Nondestructive Analysis of Litchi Fruit Quality Using FT-NIR Spectroscopy

A non-destructive optical method based on near-infrared spectroscopy has been used for the evaluation of litchi fruit quality. Diffuse reflectance measurements (12500–3600 cm-1), physical, and biochemical measurements were performed individually on 100 litchi fruits of cv.Shahi cultivar harvested at different ripening stages. Relationships between spectral wavelengths and quality attributes were evaluated by application of chemometric techniques based on partial least squares (PLS) regression. The fruit set was divided into two groups: 60 fruits for calibration and 39 for validation. Good prediction performance was obtained for pH, soluble solids, and titratable acidity with correlation coefficients of 0.96, 0.91 and 0.94 respectively and root mean square errors of prediction of 0.009, 0.291ºBrix and 0.011% malic acid respectively. For the other quality traits such as vitamin C and color the prediction models were not satisfactorily accurate due to the higherror of calibration and prediction.

A Regression Model to Predict Diameter of Mitral Valve Prosthesis Preoperatively: An Aid to Clinical Decision Making.

Aim: Accurate estimation of the prosthetic valve size pre-operatively can aid to the efficiency and effectiveness to mitral valve surgery. Traditionally Two dimensional Echocardiography is being used for this purpose but cannot be claimed as optimum tool. This study computes and analyses several linear regression equations in order to obtain a best fit model for predicting mitral prosthesis size well before operation. Materials and Methods: This hospital based longitudinal study was conducted in a tertiary care Cardio Thoracic Vascular Department from August 2011 to August 2012. A total of 67 participants suffering from Rheumatic Heart Disease (with severe mitral valve disease) were recruited. Short and long axis of the mitral annulus were measured through 2-dimensional transthoracic echocardiography. Further three regression models were plots using short axis, long axis and area of the annulus as independent variables and diameter of prosthetic valve as dependent variable. Results: Among the three predictors namely the anterio-posterior axis (short axis), commissurecommissural axis (long axis) and area of mitral valve annulus; the regression equation with short axis predicted the diameter of prosthesis more accurately. The optimum regression model for short axis is calculated as -Diameter of prosthetic valve= -0.165 + 0.769X short axis of Ellipse. The coefficient of determination for this equation (R2) is 0.905. This equation offers the explanation for maximum observations in the model (F=609.48). Conclusion: The size of optimum prosthetic valve may be determined preoperatively as a function of anterio-posterior axis (short axis) of annulus through non invasive 2-D Echocardiography. However this finding is amenable for further multi-centric validation.

Antibiotic resistance and pathogenicity factors in Staphylococcus aureus isolated from mastitic Sahiwal cattle.

Methicillin-resistant Staphylococcus aureus (MRSA) poses a serious problem in dairy animals suffering from mastitis. In the present study, the distribution of mastitic MRSA and antibiotic resistance was studied in 107 strains of S. aureus isolated from milk samples from 195 infected udders. The characterizations pathogenic factors (adhesin and toxin genes) and antibiotic susceptibility of isolates were carried out using gene amplification and disc diffusion assays, respectively. A high prevalence of MRSA was observed in the tested isolates (13.1%). The isolates were also highly resistant to antibiotics, i.e. 36.4% were resistant to streptomycin, 33.6% to oxytetracycline, 29.9% to gentamicin and 26.2% each to chloramphenicol, pristinomycin and ciprofloxacin. A significant variation in the expression of pathogenic factors (Ig, coa and clf) was observed in these isolates. The overall distribution of adhesin genes ebp, fib, bbp, fnbB, cap5, cap8, map and cna in the isolates was found to be 69.1, 67.2, 6.5, 20.5, 60.7, 26.1, 81.3 and 8.4%, respectively. The presence of fib, fnbB, bbp and map genes was considerably greater in MRSA than in methicillin-susceptible S. aureus (MSSA) isolates. The proportions of toxin genes, namely, hlb, seb, sec, sed, seg and sei, in the isolates were found to be 94.3, 0.9, 8.4, 0.9, 10.2 and 49.5%, respectively. The proportions of agr genes I, II, III and IV were found to be 39.2, 27.1, 21.5 and 12.1%, respectively. A few isolates showed similar antibiotic-resistance patterns, which could be due to identical strains or the dissemination of the same strains among animals. These findings can be utilized in mastitis treatment programmes and antimicrobials strategies in organized herds.

Orbital lymphoma: role of radiation.

