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   2011| May  | Volume 133 | Issue 5  
    Online since May 26, 2011

 
 
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ORIGINAL ARTICLES
Fibrous dysplasia & McCune-Albright syndrome: An experience from a tertiary care centre in north India
Sanjay Kumar Bhadada, Anil Bhansali, Sambit Das, Ramanbir Singh, R Sen, A Agarwal, BR Mittal, Uma Nahar, Pinaki Dutta, Niranjan Khandelwal
May 2011, 133(5):504-509
PMID:21623035
Background & objectives : Fibrous dysplasia (FD) is a rare metabolic bone disease and information available from India is limited to only anecdotal case reports. We describe the clinical profile and therapeutic outcome of 25 patients with FD observed over a period of 14 yr in a tertiary care centre from north India. Methods : In this retrospective study patients (n = 25) with diagnosis of fibrous dysplasia based on either classical radiological features and/or histological evidence on bone biopsy, were analyzed. Associated endocrinopathies if any, were evaluated. The diagnosis of McCune Albright syndrome (MAS) was considered when fibrous dysplasia was accompanied by either cafι-au-lait macules and/or endocrinopathies. The clinical presentation, biochemical parameters and imaging were analysed. Seven patients received bisphosphonate therapy. The final outcome and side effects were noted. Results : Age of the patients ranged from 7 to 48 yr (mean ± SD, 24.2 ± 11.4 yr) with a lag time between onset of symptoms and presentation ranging from 1 to 20 yr (mean ± SD, 6.6 ± 6.2 yr). The mean duration of follow up was 3.5 ± 2.1 yr. Eighteen (72%) patients had polyostotic disease while the remaining had monostotic FD. Eight patients had endocrinopathies: five had acromegaly, one each had gonadotropin independent precocious puberty (GIPP), hyperthyroidism and hypophosphatemic rickets. One child with GIPP later developed hyperthyroidism. McCune Albright syndrome was observed in 10 (40%) patients. A majority of the patients underwent various minor or major surgical procedures and seven patients received bisphosphonates for recurrent pathological fractures. Bone pain was reduced in all bisphosphonate treated patients with a decrease in subsequent fractures. Interpretation & conclusions : This series of FD patients from north India shows the varying presentations of this rare disease. Medical treatment with bisphosphonates appears to be potentially rewarding.
  2,443 364 -
Normative data of cervical length in singleton pregnancy in women attending a tertiary care hospital in eastern India
Joydev Mukherji, Monika Anant, Suhas Ghosh, Subir Kumar Bhattacharyya, Avijit Hazra, Gouri Sankar Kamilya
May 2011, 133(5):492-496
PMID:21623033
Background & objectives : The length of cervix predicts the risk of preterm delivery. The objective of this study was to assess cervical length in pregnancy by transvaginal ultrasonography for generating normative data for nulliparous women at no special risk of preterm labour. Methods : An observational study was carried out in a tertiary care teaching hospital in eastern India in nulliparous women who delivered at term. A single sonologist assessed 224 women (once per subject) between 20 and 34 wk of gestation. Nulliparous women carrying a single foetus of confirmed gestational age were included; 216 subjects were finally considered for generation of normative data, excluding those delivering earlier than 37 or later than 42 wk. Other exclusion criteria were history of cerclage, any previous cervical surgery, smoking, or any medical disorder complicating pregnancy. Results : Cervix length at each week of gestation gradually decreased over the study period. Length at 20 and 34 wk was 40.5 ± 1.14 mm (mean ± SD) and 34.8 ± 1.34 mm respectively. The overall shortening over this 14 wk period was 5.7 mm, with 0.58 mm per week median rate of shortening. Pearson's correlation coefficient was - 0.69 (95% CI - 0.75 to - 0.60; P< 0.001) for cervical length vis-ΰ-vis gestational age. Interpretation & conclusions : The serial normative data generated in our setting can be used to decide cut-off points for predicting risk of preterm labour in future studies. Validity of such prediction needs to be tested in larger cohorts of women assessed at specific gestational ages.
