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Byline: Dinesh. Sarda, Paras. Kothari, Ashok. Laddha, Bharati. Kulkarni We report a case where two distinct meningoceles (thoracic and lumbosacral) with a normal intervening spinal canal was encountered. It was [...]

Byline: Paras. Kothari, Dinesh. Sarda, Gauri. Shankar, Bharati. Kulkarni A four-day-old neonate presented with severe abdominal distention, intermittent bilious vomiting, typical black lock, partial albinism and heterochromatic iris. Ileostomy was [...]

Byline: Paras. Kothari, Gowri. Shankar, Arun. Gupta, Anurag. Rastogi, Bharati. Kulkarni Nodular fasciitis (NF) is a relatively common soft tissue lesion and represents a rapidly growing benign reactive process. Their [...]

Byline: Paras. Kothari, Arun. Gupta, Gowri. Shankar, Bharati. Kulkarni, Satish. Dharap Cutis laxa is a rare disorder characterized by degenerative changes in elastic fibres. Congenital cutis laxa is more common [...]

ABSTRACT An 11-year-old boy presented with multiple swellings all over the body. One of the swellings present over the chest was incised and drained. This revealed the diagnosis by the [...]

Osteoporosis and cardiovascular disease (CVD) share common risk factors, yet both are usually underdiagnosed in the absence of major complications. We investigated associations between arterial stiffness, cardiac workload, carotid intima media thickness (CIMT) and areal bone mineral density (aBMD) in Indian adults. Men and women aged >45 years from the Andhra Pradesh Children and Parents Study (APCAPS) were included for cross-sectional analysis (521 women and 696 men). Dual energy x-ray absorptiometry (DXA) measured aBMD at the whole body, total hip and lumbar spine. Supine blood pressure and heart rate were measured and used to calculate rate pressure product and pulse pressure; augmentation index, pulse wave velocity and CIMT were measured. Sex-interactions were tested (denoted as p-int); adjustments were made for confounders. Data were expressed as SD differences with 95 % confidence intervals. There were significant negative associations between pulse pressure and aBMD at all sites in women only. In unadjusted analyses, for every 1SD increase in pulse pressure, women had greater negative differences in aBMD at the whole body (−0.13 vs 0.007), total hip (−0.20 vs −0.05) and lumbar spine (−0.12 vs 0.05) compared with men. After adjustments, sex differences remained. Similar negative associations were seen between pulse wave velocity and augmentation index with aBMD in women only. There were no sex differences between CIMT and rate pressure product with aBMD. Markers of arterial stiffness are associated with poorer bone health in Indian women, but not in men. There is a need to identify the shared risk factors and markers of arterial stiffness and poor bone health to detect those who require co-management of these diseases to prevent cardiovascular events and fractures. • There are sex differences in cardiac and bone health associations in India. • Arterial stiffness is associated with poorer bone health in Indian women, not men. • Identifying shared risk factors is critical for co-management of CVD and bone health. [ABSTRACT FROM AUTHOR]

Objective: To assess the benefits of nutrition supplementation in children living with HIV (CLHIV).Methods: A prospective observational study was carried out at antiretroviral therapy (ART)/pediatric centre of excellence (PCOE), Niloufer hospital for a period of one year in CLHIV (N = 164) aged 1 to 18 y referred to ART/PCOE. Nutrition supplementation was given in the form of Ready to Use Food (About 350 kcal and 12 g of protein per day) supplementation to assess improvement in Height for age Z (HAZ), Weight for Age Z (WAZ), Weight for Height Z (WHZ) and Body Mass Index for age Z (BMIZ) scores over a period of one year.Results: At baseline, 65.5 % and 57.5 % of children below and above 5 y respectively were stunted. 24.1 % and 45.3 % children below and above 5 y respectively were wasted/thin (as assessed by BMI for age). Mean BMIZ score significantly improved in both the age groups (0.96 Z score, P < 0.001) in below and above 5 (0.37 Z score, P < 0.001) respectively at the end of 12 mo. Mean HAZ score also significantly improved in children above 5 y (0.09 Z score, P < 0.05) with non-significant improvement below 5 y (0.14 Z score, P < 0.57) by the end of 12 mo.Conclusions: Nutrition supplementation over one year resulted in moderate improvement in the nutritional status of CLHIV. However, it is unclear, whether the improvement in nutritional status was due to regular visits to ART centre that may have resulted in better adherence to treatment or an additional benefit of nutrition intervention. This warrants a well-designed randomized controlled trial to examine the benefits of nutrition supplementation in CLHIV attending ART centre. [ABSTRACT FROM AUTHOR]

