Behavioral and Emotional problems of Children under institutional care in Coimbatore District of Tamil Nadu

Background: Children living under institutional care are more prone to behavioral and emotional problems than others, as they are deprived a family environment. There a more number of studies focusing the mental health problems of children under institutional care in India. Aims & Objectives: This was a descriptive study which explores the behavioral and emotional problems of children’s under institutional care. Material & Methods: The sample consisted of 50 children living under institutional care run by voluntary run institutional homes (private individuals) in Coimbatore city. A semi structure questionnaire was used to get the socio demographic data. The Self Report Strengths and Difficulties Questionnaire (SDQ) were used to assess the behavioral problems in children under institutional care. Results: In our study, 21 (42%) out of 50 children were found to be having behavioral problems. Conduct problem and peer pressure (42%) were found to be most prevalent followed by emotional problem (34%), hyperactivity (24%) and low prosocial behavior (14%). Conclusion: The children under institutional care are vulnerable to conduct, peer pressure and emotional problems.

A review on ethnobotanical uses of some common plants in matli village, uttarkashi, uttarakhand

The present study focuses on the Ethnobotanical uses of some common plants of Matli village, Uttarkashi district. 15 tree species belonging to 14 families common in the area have been reported. All the plants reported from the area have medicinal importance. The details of the plants such as botanical name, family, parts used, uses, common name, plant parts most harvested and the use of different parts for different medicinal purpose etc are also given in the paper.

Ulcerative lupus vulgaris of face: an uncommon presentation in India.

Tuberculosis affects the population world wide, more among those living in developing countries. The incidence of tuberculosis registered an upward trend even in developed countries, with the advent of HIV infection. Cutaneous tuberculosis accounts for about 1% of cases of extra-pulmonary tuberculosis. Cutaneous tuberculosis presents with various lesions ranging from ulcerative to proliferative or hyperkeratotic lesions. The lesions may sometimes be associated with marked destruction of the tissues resulting in marked disfigurement, especially when it involves face as seen in cases of Lupus Vulgaris. A case of Lupus Vulgaris in a young woman with extensive ulceration of face which responded to ATT resulting in scarring of the face is reported for its rarity amongst Indian population as against western population.

Prevalence of known diabetes in Chennai City.

AIM: To determine prevalence of known diabetes in those more than 20 years of age in Chennai city. METHODOLOGY: Urban population was selected for the survey. Assuming the prevalence of known diabetes as 5.0% in those aged > 20 years, the cluster sample size calculated to estimate it with 95% CI and +/- 10% precision, was 25800 individuals of all ages. This population obtained from 200 households in each of 30 randomly selected corporation divisions of the city, was surveyed by social workers by house to house enquiry. General information and health status of every member of the household were recorded on prescribed forms. This survey was conducted during January-July, 1998. RESULTS: Among 26,066 individuals of all ages 779 had known diabetes and 99.4% of them had type 2 diabetes. The prevalence of known diabetes was 2.9% for all ages and both sexes combined. Crude and age-standardized prevalence was 4.9% (95% CI 4.6-5.2) for those aged > 20 years. The standardized prevalence was 10.5% (95% CI 9.8 - 11.2) in those aged > or = 40 years. The prevalence was significantly high (P < 0.05) in females. CONCLUSION: The prevalence of known diabetes was low in total population but increased in those aged > 20 and further increased in those aged > or = 40 years. The causes for high prevalence in > or = 40 year age group needs to be explored in this population.

Adenosine as an adjunct to inducing rapid asystole during cardioplegic arrest.

A study was undertaken in 68 patients to assess the beneficial effect of adenosine as an adjunct to K(+)-enriched cardioplegia to induce rapid asystole. In the study group (n = 22), adenosine was given in the dose of 3 mg bolus into the aortic root immediately after aortic cross clamp along with K(+)-enriched cardioplegia. In the control group (n = 46) K(+)-enriched cardioplegia solution was used without adenosine. Important parameters monitored were: time to asystole in seconds and recovery of normal sinus rhythm following release of aortic cross clamp. In addition, standard haemodynamic parameters were measured. The results showed a marked reduction in the time to achieve asystole in the study group (3.53 +/- 1.18 seconds) as compared to the control group (18.19 +/- 11.80 seconds) (p < 0.001). Restoration of sinus rhythm was achieved in the study group at 43.53 +/- 33.60 seconds while in the control group it was achieved at 161.90 +/- 11.36 seconds (p < 0.001). The haemodynamic parameters measured 10 minutes after the termination of cardiopulmonary bypass were not different in the two groups. When measured one hour after the termination of cardiopulmonary bypass, haemodynamic parameters in the study group revealed a statistically significant improvement in inotropicity. No side effects or complications were encountered in the study group. We conclude that adenosine given as an adjunct to K(+)-enriched cardioplegia helps to achieve rapid asystole and faster recovery of sinus rhythm with no adverse effects and may aid in better myocardial preservation.