  2,208 140 -
Effect of efflux pump inhibitors on drug susceptibility of ofloxacin resistant Mycobacterium tuberculosis isolates
Mradula Singh, GPS Jadaun, Ramdas , K Srivastava, Vipin Chauhan, Ritu Mishra, Kavita Gupta, Surya Nair, DS Chauhan, VD Sharma, K Venkatesan, VM Katoch
May 2011, 133(5):535-540
PMID:21623040
Background & objectives : In drug resistant, especially multi-drug resistant (MDR) tuberculosis, fluoroquinolones (FQs) are used as second line drugs. However, the incidence of FQ-resistant Mycobacterium tuberculosis is rapidly increasing which may be due to extensive use of FQs in the treatment of various other diseases. The most important known mechanism i.e., gyrA mutation in FQ resistance is not observed in a significant proportion of FQ resistant M. tuberculosis isolates suggesting that the resistance may be because of other mechanisms such as an active drug efflux pump. In this study we evaluated the role of the efflux pumps in quinolone resistance by using various inhibitors such as carbonyl cyanide m-chlorophenyl hydrazone (CCCP), 2,4-dinitrophenol (DNP) and verapamil, in clinical isolates of M. tuberculosis. Methods : A total of 55 M. tuberculosis clinical isolates [45 ofloxacin (OFL) resistant and 10 ofloxacin sensitive] were tested by Resazurin microtitre assay (REMA) to observe the changes in ofloxacin minimum inhibitory concentration (MIC) levels in presence of efflux inhibitors as compared to control (without efflux inhibitor). Results : The MIC levels of OFL showed 2-8 folds reduction in presence of CCCP (16/45; 35.5%), verapamil (24/45; 53.3%) and DNP (21/45; 46.6%) while in case of isolates identified as OFL sensitive these did not show any effect on ofloxacin MICs. In 11 of 45 (24.5%) isolates change in MIC levels was observed with all the three inhibitors. Overall 30 (66.6%) isolates had reduction in OFL MIC after treatment with these inhibitors. A total of eight isolates were sequenced for gyrA gene, of which, seven (87.5%) showed known mutations. Of the eight sequenced isolates, seven (87.5%) showed 2 to 8 fold change in MIC in presence of efflux inhibitors. Interpretation & conclusions : Our findings suggest the involvement of active efflux pumps of both Major Facilitator Super Family (MFS) family (inhibited by CCCP and DNP) and ATP Binding Cassette (ABC) transporters (inhibited by verapamil) in the development of OFL resistance in M. tuberculosis isolates. Epidemiological significance of these findings needs to be determined in prospective studies with appropriate number of samples / isolates.
  1,637 550 -
REVIEW ARTICLES
Involvement of nitric oxide in learning & memory processes
Vanaja Paul, Perumal Ekambaram
May 2011, 133(5):471-478
PMID:21623030
Nitric oxide (NO), synthesized from the amino acid, L-arginine by nitric oxide synthase (NOS) has received attention as a neurotransmitter in the brain. NO has been found to induce cognitive behaviour in experimental animals. In order to show evidence for the involvement of NO in learning and memory processes, the reports indicating the effects of its precursor, donors, and inhibitors of its synthesis in mammals, birds, fishes and invertebrates have been reviewed. Further, learning and memory impairment occurring in man and animals due to defective NO activity in the brain due to pathological conditions such as epilepsy, stress, diabetes and side effects of therapeutic agents and reversal of this condition by L-arginine and NO donors have been included. In addition, the reports that indicate ageing-induced impairment of cognition that is known to occur in Alzheimer's disease due to deposition of the toxic protein, beta amyloid and the effect of L-arginine and NO donors in preventing dementia in these patients have been reviewed.
