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   2011| March  | Volume 133 | Issue 3  
    Online since April 6, 2011

 
 
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ORIGINAL ARTICLES
Age at initiation & prevalence of tobacco use among school children in Noida, India: A cross-sectional questionnaire based survey
Raj Narain, Sarita Sardana, Sanjay Gupta, Ashok Sehgal
March 2011, 133(3):300-307
PMID:21441684
Background & objectives : Tobacco use among school children is becoming a serious problem in developing countries. The early age of initiation underscores the urgent need to intervene and protect this vulnerable group from falling prey to this addiction. The present study was thus undertaken to assess the prevalence of tobacco habits among school children, determine the age of initiation of these habits, and compare the age of initiation between students who were more than 15 and ≤ 15 yr of age. Methods: Data on tobacco use were collected from 4786 students of class 7 to 12 (age: 11-19 yr) studying in different private and government schools of Noida city during July- December 2005, through cluster and random sampling using a self-administered questionnaire. Results: Any kind of tobacco use was found in 537 (11.2%) students; 419 (8.8%) were 'ever smokers (including current smokers)' 219 (4.6%) were 'ever tobacco chewers (including current chewers)', 179 (3.7%) were 'exclusive smokers' and 118 (2.5%) were 'exclusive tobacco chewers'. The mean age of initiation of these habits was around 12.4 yr. More than 50 per cent of tobacco chewers reported use of khaini at least once. Nearly 70 per cent of boys and 80 per cent of girls ≤ 15 yr initiated the habit of tobacco before the age of 11 yr. A significant early uptake of tobacco chewing was reported from private school students as compared to government school students (P<0.05). Interpretation & conclusions : Tobacco addiction is emerging as a big threat among children. Our findings indicate a recent downward shift in the age at initiation of tobacco uptake and rising prevalence among girls. Such data need to be collected from different parts of the country to develop anti-tobacco campaigns and take policy decision.
  4,587 426 -
REVIEW ARTICLE
Recent developments in treatment of latent tuberculosis infection
Dick Menzies, Hamdan Al Jahdali, Badriah Al Otaibi
March 2011, 133(3):257-266
PMID:21441678
Latent tuberculosis infection (LTBI) can be detected with immune based tests such as the tuberculin skin test (TST) or interferon gamma release assays (IGRA). Therapy for those with positive tests can reduce the subsequent risk of re-activation and development of active TB. Current standard therapy is isoniazid (INH) which reduce the risk of active TB by as much as 90 per cent if taken daily for 9 months. However, this lengthy duration of therapy discourages patients, and the risk of serious adverse events such as hepatotoxicity, discourages both patients and providers. As a result completion of INH therapy is less than 50 per cent in many programmes. However, programmes that offer close follow up with supportive staff who emphasize patient education, have reported much better results. The problems with INH have stimulated development and evaluation of several shorter regimens. One alternative was two months daily rifampin and pyrazinamide; this regimen has been largely abandoned due to unacceptably high rates of hepatotoxicity and poor tolerability. The combination of INH and rifampin, taken for 3 or 4 months, has efficacy equivalent to 6 months INH albeit with somewhat increased hepatotoxicity. Four months rifampin has efficacy at least equivalent to 6 months INH but there are inadequate trial data on efficacy. The safety of this regimen has been demonstrated repeatedly. Most recently, a regimen of 3 months INH rifapentine taken once weekly under direct observation has been evaluated in a large scale trial. Results have not yet been published, but if this regimen is as effective as INH, this may be a very good alternative. However, close monitoring and surveillance is strongly suggested for the first few years after its introduction. Evidence from several randomized trials has shown that the benefits of LTBI therapy is only in individuals who are tuberculin skin test (TST) positive even among those with HIV infection. Hence, LTBI therapy should be given only to those with positive tests for LTBI. We conclude that LTBI therapy is considerably underutilized in many settings, particularly in low and middle income countries.
