polarization mode of operation. Additionally a quad polarization stripmap mode is provided for availing additional resource classification. In all these modes, resolutions from 3 to 50 m can be achieved with swath ranging from 25 to 223 km. On experimental basis, a sliding spotlight mode is also available. In all the imaging modes, a novel polarimetry mode called circular or hybrid polarimetry can be exercised seamlessly. The system is capable of imaging on either side of the flight track depending upon prior programming of the satellite. The satellite is placed in a Sun-synchronous orbit with 6 am-6 pm equatorial crossing. This orbit configuration is chosen to maximize solar power availability. The satellite has an on-board-solid state recorder for supporting data acquisition beyond ground station visibility. The payload is based on active antenna array technology. Crucial technology elements like C-band MMICs, TR module and miniaturized power supplies have already been developed in India. A pulsed mode near-field test facility has also been developed in-house in order to characterize the payload in the integration laboratory itself. [ABSTRACT FROM AUTHOR]

Concentrated solar power (CSP) plants have invited wide attention in various sunlight-rich regions around the world, including India. Under sponsorship of the Ministry of New and Renewable Energy, Government of India, the Indian Institute of Technology Bombay, Mumbai has conceptualized and carried out the basic engineering design, installation, commissioning and operation of a 1 MW(e) CSP plant on the campus of the National Institute of Solar Energy at Gwalpahari, near Gurgaon, Haryana, India. This is a unique facility integrating two different solar collector fields; direct steam-generating linear Fresnel reflector (LFR) field and conventional heat transfer fluid-based parabolic trough collector (PTC) field. It is a research-cum-demonstration facility intended to enable the development of future cost-effective CSP plants in the country. The design basis, brief description of the power plant, learning experiences during commissioning and operation of the plant as well as preliminary performance results are presented here. The plant is grid-connected and operational. The preliminary results show low performance due to the lower optical efficiencies of both the collector fields, tracking error, loop imbalance of PTC field and improper receiver size of LFR field. [ABSTRACT FROM AUTHOR]

The present study aimed to develop the normative data on Rorschach Test and present a comparative view of Indian male and females. Subjects for the study were taken from Delhi by using systematic random sampling technique. The Rorschach Ink Blot Test was administered on 238 subjects, consisting of 130 male and 108 females by following Beck system of administration. Chi-square, t-test and U-test were computed to compare the Rorschach variables. Result obtained on Rorschach protocol of normal Indian adults does not show significant difference between Male and females except on two variables-Dd and Sex. Results are in contrast with western norm and to some extent with Indian studies also. In addition religious responses on Rorschach Test focus on some newer type of content and opened new dimension of further research. In the absence of any standardized Indian norms, analysis and interpretation of Rorschach protocols would be mala-fide. So, the foremost work will be to set standard Indian norms which may comply with parameter of Indian socioculture settings. [ABSTRACT FROM AUTHOR]