The purpose of this article is to review the literature for clinical presentation, treatment, outcome and complications of using radiotherapy for the treatment of orbital lymphoma. For this, MEDLINE, EMBASE, and the Cochrane Library were searched through January 2007 for published data on primary non-Hodgkin's lymphoma (NHL) of the orbit. The search was conducted in all document types, using the following terms "Non-Hodgkin's lymphoma, MALT (mucosa associated lymphoid tissue) and orbit". Data extracted were based on age, sex, therapeutic methods and outcome of treatment. When full articles were not available, abstracts were used as a source of information. Only those articles whose abstracts or full text were available in English were included in table. The review of reports of NHL of the orbit, in general, served as a source of information about its clinical behavior, treatment and overall prognosis. Fifty-six publications were identified, including six in languages other than English. There was no randomized trial. All the studies were retrospective. The studies were heterogeneous in patient number (3 to 112), histology, disease stage (IE to IV), radiotherapy doses used (4 to 53.8Gy), local control rates (65 to 100%), distant relapse rates (0 to 67%, from low grade to high grade) and five-year survival rates (33 to 100%). Three of the studies with a good number of patients also demonstrated clinical benefit with radiotherapy in terms of superior efficacy or less toxicity. Available data support the acceptance of radiotherapy as a standard therapeutic option in patients with low to intermediate grade orbital lymphoma. Toxicity of radiotherapy is mild if delivered precisely.

Japanese Encephalitis in Children admitted at Patan Hospital.

This is a hospital based retrospective study, which was done in Pediatric ward of Patan hospital. Study period was one and half year (from Srawan 2063 to 2064 poush).Data were taken from discharge book of Pediatric ward, from the record section of this hospital, and from JE surveillance office, WHO, Kathmandu. All children from 1 month to 14 years ,who were admitted in Pediatric ward with symptoms of Meningitis, Meningoencephalitis and Encephalitis were included in this study and patients more than 14 years of age and symptoms not suggestive of meningitis, meningoencephalitis or encephalitis were excluded from the study. Headache; vomiting and fever were the chief complaints of patients. Two patients died during study period. There were 16 patients with serologically confirmed Japanese encephalitis.

The prevalence and characteristics of disability in Eastern Nepal.

BACKGROUND: Disability is related to poverty and development. Enough information and documentation is not available for developing countries like Nepal. AIMS AND OBJECTIVES: To assess the self-reported prevalence of disability in terms of age, sex, types, cause and age of onset. METHODOLOGY: A cross-sectional house to house census was carried out by means of structured questionnaires. RESULTS: A total of 31,160 individuals (4.87%) were found disabled out of a total of 640,259 individuals. The three most common types of disability are physical affecting limbs, hearing and vision. The most common perceived cause of disability is inborn syndrome followed by injury/accidents. DISCUSSION: Various publications for the prevalence of reported disability show a figure between three and ten percent, with physical disability affecting locomotion and manipulation as the leading type of disability. The prevalence rate can vary depending upon the disability indicators, methods and population surveyed and perceptions of the people. CONCLUSION: The self-reported prevalence of disability in Sunsari District is 4.87%, with inborn-syndrome as the leading perceived cause.

Postmastectomy radiation and survival in patients with breast cancer.

PURPOSE: To analyze the impact of postmastectomy radiotherapy on locoregional control and overall survival in patients with carcinoma breast. MATERIALS AND METHODS: Between 1995 and 2000, 688 patients of carcinoma breast were analyzed. Out of these, 608 received postmastectomy radiotherapy and 80 patients were not given any radiation therapy. At a median follow-up of 67 months, the outcomes studied were locoregional recurrence (LRR), distant metastases, disease-free survival (DFS) and overall survival (OS) using univariate and multivariate analyses. RESULTS: The frequency of LRR with or without distant metastases was 8.5%, and distant metastases was seen in 18.7% of patients. On univariate analyses, factors affecting LRR were age < 40 years (0.019), tumor stage ( P = 0.001 ), grade ( P = 0.027 ), pathological nodal status ( P ), deep resection plane (0.041), ER/PR status ( P = 0.032 ) and postmastectomy radiation therapy (PMRT) ( P ). DFS rate was 69% at 5 years. Factors affecting distant metastases were age < 40 years (0.005), tumor stage ( P ), grade ( P = 0.0007 ), pathological nodal status ( P ), extra capsular extension (ECE) ( P = 0.002 ), hormonal therapy ( P ) and PMRT ( P ). The OS rate was 81% at 5 years. Factors affecting OS were tumor stage ( P ), grade ( P = 0.0001 ), pathological nodal status ( P ), ECE ( P = 0.002 ) ER/PR status ( P = 0.008 ), hormonal therapy ( P = 0.001 ) and PMRT ( P = 0.004 ). On multivariate analysis, factors affecting LRR were age ( P = 0.001 ), tumor stage ( P = 0.021 ), deep resection plane (0.003), ECE ( P = 0.022 ) and PMRT ( P = 0.047 ). Factors affecting distant metastases were menopause ( P = 0.044 ), grade ( P = 0.012 ), ECE ( P = 0.017 ) and PMRT ( P = 0.012 ). Factors affecting OS were menopausal status ( P = 0.017 ), tumor stage ( P = 0.029 ), pathological nodal status ( P = 0.011 ) and PMRT ( P = 0.002 ). CONCLUSION: PMRT improves LRR as well as OS in patients with carcinoma breast. Other factors of prognostic importance were menopausal status, tumor stage and pathological nodal status.