  1,432 538 -
ORIGINAL ARTICLES
Outcome of standardized treatment for patients with MDR-TB from Tamil Nadu, India
Pauline Joseph, Vijaya Bhaskara Rao Desai, Nalini Sunder Mohan, Jemima Sheila Fredrick, Rajeswari Ramachandran, Balambal Raman, Fraser Wares, Ranjani Ramachandran, Aleyamma Thomas
May 2011, 133(5):529-534
PMID:21623039
Background & objectives : Programmatic management of MDR-TB using a standardized treatment regimen (STR) is being implemented under the Revised National Tuberculosis Control Programme (RNTCP) in India. This study was undertaken to analyse the outcomes of MDR-TB patients treated at the Tuberculosis Research Centre, Chennai, with the RNTCP recommended 24 months STR, under programmatic conditions. Methods : Patients failed to the category II re-treatment regimen and confirmed to have MDR-TB, were treated with the RNTCP's STR in a prospective field trial on a predominantly ambulatory basis. Thirty eight patients were enrolled to the trial from June 2006 to September 2007. Results : Time to culture conversion was two months or less for 82 per cent of patients. Culture conversion rates at 3 and 6 months were 84 and 87 per cent respectively. At the end of treatment, 25 (66%) were cured, 5 defaulted, 3 died and 5 failed. At 24 months, 30 (79%) patients, including 5 defaulters, remained culture negative for more than 18 months. Twenty two (58%) patients reported adverse drug reactions (ADRs) which required dose reduction or termination of the offending drug. No patient had XDR-TB initially, but 2 failure cases emerged as XDR-TB during treatment. Interpretation & conclusions: Outcomes of this small group of MDR-TB patients treated with the RNTCP's STR is encouraging in this setting. Close attention needs to be paid to ensure adherence, and to the timely recognition and treatment of ADRs.
  1,486 312 -
Virulence attributes of Helicobacter pylori isolates & their association with gastroduodenal disease
A Saxena, S Shukla, KN Prasad, UC Ghoshal
May 2011, 133(5):514-520
PMID:21623037
Background & objectives : Certain genotype(s) of Helicobacter pylori strains may play important role in the development of gastric cancer (GC) and peptic ulcer disease (PUD). This study was undertaken to investigate the association of cagA, cagA3 / region subtypes, babA2 and vacA genotypes of H. pylori with GC, PUD and non-ulcer dyspepsia (NUD) as there are no such studies from India. Methods : A total of 348 consecutive adult patients (NUD 241, PUD 45, GC 62) undergoing upper gastrointestinal endoscopy between September 2002 and May 2007 in a tertiary referral centre at Lucknow, north India, were enrolled. H. pylori infection was diagnosed by rapid urease test, culture, histopathology and PCR. Genotyping for cagA, cagA3 / subtypes, babA2 and vacA was performed by PCR using sequence specific primers. Results : H. pylori infection was higher in patients with PUD than with GC (80 vs. 56.5%, P < 0.01) and NUD (80 vs. 55.2%, P= 0.002). cagA positive H. pylori isolates were detected in 80 per cent in GC, 83.3 per cent in PUD and 76.7 per cent in NUD with no significant difference among them. Only A subtype of cagA3/ was detected and its distribution in GC, PUD and NUD was 68.8, 69.4 and 52.6 per cent respectively. Presence of babA2 genotype was 31.4 per cent and it had significant association with PUD when compared with NUD (52.8 vs. 26.3%, P<0.003). On univariate regression analysis, s1a allele was associated with GC (P<0.050) and s1a/m2 vacA genotype with both GC (P=0.014) and PUD (P=0.016). Interpretation & conclusions : H. pylori infection was strongly associated with PUD with a very high proportion of patients with GC have s1a allele and s1a/m2 vacA genotype. Both s1a/m2 vacA genotype and babA2 are associated with PUD. The study shows that different virulence attributes of H. pylori are involved in different gastroduodenal disorders.