Adverse cardiovascular (CV) events have declined in Western countries due at least in part to aggressive risk factor control, including dyslipidemia management. The American and European (Western) dyslipidemia treatment guidelines have contributed significantly to the reduction in atherosclerotic cardiovascular disease (ASCVD) incidence in the respective populations. However, their direct extrapolation to Indian patients does not seem appropriate for the reasons described below. In the US, mean low-density lipoprotein cholesterol (LDL-C) levels have markedly declined over the last 2 decades, correlating with a proportional reduction in CV events. Conversely, poor risk factor control and dyslipidemia management have led to increased CV and coronary artery disease (CAD) mortality rates in India. The population-attributable risk of dyslipidemia is about 50% for myocardial infarction, signifying its major role in CV events. In addition, the pattern of dyslipidemia in Indians differs considerably from that in Western populations, requiring unique strategies for lipid management in Indians and modified treatment targets. The Lipid Association of India (LAI) recognized the need for tailored LDL-C targets for Indians and recommended lower targets compared to Western guidelines. For individuals with established ASCVD or diabetes with additional risk factors, an LDL-C target of <50 mg/dL was recommended, with an optional target of ≤30 mg/dL for individuals at extremely high risk. There are several reasons that necessitate these lower targets. In Indian subjects, CAD develops 10 years earlier than in Western populations and is more malignant. Additionally, Indians experience higher CAD mortality despite having lower basal LDL-C levels, requiring greater LDL-C reduction to achieve a comparable CV event reduction. The Indian Council for Medical Research-India Diabetes study described a high prevalence of dyslipidemia among Indians, characterized by relatively lower LDL-C levels, higher triglyceride levels, and lower high-density lipoprotein cholesterol (HDL-C) levels compared to Western populations. About 30% of Indians have hypertriglyceridemia, aggravating ASCVD risk and complicating dyslipidemia management. The levels of atherogenic triglyceride-rich lipoproteins, including remnant lipoproteins, are increased in hypertriglyceridemia and are predictive of CV events. Hypertriglyceridemia is also associated with higher levels of small, dense LDL particles, which are more atherogenic, and higher levels of apolipoprotein B (Apo B), reflecting a higher burden of circulating atherogenic lipoprotein particles. A high prevalence of low HDL-C, which is often dysfunctional, and elevated lipoprotein(a) [Lp(a)] levels further contribute to the heightened atherogenicity and premature CAD in Indians. Considering the unique characteristics of atherogenic dyslipidemia in Indians, lower LDL-C, non-HDL-C, and Apo B goals compared to Western guidelines are required for effective control of ASCVD risk in Indians. South Asian ancestry is identified as a risk enhancer in the American lipid management guidelines, highlighting the elevated ASCVD risk of Indian and other South Asian individuals, suggesting a need for more aggressive LDL-C lowering in such individuals. Hence, the LDL-C goals recommended by the Western guidelines may be excessively high for Indians and could result in significant residual ASCVD risk attributable to inadequate LDL-C lowering. Further, the results of Mendelian randomization studies have shown that lowering LDL-C by 5-10 mg/dL reduces CV risk by 8-18%. The lower LDL-C targets proposed by LAI can yield these incremental benefits. In conclusion, Western LDL-C targets may not be suitable for Indian subjects, given the earlier presentation of ASCVD at lower LDL-C levels. They may result in greater CV events that could otherwise be prevented with lower LDL-C targets. The atherogenic dyslipidemia in Indian individuals necessitates more aggressive LDL-C and non-HDL-C lowering, as recommended by the LAI, in order to stem the epidemic of ASCVD in India., (© Journal of the Association of Physicians of India 2024.)

Objective: The present study was conducted to determine the extent of exposure to and use of mobile devices by children (aged 0-60 months) with a diagnosed neurodevelopmental disability., Design: A self-report survey-based design was employed., Setting: Questionnaires were administered at a tertiary care hospital in Mumbai, India., Participants: The study included a convenience sample of 423 children with a neurodevelopmental disability (aged 0-60 months). The self-report survey was administered to the parents of the children., Results: Analyses showed that 92.7% ( n  = 392) of all respondents have smartphones. 61% ( n  = 258) of the respondents stated that their children used mobile devices before 2 years of age. 58% ( n  = 246) of the parents gave children devices while feeding. A statistically significant difference was found in the mobile media usage between groups of children with different diagnoses ( p  < 0.001). Children diagnosed with ASD appeared to spend the largest amount of time on mobile media ( m  = 180.44 mins), as compared to children included with other diagnoses. Of the diagnosed children, only 13.4% ( n  = 57) of parents were informed about the possible negative effects of media use by their paediatricians., Conclusion: The results suggest premature mobile media habits, frequent use and lack of awareness about the effects of mobile media usage among children diagnosed with a neurodevelopmental disability. We suggest there is a need to update recommendations for caregivers on the use of mobile media by young children with disability.Implications for rehabilitationThe usage and consequences of mobile media use differ based on the type of neurodevelopmental disorder diagnosis. Parents of children with neurodevelopmental disorders often use mobile media as a distraction while engaging in various activities themselves, this information helps identify times at which mobile media might be purposefully used by parents as distractorsThere is an urgent need for clinical guidelines regarding mobile media usage among young children with neurodevelopmental disorders.

