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Background and Objectives: Diabetes Mellitus (DM) is a significant health concern in India, characterized as a modern-day epidemic, with the potential to affect multiple organs and lead to various complications. Cardiac autonomic neuropathy (CAN) represents one of the serious yet often overlooked complications of diabetes. This study aims to ascertain the prevalence of CAN in diabetic patients and investigate its correlation with the duration of DM and glycemic control. Materials and Methods: 134 diabetic patients were included based on predetermined criteria. Demographic information, medical history, and clinical examinations were recorded. CAN assessment involved three tests for parasympathetic and two tests for sympathetic function, with patients categorized as normal, early CAN, definite CAN, or severe CAN according to Ewing's criteria. Results: The prevalence of CAN among the study population was 60%. Individuals with CAN exhibited significantly longer durations of diabetes and higher HbA1c levels compared to those with normal cardiac autonomic function. CAN showed a significant association with DM duration and glycemic control, but not with age. CAN patients presented with background retinopathy, various retinopathies, maculopathy and clinical symptoms such as diabetic foot, cataracts, muscle wasting, and tingling. Conclusion: CAN emerges as a prevalent and often asymptomatic consequence of diabetes. Hence, routine screening for CAN is recommended for all diabetic patients to facilitate early detection and intervention. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a major public health problem among non communicable diseases in India. It is an important area of research due to its high prevalence and being major risk factor for cardiovascular diseases and other complications. Objectives: Aim of this study to determine the prevalence of hypertension and its associated risk factors among adult population living in study area. Material & Methods: This was a cross sectional observational study conducted in department of medicine, in a tertiary care hospital, India. Participants > 18 years of age with both sexes were enrolled in the study. A socio-demographics data was collected; family history of hypertension, clinical examination, blood pressure measurement and all relevant investigation was done. Results The prevalence of hypertension among study participants was 24.35%. Prevalence of hypertension was found more in male subjects as compared to females' subjects. The risk factors found to be significantly associated with HTN in this study were increasing age, male gender, family history of hypertension, obesity (high\BMI), diabetes, smoking, alcohol, sedentary lifestyle and hyperlipidemia Conclusion: There is significant association of hypertension was found in obesity, smoking, alcohol consumption, physical inactivity, stress and diabetes mellitus. Strong public health measures need to be seriously implemented to combat hypertension and its consequences. [ABSTRACT FROM AUTHOR]

