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   2010| December  | Volume 132 | Issue 6  
    Online since April 9, 2011

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History of pharmacy in India & related aspects (Vol. 6): Medico-pharmaceutical professionals
BN Dhawan
December 2010, 132(6):748-750
  4,273 371 -
Metabolic syndrome in adult population of rural Wardha, Central India
Pranita Kamble, Pradeep R Deshmukh, Neelam Garg
December 2010, 132(6):701-705
Background and Objectives : Prevalence of metabolic syndrome is high among Asians including Indians. Scarce information is available about the magnitude of metabolic syndrome in rural areas and hence present study in rural area of Wardha district, central India. Methods: In 300 randomly selected subjects, blood pressure and anthropometric measurements such as height, weight, waist circumference and hip circumference were noted. Blood sample was collected after overnight fasting and was subjected to biochemical quantification such as fasting blood sugar, total cholesterol, triglycerides, HDL-C, VLDL-C and LDL-C. Data were analyzed using ATP-III definition as well as by modifying the waist circumference cut-offs as per Asia-Pacific guidelines. Results: Overall metabolic syndrome as per ATP-III criteria was observed in 5.0 per cent adult rural population. When ATP-III criteria were modified using waist circumference cut-offs recommended by Asia-Pacific guidelines, metabolic syndrome was seen in 9.3 per cent. It was 10.7 per cent among females and 8.2 per cent among males. Receiver operating characteristic curve was plotted to find out the best cut-off of BMI to identify the individuals with metabolic syndrome. The best cut-off for BMI came out to be 23.32 kg/m 2 . Interpretation and Conclusions : The magnitude of metabolic syndrome was low among rural adults of Wardha as compared to reported values in urban areas. BMI of 23.32 kg/m 2 and higher was found to predict significant risk of metabolic syndrome in these study subjects. However, studies with larger sample need to be conducted to confirm these findings.
  2,335 351 -
Association of serotonin transporter gene polymorphisms with obsessive-compulsive disorder (OCD) in a South Indian population
Prashant Tibrewal, HB Kiran Kumar, GN Shubha, D Subhashree, Meera Purushottam, K Thennarasu, Y.C.J Reddy, Sanjeev Jain
December 2010, 132(6):690-695
Background and Objectives : Serotonin transporter polymorphisms, 5-HTTVNTR and 5-HTTLPR, have been found to be associated with obsessive-compulsive disorder (OCD) and particularly with neurotic characteristics. In the present study we looked for an association between OCD and these polymorphisms in OCD patients and controls of south Indian origin. Methods: 5-HTTVNTR and 5-HTTLPR/rs25531 were genotyped in 93 OCD patients and 92 healthy controls. The allelic distribution and genotype frequency in cases and controls were compared using chi square test. In order to test for the effects of genotype on heterogeneity of the illness, linear regression analysis was undertaken for co-morbid depression status and YBOCS score (severity index). Results: There was no significant association with the 5-HTTVNTR or the 5-HTTLPR polymorphism. No significant association of OCD with the 5-HTTLPR genotype was found even on inclusion of the rs25531 locus, which is part of the transcription factor binding site as reported in earlier studies. However, severity of the illness showed a modest association with the dominant model. Interpretation and Conclusions : Our data show that genetic variation in the SLC6A4 gene regulatory region may not have a significant effect on OCD in the present population. Further replication in a large and independent cohort with an equal number of female subjects would help to ascertain if the absence of association in this cohort is due to the nullifying effect of the larger proportion of male subjects in our sample population. The marginal effect of the 5-HTTLPR (A/G) genotype obtained on linear regression with disease severity is suggestive of a potential role for this locus in the disease process.
  1,993 370 -
A review on peripheral blood CD4+ T lymphocyte counts in healthy adult Indians
Ashwini Shete, Madhuri Thakar, Philip Raj Abraham, Ramesh Paranjape
December 2010, 132(6):667-675
The CD4+ T lymphocytes are the crucial cells in the cascade of events in forming immune response to the foreign antigen and hence monitoring the CD4+ T cell counts to understand the extent of immune deficiency is a common practice. CD4+ T cells are also the primary target cells for human immunodeficiency virus (HIV). Hence CD4+ T lymphocyte count is the most important marker of immune dysfunction in HIV disease progression. The estimation of CD4+ T cell counts is used to decide the initiation of anti retroviral therapy (ART), to monitor the efficacy of ART and to start treatment for opportunistic infections (OIs). To develop the threshold levels of CD4+ T cell counts, data from western countries are being used in India. The CD4+ T cell counts are known to be influenced by race and environmental factors. Hence it is important to establish the reference ranges for the CD4+ T cell counts in the target population to understand the immune dysfunction. The information on the lower limits of the CD4+ T cells count is necessary to decide the initiation and monitoring of ART. The published data on the CD4+ T cells count in healthy Indian adult population have been reviewed, analyzed and discussed in this review article. The requirement of establishment of reference ranges in Indian population is discussed.