There is limited evidence on various clinical aspects of SARS-CoV-2 infection in patients with haematological cancers. The risk factors, prognosis, and outcome of patients with haematological cancers with coexistent COVID-19 need to be explored in different subsets of population. A single-institutional prospective observational study was conducted at a tertiary level medical institute in North India. The clinical details of the recruited patients having haematological malignancies and diagnosed with COVID-19 between 15 March 2020 and 31 May 2021 were prospectively collected through the electronic patient database system. The outcomes with respect to 28-day and 56-day mortality and the associated risk factors for prognostication were analysed. Of the 5750 hospital admissions (inpatient and day-care) during the study period, two hundred and forty-two patients (4.2%) were diagnosed with COVID-19. Acute leukaemia was the most common haematological malignancy, seen in 117 (48.3%) patients. Eighty-nine (36.8%) patients had moderate-to-severe COVID-19 while 153 (63.2%) patients presented with mild infection. The 28-day and 56-day mortality rates in our cohort were 13.3% and 19.8% respectively. Amongst the risk factors associated with poor outcome, the severity of COVID-19 (HR = 1.8, 95% CI 1.16-10.35; p = 0.04), presence of secondary infection (HR = 2.1, 95% CI 2.45-21.3; p = 0.023), and need for invasive mechanical ventilation (HR = 2.3, 95% CI 1.8-18.43; p = 0.01) were prognostically significant on multivariate log rank analysis. The risk of SARS-CoV-2 infection does not increase with haematological malignancies; however, the outcome remains poor in patients with severe COVID-19, requirement of invasive mechanical ventilation, and pre-existing bacterial/fungal infection at presentation., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Disclosure of epilepsy is a relevant but under-researched topic in epilepsy research. This study was done to assess the disclosure strategies in parents of CWE in a developing country with conservative culture. The study also assessed the influence of demographic factors and seizure characteristics on the choice of disclosure. Enablers and barriers behind disclosure and the consequences after disclosure were evaluated., Methods: A cross-sectional analytical, self-report survey was done in 284 parents of CWE with the help of a semi-structured questionnaire over a 7-month period in the paediatric epilepsy clinic. Disclosure was considered present if epilepsy was revealed to two or more of the five target groups (extended family, school, friends, neighbours, and peers of children). Separate set of questions was given for reasons behind their choice and consequences after disclosure. For continuous variables, unpaired T test or Mann - Whitney U test between group and for categorized variables, Pearson's Chi square test or Fisher's exact test was used., Results: 92.96 % of 284 subjects disclosed their child's epilepsy while 7.04% concealed. Demographic factors and seizure characteristics did not influence the disclosure choice. Most parents revealed to the extended family followed by teachers. Type of seizure was the commonest information revealed. The main reason behind disclosure was better acceptance of the child followed by safety while main barrier was considering epilepsy as private grief. 92.8% felt their children were better accepted after disclosure., Conclusion: Disclosure practices have improved in parents of CWE in India and well-being and safety of the child has overridden the fear of stigma and discrimination. This could be the first major step to bring epilepsy out of the shadows at national and global levels., (Copyright © 2021 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Malaria in India, while decreasing, remains a serious public health problem, and the contribution of submicroscopic and asymptomatic infections to its persistence is poorly understood. We conducted community surveys and clinic studies at three sites in India differing in their eco-epidemiologies: Chennai (Tamil Nadu), Nadiad (Gujarat), and Rourkela (Odisha), during 2012-2015. A total of 6,645 subject blood samples were collected for Plasmodium diagnosis by microscopy and PCR, and an extensive clinical questionnaire completed. Malaria prevalence ranged from 3-8% by PCR in community surveys (24 infections in Chennai, 56 in Nadiad, 101 in Rourkela), with Plasmodium vivax dominating in Chennai (70.8%) and Nadiad (67.9%), and Plasmodium falciparum in Rourkela (77.3%). A proportional high burden of asymptomatic and submicroscopic infections was detected in community surveys in Chennai (71% and 71%, respectively, 17 infections for both) and Rourkela (64% and 31%, 65 and 31 infections, respectively). In clinic studies, a proportional high burden of infections was identified as submicroscopic in Rourkela (45%, 42 infections) and Chennai (19%, 42 infections). In the community surveys, anemia and fever were significantly more common among microscopic than submicroscopic infections. Exploratory spatial analysis identified a number of potential malaria hotspots at all three sites. There is a considerable burden of submicroscopic and asymptomatic malaria in malarious regions in India, which may act as a reservoir with implications for malaria elimination strategies.

The burden of atherosclerotic cardiovascular (CV) disease is alarmingly high and increasing in our country. Dyslipidemia is one of the major modifiable risk factors, and INTERHEART study showed that dyslipidemia had the highest population attributable risk for myocardial infarction. In the management of dyslipidemia, low-density lipoprotein cholesterol (LDL-C) is the primary therapeutic target. In addition to therapeutic lifestyle changes, statins and ezetimibe effectively lower LDL-C and consequently improve CV outcomes. However, there are situations where these drugs fall short of achieving the target or they may not be well tolerated., (© Journal of the Association of Physicians of India 2011.)