Understanding natural phenomena with the help of modern scientific approaches helps to reach sustainable solutions for current and future water-related problems. In this context, present study aims to assess relative influencing level of physical factors in controlling groundwater level, using a novel grid-based delineation technique, in Lower Palar River Basin, in Kanchipuram and Chengalpattu districts of South India. The influencing factors viz-a-viz: rainfall, soil texture, land use/land cover, terrain slope, geomorphology, lithology, and drainage characteristics were considered for the study. Archived data (2011 to 2020) of monthly rainfall at four rain gauge stations and monthly groundwater level of 22 locations, soil texture, lithology, and geomorphology data were considered for the study. SRTM digital elevation model with 30-m resolution was used for analyzing drainage characteristics and terrain slope. Thematic maps for considered factors were prepared, using common grid delineation method in GIS platform that divided study area into 52 grids, to inter-relate the discrete and continuous parameters with groundwater level. Results indicate that level of influence increases in the order of precipitation followed by lithology, land use/land cover, terrain slope, geomorphology, infiltration number, and soil texture. The study shows groundwater resilience is highly influenced by soil texture and infiltration number compared to other factors considered. It can be concluded that grid-based delineation successfully identifies grids with significant influence of individual factors by comparing with groundwater resilience. Common grid-based delineation method proves to be more effective in assessing groundwater resilience and can be used more efficiently in groundwater studies., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Fluoride pollution is a major issue worldwide, posing health risks such as dental and skeletal fluorosis. This study was conducted in fluoride enrichment hard rock regions of Vaniyambadi and Ambur talks in Tirupathur district, Tamil Nadu. Four hundred eighty groundwater samples were collected from May 2021 to April 2022 and grouped as summer, southwest monsoon (SWM), northeast monsoon (NEM), and winter. Maximum concentration of fluoride was found to be 4 mg/L in the summer season in Vellakuttai region of Vaniyambadi taluk. The study aims to investigate the hydrogeochemical process and mechanism influencing groundwater chemistry and it also provides the confirmation of exploratory data analysis in groundwater quality using structural equation modeling. The Piper and Gibbs diagrams illustrate the rock-water interaction and anthropogenic sources that contribute to the NaHCO 3 and NaCl-type waters, respectively. Multivariate statistical analysis such as hierarchical cluster analysis (HCA), principal component analysis (PCA), multiple linear regression (MLR), and structural equation modeling (SEM) has been carried out to determine the groundwater quality. HCA manifests the nature and sources of groundwater, whereas PCA divides all the physicochemical parameters into two PC loadings, accounting for 97.46%, 99.46%, 99.18%, and 98.93% of cumulative % of variance during the summer, SWM, NEM, and winter seasons, respectively. PC1 has a higher loading factor to Cl, Ca, and Mg, whereas PC2 has a higher loading factor to Na, HCO 3 , SO 4 , and NO 3 . The results of the MLR model provide higher accuracy in detecting the contamination factors associated with the environment and natural rocks. SEM revealed the goodness-of-fit indices 0.993, 0.999, 1.000, and 0.999 in summer, SWM, NEM, and winter, respectively. Hence, this study provides insight view of variation of fluoride concentration in groundwater in different seasons and also mentions the factors that influence fluoride concentration in Vaniyambadi and Ambur taluk., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: An unprecedented rise in the number of COVID-19-associated mucormycosis (CAM) cases has been reported in India. Myriad hypotheses are proposed for the outbreak. We recently reported uncontrolled diabetes and inappropriate steroid therapy as significant risk factors for the outbreak. However, Mucorales contamination of hospital environment was not studied., Aim: To perform a multi-centre study across India to determine possible Mucorales contamination of hospital environment during the outbreak., Methods: Eleven hospitals from four zones of India representing high to low incidence for mucormycosis cases were included in the study. Samples from a variety of equipment used by the patients and ambient air were collected during May 19 th , 2021 through August 25 th , 2021., Findings: None of the hospital equipment sampled was contaminated with Mucorales. However, Mucorales were isolated from 11.1% air-conditioning vents and 1.7% of patients' used masks. Other fungi were isolated from 18% of hospital equipment and surfaces, and 8.1% of used masks. Mucorales grew from 21.7% indoor and 53.8% outdoor air samples. Spore counts of Mucorales in air were significantly higher in the hospitals of North and South zones compared to West and East zones (P < 0.0001). Among Mucorales isolated from the environment, Rhizopus spp. were the most frequent genus., Conclusion: Contamination of air-conditioning vents and hospital air by Mucorales was found. Presence of Mucorales in these areas demands regular surveillance and improvement of hospital environment, as contamination may contribute to healthcare-associated mucormycosis outbreaks, especially among immunocompromised patients., (Copyright © 2022 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)

Introduction: Many of the assessment tools used to study depression amongst older people in low- and middle- income countries (LMICs) are adaptations of instruments developed in other cultural settings. There is a need to validate those instruments in LMICs., Methods: 721 men and women aged 55-80 years from the Mysore Birth Records Cohort underwent standardised assessments for sociodemographic characteristics, cardiometabolic risk factors, cognitive function and mental health. Sensitivity, specificity and level of agreement of EURO-D diagnosis of depression with diagnosis of depression derived by the Geriatric Mental State (GMS) examination were calculated. To validate the EURO-D score against GMS depressive episode, we used maximum Youden's index as the criterion for each cut-off point. Concurrent validity was assessed by measuring correlations with the WHO Disability Assessment Schedule (WHO DAS II)., Results: Of the 721 (408 men and 313 women) who participated in this study, 138 (54 men and 84 women) were diagnosed with depression. Women had higher depression scores on the EURO-D scale and disability on the WHO DAS II scale. A maximum Youden's Index of 0.60 was observed at a EURO-D cut-off of 6, which corresponded to 95% sensitivity, 64% specificity, kappa value of 0.6 and area under the curve (AUC) of 80%. There was significant and positive correlation between EURO-D and WHO DAS II scores., Limitations: Future independent validation studies in other settings are required., Discussion: This study supports the use of the EURO-D scale for diagnosing depression amongst older adults in South India., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Lack of robust data on economic burden due to enteric fever in India has made decision making on typhoid vaccination a challenge. Surveillance for Enteric Fever network was established to address gaps in typhoid disease and economic burden., Methods: Patients hospitalized with blood culture-confirmed enteric fever and nontraumatic ileal perforation were identified at 14 hospitals. These sites represent urban referral hospitals (tier 3) and smaller hospitals in urban slums, remote rural, and tribal settings (tier 2). Cost of illness and productivity loss data from onset to 28 days after discharge from hospital were collected using a structured questionnaire. The direct and indirect costs of an illness episode were analyzed by type of setting., Results: In total, 274 patients from tier 2 surveillance, 891 patients from tier 3 surveillance, and 110 ileal perforation patients provided the cost of illness data. The mean direct cost of severe enteric fever was US$119.1 (95% confidence interval [CI], US$85.8-152.4) in tier 2 and US$405.7 (95% CI, 366.9-444.4) in tier 3; 16.9% of patients in tier 3 experienced catastrophic expenditure., Conclusions: The cost of treating enteric fever is considerable and likely to increase with emerging antimicrobial resistance. Equitable preventive strategies are urgently needed., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)