  1,875 360 -
Zinc: A promising agent in dietary chemoprevention of cancer
DK Dhawan, Vijayta D Chadha
December 2010, 132(6):676-682
Proper intake of dietary nutrients is considered crucial for preventing the initiation of events leading to the development of carcinoma. Many dietary compounds have been considered to contribute in cancer prevention including zinc, which plays a pivotal role in host defense against the initiation and promotion of several malignancies. Zinc is an essential element that is integral to many proteins and transcription factors which regulate key cellular functions such as the response to oxidative stress, DNA replication, DNA damage repair, cell cycle progression, and apoptosis. Zinc has been ascribed roles in the metabolism and interaction of malignant cells, particularly in apoptosis. Zinc is involved in structural stabilization and activation of the p53 that appears to be an important component of the apoptotic process and also in activation of certain members of the caspase family of proteases. Zinc exerts a positive beneficial effect against chemically induced preneoplastic progression in rats and provides an effective dietary chemopreventive approach to disease in vulnerable section of population with family history of carcinoma. The present review provides an insight into the research conducted on animals as well as on human subjects for providing the concept that zinc deficiency is an important factor in the development and progression of malignancy and that zinc could be efficacious in the prevention and treatment of several cancers viz., colon, pancreas, oesophageal and head and neck. However, it needs further exploration with regard to other definitive bioassays including protein expression and documentation of specific molecular markers to establish the exact mechanism for zinc-mediated cancer chemoprevention. Preclinical trials need to investigate the genetic and epigenetic pathways of chemoprevention by zinc.
  1,595 563 -
Epidemiology of hepatitis C virus infection & liver disease among injection drug users (IDUs) in Chennai, India
Shruti H Mehta, Samantha L Vogt, Aylur K Srikrishnan, Conjeevaram K Vasudevan, Kalilapuri G Murugavel, Shanmugam Saravanan, Santhanam Anand, M Suresh Kumar, Stuart C Ray, David D Celentano, Suniti Solomon, Sunil S Solomon
December 2010, 132(6):706-714
Background and Objectives : We characterized HCV antibody prevalence, viral persistence, genotype and liver disease prevalence among IDUs in Chennai, India as the study of the association of HIV with each of these states is important and there are no data available. Methods: Between 2005-2006, 1158 IDUs were recruited and followed semi-annually. All were tested for HCV antibodies at baseline; a random sample of 400 antibody positives (200 HIV-positive and 200 HIV-negative) were tested for HCV RNA; 13 of these were sequenced. Assessment of asparate amino transferase (AST)-to-platelet ratio index (APRI) was done on 557 IDUs. Prevalence ratios of each outcome were examined. Results: Median age was 35 yr; 99 per cent were male. HCV antibody prevalence was 55 per cent and was associated with older age, being unmarried, longer injection history, tattoo and injecting at a dealer's place. Of the 400 HCV antibody positive IDUs, 281 (70.3%) had persistent infection which was less common among hepatitis B-infected persons but not associated with HIV. Of the 13 samples sequenced, 11 (85%) were HCV genotype 3a. Fibrosis prevalence according to APRI was: HIV/HCV-uninfected, 4 per cent; HIV mono-infected, 3 per cent; HCV mono-infected, 11 per cent; HIV/HCV co-infected, 12 per cent (P<0.001). In addition to being associated with HCV and HIV/HCV, fibrosis prevalence was higher among those drinking alcohol frequently; daily marijuana use was protective. Interpretation and Conclusions : Our findings show that IDUs in Chennai have high HCV prevalence and associated disease burden. The burden will increase as access to antiretroviral therapy improves particularly given the high prevalence of HIV, HCV and alcohol use.
  1,707 396 -
HIV in Indian prisons: Risk behaviour, prevalence, prevention & treatment
Kate Dolan, Sarah Larney
December 2010, 132(6):696-700
Background and Objectives : HIV is a major health challenge for prison authorities. HIV in prisons has implications for HIV in the general community. The aim of this paper was to gather information on HIV risk, prevalence, prevention and treatment in prisons in India. Methods: Relevant published and unpublished reports and information were sought in order to provide a coherent picture of the current situation relating to HIV prevention, treatment and care in prisons in India. Information covered prison management and population statistics, general conditions in prisons, provision of general medical care and the HIV situation in prison. Results: No data on drug injection in prison were identified. Sex between men was reported to be common in some Indian prisons. A national study found that 1.7 per cent of inmates were HIV positive. Some prisons provided HIV education. Condom provision was considered illegal. A few prisoners received drug treatment for drug use, HIV infection or co-infection with sexually transmitted infections (STIs). Interpretation and Conclusions : HIV prevalence in prisons in India was higher than that in the general community. Regular monitoring of information on HIV risk behaviours and prevalence in Indian prisons is strongly recommended. Evidence based treatment for drug injectors and nation-wide provision of HIV prevention strategies are urgently required. Voluntary counselling, testing and treatment for HIV and STIs should be provided.