Background: Dropout from an outpatient clinic is the loss of patient to the scheduled follow-up. Noncompliance in the form of treatment dropouts is a major problem across outpatient mental health settings and can range from 15% to 60%. Follow-up studies provide valuable insights into improving the quality of existing mental health facilities. Quality Rights Gujarat (QRG) is a step toward improving mental health facilities across various centers., Methods: This retrospective observational study aims to explore follow-up pattern, predictors and any change after QRG implementation. Pre intervention Group (A) attended psychiatry OPD for 6 months before implementation of QRG project and Post intervention Group (B) attended psychiatry OPD for 3 months after implementation of QRG project., Results: Total 1632 Patients consulted in group A and 926 patients consulted Psychiatry OPD in group B. The most common Psychiatric disorder were Depression (A-19.55%, B-28.62%), Schizophrenia and related disorders (A-14.15%, B-15.01%), Neuropsychiatric disorders like headache and epilepsy (A-14.52%, B-18.68%), substance use disorder (A-15.26%, B-13.71%) and Bipolar disorder (A-11.76%, B-13.17%). 59.56% patients dropped out after the first visit in pre intervention group as compared to 51.94% patients in post intervention group. Significant reduction of about 8% in loss to follow up and 16% increase in follow-ups of initial visits after implementation of Quality Rights Gujarat project., Conclusions: Much can be done to improve attendance in most services. The initiative like QRG significantly has positive results on patient's follow-up., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The epidemiological data are limited for the spontaneous adverse drug reaction (ADR) reporting system in psychiatry and its comparison with intensive monitoring studies in terms of causative drugs, seriousness, preventability and drug interactions. This spontaneous ADR reporting study was carried out over a period of three years in the psychiatry department. We adopted WHO definition for an ADR, Naranjo's algorithm for causality, WHO-ADR terminology for the labeling of involved organ-system, International conference on harmonisation (ICH) E2A guidelines for seriousness, modified Schumock and Thornton's criteria for preventability and Medscape drug interaction checker for drug interactions. Two subgroup analyses were performed to find out the risk factors for the serious and preventable reactions. A total of 97 ADRs from 67 patients were included for analysis. The incidence of 'overall' and 'serious ADRs were 0.69% (95% CI: 0.54%, 0.88%) and 0.18% (95% CI: 0.12-0.29%), respectively. The females experienced more ADRs than males. The most commonly reported ADR, incriminated pharmacology group and drug, were extrapyramidal movement disorders (22.68%), atypical antipsychotics (35.62%) and escitalopram (13.91%), respectively. One out of five and one out three reactions were considered as 'serious' and 'preventable', respectively. The drug interactions contributed in 34.02% reactions. The factors significantly associated with 'serious' reactions were typical antipsychotics [OR: 5.47 (1.68, 17.87)], central and peripheral nervous system disorders [OR: 24.00 (5.12, 112.5)] and extrapyramidal reactions [OR: 14.03 (4.43, 44.43)]. The polypharmacy [OR: 5.85 (1.90, 18.03)] was significantly associated with 'preventable' reactions. The spontaneous reporting system is efficient to detect serious reactions and preventable reactions., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Water extract of respirable particulate matter (RPM) was analyzed by Ion chromatography technique to investigate the presence of nitrite (NO2) as secondary aerosol in ambient environment. The nitrite particulates undergo photo hydroxyl radical reaction in environment produce nitrous acid, which reacts with metal and absorbs on RPM as water-soluble metal salt. The mean concentration of nitrite was 20.86 microg m(-3) in ambient environment. Regression analysis showed that the relationship for respirable particulate matter and nitrite (RPM-NO2, R2 = 0.742) was positively significant. We are reporting the presence of nitrite as an aerosol in ambient environment.

Aims: To study the profile of irritable bowel syndrome (IBS), and the frequency of such symptoms among the general population, in India., Methods: In this prospective, multi-center study, data were obtained from 2785 patients with chronic lower gastrointestinal symptoms (complainants) with no alarm feature and negative investigations for organic causes visiting physicians at 30 centers, and from 4500 community subjects (non-complainants), using separate questionnaires., Results: Most complainants were middle-aged (mean age 39.4 years) and male (1891; 68%). The common symptoms were: abdominal pain or discomfort (1958; 70%), abdominal fullness (1951; 70%); subjective feeling of constipation (1404 of 2656; 53%), or diarrhea (1252 of 2656, 47%), incomplete evacuation (2134; 77%), mucus with stools (1506; 54%), straining at stools (1271; 46%), epigastric pain (1364; 49%) and milk intolerance (906; 32%). Median stool frequency was similar in patients who felt they had constipation or those who felt they had diarrhea. Information to subtype symptoms using standard criteria was available in 1301 patients; of these, 507 (39%) had constipation-predominant IBS ( 3 3 stools/day) and 744 (57%) had indeterminate symptoms. Among non-complainants, most subjects reported daily defecation frequency of one (2520 [56%]) or two (1535 [34%]). Among non-complainants, 567 (12.6%) reported abdominal pain, 503 (11%) irregular bowel, 1030 (23%) incomplete evacuation, 167 (4%) mucus and 846 (18%) straining at stools; a combination of abdominal pain or discomfort relieved by defecation, and incomplete evacuation was present in 189/4500 (4.2%) community subjects., Conclusions: Most patients with IBS in India are middle-aged men, and have a sense of incomplete evacuation and mucus with stools. Abdominal pain or discomfort is frequent but not universal. Importantly, stool frequency was similar irrespective of whether the patients felt having constipation or diarrhea. Most (90%) non-complainant subjects had 1 or 2 stools per day; symptoms complex suggestive of IBS was present in 4.2% of community subjects.

