Diversity and management of plant species in an Eri silkworm agroforestry system by Mishing tribe of Assam, India

Aim: The present study was conducted to investigate the status and diversity of plant species used for rearing of Eri silkworm and their traditional management in the homegardens of Mishing tribe.Methodology: A total of 45 homegardens from three villages were surveyed randomly which were primarily associated with rearing of Eri silkworm. Vegetation was studied using quadrat method. The data on traditional knowledge associated with the management of plants species for rearing of Eri silkworm were collected using semi structured questionnaires. Results: The average size of studied homegardens was 0.35 ha. A total of 243 plant species were recorded from the studied homegardens of which six species were used as food plants for rearing of Eri silkworm and 10 species were used in construction of mountage. Trees related to Eri culture contributed to 37.47% of the total importance value index (IVI) in the studied homegardens. Heteropanax fragrans (Roxb.) Seem and Ricinus communis L. were the primary food plants of Eri silkworm and were found to be dominant in the homegardens. Activities such as land preparation, sowing, pruning, weeding and watering are carried out for the management of Eri silkworm food plant species and were found to vary for different species. Interpretation: There is an urgent need to document the indigenous knowledge and traditional practices associated with the management of host and food plants used in the rearing of Eri silkworm in the present day context as it is a part of their cultural heritage and should be reoriented through integration of modern farming technique.

Clear cell sarcoma arising from paraspinal ligament of thoracic spine: Report of an unusual case

Clear cell sarcoma (CCS) is an unusual but aggressive soft-tissue tumor with an incidence of <1% of all soft-tissue sarcomas. It was previously termed “malignant melanoma of soft parts” due to its resemblance clinically and morphologically. Normally CCS is seen in patients aged 20–40 years. A rare case of CCS of paraspinal ligament in a 5-year-old boy is being reported. Histopathology and immunohistochemistry markers confirmed the diagnosis. The present case is unique since the entity itself is rare and also due to its occurrence in a child.

Management protocols for chronic heart failure in India

Heart failure is a common clinical syndrome and a global health priority. The burden of heart failure is increasing at an alarming rate worldwide as well as in India. Heart failure not only increases the risk of mortality, morbidity and worsens the patient’s quality of life, but also puts a huge burden on the overall healthcare system. The management of heart failure has evolved over the years with the advent of new drugs and devices. This document has been developed with an objective to provide standard management guidance and simple heart failure algorithms to aid Indian clinicians in their daily practice. It would also inform the clinicians on the latest evidence in heart failure and provide guidance to recognize and diagnose chronic heart failure early and optimize management.

Percutaneous treatment of bifurcation coronary stenosis: a long-term follow-up.

BACKGROUND: The treatment of bifurcation coronary stenosis involved several techniques in the last few years, with the use of one stent, two stents, kissing balloon, crush stenting. Basic objective was to reduce MACE rate and improve event-free survival. OBJECTIVE: To examine the performance of some techniques of stent placement adopted in the last few years by evaluating MACE (major adverse cardiac events) and TLR (target lesion revascularization). METHODS: Between 1999 and 2003, 74 consecutive patients with bifurcation lesions were treated with either stenting two vessels (type A, n = 8) or single vessels (type B, n = 66) and were followed for 30 days, 6 months, with a mean follow-up of 23 months for clinically driven MACE and TLR. RESULTS, The mean reference diameters of the main and side branches were 2.97 +/- 0.27 mm and 2.28 +/- 0.49 mm, respectively. The side branch was stented in 11% cases. Less than 30% residual stenosis in the main branch was achieved in 100% cases, <50% in the side branch in 94.5% of the cases. In-hospital major adverse cardiac events were non-Q-wave MI in 5% patients. During follow-up, death was 1.35%, subacute stent thrombosis (SAT) was 4%, and TLR (CABG) was 10.8%. Multivariate analysis showed type 1 lesion, and STEMI was associated with more MACE than others. There was 4.35-fold greater odds of MACE, associated with stenting both vessels in bifurcation lesion. CONCLUSION, Stenting of the main branch along with kissing balloon dilatation or provisional stenting of the side branch is a safe and effective treatment of coronary bifurcation lesions with acceptable TLR rates.

How predictive is the Framingham's risk prediction algorithm in Indian perspective? A retrospective case-control study from Kolkata.