  1,592 314 -
Characteristics, immunological response & treatment outcomes of HIV-2 compared with HIV-1 & dual infections (HIV 1/ 2) in Mumbai
Montaldo Chiara, Zachariah Rony, Mansoor Homa, Varghese Bhanumati, Joanna Ladomirska, M Manzi, N Wilson, Deshpande Alaka, AD Harries
December 2010, 132(6):683-689
Background and Objectives : Information available on HIV-2 and dual infection (HIV-1/2) is limited. This study was carried out among HIV positive individuals in an urban referral clinic in Khar, Mumbai, India, to report on relative proportions of HIV-1, HIV-2 and HIV-1/2 and baseline characteristics, response to and outcomes on antiretroviral treatment (ART). Methods: Retrospective analysis of programme data (May 2006-May 2009) at Khar HIV/AIDS clinic at Mumbai, India was done. Three test algorithm was used to diagnose HIV-1 and -2 infection. Standard ART was given to infected individuals. Information was collected on standardized forms. Results: A total of 524 individuals (male=51%; median age=37 yr) were included in the analysis over a 3 year period (2006-2009) - 489 (93%) with HIV-1, 28 (6%) with HIV-2 and 7(1%) with dual HIV-1/2 infection. HIV-2 individuals were significantly older than HIV-1 individuals (P<0.001). A significantly higher proportion of HIV-2 patients and those with dual infections had CD4 counts <200 cells/μl compared to HIV-1. HIV-2 individuals were more likely to present in WHO Clinical Stage 4. Of the 443 patients who were started on ART, 358 (81%) were still alive and on ART, 38 (8.5%) died and 3 were transferred out. CD4 count recovery at 6 and 12 months was satisfactory for HIV-1 and HIV-2 patients on protease inhibitor based regimens while this was significantly lower in HIV-2 individuals receiving 3 nucleoside reverse transcriptase inhibitors. Interpretation and conclusions: In an urban HIV clinic in Mumbai, India, HIV-2 and dual infections are not uncommon. Adaptation of the current national diagnostic and management protocols to include discriminatory testing for HIV types and providing access to appropriate and effective ART regimens will prevent the development of viral resistance and preserve future therapeutic options.
  1,540 357 -
Faecal bifidobacteria in Indian neonates & the effect of asymptomatic rotavirus infection during the first month of life
Ramadass Balamurugan, Fabien Magne, Divya Balakrishnan, Antonia Suau, Sasirekha Ramani, Gagandeep Kang, Balakrishnan S Ramakrishna
December 2010, 132(6):721-727
Background and Objectives : Bifidobacteria colonize the gut after the first week of life and remain an important component of the gut microbiota in infancy. This study was carried out to characterize the diversity and number of bifidobacteria colonizing the gut in Indian neonates and to investigate whether asymptomatic infection with rotavirus in the first month of life affected gut colonization by bidifobacteria. Methods: DNA was isolated from faeces of 14 term-born neonates who were under surveillance for rotavirus infection. Bacterial and bifidobacterial diversity was evaluated by temporal temperature gradient electrophoresis (TTGE) of 16S rDNA amplified using total bacteria and bifidobacteria-specific primers. Real time PCR, targeting 16S rDNA, was used to quantitate faecal bifidobacteria and enterobacteria. Results: TTGE of conserved bacterial 16S rDNA showed 3 dominant bands of which Escherichia coli (family Enterobacteriaceae) and Bifidobacterium (family Bifidobacteriaceae) were constant. TTGE of Bifidobacterium genus-specific DNA showed a single band in all neonates identified by sequencing as Bifidobacterium longum subsp. infantis. Faecal bifidobacterial counts (log 10 cfu/g faeces) ranged from 6.1 to 9.3 and enterobacterial counts from 6.3 to 9.5. Neonates without and with rotavirus infection in the first week of life did not show significant differences in the median count of bifidobacteria (log 10 count 7.48 vs. 7.41) or enterobacteria (log 10 count 8.79 vs. 7.92). Interpretation and Conclusions : B. longum subsp. infantis was the sole bifidobacterial species colonizing the gut of Indian neonates. Asymptomatic rotavirus infection in the first month of life was not associated with alteration in faecal bifidobacteria or enterobacteria.