This study compares the blood pressure (BP) in young population of North India and South India. Age, height and sex specific BP was estimated for 6320 North Indian subjects aged 7-18 years and compared with BP values of South Indian subjects. North Indian boys and girls had lower diastolic BP (DBP) with no difference in systolic BP (SBP) than South Indian boys and girls between 7-12 years. Between 13-18 years North Indian boys and girls had significantly higher SBP with no difference in DBP. The significant regional differences in BP distribution among young Indians suggest considering geographic location of the population in evaluating blood pressure.

Background: Cirrhotic cardiomyopathy has been reported to be a major cause of morbidity and mortality in liver transplant recipients. However, there is scant data from Asia. With liver transplantation programs gradually being established in the region, Asian hepatologists are bound to face this entity., Methods: Thirty patients with alcoholic cirrhosis and 30 with cirrhosis of nonalcoholic etiology were enrolled, after excluding those with recent bleeding, gross ascites, severe anemia and other conditions which could alter cardiovascular status. Thirty healthy subjects without cardiovascular risk factors were enrolled as controls. Hepatic function status was assessed by biochemical tests and prothrombin time. Cardiac structural and functional assessment was performed non-invasively using transthoracic echocardiography., Results: Deceleration time was significantly (P < 0.05) prolonged in both the cirrhotic groups (235.03 +/- 44.23 ms and 255.87 +/- 46.16 ms) compared to controls (185.83 +/- 25.04 ms), indicative of diastolic dysfunction in cirrhotic patients. Other parameters, viz. ejection fraction, E : A ratio, left ventricular relative wall thickness, interventricular septal thickness and left ventricular systolic as well as diastolic chamber dimensions did not show statistically significant difference between any of the groups. Cardiac structural and functional parameters were not correlated with the severity of liver dysfunction. There was no statistically significant difference between the alcoholic and nonalcoholic groups., Conclusions: Asian patients with cirrhosis do have evidence of diastolic dysfunction. Cardiac structural and functional parameters did not correlate with the severity of liver dysfunction. Cardiac dysfunction seemed to be the consequence of cirrhosis itself, rather than of alcohol.

Background: The blood pressure levels may vary in population because of genetic, ethnic and socio economic factors. Local reference values have to be established to understand the blood pressure variable., Methods: Blood pressure data of 2278 boys and 2930 girls in the age group of 3-18 years were analysed to study the distribution pattern of systolic blood pressure and diastolic blood pressure and to develop reference values to define hypertension. Blood pressure was measured using standardised techniques in all. The first and fifth phases of Korotkoff sounds were taken as indicative of systolic blood pressure and diastolic blood pressure respectively. Height percentiles were computed for each one year age group. According to percentiles of height 50th, 90th, 95th and 99th percentiles of systolic blood pressure and diastolic blood pressure were estimated for every one year age., Results: The blood pressure (both systolic and diastolic) tends to increase with age. The stepwise regression analysis revealed that the age and height but not gender, are important determinants of blood pressure. Age and height specific, 50th, 90th and 95th and 99th percentiles of systolic and diastolic blood pressure were derived and are presented in tabular form., Conclusion: The blood pressure of children and adolescents can be evaluated using the reference table according to body size. The table provided helps to classify blood pressure as normal or pre hypertension and to define different stages of hypertension.