Radiation Schedules for Palliation in Carcinoma Esophagus.

This study was undertaken to compare the three different radiation schedules for their efficacy in symptom relief, dysphagia free survival and radiation morbidity (if any), in carcinoma oesophagus. A total of 116 inoperable patients were prospectively randomized to three different arms of radiation. Arm-A received external beam radiation (EBRT) to a dose of 30Gy/10 #/2 weeks along with two sessions of intraluminal brachytherapy (ILBT), 600cGy each, one week apart, after a gap of two weeks from EBRT. Arm-B received only EBRT to a dose of 30Gy/10 #/2 weeks. Arm-C received EBRT to a dose of 20Gy/5#/1week without brachytherapy. The age of the patients ranged from 30 - 70 years. Improvement in dysphagia was seen in 76% of patients in Arm-A, 56% in Arm-B & 54% in Arm-C at 1 month. The dysphagia progression free survival was 10.6+0.6 months in Arm-A, 9.8+0.8 months in Arm-B and 9.9+0.6 months in Arm-C respectively. Grade 1 & 2 acute radiation toxicity was seen in 50% of patients in Arm-A, 55% patients in Arm-B & 30% patients in Arm-C. It is concluded that all the three radiation schedules achieved good palliation with similar dysphagia free survival.

Results of letrozole in postmenopausal women after tamoxifen treatment for advanced breast cancer.

AIM: To analyze overall and progression-free survival after letrozole in postmenopausal women with advanced breast cancer who failed after tamoxifen therapy. MATERIALS AND METHODS: This is a retrospective analysis of 95 patients with breast cancer who were postmenopausal and had failed after tamoxifen therapy. Dose of letrozole was 2.5 mg daily until disease progressed. Patients had estrogen receptor- and/or progesterone receptor-positive tumors or both receptors were unknown. One complete course of (6 cycles) chemotherapy for metastatic disease was allowed. The primary end point was time to progression (TTP). Secondary end points included overall objective response rate (ORR), its duration, time to treatment failure (TTF), overall survival and tolerability. RESULTS: Median TTP was 10 months. ORR was 21% with complete response rate of 9%. Nine patients died of disease during treatment. Median overall survival was 36 months. Median time to response was three months and median duration of response was 13 months. Time to chemotherapy was 13.5 months and TTF was 9.3 months. Treatment failure was seen in 76% of patients. Disease progression was the main cause for treatment failure. Treatment was well-tolerated by all patients. CONCLUSION: This retrospective analysis shows that letrozole is quite effective as second line therapy in postmenopausal patients with advanced breast cancer who had failed after tamoxifen therapy.

Patterns of relapse in locally advanced breast cancer treated with neoadjuvant chemotherapy followed by surgery and radiotherapy.

AIMS: To define the clinical and pathological predictors of locoregional recurrence (LRR) in locally advanced breast cancer (LABC) patients treated with neoadjuvant chemotherapy (NACT). MATERIALS AND METHODS: We retrospectively reviewed the outcome of 141 patients with stage II to stage III carcinoma breast treated at Department of Radiotherapy, PGIMER, Chandigarh from 1998-2002. Mean age of the patients was 46 years, 49% of patients were premenopausal and 51% were postmenopausal. The tumor stage was T2 in 18%; T3 in 61% and T4 in 26% of the patients. NACT regimen given was FAC (5-fluorouracil, adriamycin and cyclophosphamide) in 85% and CMF (cyclophosphamide, methotrexate and 5-Fu) in 15% patients. RESULTS: After NACT, surgery was possible in 95% patients. Conservative surgery was possible in 23% patients and mastectomy was done in 72% of patients. Pathological complete response (pCR) was seen in 18% patients and pathological partial response (pPR) in 69% of patients. Stable and progressive disease was seen in 6% and 7% of patients respectively. Adjuvant radiation therapy was given to 86% patients. Six percent patients developed progressive disease and 4% of patients did not turn up for radiation. Five year LRR was 6% and relapse free survival (RFS) was 94%. Thirty-two (23%) patients developed distant metastasis resulting in distant metastasis free survival of 77%. The factors that correlated positively with LRR on univariate analysis included tumor stage, stage and pathological nodal stage. However, on multivariate analysis, tumor stage and pathological nodal stage were significant. Factors that correlated for distant relapse were tumor stage, response to chemotherapy, type of surgery, extracapsular extension (ECE) and tamoxifen therapy. On multivariate analysis only ECE was the significant factor that correlated with distant relapse free survival. CONCLUSION: Thus, tumor stage and pathological nodal stage remains the most important predictor of LRR in LABC. Factors that correlated for distant relapse were tumor stage, response to chemotherapy, type of surgery and ECE and tamoxifen therapy.

