Serum Alkaline Phosphatase for Screening of Hypovitaminosis D.

This study assessed the utility of serum alkaline phosphatase as a screening test to identify vitamin D deficiency and documented that it was not a useful screening tool.

Community based estimation of extent and determinants of cost of injuries in a north Indian city.

Background and Objectives: Very few community based studies on the economic impact of injuries are available from India. Being based on secondary data sources these underestimate the true burden. Current study aimed to ascertain the incidence and economic impact of injuries in an Indian city. Materials and Methods: Details of injury events during the reference period were elicited in the study population through a community based survey in 2008. The severity of injury was categorized on the basis of need and duration of hospitalization. Direct and productivity costs were assessed for each event of injury. Results: Out of 230 households contacted 212 participated in the study. Overall, 985 people were interviewed. The overall incidence of injury was 48.73/1000 population, Road traffic injuries (RTIs) were the leading cause (35%) of injury, followed by the falls (17%), contact with hot substances (13%), inanimate mechanical force (13%), animate mechanical force (8%), assault (8%) and others (6%). The ratio of fatal: severe non-fatal: mild injuries were 1:14:33. The total direct cost (DC) incurred was Rs. 310,951.67, contributed by medical (44%), surgical (21%), legal (15%), cost of informal care (10%). The total productivity cost of injuries was Rs. 416,700, contributed by mortality cost of Rs. 336, 000 (81%) and morbidity cost of Rs. 807,00 (19%). Conclusions: For every case of fatal injury, there were 14 cases of severe hospitalized injuries and 33 cases of mild injuries. RTIs were the commonest. Injuries had sizeable direct and indirect cost on the society.

Investigation of Viral Hepatitis E Outbreak in a Town in Haryana.

An outbreak of 160 cases of viral hepatitis which occurred in Shahbad, Haryana, was investigated to ascertain the agent, cause of the outbreak and to initiate remedial measures. Out of the 30 samples tested, 26 (86.7%) were positive for IgM antibody against HEV, establishing hepatitis E virus responsible for the outbreak. Significant association of higher attack rates (4%) in ward 14 (OR= 17.9; 95% CI= 12.7-25.2) of the town along with leakage in water distribution system running co-existent with open drains containing household waste and sewage; and absence of residual chlorine in water samples tested at household level in ward 14 established fecal contamination of water as the cause of the outbreak. Remedial repair work was initiated along with superchlorination of water which contained the outbreak.

Intracranial pressure changes with different doses of lignocaine under general anaesthesia.

The effect of intravenous lignocaine on intracranial pressure (ICP) was studied on thirty patients of either sex, aged above 5 years and scheduled for elective ventriculoperitoneal shunt surgery. The patients were randomly divided into 3 groups, which received intravenous lignocaine in the dose of 1 mg, 1.5 mg and 2 mg/kg body weight respectively. Intracranial pressure, heart rate, ECG, arterial pressure and arterial blood gases were monitored at various intervals for a period of 30 minutes. Maximum decrease in ICP was seen at 2 minutes after IV lignocaine in all the three groups (p<0. 001). The fall in ICP was significantly more in group II and group III (35.65% and 37.5% respectively) as compared to group I (17.47%) (p<0.001). This fall in ICP in all the three groups persisted below the basal level, throughout the study period. None of the groups showed any significant change in the heart rate, but a statistically significant fall in arterial pressure was observed in group III (p<0. 05). In conclusion intravenous lignocaine, in a dose of 1.5 mg/kg, causes significant fall in ICP without causing any untoward cardiovascular effects and is recommended for routine clinical use.