  3,578 1,019 -
ORIGINAL ARTICLES
Prevalence of multidrug-resistant tuberculosis among category II pulmonary tuberculosis patients
Surendra K Sharma, Sanjeev Kumar, PK Saha, Ninoo George, SK Arora, Deepak Gupta, Urvashi Singh, M Hanif, RP Vashisht
March 2011, 133(3):312-315
PMID:21441686
Background & objectives : Multidrug-resistant tuberculosis (MDR-TB) has emerged as a significant global health concern. The most important risk factor for the development of MDR-TB is previous anti-tuberculosis therapy. Category II pulmonary TB includes those patients who had failed previous TB treatment, relapsed after treatment, or defaulted during previous treatment. We carried out this study to ascertain the prevalence of MDR-TB among category II pulmonary TB patients. Methods: This was a cross-sectional, descriptive study involving category II pulmonary TB patients diagnosed between 2005 and 2008. All sputum-positive category II TB cases were subjected to mycobacterial culture and drug-susceptibility testing (DST). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin. Results: A total of 196 cases of sputum-positive category II pulmonary tuberculosis patients were included. Of these, 40 patients (20.4%) had MDR-TB. The mean age of MDR-TB patients was 33.25 ± 12.04 yr; 9 patients (22.5%) were female. Thirty six patients showed resistance to rifampicin and isoniazid; while 4 patients showed resistance to rifampicin, isoniazid and streptomycin. The prevalence of MDR-TB among category-II pulmonary tuberculosis patients was 20.4 per cent. Interpretation & conclusions : The prevalence of MDR-TB in category II TB patients was significant. However, nation-wide and State-wide representative data on prevalence of MDR-TB are lacking. We stress the importance of continuous monitoring of drug resistance trends, in order to assess the efficacy of current interventions and their impact on the TB epidemic.
  2,357 483 -
Vitamin D deficiency in healthy breastfed term infants at 3 months & their mothers in India: Seasonal variation & determinants
Vandana Jain, Nandita Gupta, Mani Kalaivani, Anurag Jain, Aditi Sinha, Ramesh Agarwal
March 2011, 133(3):267-273
PMID:21441679
Background & objectives : Vitamin D deficiency with a resurgence of rickets and tetany are increasingly being reported in young infants from temperate regions, African Americans and also from India. The data on vitamin D status of healthy term breastfed Indian infants and mothers are scant. Therefore, we undertook this study to determine the prevalence of vitamin D deficiency and insufficiency [serum 25 hydroxyvitamin D (25OHD) < 15 ng/ml and 15-20 ng/ml, respectively] among healthy term breastfed 3 month old infants and their mothers, evaluate for clinical and radiological rickets in those infants having 25OHD < 10 ng/ml, and check for seasonal variation and predictors of infants' vitamin D status. Methods: A total of 98 infants aged 2.5 to 3.5 months, born at term with appropriate weight and their mothers were enrolled; 47 in winter (November- January) and 51 in summer (April-June). Details of infants' feeding, vitamin D supplementation, sunlight exposure and mothers' calcium and vitamin D intake were recorded. Serum calcium, phosphate, alkaline phosphatase, 25 hydroxyvitamin D (25OHD) and parathormone were estimated. Results: Vitamin D deficiency was found in 66.7 per cent of infants and 81.1 per cent of mothers; and insufficiency in an additional 19.8 per cent of infants and 11.6 per cent of mothers. Radiological rickets was present in 30.3 per cent of infants with 25OHD < 10 ng/ml. 25OHD did not show seasonal variation in infants but maternal concentrations were higher in summer [11.3 (2.5 - 31) ng/ml] compared to winter [5.9 (2.5-25) ng/ml, P=0.003]. Intake of vitamin supplement, sunlight exposure and mother's 25OHD were predictors of infants' 25OHD levels. Interpretation & conclusions : Prevalence of vitamin D deficiency and insufficiency was found to be high in breastfed infants and their mothers, with radiological rickets in a third of infants with 25OHD < 10 ng/ml in this study. Studies with large sample need to be done in different parts of the country to confirm these findings.
