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The present paper illustrates our attempt to design and test the reproducibility of low-cost patient positioning devices prepared in-house in our radiotherapy department. Rigid thermocole boards with angulations, scales and support were designed as breast, pelvis and head positioning devices. Reproducibility and accuracy were tested by serial electronic portal imaging detector imaging. The positioning devices (with or without superimposed moulds) showed variations within 2-3 mm on serial treatment days which were within acceptable limits. It is therefore concluded that low-cost patient positioning devices for head, breast and pelvis (the common sites of treatments in radiotherapy) can be fabricated from available materials in-house. These have been shown to be resulting in accurate immobilization, can be customized for particular techniques and are considerably cheaper than commercially available solutions.

A letter to the editor is presented in response to the article "Survival and quality of life after renal angioplasty," by Gert Jensen.

A letter to the editor is presented in response to the article about the study of urinary sodium and potassium excretion in karate competitions.

A letter to the editor is presented on indigenous drugs as an uncommon cause of minimal change disease (MCD) relapse.

Purpose of Study: Rheumatic heart disease is still the commonest valvular heart disease in India. There is no population based study regarding the prevalence of rheumatic fever/rheumatic heart disease (RF/RHD) from Himachal and hence the purpose of study., Methods and Results: A community based survey for prevalence of RF/RHD was done in four villages of different districts of Himachal. The subjects suspected to have RF/RHD on clinical ground were subjected to echocardiography to confirm the diagnosis. Total 1882 subjects were screened. 909 were male and 973 were female. 11 of these were found to have RF/RHD (5.8/1000). Mean age of these patients was 30.35 +/- 14.17 years. 10 of these were female and one was male. Mitral valve was the commonest to be involved. Seven were known to have RF/ RHD and five were on penicillin prophylaxis., Conclusion: RF/RHD is still common in rural population of Himachal. Mitral valve is commonest to be involved and prevalence is much more in female than in male.

Purpose: There is no community based study of prevalence of hypertension from Himachal Pradesh, so we undertook this study., Methods and Results: Population based survey was done in three villages of Himachal Pradesh of different Districts. Total 1092 adults of > or =18 years of age were examined. 507 (46.42%) were males and 573 (52.47%) were females. 392 (35.89%) were found to have hypertension (39.8% in males and 33.15% in females). 267 had their blood pressure in pre-hypertensive range (24.45%). Only 433 (39.6%) had their blood pressure in normal range. 84 (21.98%) of 392 hypertensive persons were aware of their hypertensive status and only 17 of these 84 (20.23%) had their blood pressure under control., Conclusion: Prevalence of hypertension was higher than the national average. Only one fifth of hypertensive persons were aware of their disease and only fifth of these had their blood pressure under control.

Background: Cardiovascular disease has emerged as a major health burden worldwide. There is no study in Himachal about the prevalence of coronary heart disease (CHD), hence the purpose of the study., Material and Methods: Population based study was done in three different villages of different districts of Himachal Pradesh. The people were well notified about the survey in advance. We tried to cover all persons above the age of 30 years. We could cover around 70% of population. Total 812 persons were examined. History regarding presence and nature of chest pain was taken. Detailed physical examination was done. The detailed history about risk factors was taken. ECG of all patients was taken. Patients known to have suffered myocardial infarction, having typical angina on exertion or having undergone coronary angioplasty or coronary artery bypass surgery were labeled to have CHD., Results: Eight hundred twelve patients were examined. Mean age was 47.44 +/- 12.2 yrs. Three hundred ninty-nine were males and 413 were females. Thirty three patients were found to have coronary heart disease, giving the prevalence of 4.06%. Twenty six of 399 males had CHD (6.9%) and 26 of 413 females had CHD (1.69%). Seventeen of these CHD patients were hypertensive, two were diabetic and 10 patients had family history of CHD., Conclusion: The prevalence of CHD was low in rural population of Himachal Pradesh, being around 4%, more in males than in females.