  952 276 -
EDITORIALS
Superbug - the so-called NDM-1
RK Srivastava, RI Ichhpujani, Shashi Khare, Arvind Rai, LS Chauhan
May 2011, 133(5):458-460
PMID:21623026
  799 367 -
REVIEW ARTICLES
Use of minocycline in viral infections
Kallol Dutta, Anirban Basu
May 2011, 133(5):467-470
PMID:21623029
Repurposing of old drugs is a useful concept as it helps to minimize costs associated with the research and development of a new drug. Minocycline, a common second generation antibiotic, has been shown to possess several other beneficial effects other than its intended uses. The antiviral role of minocycline has generated considerable interest from the last decade. It was first shown to be beneficial in preventing human immunodeficiency virus (HIV) infections and later it was reported to improve cognitive deficiencies associate with neuroAIDS. However, its antiviral efficacies are not limited to retroviruses alone. In animal models or in vitro systems of flaviviral infections (especially Japanese encephalitis virus), minocycline has been shown to be highly effective. However, not all effects are based on direct inhibition of viral replication. The general anti-inflammatory and immunomodulatory properties of minocycline are also responsible in part, in imparting the protective effects. Owing to the fact that minocycline is well tolerated by most people and that the drug has nearly 40 years history of usage, it is an exciting prospect to try out in other viral infections.
  870 232 -
ORIGINAL ARTICLES
Study on cow ghee versus soybean oil on 7,12-dimethylbenz(a)-anthracene induced mammary carcinogenesis & expression of cyclooxygenase-2 & peroxisome proliferators activated receptor- γ in rats
Rita Rani, Vinod K Kansal
May 2011, 133(5):497-503
PMID:21623034
Background & objectives : Breast cancer is a leading cause of cancer death in women; dietary fat is the one of the factors that influences its incidence. In the present study we investigated the effect of feeding cow ghee versus soybean oil on 7,12-dimethylbenz(a)anthracene (DMBA) induced mammary cancer in rat and expression of cyclooxygenase-2 and peroxisome proliferators activated receptor- γ (PPAR-γ) in mammary gland. Methods : Two groups of 21 day old female rats (30 each) were fed for 44 wk diet containing cow ghee or soybean oil (10%). The animals were given DMBA (30mg/kg body weight) through oral intubation after 5 wk feeding. Another two groups (8 each) fed similarly but not given DMBA served as control for the gene expression study. Results : In DMBA treated groups, the animal fed soybean oil had higher tumour incidence (65.4%), tumour weight (6.18 g) and tumour volume (6285 mm 3 ) compared to those fed cow ghee (26.6%, 1.67 g, 1925 mm 3 , respectively). Tumour latency period was 23 wk on soybean oil compared to 27 wk on cow ghee. Histological analysis of tumours showed that the progression of carcinogenesis was more rapid on soybean oil than on cow ghee. The expression of cyclooxygenase-2 was observed only in DMBA treated rats and it was significantly less on cow ghee than on soybean oil. The expression of PPAR-γ was significantly more on cow ghee than on soybean oil. Interpretation & conclusions : Our results show that dietary cow ghee opposed to soybean oil attenuates mammary carcinogenesis induced by DMBA; and the effect is mediated by decreased expression of cyclooxygenase-2 and increased expression of PPAR-γ in the former group.