  2,119 591 -
Analysis of penicillin-binding proteins (PBPs) in carbapenem resistant Acinetobacter baumannii
Jitendra Vashist, Vishvanath Tiwari, Rituparna Das, Arti Kapil, Moganty R Rajeswari
March 2011, 133(3):332-338
PMID:21441690
Background & objectives : Acinetobacter baumannii is a Gram-negative, cocco-bacillus aerobic pathogen responsible for nosocomial infections in hospitals. In the recent past A. baumannii 0had developed resistance against β-lactams, even against carbapenems. Penicillin-binding proteins (PBPs) are crucial for the cell wall biosynthesis during cell proliferation and these are the target for β-lactams. Therefore, the present study was carried out to identify the PBPs in three (low, intermediate and high MICs) groups of carbapenem resistant isolates strains of A. baumannii. Methods: ATCC 19606 and 20 β-lactam resistant isolates of A. baumannii were obtained. Selective identification of the PBPs was done using Bocillin FL, a non-radioactive fluorescent derivative of penicillin. Results: The fluorescence emission from Bocillin-tag in SDS-PAGE gel of native strain identified eight PBPs, with apparent molecular weight of 94, 65, 49, 40, 30, 24, 22 and 17 kDa, however, these PBPs revealed alteration in carbapenem-resistant isolates. Interpretation & conclusions: A comparative analysis of PBPs in the resistant isolates with those of ATCC revealed a decreased expression of all PBPs except that of 65 and 17 kDa PBPs which were marginally downregulated, and simultaneous appearance of new 28 kDa PBP (in low and intermediate resistant isolates) and 36 kDa in high meropenem resistant group of A. baumannii. The present study indicated an association between alteration in PBPs and β-lactam resistance in A. baumannii.
  2,050 652 -
Prevalence of multidrug-resistant tuberculosis among newly diagnosed cases of sputum-positive pulmonary tuberculosis
Surendra K Sharma, Gaurav Kaushik, Brajesh Jha, Ninoo George, SK Arora, Deepak Gupta, Urvashi Singh, Mahmud Hanif, RP Vashisht
March 2011, 133(3):308-311
PMID:21441685
Background & objectives : The prevalence of multidrug-resistant tuberculosis (MDR-TB) is increasing throughout the world. Although previous treatment for TB is the most important risk factor for development of MDR-TB, treatment-naοve patients are also at risk due to either spontaneous mutations or transmission of drug-resistant strains. We sought to ascertain the prevalence of MDR-TB among new cases of sputum-positive pulmonary TB. Methods: This was a prospective, observational study involving newly diagnosed cases of sputum-positive pulmonary tuberculosis diagnosed between 2008 and 2009 carried out in New Delhi, India. All sputum-positive TB cases were subjected to mycobacterial culture and first-line drug-susceptibility testing (DST). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin. Results: A total of 218 cases of sputum-positive pulmonary tuberculosis were enrolled between 2008 and 2009. Of these, 41 cases had negative mycobacterial cultures and DST was carried out in 177 cases. The mean age of the patients was 27.8 ± 10.2 yr; 59 patients (27%) were female. All patients tested negative for HIV infection. Out of 177 cases, two cases of MDR-TB were detected. Thus, the prevalence of MDR-TB among newly diagnosed pulmonary tuberculosis patients was 1.1 per cent. Interpretation & conclusion s: MDR-TB prevalence is low among new cases of sputum-positive pulmonary TB treated at primary care level in Delhi. Nation-wide and State-wide representative data on prevalence of MDR-TB are lacking. Efforts should be directed towards continued surveillance for MDR-TB among newly diagnosed TB cases.
  2,043 518 -
Profiling single nucleotide polymorphisms (SNPs) across intracellular folate metabolic pathway in healthy Indians
Yogita Ghodke, Arvind Chopra, Pooja Shintre, Amrutesh Puranik, Kalpana Joshi, Bhushan Patwardhan
March 2011, 133(3):274-279
PMID:21441680
Background & objectives : Many pharmacologically-relevant polymorphisms show variability among different populations. Though limited, data from Caucasian subjects have reported several single nucleotide polymorphism (SNPs) in folate biosynthetic pathway. These SNPs may be subjected to racial and ethnic differences. We carried out a study to determine the allelic frequencies of these SNPs in an Indian ethnic population. Methods: Whole blood samples were withdrawn from 144 unrelated healthy subjects from west India. DNA was extracted and genotyping was performed using PCR-RFLP and Real-time Taqman allelic discrimination for 12 polymorphisms in 9 genes of folate-methotrexate (MTX) metabolism. Results: Allele frequencies were obtained for MTHFR 677T (10%) and 1298 C (30%), TS 3UTR 0bp (46%), MDR1 3435T and 1236T (62%), RFC1 80A (57%), GGH 401T (61%), MS 2756G (34%), ATIC 347G (52%) and SHMT1 1420T (80%) in healthy subjects (frequency of underlined SNPs were different from published study data of European and African populations). Interpretation & conclusions : The current study describes the distribution of folate biosynthetic pathway SNPs in healthy Indians and validates the previous finding of differences due to race and ethnicity. Our results pave way to study the pharmacogenomics of MTX in the Indian population.