Prevalence and incidence of type-2 diabetes and impaired glucose tolerance in a selected Indian urban population.

AIM: To study the impact of diabetes mellitus on a selected Indian urban population. METHODS: The staff of Indian Institute of Technology in Chennai and their relatives were screened for diabetes by oral glucose tolerance test (OGTT) in 1992. But those on treatment for diabetes were not screened by OGTT. All those found to have diabetes during initial screening were excluded from further follow-up. Those without diabetes were followed with repeat OGTT one year later in 1993. RESULTS: A total of 1198 persons, 455 (38.0%) females and 743 (62.0%) males, participated in this study. While 116 (9.7%), 80 (69.0%) males and 36 (31.0%) females, suffering from diabetes were exempted from OGTT, the remaining 1082 (90.3%), 663 (61.3%) males and 419 (38.7%) females, were screened by OGTT. Among the 663 males, 450 (67.9%) were normal, 155 (23.4%) had impaired glucose tolerance (IGT) and 58 (8.7%) had diabetes. Among the 419 females, 275 (65.6%) were normal, 120 (28.6%) had IGT and 24 (5.7%) had diabetes. Out of 1000 persons without diabetes, 696 (69.6%), 444 (63.8%) with normal glucose tolerance and 252 (36.2%) with IGT had participated in the repeat screening by OGTT after one year. One (0.7%) normal person and 14 (5.5%) with IGT, progressed to diabetes in one year. All had type-2 diabetes and non type-1 diabetes. Of 444 normal persons 34 (7.7%) developed IGT during one year. CONCLUSIONS: The prevalence of 9.7% and 7.7% for known and newly detected type-2 diabetes respectively and the annual incidence of 2.2% indicate the magnitude of impact of diabetes mellitus on this population. Though IGT was found to be a risk factor, factors leading to its progression to diabetic state could not be identified in this study.

Effects of intranasal challenge with group A beta haemolytic streptococcus M type 49 in Swiss albino mice.

Mice are susceptible to natural infections with streptococci and therefore can serve as suitable animal models to study experimental streptococcal infections. In an earlier study, we had shown the development of pharyngeal colonization, antibody response and histopathological changes in the heart following intranasal (IN) challenge with a rheumatogenic serotype of group A beta haemolytic streptococcus, the M type 18. To determine if nonpharyngitis associated serotypes can also elicit similar responses, 30 Swiss albino mice were challenged intranasally with 2 x 10(7) colony forming units of a skin associated serotype of group A beta haemolytic streptococcus, the M type 49. Pharyngeal colonization varied from 64% (n = 30) in the first week to 69% (n = 16) during the fourth week after IN challenge. Eleven (36.7%) of the 30 animals studied showed antibody response to DNase B (ADNB) with peak titers varying from 150 to 1200 units. Wide variations were seen in ADNB titers in individual mice. Histopathological evidence for cardiac lesions were seen in three animals. The changes were mild and varied from mild to chronic endocardial inflammation to calcification. The study shows that Swiss albino mice are also susceptible to IN challenge with skin associated strains of GABHS and therefore can serve as useful models to study the effects of experimental infection with diverse serotypes of GABHS.

Rheumatic fever chemoprophylaxis in adults.

In 2340 adult patients above the age of 26 years with rheumatic valvular disease (RHD) seen since 1987, injection benzathine penicillin (once in 3 weeks) was discontinued and the patients were followed for evidence of rheumatic fever for a period of one to nine years (mean of 3 years). Recurrence of rheumatic fever was seen in 5 patients (0.21%). This study confirms that recurrence of rheumatic fever in patients with RHD above 26 years of age is very low and hence we recommend long term chemoprophylaxis to the patients above the age of 26 on an individual basis.

Pharyngeal colonisation, ADNB response and development of cardiac lesions in mice following intranasal inoculation with group A beta haemolytic streptococcus M type 18.