Background: Small-bowel diarrhea is reported to account for 10% of all cases of chronic diarrhea. Data on the etiology and clinical presentation of chronic small-bowel diarrhea in adult Indians is scarce., Methods: 50 patients (mean age 32.8 years; 26 men) with chronic small bowel diarrhea were evaluated clinically, and investigated to determine etiology. The diagnosis of small-bowel diarrhea was based on history, stool volume and associated symptoms., Results: Abdominal pain (n=22, 44%) and weight loss (n=37, 74%) were the most common symptoms, apart from diarrhea. Anemia (70%) and hypoalbuminemia (48%) were other important biochemical abnormalities. Intestinal tuberculosis (26%) and celiac disease (26%) were the most common causes of chronic small-bowel diarrhea., Conclusion: Tuberculosis of intestine and celiac disease are common causes of small-bowel diarrhea in our population. Tropical sprue seems to be a rare cause.

Exposure to benzene and toluene from the combustion of solid biomass fuels is one of the important causes of morbidity and mortality in developing countries. In this study, we assessed the exposure of cooks to benzene and toluene from biomass fuel combustion in 55 rural homes. The GC-MS was used for quantification while a personnel sampler was used for environmental monitoring. The benzene exposure differed significantly (p < 0.0001) across different types of indoor kitchen fuel combinations. The geometrical mean (GM) of benzene exposure for cooks during cooking hours in an indoor kitchen using mixed fuel was 75.3 microg/m3 (with partition) and 63.206 microg/m3 (without partition), while the exposure was 11.7 microg/m3 for open type. The benzene exposure was significantly higher (p < 0.05) in an indoor kitchen with respect to open type using mixed fuels. Concentration of benzene (114.1 microg/m3) for cooks in an indoor kitchen with partition using dung fuel was significantly higher in comparison to non-cooks (5.1 microg/m3) for open type. Benzene exposure was not significantly different for kitchen with ventilation (31.2 microg/m3) and without ventilation (45.0 microg/m3) using wood fuel. However, this value was significantly (p < 0.05) lower than in indoor kitchens with or without partition. An almost similar trend was observed for toluene but the difference was statistically non-significant. This study may be helpful in developing a regional exposure database and in the facilitation of health risk assessment due to volatile organic pollutants in our day-to-day environment.

Background: Prokinetic drugs are widely used for treatment of non-ulcer dyspepsia (NUD)., Aims and Objectives: To assess the efficacy and tolerability of a new prokinetic agent, itopride hydrochloride in patients of NUD and compare it with domperidone., Methods: Fifty-six patients who fulfilled the inclusion and exclusion criteria were enrolled in the study. Patients underwent upper gastrointestinal endoscopy to rule out organic pathology as a cause for their symptoms. The patient's symptoms were graded on a 4-point scale (0 to 3) at the beginning of treatment and at the end of Week-one and Week-two Patients were randomly allocated to receive either one tablet of itopride hydrochloride 50mg three times daily or one tablet of domperidone 10mg three times daily for two weeks. Pre-treatment and post-treatment hemogram, liver function and renal function tests, prolactin level and ECG were done in all patients. The response to therapy was evaluated by assessing the relief of symptoms at the end of two weeks on a 5-point scale. Statistical analysis was done using two-tailed paired t-test; Wilcoxon matched pairs ranks sum test, Mann-Whitney-U test and chi-square test as applicable., Results: Of the fifty-five patients enrolled in the study (age range of 18-60 yrs, median age of 35yrs), 26 were males and twenty nine were females. They had a median duration of symptoms for 4 weeks. Twenty-seven patients received itopride and 28 received domperidone. One patient did not follow up in the domperidone group, thus 54 patients were evaluable for analysis. Moderate to complete symptomatic relief was observed in 22 (81%) patients in the itopride group and 19 patients (70%) in the domperidone group (p > 0.05, NS). Both the drugs were well tolerated and neither caused prolongation of QT interval nor any abnormality in any serum biochemistry values., Conclusion: Therapy with itopride resulted in good symptomatic relief, was safe, well tolerated and comparable in efficacy to domperidone in relieving the symptoms of NUD. By virtue of its efficacy and tolerability, it could be an ideal choice for providing symptomatic relief to patients suffering from non-ulcer dyspepsia.

Self-report validity of recent drug use among heroin abusers depends on many factors including the population being studied and the setting in which the study is carried out. This study was conducted by the treating physicians to assess the self-report validity of recent heroin use by heroin dependent patients in the outdoor setting using 'thin layer chromatography' (TLC) and two highly sensitive methods of urinalysis viz. 'gas liquid chromatography' (GLC) and 'high performance liquid chromatography' (HPLC). Out of seventy-six heroin dependent patients who entered the study, 64 provided urine sample on the same day. Patients' self-report about recent opiate use was found to have a moderate agreement with urinalysis report. However, it is important to validate it with urinalysis during the treatment process because a substantial proportion of patients fails to report recent opiate use. It is recommended that all drug dependence treatment centres should be equipped with a sensitive urinalysis facility. Otherwise, the outcome of the treatment process should be considered with caution.