Background: Systematic studies to estimate the disease burden of typhoid and paratyphoid in India are limited. Therefore, a multicenter study on the Surveillance of Enteric Fever in India was carried out to estimate the incidence, clinical presentation, and antimicrobial resistance (AMR) trend. The data presented here represent the national burden of AMR in Salmonella Typhi and Salmonella Paratyphi A., Methods: Antimicrobial susceptibility testing was performed for S. Typhi and S. Paratyphi A (n = 2373) isolates collected prospectively during a 2-year period from November 2017 to January 2020., Results: Of 2373 Salmonella isolates, 2032 (85.6%) were identified as S. Typhi and 341 (14.4%) were S. Paratyphi A. Approximately 2% of S. Typhi were multidrug-resistant (MDR), whereas all 341 (100%) of S. Paratyphi A isolates were sensitive to the first-line antimicrobials. Among 98% of ciprofloxacin nonsusceptible isolates, resistance (minimum inhibitory concentration [MIC] >0.5 µg/mL) was higher in S. Typhi (37%) compared with S. Paratyphi A (20%). Azithromycin susceptibility was 99.9% and 100% with a mean MIC of 4.98 μg/mL for S. Typhi and 7.39 μg/mL for S. Paratyphi A respectively. Ceftriaxone was the only agent that retained 100% susceptibility. Moreover, beta-lactam/beta-lactamase inhibitors showed potent in vitro activity against the study isolates., Conclusions: Data obtained from this systematic surveillance study confirms the declining trend of MDR Salmonella isolates from India. The higher prevalence of ciprofloxacin nonsusceptibility enforces to limit its use and adhere to the judicious usage of azithromycin and ceftriaxone for enteric fever management., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)

Background: Ileal perforation occurs in about 1% of enteric fevers as a complication, with a case fatality risk (CFR) of 20%-30% in the early 1990s that decreased to 15.4% in 2011 in South East Asia. We report nontraumatic ileal perforations and its associated CFR from a 2-year prospective enteric fever surveillance across India., Methods: The Surveillance for Enteric Fever in India (SEFI) project established a multitiered surveillance system for enteric fever between December 2017 and March 2020. Nontraumatic ileal perforations were surveilled at 8 tertiary care and 6 secondary care hospitals and classified according to etiology., Results: Of the 158 nontraumatic ileal perforation cases identified,126 were consented and enrolled. Enteric fever (34.7%), tuberculosis (19.0%), malignancy (5.8%), and perforation of Meckel diverticulum (4.9%) were the common etiology. In those with enteric fever ileal perforation, the CFR was 7.1%., Conclusions: Enteric fever remains the most common cause of nontraumatic ileal perforation in India, followed by tuberculosis. Better modalities of establishing etiology are required to classify the illness, and frame management guidelines and preventive measures. CFR data are critical for comprehensive disease burden estimation and policymaking., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)