  883 181 -
Detection & characterization of Shiga toxin producing Escherichia coli (STEC) & enteropathogenic Escherichia coli (EPEC) in poultry birds with diarrhoea
TK Dutta, P Roychoudhury, S Bandyopadhyay, SA Wani, I Hussain
May 2011, 133(5):541-545
PMID:21623041
Background & objectives : Limited information is available on shiga toxin producing Escherichia coli (STEC) in animals and birds from India. An outbreak of acute diarrhoea in poultry birds at Aizawl, Mizoram was investigated for detection and characterization of STEC and enteropathogenic E. coli (EPEC). Methods : E. coli was isolated and identified from rectal swabs, intestinal contents, heart blood and spleen of 19 poultry birds that died due to acute diarrhoea during the outbreak. Phenotypic characterization was done by standard bacteriological and biochemical techniques. All the isolates were serotyped based on their somatic antigens. Virulence genes (stx 1, stx 2, eaeA and hlyA) were detected by multiplex PCR assay. Results : A total of 42 E. coli isolates were obtained, of which 24 belonged to 3 serogroups (O64, O89 and O91) and the remaining 18 were untypable (UT). Altogether, 14 (33.33%) isolates carried at least 1 virulence gene, of which 10 (23.81%) and 4 (9.52%) were recorded as STEC and EPEC, respectively. Of the 10 STEC isolates, one carried only stx2 , one carried stx 2 and hlyA, four carried stx1 , stx2 and hlyA, two carried stx 1, eaeA and hlyA genes and two carried stx 1 and eaeA. Of the four EPEC isolates, two carried eaeA and hlyA, one carried only eaeA gene and 1 carried only hlyA gene. Interpretation & conclusions : This is the first report on the involvement of STEC in poultry in India.
  849 214 -
Prevalence of endothelial nitric oxide synthase (eNOS) gene exon 7 Glu298Asp variant in North Eastern India
Priyanka Shankarishan, Prasanta Kumar Borah, Giasuddin Ahmed, Jagadish Mahanta
May 2011, 133(5):487-491
PMID:21623032
Background & objectives : Endothelial nitric oxide is a potent vasodilator and impairment of its generation brought about by gene polymorphism is considered a major predictor for several diseases. A single nucleotide polymorphism G894T within exon 7 of endothelial nitric oxide synthase (eNOS-7) gene, resulting in a replacement of glutamic acid by aspartic acid, has been studied as a putative candidate gene for cardiovascular diseases. The pattern of eNOS-7 Glu298Asp variant in the Indian population is poorly known. The present study was planned to determine the prevalence of the variant of this gene among tea garden community in Assam, North-East India with high prevalence of hypertension. Methods : Study participants of both sex aged ≥18 yr were recruited randomly from temporary field clinics established in tea gardens of Dibrugarh, Assam. Genomic DNA was extracted from 409 subjects by the conventional phenol-chloroform method. The prevalence of the eNOS exon 7 Glu298Asp variant was determined by polymerase chain reaction and restriction fragment length polymorphism analysis. Results : The study population was in Hardy-Weinberg Equilibrium. The frequency of the eNOS GG, GT and TT genotypes was found to be 75, 22 and 3 per cent respectively and did not show any significant difference in gender wise analysis. Interpretation & conclusions : Our results showed that the prevalence of the homozygous GG genotype was high (75%) and the rare mutant genotype (homozygous, TT) was 3 per cent in a population at risk with cardiovascular disease. Such population-based data on various polymorphisms can ultimately be exploited in pharmacogenomics.
  730 224 -
Socio-economic factors & longevity in a cohort of Kerala State, India
Catherine Sauvaget, Kunnambath Ramadas, Jean-Marie Fayette, Gigi Thomas, Somanathan Thara, Rengaswamy Sankaranarayanan
May 2011, 133(5):479-486
PMID:21623031
Background & objectives : Even though Kerala State is well-known for its egalitarian policies in terms of healthcare, redistributive actions and social reforms, and its health indicators close to those of high-resource countries despite a poor per-capita income, it is not clear whether socio-economic disparities in terms of life expectancy are observed. This study was therefore carried out to study the impact of socio-economic level on life expectancy in individuals living in Kerala. Methods : A cohort of 1,67,331 participants aged 34 years and above in Thiruvananthapuram district, having completed a lifestyle questionnaire at baseline in 1995, was followed up for mortality and cause of death until 2005. Survival estimates were based on the participants' vital status and death rates were calculated separately for men and women and for several socio-economic factors, stratified by age. Results : At 40 years, men and women were expected to live another 34 and 37 years, respectively. Life expectancy varied across the participants' different socio-economic categories: those from high income households with good housing conditions, materially privileged households and small households, had a 2-3 years longer life expectancy as compared to the deprived persons. Also, those who went to college lived longer than the illiterates. The gaps between categories were wider in men than in women. Interpretation & conclusions : Socio-economic disparity in longevity was observed: wealthy people from Kerala State presented a longer life expectancy.