Paraneoplastic leukocytoclastic vasculitis in chronic lymphoid leukemia.

A 50-year-old female who was a known case of chronic lymphoid leukemia (CLL) developed ecchymoses, purpuric spots with papules, some nodules (1-3 mm) and crusts all over the body associated with severe burning and itching along with exaggeration of CLL. The lesions were more prominent on lower limbs and face. Skin biopsy was reported as leukocytoclastic vasculitis. These lesions regressed after treatment with leukeran and glucocorticoids.

Cardiovascular changes in thyroid disorder.

Thyroid hormones have a profound effect on the metabolism. The cardiovascular system is particularly sensitive to this metabolic alteration. Therefore it is not surprising that thyroid dysfunction can produce dramatic cardiovascular effects, often mimicking primary cardiac disease. Both hypothyroidsm and hyperthyroidsm produce a clinical syndrome causing a diagnostic and therapeutic dilemma to the endocrinologist and cardiologist. Furthermore, cardiac disease and amiodarone therapy can also produce thyroid abnormality.

Alcohol use among physicians in a medical school in Nepal.

OBJECTIVE: The objective of the study was to know about the use of alcohol among physicians and factors that were related to it. METHODS: This was a cross sectional study conducted among the physicians in a medical school of eastern Nepal. A semi structured questionnaire was used to collect information. RESULTS: There were 55 subjects in the study. Half of them were between 35-45 years age group and one fourth among them were female. There were more than 88% physicians consuming alcohol for more than 10 years. One third used to preferred whisky as their favorites drink. Use of alcohol among them was due to peer pressure and to become a social human being. Most of them drink alcohol occasionally with an average amount 30-60 ml in a sitting and usually in the evening. Most of the time, they use alcohol either in parties or at home. CONCLUSION: Alcohol use in Nepal is very much prevalent. The use of alcohol is socially accepted in many communities. Uses of alcohol by physicians have direct effect on their health as well as the health of many people because they are role model for many people. They are also in direct contact with the patients. Steps to council the physicians may reduce the consumption of alcohol.

Prevalence and determinants of unmet need for family planning in a district of eastern region of Nepal.

OBJECTIVES: The unmet need for family planning is defined as the discrepancy between individual's contraceptive behaviors and their stated fertility preferences--The extent of which is very high in developing countries like Nepal. This study explores the unmet need and its determinants. METHODS: Among the teaching district of B.P. Koirala institute of Health Sciences, in the Eastern Region of Nepal, a district was selected randomly to conduct a cross-sectional study. A total of 1079 women were selected using systematic random sampling. We compared different demographic variables and sex-ration to unmet need by using means, percentage and applied chi-squared test where applicable. RESULT: The extent of unmet need is 25 percent with 9.5 percent for spacing and 15.5 percent for limiting. The mean age at marriage is 16(+/-3.2) years. A strong association of gender preferences towards male child and unmet need exist, which is highly significant. CONCLUSION: Unmet need is high despite extensive family planning program in Nepal. Mean age at marriage below legal age, low female education and gender discrimination are the factors responsible for unmet need.

Impact of family health exercise program on health knowledge and practice of a rural population of eastern Nepal.

BACKGROUND: It is important to know the impact of health education on community. This may lead to improve the programs, commitment to students and staffs by taking feedback. These activities are aimed at producing changes in the community. OBJECTIVE: To assess the impact of health education as intervention program during Family Health Exercise (FHE) about the knowledge and practice of people related to health in a village of eastern Nepal. METHODS: During FHE, health education was given by the 3rd year medical students to the head of the 30 families. The neighbour 30 families were taken as control, where no health education was given. These two groups were compared after 6 months. RESULTS: Sanitary practice (Hand washing) before meal was known to both groups. But the material used for washing hand (soap and ash) was 53% in intervention as compared to 30% in control group. People were aware about the importance of care of the mother during pregnancy and lactation, but more in intervention group. The knowledge and practice for starting semisolid food other than breast milk for infants during weaning were higher in intervention (89%) than control (31%) group. CONCLUSION: There was significant change in the knowledge and practice of woman (mainly host) who received health education. The community also benefited in terms of their health knowledge and practices. Such programs are useful for the community at large.