Purpose: Autorefractors allow non-specialists to quickly assess refractive error, and thus could be a useful component of large-scale vision screening programs. In order to better characterize the role of autorefraction for public health outreach programs in resource-limited settings, the diagnostic accuracy of two autorefractors was assessed relative to subjective refraction in an adult Indian population., Methods: An optometrist refracted a series of patients aged ≥50 years at an eye clinic in Bangalore, India using the Nidek ARK-900 autorefractor first, followed by the 3nethra Royal autorefractor, and then subjective refraction. The diagnostic accuracy of each autorefractor for myopia, hyperopia, and astigmatism was assessed using subjective refraction as the reference standard, and measures of agreement between refractions were calculated., Results: A total of 197 eyes in 104 individuals (mean age 63 ± 8 years, 52% female) were evaluated. Both autorefractors produced spherical equivalent estimates that were on average more hyperopic than subjective refraction, with a measurement bias of +0.16 D (95%CI +0.09 to +0.23D) for Nidek and +0.42 D (95%CI +0.28 to +0.54D) for 3nethra. When comparing pairs of measurements from autorefraction and subjective refraction, the limits of agreement were approximately ±1D for the Nidek autorefractor and ±1.75D for the 3Nethra autorefractor. The sensitivity and specificity of detecting ≥1 diopter of myopia were 94.6% (95%CI 86.8-100%) and 92.5% (95%CI 88.9-97.5%) for the Nidek, and 89.2% (95%CI 66.7-97.4) and 77.5% (95%CI 71.2-99.4%) for the 3Nethra. The accuracy of each autorefractor increased at greater levels of refractive error., Conclusions: The sensitivity and specificity of the Nidek autorefractor for diagnosing refractive error among adults ≥50 years in an urban Indian clinic was sufficient for screening for visually significant refractive errors, although the relatively wide limits of agreement suggest that subjective refinement of the eyeglasses prescription would still be necessary., Competing Interests: The authors have declared that no competing interests exist.

Background: The molecular structure of circulating enteric fever pathogens was studied using hospital-based genomic surveillance in a tertiary care referral centre in South India as a first genomic surveillance study, to our knowledge, of blood culture-confirmed enteric fever in the region., Methods: Blood culture surveillance was conducted at St John's Medical College Hospital, Bengaluru, between July 2016 and June 2017. The bacterial isolates collected were linked to demographic variables of patients and subjected to WGS. The resulting pathogen genomic data were also globally contextualized to gauge possible phylogeographical patterns., Results: Hospital-based genomic surveillance for enteric fever in Bengaluru, India, identified 101 Salmonella enterica Typhi and 14 S. Paratyphi A in a 1 year period. Ninety-six percent of isolates displayed non-susceptibility to fluoroquinolones. WGS showed the dominant pathogen was S. Typhi genotype 4.3.1.2 (H58 lineage II). A fluoroquinolone-resistant triple-mutant clone of S. Typhi 4.3.1.2 previously associated with gatifloxacin treatment failure in Nepal was implicated in 18% of enteric fever cases, indicating ongoing inter-regional circulation., Conclusions: Enteric fever in South India continues to be a major public health issue and is strongly associated with antimicrobial resistance. Robust microbiological surveillance is necessary to direct appropriate treatment and preventive strategies. Of particular concern is the emergence and expansion of the highly fluoroquinolone-resistant triple-mutant S. Typhi clone and its ongoing inter- and intra-country transmission in South Asia, which highlights the need for regional coordination of intervention strategies, including vaccination and longer-term strategies such as improvements to support hygiene and sanitation., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.)

Biologic disease-modifying anti-rheumatic drugs (bDMARD) have transformed the treatment paradigm of chronic autoimmune rheumatic diseases (ARDs), but they are often associated with adverse drug reactions. The present study evaluated the frequency, characteristics and type of infections, other than tuberculosis (TB), in ARD patients receiving bDMARDs. The multicentre, cross-sectional, retrospective, observational study was conducted across 12 centers in Karnataka, India, between January to August 2016. The study included patients receiving bDMARD therapy for various ARDs. Outcome variables considered were any infection, minor infections and major infections, other than TB. Clinical variables were compared between infection and no infection group, and the increase in the likelihood of infection with respect to various clinical variables was assessed. The study involved 209 subjects with a median (range) age of 41 (16-84) years and male to female ratio of 0.97:1. A total of 29 (13.88%) subjects developed infection following bDMARD therapy, out of whom a majority had minor infection (n = 26). The likelihood of developing any infection was noted to be more in subjects receiving anti-TNF (golimumab, P = 0.03) and those on three or more conventional synthetic (cs) DMARDs (P < 0.01). Infection risk was higher in patients with systemic lupus erythematosus (P = 0.04), other connective tissue disease (P < 0.01) and in patients with comorbidities (P = 0.13). The risk of infection was associated with the use of anti-TNF therapy and more than three csDMARDs, co morbidities and Adds such as systemic lupus erythematosus and connective tissue disease.