  765 159 -
CORRESPONDENCES
Sperm DNA damage & oxidative stress in recurrent spontaneous abortion (RSA)
Monis Bilal Shamsi, Sunderarjan Venkatesh, Dhananjay Pathak, Deepika Deka, Rima Dada
May 2011, 133(5):550-551
PMID:21623044
  647 219 -
ORIGINAL ARTICLES
Profile of bacterial pneumonia during Hajj
Atif H Asghar, Ahmad M Ashshi, Esam I Azhar, Syed Z Bukhari, Tariq A Zafar, Aiman M Momenah
May 2011, 133(5):510-513
PMID:21623036
Background & objectives : The congregation of a large number of people during Hajj seasons from different parts of the world in overcrowded conditions within a confined area for a long period of time presents many public health challenges and health risks. One of the main health problems of the crowding is ease transmission of pneumonia by air droplets. This study was aimed to determine the most common causes of bacterial pneumonia during the 2005 Hajj season and to relate the findings with clinical conditions. Methods : A total of 141 patients with suspected pneumonia from the three main tertiary care hospitals in Makkah, Saudi Arabia, were investigated during Hajj season, 2005. Sputum and serum samples were collected and investigated for the possible presence of typical or atypical causative agents. Results : Of the 141 clinically suspected pneumonia cases, 76 (53.9%) were confirmed positive by microbiological tests. More than 94 per cent of the confirmed cases were in the age group >50 yr, and 56.6 per cent of the cases were men. The most frequent isolates were Candida albicans (28.7%) and Pseudomonas aeruginosa (21.8%), followed by Legionella pneumophila (14.9%) and Klabsiella pneumoniae (9.2%). More than one causative pathogens were isolated in 15 patients (16.3%), and 55 per cent of patients were diabetic. Interpretation & conclusions : Clinicians should be aware that typical pneumonia treatment regimens may not work well during the Hajj season due to the wide variety of isolated organisms. This necessitates taking a sputum sample before starting treatment for identification and sensitivity testing. Special precautions need to be taken for >50 yr old patients.
  638 175 -
Clinical response of newly diagnosed HIV seropositive & seronegative pulmonary tuberculosis patients with the RNTCP Short Course regimen in Pune, India
S Tripathy, A Anand, V Inamdar, MM Manoj, KM Khillare, AS Datye, R Iyer, DM Kanoj, M Thakar, V Kale, M Pereira, AR Risbud
May 2011, 133(5):521-528
PMID:21623038
Background & objectives : In the Revised National Tuberculosis Control Programme (RNTCP) in India prior to 2005, TB patients were offered standard DOTS regimens without knowledge of HIV status. Consequently such patients did not receive anti-retroviral therapy (ART) and the influence of concomitant HIV infection on the outcome of anti-tuberculosis treatment remained undetermined. This study was conducted to determine the results of treatment of HIV seropositive pulmonary tuberculosis patients with the RNTCP (DOTS) regimens under the programme in comparison with HIV negative patients prior to the availability of free ART in India. Methods : Between September 2000 and July 2006, 283 newly diagnosed pulmonary TB patients were enrolled in the study at the TB Outpatient Department at the Talera Hospital in the Pimpri Chinchwad Municipal Corporation area at Pune (Maharashtra): they included 121 HIV seropositive and 162 HIV seronegative patients. They were treated for tuberculosis as per the RNTCP in India. This study was predominantly conducted in the period before the free ART become available in Pune. Results : At the end of 6 months of anti-TB treatment, 62 per cent of the HIV seropositive and 92 per cent of the HIV negative smear negative patients completed treatment and were asymptomatic; among smear positive patients, 70 per cent of the HIV-seropositive and 81 per cent of HIV seronegative pulmonary TB patients were cured. Considering the results in the smear positive and smear negative cases together, treatment success rates were substantially lower in HIV positive patients than in HIV negative patients, (66% vs 85%). Further, 29 per cent of HIV seropositive and 1 per cent of the HIV seronegative patients expired during treatment. During the entire period of 30 months, including 6 months of treatment and 24 months of follow up, 61 (51%) of 121 HIV positive patients died; correspondingly there were 6 (4%) deaths among HIV negative patients. Interpretation & conclusions : The HIV seropositive TB patients responded poorly to the RNTCP regimens as evidenced by lower success rates with chemotherapy and high mortality rates during treatment and follow up. There is a need to streamline the identification and management of HIV associated TB patients in the programme with provision of ART to achieve high cure rates for TB, reducing mortality rates and ensuring a better quality of life.