Summary: The long-term effects on bone health of nutritional status in adolescence are unclear. The impact of adolescent and current body mass on bone mass in young adulthood in rural India was assessed. Current lean mass was a more important determinant of bone mass than thinness during adolescence in this population. Purpose/introduction: Adolescence is a crucial period for skeletal growth. However, the long-term effects on bone health of nutritional status in adolescence, particularly in the context of nutritional transition, are unclear. The current manuscript assessed the impact of adolescent and current body size on bone mass in young adulthood in an Indian rural community that is undergoing rapid socioeconomic changes. Methods: The Andhra Pradesh Children and Parents Study is a prospective cohort study in Hyderabad, India. In 2003-2005, the study collected anthropometric and cardiovascular data on adolescents (mean age = 16 years old). The second and third waves of the study in 2009-2012 collected data on current anthropometric measures, areal bone mineral density (aBMD) in hip and lumbar spine (L1-L4) measured by dual-energy X-ray absorptiometry, and living standards of the trial participants who were now young adults (mean age = 22 years old). Results: The median body mass index (BMI) of the 722 participants included in this analysis was 16.8 kg/m during adolescence, while the median BMI as young adults was 19.3 kg/m. Lower aBMD during adulthood was associated with lower adolescent BMI (β (95 % confidence interval) for hip aBMD 0.017 (0.013 to 0.022) and LS aBMD 0.012 (0.008 to 0.016)). This association was attenuated upon adjustment for current fat and lean mass (β (95 % CI) for hip aBMD 0.00 (−0.005 to 0.005) and LS aBMD 0.005 (0.000 to 0.01)). There was clear evidence for positive associations between aBMDs and current lean mass. Conclusions: Current lean mass was a more important determinant of bone mass than thinness during adolescence in this population. Weight gain during late adolescence and young adulthood coupled with improvement in lean mass may help to mitigate any adverse effects that pre-adulthood undernutrition may have on bone mass accrual. [ABSTRACT FROM AUTHOR]

Background: Evidence of an association between serum vitamin D and cardiovascular disease risk is inconsistent and comes predominantly from studies in high-income settings. We assessed the association between serum levels of 25-hydroxyvitamin D3 (25(OH)D) and cardiovascular disease risk factors in a population of young Indian adults. Methods: Cross-sectional analyses of data from APCAPS (Andhra Pradesh Children and Parents Study); a prospective birth cohort study in rural south India. Participants were 1038 (40.3% females) adults aged 18-24 years. Main outcome measures were blood pressures, fasting serum lipids (cholesterols and triglycerides), fasting glucose, insulin, measures of arterial stiffness (aortic augmentation index and aortic pulse wave velocity (aPWV)), carotid intima-media thickness, body mass index (BMI) and body fat (dual X-ray absorptiometry). Results: Vitamin D deficiency (≤20ng/ml) was observed in 41.1% of this lean (mean BMI: 19.5) and active (mean minutes of moderate or vigorous physical activity per day: 186) population. Vitamin D deficiency was associated with higher median body fat in both males (15.9% body fat in vitamin D deficient males vs. 14.6% in non-deficient males, p<0.05) and females (29.1% body fat in vitamin D deficient females vs. 27.8% in non-deficient females, p<0.05) but no associations were observed between vitamin D deficiency and mean BMI or median fat mass index (FMI). Except a weak inverse association with fasting insulin in males, there was no clear association between serum vitamin D levels and cardiovascular disease risk factors in fully adjusted models. Conclusions: We did not find clear evidence for an association between serum vitamin D levels and cardiovascular disease risk factors. Our results, consistent with the limited evidence from randomised trials of vitamin D supplementation and Mendelian randomisation experiments, suggest that the postulated link between serum vitamin D and cardiovascular disease may be non-causal. Instead, it may be attributable to confounding by lifestyle factors such as obesity and physical inactivity which may provide more fruitful targets for cardiovascular disease prevention. [ABSTRACT FROM AUTHOR]