Aim: Tuberculosis (TB) is one of the major adverse events of concern associated with the use of biologics for managing autoimmune inflammatory rheumatic diseases (AIRDs). The study presents the data on incidence of TB in relation to biologic used, screening test and TB prophylaxis in a real-world setting., Methods: The cross-sectional, observational, retrospective study was conducted across 12 centres in Karnataka, India. The study included patients receiving biologics therapy for AIRDs, established based on the respective diagnostic criteria. The development of TB after receiving biologic therapy and other clinical variables and the predictability of the test performed for latent TB were evaluated., Results: One hundred and ninety-five AIRDs patients with an average age of 41 years were initiated on biologic therapy. Twenty-one patients were latent TB positive and were given antitubercular prophylaxis, prior to biologics treatment. During follow-up, seven patients belonging to the negative test group (n = 174) developed TB. The negative predictive values noted for Mantoux test (n = 120) and quantiFERON TB gold test (n = 178) were 96.52% and 96.25%, respectively. Patients on anti-tumor necrosis factor were more likely to develop TB. Presence of comorbidities and steroid use increased the likelihood of developing TB by 1.5 and 4.6 times, respectively., Conclusion: Close monitoring of patients receiving biologics is essential for early identification of adverse events, especially in test negative patients. Prophylaxis can effectively reduce the risk of developing TB in patients positive for screening., (© 2018 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

A survey on the presence of the viruses of two economically significant diseases, white spot syndrome virus (WSSV) and monodon baculovirus (MBV) in wild-collected Penaeus monodon broodstock, was conducted during different seasons of the year in two major coastal areas of southeast India. The broodstock were collected along the coast of Tamil Nadu and Andhra Pradesh during summer, premonsoon, monsoon and post-monsoon seasons for three consecutive years. A total of 7905 samples were collected and subjected to MBV screening, and 6709 samples that were screened as MBV negative were diagnosed for WSSV. MBV was detected using rapid malachite green staining and WSSV by nested polymerase chain reaction. Prevalence data of the viruses were analysed using the EpiCalc 2000 program at 95% confidence interval. Samples collected from the Andhra Pradesh coast displayed a slightly higher prevalence of WSSV and MBV infection than those collected from Tamil Nadu, although this difference was not statistically significant (P > 005). In addition, it was found that the prevalence of both WSSV and MBV infections fluctuated according to season. Data on prevalence of these viruses in broodstock would be useful to develop strategies for shrimp health management along the southeast coast of India., (© 2012 Blackwell Publishing Ltd.)

Carbapenem resistance among clinical isolates of Enterobacteriaceae, especially Escherichia coli and Klebsiella pneumoniae, is largely conferred by metallo-β-lactamase (MBL). Fifty-one non repetitive isolates of carbapenem-resistant (Meropenem and Imipenem) E. coli and K. pneumoniae were studied to determine the molecular mechanism for resistance. Presence of blaNDM and blaVIM was determined by polymerase chain reaction (PCR) and DNA sequencing. blaNDM was detected from majority of carbapenem-resistant K. pneumoniae (75%) and E. coli (66.6%). Timely detection and appropriate and aggressive infection control measures are required to control the spread of these bacteria in healthcare settings.

Objective: More than 75% of Indian toddlers are anemic. Data on factors associated with anemia in India are limited. The objective of this study was to determine biological, nutritional, and socioeconomic risk factors for anemia in this vulnerable age group., Methods: We conducted a cross-sectional study of children aged 12 to 23 months in 2 rural districts of Karnataka, India. Children were excluded if they were unwell or had received a blood transfusion. Hemoglobin, ferritin, folate, vitamin B(12), retinol-binding protein, and C-reactive protein (CRP) levels were determined. Children were also tested for hemoglobinopathy, malaria infection, and hookworm infestation. Anthropometric measurements, nutritional intake, family wealth, and food security were recorded. In addition, maternal hemoglobin level was measured., Results: Anemia (hemoglobin level < 11.0 g/dL) was detected in 75.3% of the 401 children sampled. Anemia was associated with iron deficiency (low ferritin level), maternal anemia, and food insecurity. Children's ferritin levels were directly associated with their iron intake and CRP levels and with maternal hemoglobin level and inversely associated with continued breastfeeding and the child's energy intake. A multivariate model for the child's hemoglobin level revealed associations with log(ferritin level) (coefficient: 1.20; P < .001), folate level (0.05; P < .01), maternal hemoglobin level (0.16; P < .001), family wealth index (0.02; P < .05), child's age (0.05 per month; P < .005), hemoglobinopathy (-1.51; P < .001), CRP level (-0.18; P < .001), and male gender (-0.38; P < .05). Wealth index and food insecurity could be interchanged in this model., Conclusions: Hemoglobin level was primarily associated with iron status in these Indian toddlers; however, maternal hemoglobin level, family wealth, and food insecurity were also important factors. Strategies for minimizing childhood anemia must include optimized iron intake but should simultaneously address maternal anemia, poverty, and food insecurity.