  1,967 350 -
Distribution pattern of HCV genotypes & its association with viral load
Anita Chakravarti, Gaurav Dogra, Vikas Verma, Amit Parkash Srivastava
March 2011, 133(3):326-331
PMID:21441689
Background & objectives: Hepatitis C virus (HCV) has emerged as a leading cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma worldwide. Genotyping and assessment of the viral load in HCV patients is important for designing the therapeutic strategies. Thus the present study was designed to determine the distribution pattern of HCV genotypes in chronic hepatitis patients and their association with the viral load and biochemical profiles. Methods: Seventy one HCV RNA positive patients were included in the study. HCV genotyping was carried out by restriction fragment length polymorphism (RFLP) followed by the direct sequencing of the core region. Viral load estimation was carried out by Taqman real time PCR system. Results: Sixty three per cent (45/71) of cases were infected with genotype 3 followed by genotype 1 in 30.98 per cent (22/71) and genotype 2 in 5.63 per cent (4/71) of cases. Genotype 1 was associated with a significantly (P<0.001) higher viral load as compared to genotypes 3 and 2. There was no significant difference seen in the biochemical profile between the three groups of genotypes except in the levels of SGOT. The commonest mode of transmission was parenteral which accounted for 68 per cent of all the infected cases. Interpretation & conclusions: The present study revealed that HCV genotype 3 and 1 accounted for approximately 95 per cent of the HCV infection in Delhi and surrounding areas. Also two atypical subtypes like 3i and 3f were identified. Genotype 1 was associated with more severity of liver disease as compared to genotypes 3 and 2 as assessed by viral load.
  1,846 439 -
Dengue disease status in Chennai (2006-2008): A retrospective analysis
P Gunasekaran, K Kaveri, S Mohana, Kavita Arunagiri, B.V Suresh Babu, P Padma Priya, R Kiruba, V Senthil Kumar, A Khaleefathullah Sheriff
March 2011, 133(3):322-325
PMID:21441688
Background & objectives: Dengue is one of the most important Arboviral diseases in man with outbreaks in Southeast Asia and India. We report a retrospective analysis of the dengue positivity in the referred samples for three years period (2006 to 2008) at the Department of Virology, King Institute of Preventive Medicine, Chennai, Tamil Nadu, India. Methods: Serum samples from 1593 suspected cases (968 male and 625 female) were obtained. Of the 1593 cases screened, 1204 (75.5%) were paediatric cases and 389 (24.4%) adults. The samples were subjected to MAC ELISA and IgG ELISA. Results: Of the 968 patients, 686 (43.0%) were positive, of which 579 (84.0%) were in the paediatric age group (<14 yr) and 107 (15.5%) were adults. The IgM positivity being 356 (36.7%) in males and 330 (52.8%) in females. Of the 686 positives, 113 (16.47%) were positive for both IgM and IgG denoting secondary infection. There was a noticeable increased occurrence during the cooler months and during the monsoon and post-monsoon months. Interpretation & conclusion: The dengue IgM seropositivity among the suspected cases indicates active dengue virus activity. Increase in the probable secondary infections especially in a country like ours where multiple serotypes are prevalent raises concern over probable increase in the incidence of the more serious DHF/DSS. Studies need to be done to identify circulating serotypes of dengue virus to design preventive strategies.
  1,774 430 -
Association of hypertension with risk factors & hypertension related behaviour among the aboriginal Nicobarese tribe living in Car Nicobar Island, India
Sathya Prakash Manimunda, Attayuru Purushottaman Sugunan, Vivek Benegal, Nagalla Balakrishna, Mendu Vishnuvardhana Rao, Kasturi S Pesala
March 2011, 133(3):287-293
PMID:21441682
Background & objectives : There are no composite estimates on prevalence of hypertension among indigenous tribes in India. The present study was carried out to estimate the prevalence of hypertension, its association with determinants, and to assess the hypertension related behaviour of the Nicobarese aborigines. Methods: This cross-sectional survey was carried during 2007 and 2009. Subjects were chosen by two stage design. Total 975 subjects of 1270 (response rate of 76.8%) were investigated (M: 43.5%; F: 56.5%). The data were collected by history, clinical examination (blood pressure), and examination (weight and height). The association of hypertension with age, education, tobacco, alcohol consumption and their dependency status (KF score, QF value, and AUDIT score) and nutritional status was estimated by bivariate regression analysis; the increasing trend in the prevalence of hypertension with increasing age and decreasing educational status was analysed by χ2 for linear trend. Significant variables in bivariate regression analysis (age, education, alcohol consumption status, and nutritional status) were subjected to multiple logistic regression analysis (MLR). Results: The prevalence of hypertension was 50.5 per cent [95% CI 46.1-54.9 (M: 50.7%; F: 50.3%)]. The prevalence of tobacco, alcohol consumption, and overweight/obesity was 88, 54, and 37 per cent respectively. The bivariate analysis has shown association between hypertension and age, education subcategories, alcohol consumption, and overweight/obesity (P<0.05). The increasing trend in the prevalence of hypertension with increasing age (χ2 for linear trend=95.88, P< 0.001) and decreasing educational status (χ2 for linear trend=25.55, P< 0.001) was statistically significant. MLR analysis revealed a significant association between hypertension and various age categories and overweight/obesity. Interpretation & conclusions: The findings of the present study highlight high prevalence of hypertension among Nicobarese aborigenes.