OBJECTIVE: In this retrospective case-control study, an attempt was made to assess the predictive efficacy of Framingham's risk prediction algorithm in Indian perspective. METHODS: A total of 350 patients and 293 age- and sex-matched controls were considered in the study. Those patients, who were presenting for the first time with acute coronary syndrome (ACS) and who did not have any prior manifestation of coronary heart disease (CHD) formed the patient group. The risk prediction algorithm was applied to obtain the risk score and the corresponding 10-year risk in each patient and control. They were divided into two groups: diabetic and nondiabetic. Depending on the 10-year risk, they were further grouped into high risk (10-year risk > 20%), moderately high risk (10-year risk between 10% to 20%), and low risk (10-year risk < 10%). The results were compared and statistically analyzed. RESULTS: In the diabetic patients with ACS, 14.29% qualified as high risk, 32.79% as moderately high risk, and 52.94% as low risk. The corresponding figures for diabetic subjects without ACS were 3.26%, 54.35%, and 42.39%, respectively. In nondiabetic patients with ACS, 19.91% were in the high-risk group, 38.96% in moderately high risk, and 41.13% in the low-risk group; while among the controls, the corresponding figures were 9.95%, 21.89%, and 68.16%, respectively. In nondiabetic subjects, the mean risk was significantly higher for patients compared to controls (14.13 vs. 8.61, p < 0.01). However, in diabetic subjects, there was no significant difference in the mean projected risk between those with ACS and those without ACS (11.37 vs. 10.41, p = NS). CONCLUSION: In the Indian perspective, Framingham's risk prediction protocol has a fair amount of predictive efficacy since the difference of mean risk score between the patients and controls was statistically significant. However, it fails to identify a large proportion of high-risk nondiabetic patients. Hence, a better protocol for the Indian perspective is badly needed.

Predictive efficacy of Framingham's risk score in Indian scenario--a retrospective case-control study.

To assess the predictive ability of Framingham's risk score in primary prevention in our population, 252 cases and 212 age and sex matched controls were taken up for study. Those patients, who were presenting for the first time with acute coronarysyndrome (ACS) and who did not have any prior manifestations of coronary artery disease (CAD) and whose medical records were available formed the patient group. Framingham's risk score was calculated and the corresponding 10 years risk was assessed in each of them. The patients and controls were divided into two groups--diabetic and non-diabetic. Depending on the 10 years risk, they were further grouped into high risk (10 years risk > 20%), moderately high risk (10 years risk 10 to 20%) and low risk (10 years risk less than 10%). Results were compared and statistically analysed. In the diabetic patients with ACS 14% would have qualified as high risk, 33% as moderately high risk and 53% as low risk whereas in diabetic patients without any manifestation of CAD the distribution was 4% in the high risk, 54% in the moderately high risk and 42% in the low risk. In the non-diabetic subjects, amongst the patients of ACS, 20% would have been in high risk, 39% in moderately high risk and 41% in the low risk. The corresponding figures in the non-diabetic control subjects were 10% in high risk, 22% in the moderately high risk and 68% in the low risk. In the non-diabetic subjects, the mean risk was significantly more in patients than in controls (14.15% versus 8.61%, p <0.01). However, in the diabetic patients there was no significant difference in the mean projected risk between patients with ACS and patients without any manifestation of CAD (11.37% versus 10.41%, p>0.05).

Compressive myelopathy due to nocardiosis from dermal lesion.

Nocardiosis refers to locally invasive or disseminated infection associated with Nocardia species. Most infections enter through respiratory tract and then disseminate systemically. Rarely primary nocardial infection of the skin of the back may spread to contiguous structures including vertebrae. A 30 years male presented with indolent skin lesion in the upper dorsal region of the back for one year following an accident and subsequently developed features of spinal cord compression and parenchymal involvement of lung. The rarity of such type of spread in an immuno-competent individual has been highlighted.

Autologous transfusion--a viable alternative.

INTRODUCTION: Transfusion of blood carries an inherent threat of immunological complications and an ever-increasing risk of transfusion transmitted diseases. A safer alternative to these potential dangers is autologous transfusion. This relatively simple and innocuous procedure strives to achieve the goal of 'Safe Blood', and can be practised easily in the peripheral hospitals. MATERIAL AND METHODS: A study was conducted to evaluate this facet of transfusion medicine, in a Services Zonal Hospital, for the period January, 1998 to July, 2000. RESULTS: A total of 45 pre-operative autologous collections were undertaken during this duration. By conducting regular interactive programmes with the healthcare workers and the patients, the rate of autologous transfusion vis-a-vis total transfusion increased from 0.34% in 1998 to 13.83% till July, 2000. CONCLUSION: It is recommended that there should be vigorous participation at all levels in a hospital, under the auspices of an active hospital transfusion committee, to make this procedure more popular and more acceptable in today's scenario. This will not only reduce the load of allogenic transfusion, but will also help to diminish the potential hazards associated with blood transfusion.

Combined effect of carbon-dioxide laser and neutral 2% NaF on acid resistance of human tooth enamel.

Specimens of human enamel were treated topically with 2% sodium fluoride solution before and after laser irradiation. The samples were examined using wet chemical analysis and SEM. The results showed that samples treated with neutral 2% NaF after irradiation caused a remarkable increase in acid resistance of the enamel, while samples treated with neutral 2% NaF before irradiation showed a lesser effect. The results were consistent with observations made by using wet chemical analysis and SEM findings.