  597 166 -
EDITORIALS
World No Tobacco Day 2011: India's progress in implementing the framework convention on tobacco control
Rachel L Schwartz, Heather L Wipfli, Jonathan M Samet
May 2011, 133(5):455-457
PMID:21623025
  563 169 -
CORRESPONDENCES
Introducing pentavalent vaccine in EPI in India: A counsel for prudence in interpreting scientific literature
Madhu Gupta, Shankar Prinja, Dinesh Kumar, Rajesh Kumar
May 2011, 133(5):560-562
PMID:21623048
  576 125 -
COMMENTARIES
Endothelial nitric oxide synthase (eNOS) variants in cardiovascular disease: pharmacogenomic implications
Manjula Bhanoori
May 2011, 133(5):464-466
PMID:21623028
  514 175 -
Research on social inequalities in health in India
Malavika A Subramanyam, SV Subramanian
May 2011, 133(5):461-463
PMID:21623027
  432 198 -
CORRESPONDENCES
Prevalence & determinants of depression in type 2 diabetes patients: Problem in generalization
Debajyoti Datta
May 2011, 133(5):555-556
PMID:21623046
  448 164 -
Treatment practices & laboratory investigations during chikungunya outbreaks in South India
Manoj V Murhekar, P Manickam, R Mohan Kumar, SR Bala Ganesakumar, V Ramachandran, R Ramakrishnan, V Kumaraswami
May 2011, 133(5):546-547
PMID:21623042
  434 134 -
Phylogenetic analysis of swine & human hepatitis E virus
Aditya Narayan Sarangi, Shambhavi Srivastava
May 2011, 133(5):548-549
PMID:21623043
  397 143 -
BOOK REVIEWS
An introduction to statistics in early phase trials
RM Pandey
May 2011, 133(5):565-567
  392 106 -
CORRESPONDENCES
Need for better anthropometric markers for prediction of cardiovascular risk in nutritionally stunted populations
S Sivasankaran, MKC Nair, George Babu, AM Zufikar
May 2011, 133(5):557-559
PMID:21623047
  391 100 -
BOOK REVIEWS
Equity, social determinants and public health programmes
Alok Mukhopadhyay
May 2011, 133(5):564-565
  371 101 -
CORRESPONDENCES
Are women with mental illness & the mentally challenged adequately protected in India?
Govindasamy Agoramoorthy
May 2011, 133(5):552-554
PMID:21623045
  360 78 -
BOOK REVIEWS
Recovery in mental health: Reshaping scientific and clinical responsibilities
Ajit Awasthi, Navendu Gaur
May 2011, 133(5):567-569
  336 71 -
CORRESPONDENCES
Authors' response
Zubair Lone, Jacob M Puliyel
May 2011, 133(5):562-563
  285 69 -
Authors' response
Amit Raval, Ethiraj Dhanaraj, Anil Bhansali, Sandeep Grover, Pramil Tiwari
May 2011, 133(5):556-556
  251 53 -
Authors' response
KR Thankappan, Ramachandran S Vasan
May 2011, 133(5):559-559
  232 57 -
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