Objective: Asthma is well controllable but non-curable disease. Exact pathophysiology involved is unresolved till today. Role of allergic hypersensitivity reaction in asthmatic on-set is well established. Present work is an effort to elucidate some basic points of unresolved pathophysiology of asthma taking platelets as marker., Material and Methods: A group of 52 normal human subjects in the age group of 20-60 years were studied for platelet histamine and serotonin levels and also for their plasma metabolising enzymes diamine oxidase (DAO) and monoamine oxidase (MAO). The data was collected for 79 asthmatic patients at different stages of asthma and accordingly were studied as four different groups of seventy nine asthmatics those were on regular treatment and were comfortable with drugs and were free from symptomatic attack formed gr. I; these (79) patients were followed-up during their symptomatic phase (gr. II) and same (79) patients immediately after their recovery from symptomatic stage studied as gr. III members. All the 79 asthmatic patients fall in gr. I, II and III in a serial manner i.e. all (n = 79) in each group. A separate group of thirty seven patients with known history of asthma but were symptom free and also off drugs for last 2-4 years formed gr. IV., Results: Results showed mean platelet count in asthmatics at all four stages were in the normal range but were slightly low in comparison with normals. Both the enzymatic levels (DAO and MAO) in gr. I, II and III were significantly higher than normals but were same in the case of gr. IV patients. Low levels of platelet biogenic amines were observed in asthmatics (gr. I to gr. IV) than normals., Conclusions: Thus, study parameters showed significant difference in asthmatics and normals. Findings of the study have been utilized to understand unanswered hypersensitivity shown by the asthmatics over normal individuals (non-asthmatics).

We studied the frequency of jaundice, bilirubin estimations, phototherapy administration and exchange transfusions performed at 5 year intervals (1981, 1986 and 1991) among babies admitted to special care unit and those managed in postnatal ward, showing a decline which was significant except for the number of exchange transfusions performed. The number of term babies with serum bilirubin > 15 mg/dl and preterm babies with serum bilirubin > 10 mg/dl also declined significantly without prophylactic phototherapy or pharmacotherapy.

Angiogenesis is essential for tumor growth and metastasis. In the present study we investigated the prognostic significance of microvessels (MV) density using immunohisto-localization of factor VIII antigen in 51 breast cancer patients. We counted microvessels per 200x field in the most active areas of neovascularization by staining factor VIII related antigen and graded MV density and correlated with stage, LN involvement and histologic grade. Patients who subsequently developed metastases had significantly high MV counts than patients without metastatic disease (p < 0.001). Patients who subsequently died of the disease had significantly high mean microvessels counts than patients who remained alive at the end of 5 years (p < 0.001). As density of factor VIII antigen staining increased the survival decreased (p < 0.001). All the patients having > 25 MV per 200x field had tumor recurrence faster as compared with patients having < 25 MV (p < 0.02). Thus, the MV count correlates with the prediction for metastasis and poor survival. Such an indicator would be useful in selection of a subgroup of patients with breast cancer who are at high risk for having occult metastasis at presentation and subsequently would benefit from aggressive therapy.

The undisputed long term solution to prevent nutritional blindness lies in changing the dietary habits of a given population through nutritional education, nutritional supplementation, and nutritional rehabilitation. Before such strategies can be successfully implemented, it becomes necessary to study the existing dietary pattern of the population and to identify locally grown foods rich in vitamin A. Seventy eight rural women were interviewed to determine the common dietary items in western Rajasthan. These items were then matched with their B-carotene contents, only to discover that, 100 grams of any of them would not provide the RDA for a 1-3 year old child, with the exception of Suva (Peucedanum graveolens) and Bathua (Chenopodium album) leaves. The B-Carotene contents of several food items is unknown at present and there is an urgent need to evaluate them.

Fifty five deaths between January, 1982 to September, 1989 in children with acute lymphoblastic leukemia (ALL) were evaluated to determine the cause of mortality. Fifty cases died during remission. Infection alone was responsible for death in 26 of 55 (47.3%) cases while hemorrhage was seen in 7 (12.7%) children. Infection and hemorrhage together were responsible in another 13 cases. Gastrointestinal tract and pulmonary system were the major sites of bleeding. Infections either alone or in combination with other factors were responsible for death in 42 of 55 (76.5%) of children. Septicemia (n = 11), gastrointestinal (n = 15) and pulmonary infections (n = 10) and meningitis in 2 cases were the major sites of infections. Pseudomonas and Klebsiella in 6 cases each accounted for 54.5% of isolates.

