A Cross sectional study of Quality of Life of Cancer patients attending Palliative Care OPD.

Abstracts: Background: In India there are 2-2.5 million estimated cancer patients at any given point of time. ‘Palliative care’ approach improves the quality of life of patients and their families facing problem associated with life-threatening illness. Quality of life (QOL) is multidimensional construct. Objectives: To assess their quality of life and factors associated with it. This is an attempt to collect baseline data to help improve palliative care services. Materials and Methods: selected patients for the study (total=108) were interviewed with the help of FACT-G Scale for Measuring the Health-related QOL (Sub scores-Physical, Social, Emotional & Functional well-being). The total scores ranged from 0-108 (0-47 poor, 48-63 average, 64-108 good). Statistical Analysis: Chi square test. Results: Out of total 108 patients, 72.22% were females. Mean age was 50.91 years (SD± 2.02). 78.70% were married, 29.63% illiterate, 43.52% belonged to Middle Socio-economic class, 89.81% had Stage 2 and 3 cancer. Mean total FACT-G scale QOL score was 54.61 (SD ±8.18). Relation between marital status and socio-economic status with total QOL score was statistically significant. Conclusions: The median of all sub-scores worsened with progress of stage of cancer. Patients with better socio-economic status and were married had better QOL scores. Counselling will improve their QOL through palliative care services.

Plant functional traits with particular reference to tropical deciduous forests: A review.

Functional traits (FTs) integrate the ecological and evolutionary history of a species, and can potentially be used to predict its response as well as its influence on ecosystem functioning. Study of inter-specific variation in the FTs of plants aids in classifying species into plant functional types (PFTs) and provides insights into fundamental patterns and trade-offs in plant form and functioning and the effect of changing species composition on ecosystem functions. Specifically, this paper focuses on those FTs that make a species successful in the dry tropical environment. Following a brief overview, we discuss plant FTs that may be particularly relevant to tropical deciduous forests (TDFs). We consider the traits under the following categories: leaf traits, stem and root traits, reproductive traits, and traits particularly relevant to water availability. We compile quantitative information on functional traits of dry tropical forest species. We also discuss trait-based grouping of plants into PFTs. We recognize that there is incomplete knowledge about many FTs and their effects on TDFs and point out the need for further research on PFTs of TDF species, which can enable prediction of the dynamics of these forests in the face of disturbance and global climate change. Correlations between structural and ecophysiological traits and ecosystem functioning should also be established which could make it possible to generate predictions of changes in ecosystem services from changes in functional composition.

A study of sutopsy findings in 62 cases of leptospirosis in a metropolitan city in India.

BACKGROUND: Leptospirosis is an important sporadic zoonotic disease caused by the spirochete Leptospira icterohaemorrhagiae . The disease becomes a major public health problem, particularly during the monsoon months. MATERIALS AND METHODS: Analysis of autopsy findings of 62 cases of clinically suspected leptospirosis was carried out to identify the pathology and determine the cause of death. RESULTS: Most patients were young males who presented with fever, breathlessness, haemoptysis, bleeding, oliguria and icterus. They died after a brief stay in hospital. A post-mortem diagnosis of leptospirosis was made on the basis of characteristic organ findings, aided by results of serology, Levaditi's staining and / or immunohistochemistry (IHC) on kidney sections. Massive intra-alveolar haemorrhage (48 cases), acute interstitial nephritis and / or acute tubular necrosis (45 cases) and myocarditis (24 cases) were the main autopsy findings. Haemorrhage in various organs like the heart, gastrointestinal tract, brain, pancreas and adrenals were also seen. Thirty of 54 kidney sections were positive for leptospiral antigens by IHC. There was extensive haemorrhages in the lungs in 48 (77%) cases and that was the cause of death in most of these cases. CONCLUSION: Bleeding into various tissues and organs is the main finding noted in this study. The post-mortem examination of patients dying of leptospirosis revealed that pulmonary haemorrhage was the cause of death in most individuals.

Cranial irradiation--an unusual cause for diabetes insipidus.

Central diabetes insipidus frequently occurs due to tumours in the region of pituitary or hypothalamus or following surgical trauma to these regions. Rarely it has been reported following cranial irradiation. We report the case of a middle aged woman who underwent surgical removal of a frontal capillary hemangioblastoma and received cranial irradiation. She presented ten months later with features of diabetes insipidus which was confirmed to be of central origin. She responded well to desmopressin nasal spray. Radiation induced damage to the hypothalmo-pituitary axis presents usually with anterior pituitary hormone deficiencies, most commonly that of growth hormone. Presentation as central diabetes insipidus is very uncommon.

Effect of light intensity on in vitro multiple shoot induction and regeneration of cotton (Gossypium hirsutum L. cv Khandawa-2).

Cotyledonary nodes taken alongwith shoot apex from seedlings of cotton (G. hirsutum) proliferated into shoots on nutrient agar medium supplemented with cytokinins. In the presence of optimal plant growth regulators, low light intensity enhanced the number of shoots initiated per explant in cotton. An average of 33.5 +/- 2.9 shoots were obtained from a single explant cultured for 8 weeks which is about four fold higher than the values reported in earlier protocols. The isolated shoots were rooted on nutrient agar medium supplemented with alpha-naphthalene acetic acid and transferred to soil after acclimatization. Regenerated plants were morphologically identical to the seed-germinated plants and were fertile.

Degradation and de novo synthesis of D1 protein and psbA transcript levels in Chlamydomonas reinhardtii during UV-B inactivation of photosynthesis and its reactivation.