The study was carried out among the adolescents in respect to their beliefs about sexual behavior and their intended decision with regard to engaging in sexual activity. Both male and female respondents indicated that they believe that individuals of their age should wait until they are older before engaging in sexual activity. However, there were significant differences between the responses of male and female adolescents.

Background: We previously used the 24-h indicator amino acid balance method to show that the lysine requirement in undernourished Indian men from low socioeconomic and unsanitary environments is approximately 50% higher than the mean requirement of 30 mg lysine. kg(-1). d(-1) in well-nourished men., Objective: It is possible that this higher lysine requirement in persons with chronic undernutrition is due to environmental influences, including the presence of intestinal parasites. We assessed this possibility by using 24-h indicator amino acid balance (with leucine) at both the "normal" requirement for lysine intake and the higher requirement, before and after successful treatment to eradicate intestinal parasites in affected, undernourished men., Design: Fourteen chronically undernourished men were studied before and after treatment for intestinal parasites, during each of two 7-d (6-d dietary adaptation plus 1-d tracer experiment) diet periods supplying either 30 (n = 7) or 45 (n = 7) mg lysine. kg(-1). d(-1) from an L-amino acid diet. Twenty-four-hour indicator amino acid balance was estimated on day 6 by [(13)C]leucine tracer infusion., Results: Before the parasite treatment, subjects were in neutral 24-h leucine balance at both lysine intakes. After the eradication of intestinal parasites, there was a significant (P < 0.001) improvement in 24-h leucine balances, which were positive at both lysine intakes., Conclusions: On the basis of the 24-h indicator amino acid balance approach, it appears that intestinal infestation with parasites increases the requirement for lysine and that this may be one factor responsible for the higher lysine requirement observed in persons with chronic undernutrition.

Objectives: To study whether there are any differences in growth of the femoral and humeral length between the three major ethnic groups in Malaysia viz Malays, Chinese and Indians. The effect on fetal growth by gender of the baby and parity of the mother was also studied., Methods: The setting was the University of Kuala Lumpur. Thirty-four Malay, 35 Chinese and 34 Indian normal pregnant middle-class women were studied longitudinally by monthly ultrasound scans for 18 to 38 weeks of gestation. The data were subjected to regression analysis; the quadratic curve was found to be the most adequate. Dummy variables were used to determine any effects by gender, parity as well as ethnicity on the length of limb growth. There was no difference in birth weights of the three ethnic groups studied, nor in gender or parity., Results: There were found to be significant differences in limb lengths of the Indians (longer) when compared with the Malays and Chinese. Parity seems to affect only Indians in whom the multiparous fetuses have shorter limb lengths than the primaparous. There appears to be no effect by gender., Conclusion: There appear to be definite differences in growth of limb length between the different Malaysian ethnic groups and this should be taken into account when growth charts are used and when fetal weight formulas are calculated using limb lengths. The limitation of this study was that the numbers of subjects studied were small. Larger studies will be able to confirm or refute the findings.

This multicentric study was conducted with the aim of knowing the nature and magnitude of the problem of rabies in Bangalore city. The disease was enzootic and endemic and the principal reservoir of infection was dog. There was stray dog menace due to ineffective dog control measures. Nearly 30% of animal bite victims did not wash their wounds and about 60% of patients started antirabic vaccine late after 24 hours of bite. The antirabies serum (equine) was not available at all. The victims of hydrophobia were both children (37.5%) and adults (62.5%) and the average incubation period ranged from 35-111 days. Pre-exposure antirabic vaccination was not given to dog catching and dog pound staff. Lastly, there was lack of proper laboratory diagnostic facilities for rabies in Bangalore.