  1,476 354 -
Serial assessment of biochemical parameters of red cell preparations to evaluate safety for neonatal transfusions
Somnath Mukherjee, Neelam Marwaha, Rajendra Prasad, Ratti Ram Sharma, Beenu Thakral
December 2010, 132(6):715-720
Background and Objectives : Neonatologists often prefer fresh blood (<7 days) for neonatal transfusions. The main concerns for stored RBCs are ex vivo storage lesions that undermine red cell functions and may affect metabolic status of neonatal recipients. This study was designed to evaluate serial in vitro changes of biochemical parameters in different RBC preparations during storage to consider for neonatal transfusions even after storage beyond one week. Methods: Twenty five units each of whole blood (CPDA-1 RBC, SAGM RBC) were selected for serial biochemical parameter assessment after each fulfilled the quality criteria (volume and haematocrit). These units were tested serially for supernatant potassium, pH, lactate, haemoglobin, glucose and red cell 2,3 diphosphoglycerate (2,3 DPG) up to 21 days of storage. Results: Within each group of RBC, rise in mean concentration of potassium, lactate and plasma haemoglobin from day 1 to 21 of storage was significant in CPDA-1 RBC having the highest levels at day 21. From day 3 to 21, SAGM RBC had higher mean pH value than CPDA-1 RBC though this difference was not statistically significant. SAGM RBC had highest mean glucose concentration during storage than other two types of red cell preparations (P<0.005). Within each group, fall in mean 2,3 DPG concentration from day 1 to 7 was significant (P<0.05). A positive correlation existed between mean plasma potassium and haemoglobin in all three types of red cells (r=0.726, 0.419, 0.605 for CPDA-1 RBC, SAGM RBC and whole blood respectively, P<0.005). Interpretation and Conclusions : All the three red cell preparations tested revealed biochemical changes within acceptable limits of safety till 21 days of storage. CPDA-1 RBCs had the highest degree of these changes.
  1,563 263 -
Dengue haemorrhagic fever among adults - An observational study in Chennai, South India
M Emmanuel Bhaskar, Swathy Moorthy, N Senthil Kumar, Preetam Arthur
December 2010, 132(6):738-740
  1,005 357 -
Microbicides & their implications in HIV prevention
Salim S Abdool Karim, Cheryl Baxter
December 2010, 132(6):656-659
  1,024 236 -
Attenuation of oxidative stress & DNA damage in varicocelectomy: Implications in infertility management
Rima Dada, Monis Bilal Shamsi, Sunderarjan Venkatesh, Naramada Prasad Gupta, Rajeev Kumar
December 2010, 132(6):728-730
Sperm DNA integrity is of vital importance for foetal development and birth of healthy offspring. Oxidative stress and consequent DNA damage are the major cause of decline in semen quality in men with varicocele. A preliminary study was conducted on 11 men with clinical varicocele who also had high levels of reactive oxygen species (ROS), to assess DNA damage in sperms and ROS levels before and after varicocelectomy. Varicocelectomy resulted in rapid (1 month) significant (P<0.001) decline in free radical levels and slow (3-6 months) significant decline in DNA damage levels. Thus men undergoing varicocelectomy should try concieving only 6 months following surgery.
  835 301 -
Nutrigenomics: Opportunities in Asia (Forum of nutrition)
Koumudi Godbole
December 2010, 132(6):747-748
  937 179 -
Breeding potential of Aedes albopictus (Skuse, 1895) in chikungunya affected areas of Kerala, India
Alex Eapen, K John Ravindran, AP Dash
December 2010, 132(6):733-735
  830 199 -
emm type distribution pattern of group A streptococcus in North India: Need for a new preventive approach
V Dhanda, R Kumar, JS Thakur, A Chakraborti
December 2010, 132(6):741-744
  731 246 -
HIV-2 goes global: An unaddressed issue in Indian anti-retroviral programmes
Thushan de Silva, Robin A Weiss
December 2010, 132(6):660-662
  747 228 -
Influenza A virus outbreak in police training school, Nazafgarh, Delhi 2009
DK Raut, Saudan Singh, Neelam Roy, Deepthi Nair, Rinku Sharma
December 2010, 132(6):731-732
  745 165 -
Paul Klee and his illness
Sanjeev Handa
December 2010, 132(6):750-751
  770 126 -
Serotonin transporter gene polymorphisms & obsessive-compulsive disorder
Humberto Nicolini
December 2010, 132(6):663-665
  692 189 -
Need for improved access to HIV prevention programmes
Trevor A Hart
December 2010, 132(6):653-655
  691 158 -
The need for rejuvenation of Indian biomedical journals
Shampa Ghosh, Jitendra Kumar Sinha
December 2010, 132(6):736-737
  640 151 -
Controversies in the treatment of lung cancer
PK Julka
December 2010, 132(6):745-746
  620 117 -