UV-B induces intensity and time dependent inhibition of photosynthetic O2 evolution and PS II electron transport activity in Chlamydomonas reinhardtii. The D1 and D2 proteins of chloroplast membranes are rapidly and specifically degraded in the course of irradiation of cells to UV-B. Continuous synthesis of the two proteins was essential for the repair of damaged PS II as chloramphenicol accelerated UV-B inactivation of photosynthesis and prevented photoreactivation. Northern analysis revealed that UV-B also affected the expression of psbA gene coding for the D1 protein. Cells showing 72% inhibition of PS II activity, revealed a modest net loss of 25% in the level of D1 protein. This shows that synthesis of D1 protein is not the only component involved in the recovery process. Our results indicate that besides affecting the synthesis of the D1 protein UV-B may impair certain post-translational events, which in turn may limit the repair of damaged PS II.

Family planning: views of female non-acceptors in rural India.

A study conducted on eligible rural women who were unwilling to accept family planning methods revealed that many women were concerned about child survival and viewed children as a source of support in old age. Family size was usually decided by in-laws. Pressure from in-laws to have more children was significantly higher in families where the women were less educated or illiterate.

A profile of nutritional practices and its cost in an intensive care in India.

In a retrospective study fifty patients admitted to a combined medical and surgical intensive care unit were surveyed to see the pattern of nutritional support. The routine practices of initial assessment and monitoring of the nutritional state, ordering and technique of feeding, routes of administration and complications were noted over a 3 week period. This gives an idea of the pattern of care and problems associated with nutritional support of the critically ill in this part of the world. The average cost of parenteral nutrition for three weeks was approximately Rs. 25,960 ($865 approx.) per patient.

Pattern of leprosy deformities among agricultural labourers in an endemic district: a pilot study.

A study of 1,338 leprosy affected agricultural labourers in an endemic district revealed that 12% had deformities. The patient's sex, type of disease, duration and educational status seemed to influence pattern of leprosy deformities. The patients continued working despite deformities in order to avoid financial dependence on their family members and loss of dignity.

Auditory evoked response in patients of diabetes mellitus.

Brainstem auditory evoked response (BAER) and the mid latency response (MLR) were recorded in 25 diabetic men and compared with a group of 25 control subjects. The threshold of hearing was higher (P less than 0.001) in the patients. The BAER peak latencies were also significantly prolonged in both the ears; however, the degree of prolongation was more prominent in the right ear. The interpeak latencies of waves I-III were also prolonged (P less than 0.01) in the left ear, with non significant increase noticed in the right ear also. The wave V amplitude was lower (P less than 0.05) in diabetics. The MLR, on the other hand, was not affected in patients. These findings suggest functional impairment in the auditory pathway in patients of diabetes mellitus.

Role of the family in drug abuse.

A simple random survey of 9863 population out of the total 70,000 population is one slum pocket of Bombay revealed drug dependence in 104 persons. Out of 104, 83.65% smoked 'brown sugar' 10.68% used cannabis and 5.77% opium. Most of the addicts (95.2%) belonged to large families. Family history of alcoholism and drug abuse was present in 41.35%. Parental deprivation was additional contributing factor in 30.7%.

Child-to-parent education: a pilot study.

A controlled study carried out in the hilly Konkan region on the West coast of India showed that school children have the potential for transmitting their newly acquired knowledge to their parents. Though the results indicate that acquisition of knowledge does not mean a change in attitudes concerning leprosy, child-to-parent education may show promising results in leprosy education in developing countries where most parents of school children are illiterate and are not easily reached by conventional methods of health education.

Anti-leprosy vaccines: current status and future prospects.

Different types of leprosy vaccines are currently used in field trials in India. The rationale behind their use, the parameters for determining their efficacy, their merits and demerits are discussed and the future prospects are highlighted.

Influence of noise spectra on auditory frequencies & degree of temporary threshold shift.

Influence of noise spectra on auditory frequencies of 131 audiometrically normal human volunteers was assessed. Each subject was exposed to four different types of noise on different days for a period of 30 min. Noises utilized in this study were broadband noise (100 dBA), broadband noise (BBN) mixed independently with tones of 0.5, 1.2 and 4 kHz at three intensity levels (85, 95 and 105 dBA) and noises of different bandwidths (100 dBA) around the above tones as centre frequencies. BBN produced maximum TTS2 at 4 kHz (21.42 +/- 0.61 to 26.15 +/- 1.00 dB), while concentration of sound energy around these tones, affected hearing at one-half octave above the point of concentration of sound energy. TTS2 produced by 4 kHz tonal component of 95 and 105 dBA and 2 kHz of 105 dBA were significantly higher than the one produced by BBN at 4 kHz. The single tones of 2 and 4 kHz and noise of 1/3rd octave bandwidth (cf 4 kHz) produced TTS2s which were significantly higher as compared to that of BBN at 4 kHz. At the same centre frequency, noise concentrated in thinner bands was more injurious than that in the thicker bands. Lower frequencies of hearing appears to be more resistant to noise as for the same sound pressure level the TTS2 observed in low frequencies was less as compared to higher frequencies.

Therapeutic role of carbogen in impaired hearing.

The therapeutic role of carbogen was evaluated in subjects with sensorineural hearing loss by administering carbogen, a gas mixture of 95 per cent O2 and 5 per cent CO2, for seven consecutive days (30 min/day) and monitoring puretone audiometry before and after the administration. Significant improvement was observed both in air and bone conduction threshold levels on seventh day, indicating that there was some recoverable portion in the hearing level of these subjects. The improvement in hearing may be due to action of CO2 as an otic vasodilator coupled with supplementation of the O2 requirement of degenerating hair cells. Carbogen thus appears to be useful in persons with impaired hearing, involving the inner ear.