Swiss albino mice from a randomly bred colony were inoculated intranasally with 1.6, 2 or 2.4 x 10(7) colony forming units of a mid-logarithmic phase culture of group A beta haemolytic streptococcus M type 18 for 3 days, 6 days or once a week respectively for three weeks. Pharyngeal colonisation could be observed in 67 (59.8%) of 112 mice on 4th day after inoculation and 14 (38%) of the 37 mice on 21st day. Out of 27 mice tested for determination of antibodies to deoxyribonuclease B at regular intervals for 98 days, 15 (55.5%) showed responses, with maximum titers varying from 50 units to 4800 units in individual mice. Histopathological evidence for cardiac lesions were seen in five (3.03%) of the 165 animals studied. These included one case of severe endocarditis, two cases of endocarditis with valvular lesions and one case with non-specific lymphocyte infiltration in the heart. One other animal showed subendocardial oval nodular aggregates. Although the cellular nature of these lesions were not determined, this study shows that Swiss albino mice can serve as suitable animal models to study experimental streptococcal infections. However these are preliminary observations and are to be confirmed and revalidated by further controlled experiments.

Exercise capacity in untrained normal adults: a nomogram for Indians.

The exercise capacity of 155 hospital-based patients (125 males and 30 females) who underwent treadmill testing and coronary angiography for investigation of chest pain was used to derive regression equations for exercise capacity (METS) against age. A regression equation [18 - 0.16 x (age)] for males and [11 - 0.84 x (age)] for females was obtained. Using these equations an exercise capacity nomogram was developed. From this nomogram the predicted exercise capacity was calculated for another set of 228 patients (209 males and 19 females) whose treadmill tests were negative. The results confirmed that the nomogram could be applied to determine the expected and actual exercise capacity of Indians within a mean difference of 0.08 METS. This nomogram is being offered for clinical, therapeutic and preventive use for Indian patients.

Coronary angiographic findings in patients with diabetes: an exercise in cardiovascular epidemiology.

A study of 516 patients with diabetes mellitus who presented with chest pain and an equal number of matched controls without diabetes examined by selective coronary arteriography was undertaken. Detailed analysis of the angiograms showed that prevalence of CAD in diabetics with symptoms was 86.6%. This prevalence increased with age. Multivessel disease was more common in diabetics that in controls (p < 0.01). In diabetic patients disease involvement of proximal and distal segments in the same vessel was more common (p < 0.01). The Gensini score of quantitative expression of severity of CAD was higher in diabetics (p < 0.05). The number of occluded segments in the coronary tree was higher in diabetics (p < 0.01). No correlation could be established between severity of disease and age, body mass index or duration of diabetes. It is concluded that diabetes affects the coronary arteries of Indian patients more adversely than those of non-diabetics. The prevalence of CAD among diabetics increases linearly with age.

Prevalence of diabetes in the young in south India.

Students from nine schools and one college in Madras city, were screened for diabetes by oral glucose tolerance test. The criteria recommended by the World Health Organization was adopted to classify glucose tolerance. Among 3,515 students, between 5 and 19 years of age, participated in this survey, 1982 (56.4%) were males and 1.533 were (43.6%) females. Family history of diabetes was positive in 302 (8.6%) students. There was no overt case of diabetes of any type. Three (0.09%) males had renal glycosuria. It is therefore concluded that insulin-dependent diabetes, non-insulin dependent diabetes or any other type of diabetes in the young is rare in South India.

Plasma insulin levels in coronary artery disease.

Seventy two consecutive patients without a history of diabetes and normal fasting plasma glucose were included in this study of insulin levels. Standard oral glucose tolerance test with 75 gm glucose and fasting and two hour insulin levels were estimated in all patients. Coronary artery disease (CAD) was confirmed or excluded by selective coronary arteriography. In 20 patients, CAD was diagnosed by electrocardiographic (ECG) and clinical evidence of earlier myocardial infarction. Mean fasting plasma insulin was 31.40 +/- 22.2 IU/dl in the CAD positive and 32.3 +/- 13.6 IU/dl in the CAD negative group. The mean two hour plasma insulin was 274.6 +/- 301.1 IU/dl in the CAD positive and 104.8 +/- 74.9 IU/dl in the CAD negative group (p < 0.04). Two hour plasma insulin levels were significantly higher in patients with atherosclerotic coronary artery disease. It is concluded that the estimation of a two hour plasma insulin level after 75 gm of glucose load, could help differentiate CAD from normals.