Occurrence of aflatoxin in some of the food and feed in Nepal.

BACKGROUND: There are many contaminants like aflatoxin present in food products. Aflatoxin in comparison to many other contaminants is very toxic and also carcinogenic. There are reports of outbreak of aflatoxin toxicity in many parts of the world. AIM: To find out the level of aflatoxin in common food and feed. SETTING: The study was conducted in 16 districts of the Eastern region of Nepal. METHODS AND MATERIALS: Samples were collected from retailers and whole sellers from 1995 to 2003. Common food items that had high chances of infestation were collected. Food sample were taken to the laboratory to estimate the level of aflatoxin. The thin layer chromatography method was used to detect aflatoxin in the samples and comparison of fluorescence of sample spot with fluorescence of standard for estimation. RESULT: There were 832 samples for aflatoxin detection and estimation. One-third samples were found to be contaminated with aflatoxin. The highest percentage of contamination was found in peanut butter/vegetable oil (42.5%) and the lowest in areca nut (25%). Highest proportion of cornflakes samples were found to be contaminated with aflatoxin by more than the recommended value (30 ppb) and contamination in peanut was the lowest. CONCLUSION: People consume many common food items that contain aflatoxin. It is of high importance for the concerned department to give attention to this important public health issue. Even in small doses, continuous consumption can lead to many health problems. So it is of paramount importance to detect and control these contaminants in food items.

Attitude of women towards family planning methods and its use--study from a slum of Delhi.

BACKGROUND: To predict the need of family planning methods, family planning managers often rely on unmet need derived from measure of contraceptive demand. However women's intention and her background knowledge of family planning methods not received as much attention as a measure of family planning methods demand. OBJECTIVE: To know the attitude of women regarding use of family planning methods and to find out the factors that restricts its use, and the change in pattern of use over a period of one year. METHODS: This was a prospective study. One (Block G) out of eight blocks was selected randomly. Using convenient sample method, families were selected starting from a point in the selected block (Block G). 40 women of childbearing age group (15- 49 years) were enrolled. All women were followed for a period of one year. RESULTS: Weakness was narrated as the commonest side effect from all family planning methods. More than 70% women told that irregular menstruation from Oral Contraceptive pills and ill health from tubectomy as the other side effects. Demands for more children and for son preferences were the leading reason for not using any methods followed by afraid of side effects and health problems. There was negligible change in the use of family planning methods during the period of the study. CONCLUSION: Effective family planning methods use should be advocated through adequate counseling about the correct use, side effects and their proper management and their benefit in the back ground of custom and belief.

Utility of gamma-glutamyl transpeptidase and mean corpuscular volume in alcoholic liver disease.

The present study was designed to establish the role of Gamma-glutamyl transpeptidase (gamma-GT) and mean corpuscular volume (MCV) in alcoholic liver disease (ALD). Serum gamma-GT, total and direct bilirubin, albumin, total protein, AST, ALT and ALP were assayed by standard methods in a clinical chemistry autoanalyser. MCV, Hb, PCV and RBC were measured by an automated cell counter. Activity of gamma-GT and MCV levels were significantly higher in the patients with ALD compared to controls. A gamma-GT level of > or = 25 U/l was found to be significantly associated with ALD. MCV level > or = 100 fl/l showed a significant association with ALD. An AST to ALT ratio > 1 was found in 92% of the patients. None of the patients showed an ALT level > or = 300 IU/l. The degree of AST elevation in the patients with ALD was higher (3.7 times) then ALT (3.2 times). A gamma-GT level > or = 25 IU/L and an MCV level > or = 100 fl/l stand as markers of heavy alcohol consumption in this study. An AST to ALT ratio > 1 was present in most of the patients with ALD. The degree of elevation of AST was higher than ALT in the patients with ALD.

Field investigaton of an outbreak of epidemic dropsy in eastern Nepal.

About 17 cases with clinical syndrome suggestive of epidemic dropsy attended to the B P Koirala Institute of Health Sciences, Dharan, for treatment. These cases were from three villages of Saptari district in eastern Nepal. Some of the mustard oil samples were tested positive with Nitric acid test. In the wake of this, an extensive field investigation was conducted covering a wider area in these villages.