Even though the primary prevention of many eye diseases can be effectively incorporated into the existing pattern of rural eye camps, efforts in this direction are restrained and insubstantial. We describe our technique and experience in the prevention of xerophthalmia by organising a distinct entity called a xerophthalmia clinic in our eye camps. The clinic consists of an Ophthalmologist or an Ophthalmic assistant who will exclusively examine children who come to the eye camp. This is perhaps, the first report on rural xerophthalmia clinics, in ophthalmic literature. Over a seven year period from 1984 to 1990 we have conducted 71 xerophthalmia clinics amongst the ninty eye camps organised. A total of 11,370 children were examined in the xerophthalmia clinic out of which 18.9% were afflicted with the disease. Therapeutic doses of Vitamin A were administered on the spot to the afflicted and prophylactic doses were administered to the rest. Intensive health education efforts are made through clinics to effectuate change in dietry habits towards consumption of locally grown DGLV (Dark Green Leafy Vegetables) like Anthenum, chenopodium and Amaranthus. A bipronged offensive consisting of mega-dosing and health education is, for the present and the foreseeable future, the best strategy to combat xerophthalmia in this desert region. A year by year breakdown of prevalence rates in the present study shows that in years of severe drought the prevalence of xerophthalmia increases three fold over the non-drought or mild drought years, thereby demonstrating that drought is a substantial risk factor in developing countries leading to vitamin A deficiency and xerophthalmia.

The results are presented of a rapid survey screening method of general population for identifying dependent and non dependent drug abusers, especially in vulnerable groups such as slum dwellers. The results showed that with the help of instrument with modified DSM III and interviewing only the heads of the households it was possible to get reliable estimates of dependence disorder in the community. This method can be of assistance to health planners for a quick assessment of the magnitude of the problem leading to better allocation of funds and developing services for the affected population. The method is an improvement on key informant technique and a full fledged survey.

This study is aimed at presenting the profile of ocular lesions observed in the inmates of a leprosy rehabilitation centre. Corneal involvement was found to be the highest (52.7%), followed by lesions of the eyebrows (47.3%) and eyelids (30.9%), uveal tract involvement (18.1%) and chronic conjunctivitis (1.8%).

1 Antipyrine clearance has been measured using saliva samples in 50 Maharashtrans from a village to the north of Bombay. 2 All subjects were very lean and were also anaemic probably as a result of hookworm infestation. 3 Antipyrine clearance was 36% faster than in White Londoners studied previously and more than twice as fast as in Asian immigrants living in London. 4 Clearance was 25% faster in men than in women but volume of distribution was also greater in men and mean half-lives did not differ significantly between the sexes. 5 There was a negative correlation between antipyrine clearance and haemoglobin concentration. 6 The study has identified geographic differences in antipyrine metabolism which could be clinically important. The role of anaemia merits further study.

School children form an important large target group which must be screened adequately for early detection of eye diseases and prevention of blindness. A total approach in a school eye health programme must include teacher orientation and health education of children in addition to screening for eye diseases. The ocular morbidity pattern in 5135 school children of Jodhpur is discussed in this paper and it is hoped that it will be an indicator to all eye care agencies to help plan their priorities in the delivery of school based eye care.

The prevalence of xerophthalmia was studied in 5135 school children of Jodhpur ranging between 6 and 16 years of age. The total prevalence of xerophthalmia was found to be 9.89%. Night blindness (XN) and milder conjunctival form (XIA, XIB) of the disease were predominantly prevalent in the studied population. Corneal disease (X2, X3A, X3B) was found in 8 cases and xerophthalmia scar (XS) in only one case. Recognition of early xerophthalmia and urgent vitamin A therapy is of paramount importance to preclude the onset of the corneal stage and irreversible blindness. It is suggested that xerophthalmia screening be made an essential component of routine medical check-up in schools with XN (night blindness with or without conjunctival xerosis) and XIB (Bitot's spots) used as criterion for screening to effectuate early detection and treatment of xerophthalmia.

The effect of the menstrual cycle on antipyrine pharmacokinetics was studied in 11 normal, healthy Indian female volunteers. Antipyrine half-life, apparent volume of distribution, clearance and AUC were calculated by standard methods. Results indicated that in females, antipyrine half-life was significantly longer on day 5 as compared with that on days 15 and 21 of the menstrual cycle. It appears that hormonal changes during the menstrual cycle affect the pharmacokinetics of drugs in normal healthy females.