  1,755 412 -
Screening with OGTT alone or in combination with the Indian diabetes risk score or genotyping of TCF7L2 to detect undiagnosed type 2 diabetes in Asian Indians
V Mohan, Jeremy D Goldhaber-Fiebert, V Radha, K Gokulakrishnan
March 2011, 133(3):294-299
PMID:21441683
Background & objectives : With increasing number of people with diabetes worldwide, particularly in India, it is necessary to search for low cost screening methods. We compared the effectiveness and costs of screening for undiagnosed type 2 diabetes mellitus (T2DM), using oral glucose tolerance testing (OGTT) alone, or following a positive result from the Indian Diabetes Risk Score (IDRS) or following a positive result from genotyping of the TCF7L2 polymorphisms in Asian Indians. Methods: In subjects without known diabetes (n=961) recruited from the Chennai Urban Rural Epidemiology Study (CURES), OGTT, IDRS, and genotyping of rs12255372 (G/T) and rs7903146(C/T) of TCF7L2 polymorphisms were done. IDRS includes four parameters: age, abdominal obesity, family history of T2DM and physical activity. Results: OGTT identified 72 subjects with newly diagnosed diabetes (NDD), according to the World Health Organization criteria of fasting plasma glucose ≥ 126 mg/dl or a plasma glucose ≥ 200 mg/dl, 2 h after 75 g oral glucose load. IDRS screening (cut-off ≥ 60) yielded 413 positive subjects, which included 54 (75%) of the 72 NDD subjects identified by OGTT. Genotyping yielded 493 positive subjects which only included 36 (50%) of the 72 NDD subjects showing less discriminatory power. Screening with both SNPs missed 27 (37.5%) NDD subjects identified by IDRS. In contrast, IDRS missed only 9 (12.5%) of the NDD subjects identified by genotyping. Total screening cost for OGTT alone, or with IDRS were ` 384,400 and 182,810 respectively. Comparing OGTT alone to IDRS followed by OGTT, the incremental cost per additional NDD subject detected by doing OGTT on everyone was ` 11,199 (` 201,590 for detecting additional 18 NDD subjects). Interpretation & conclusions : For screening a population of subjects without diagnosed diabetes in India, a simple diabetes risk score is more effective and less expensive than genotyping or doing OGTT on the whole population.
  1,638 362 -
EDITORIALS
Mental Health Act (1987): Need for a paradigm shift from custodial to community care
Suresh Bada Math, Pratima Murthy, Channapatna R Chandrashekar
March 2011, 133(3):246-249
PMID:21441675
  1,556 202 -
ORIGINAL ARTICLES
Rapid spread of chikungunya virus infection in Orissa: India
B Dwibedi, J Sabat, N Mahapatra, SK Kar, AS Kerketta, RK Hazra, SK Parida, NS Marai, MK Beuria
March 2011, 133(3):316-321
PMID:21441687
Background & objectives : A large number of cases of undiagnosed fever and joint pain were reported from different parts of the State of Orissa since February 2006. Epidemiological and laboratory investigation were carried out to confirm the cause of emerging illness, which was provisionally suspected as Chikungunya (CHIK) fever. Methods: Upon getting the reports of suspected CHIK like illness in different parts of the State, epidemic investigations were carried out in the outbreak affected villages. Case history was recorded, clinical examination undertaken and blood samples collected for seroconfirmation for CHIK IgM antibody using ELISA based kit. Simultaneously vector survey was also carried out. Results: With no previous record of CHIK infection in the State, the first outbreak was confirmed during February 2006. Subsequently, the infection spread to 13 of 30 districts in different episodes covering 79 villages till November 2007. Attack rate was 9-43 per cent in the different outbreaks with average seropositivity of 24 per cent to CHIK specific IgM. Morbidity was high though no deaths were recorded. Aedes aegypti and Ae. albopictus were identified as the possible vectors for transmission. Interpretation & conclusions : The report confirmed emergence of CHIK infection in the State of Orissa, India, and its spread to a larger geographic zone in a short period which warrants public health measures to control further spread.
  1,365 265 -
CORRESPONDENCES
Gonorrhoea & its co-infection with other ulcerative, non-ulcerative sexually transmitted & HIV infection in a Regional STD Centre
Manju Bala, Jhinuk Basu Mullick, Sumathi Muralidhar, Joginder Kumar, V Ramesh
March 2011, 133(3):346-349
PMID:21441694
  1,294 224 -
COMMENTARIES
Vitamin D deficiency in breastfed infants & the need for routine vitamin D supplementation
S Balasubramanian
March 2011, 133(3):250-252
PMID:21441676
  1,143 347 -
Towards personalized medicine - the role of methotrexate
Sita Naik
March 2011, 133(3):253-255
PMID:21441677
  996 325 -
CORRESPONDENCES
High levels of antimicrobial resistance at a tertiary trauma care centre of India
Bijayini Behera, Purva Mathur
March 2011, 133(3):343-345
PMID:21441693
  1,038 266 -
BOOK REVIEWS
The mystery of yawning in physiology and disease
Bindu M Kutty
March 2011, 133(3):354-355
  882 204 -
ORIGINAL ARTICLES
Immune status & enzymes activity in blood lymphocytes in adult patients at different stages of acute lymphoblastic leukaemia
Olga V Smirnova, Valery T Manchouk, Andrey A Savchenko
March 2011, 133(3):280-286
PMID:21441681
Background & objectives : Pathogenesis acute lymphoblastic leukaemia ( ALL ) in adults is not well understood, as it is more common in children. We examined the immunological status and the activity of certain enzymes in blood lymphocytes in adult patients of ALL at different stages. Methods: ALL patients (n=71) admitted during 2000-2005 were included in this study. All patients had decreased T-lymphocytes content. At first attack, they had CD4 + -cells decreasing and increasing IgM and IgG concentration. In complete remission all examined parameters were low. The peculiarities of ALL recurrence were high NK-cells content and disbalances of the main immunoglobulin concentrations. Results: In the first attack and recurrence the anaerobe glucose oxidation intensity and the reactions of macromolecular synthesis were lower in lymphocytes compared to control. In remission all these processes restored to normal. In all stages in lymphocytes GR had decreased activity. Interpretation & Conclusions : Our results showed that most of changes in immune status of ALL patients were in a stage of complete remission when patients arrived on its maintenance through the small period from spent before therapy when the immune system of the patient has not been restored. Thus, probably cytostatic action causes immune failure in the future and starts disease again.
  833 192 -
CORRESPONDENCES
Strengthening ethics in clinical research
Arvind Pandey, Abha Aggarwal, SD Seth, Mohua Maulik, Atul Juneja
March 2011, 133(3):339-340
PMID:21441691
  852 159 -
EDITORIALS
Adaptive design - An innovative tool in drug development
Ballari Brahmachari, Arun Bhatt
March 2011, 133(3):243-245
PMID:21441674
  799 212 -
BOOK REVIEWS
Alcohol and injuries: Emergency department studies in an international perspective
Rajat Ray, Alok Agrawal
March 2011, 133(3):350-352
  730 160 -
CORRESPONDENCES
Anti-nucleosome antibody in sclerodema patients
Francisco Gustavo Mendes e Ferreira de Araújo, Thelma Larocca Skare, Renato M Nisihara, Shirley R Utiyama
March 2011, 133(3):341-342
PMID:21441692
  727 142 -
BOOK REVIEWS
Antimicrobial resistance: Beyond the breakpoint
D Raghunath
March 2011, 133(3):352-353
  584 161 -
Clinical update on inflammatory disorders of gastrointestinal tract (Frontiers of gastrointestinal research)
BC Sharma
March 2011, 133(3):355-357
  608 121 -
Book Received

March 2011, 133(3):357-357
  450 93 -
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