Role of HLA alleles polymorphism in systemic lupus erythematosus: A prospective study from North India

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder and has complex etiopathogenesis. The most appropriate hypothesis states that genetic susceptibility in the presence of environmental risk factors predisposes to SLE. HLA class II alleles are critical to immune response and are highly polymorphic. Various alleles in HLA-DR and -DQ regions were analyzed in SLE patients and healthy controls to see their role in susceptibility or protection to SLE. Materials and Methods: This was a prospective observational study, in which a total of 100 SLE patients and 100 controls were analyzed. HLA typing was done by polymerase chain reaction (PCR)-sequence-specific oligonucleotide (SSO) method (SSO probe). Results: DR?1*0301 was significantly increased in SLE patients when compared to controls and had the highest odds ratio. Other risk factor alleles found to be increased were DR?1*0701, DQ?1*0202, and DQ?1*0301, which had a significant positive association with SLE, suggesting their role in susceptibility to SLE. In contrast, DR?1*0401, DR?1*1401, DR?1*1404, DR?1*1501, DQ?1*0501, and DQ?1*0201 showed statistically significant reduction in SLE patients, while these were much more common in controls, suggesting their protective role. Conclusion: This study is only the second study in patients from North India and it determines the role of DR?1*0301, DR?1*0701, DQ?1*0202, and DQ?1*0301 alleles as risk factors in SLE patients.

Assessment of Educational Environment of Newly Established Medical College by UG Medical Students: A Mixed Method Study

Introduction: Educational environment always play a crucial role in the development of students as well as faculty of any institution. In India, there is a continuous increase in the number of medical colleges and the number of MBBS seats, but the quality of education with quantity is questionable. To answer this question, the present study was planned to know the educational environment in a new Medical Institution that ejected its alumni in 2018. Aim: To analyze the educational environment of a newly established Medical College in eastern Uttar Pradesh. Materials and Methods: The present study was a descriptive cross-sectional which took six months to complete. This study used the Dundee Ready Education Environment Measure (DREEM) questionnaire, open-ended questions and focus group discussions (FGDs). The study was conducted on MBBS students in Government Medical College, Azamgarh, UP. Results: The batch-wise Global DREEM scores were 169.08 (alumni), 156.23 (interns), 168.76 (2015), 164.16 (2016), 176.23 (2017), 176.94 (2018). This demonstrates that the educational environment is satisfactory in all domains and comes under the 3rd category of the educational environment index. The FGDs showed a positive response in all batches but with high variability in scores, which indicates lack of standardization in Medical Education. The open-ended questions’ responses revealed many merits and demerits about five domains. Conclusion: The variability of DREEM score, FGDs and open ended questions denotes the lack of standardization in the Medical Education system and the scores of the Education Environment Index (all domains) must move from category III (satisfactory) to category IV (excellence).

Gallbladder tuberculosis: A rare case report with review of literature

Gallbladder tuberculosis (TB) is a rare disease, and it might be challenging to distinguish it from gallbladder cancer on clinical history and radiology. It frequently mimics carcinoma in patients who initially appear with a gallbladder mass. Gallbladder TB is only identified after histology of the resected specimen since radiography lacks pathognomic characteristics. Here, we describe a unique case of gallbladder TB that was incidentally identified when a 49-year-old lady was being evaluated for suspected gallbladder cancer. Histology of the gallbladder exhibits necrotizing granulomatous inflammation with the presence of numerous pink-colored, curved, and beaded acid-fast bacilli that were recognized on the Ziehl-Neelsen stain.

Comparison of free radicals in blood in pre-operative and post-operative phases of breast malignancies: a clinicopathological study

Background: Various factors have been identified as influencing factors of breast cancer. The free radicals can cause increased oxidative stress by negatively affecting the body’s nucleic acids, lipids and proteins leading to various illnesses including cancer. Therefore, this study was aimed at discovering the progress of treatment of breast carcinoma by exploring the connections of the disease with free radical injury.Methods: The present study was conducted among 30 breast carcinoma patients received in the surgery department of BRD Medical College Gorakhpur. Determination of the levels superoxide dismutase (SOD) (the procedure of photoluminescence), catalase (method of Cavarochi) and the lipid peroxidise was done. The results were presented as mean and standard error (SE). P value of <0.05 was considered as statistically significant.Results: Among the total participants, 73% patients had infiltrating ductal carcinoma and 27% patients had intraductal carcinoma. The dismutase levels showed an increase in the post-operative patients for both the groups. The catalase levels and the lipid peroxide levels showed a reduction in the postoperative patients (p<0.05).Conclusions: The present study result showed that the low amounts of SOD and catalase may not be sufficient to detoxify high amounts of free radicals. The administration of catalase could help in reducing the symptoms. Though, low amounts of SOD and catalase may not be sufficient to detoxify high amounts of free radicals. The administration of enzymes could help in the treatment of breast cancer patients.

Aetiological agents for pulmonary exacerbations in children with cystic fibrosis: An observational study from a tertiary care centre in northern India

Background & objectives: Pulmonary disease is the main cause of morbidity and mortality in cystic fibrosis (CF). The infection occurs with a unique spectrum of bacterial pathogens that are usually acquired in an age-dependent fashion. The objective of this study was to find out the aetiological agents in respiratory specimens from children with CF during pulmonary exacerbation and relate with demographic variables. Methods: In this observational study, airway secretions from children (n=104) with CF presenting with pulmonary exacerbations were collected and tested for bacteria, fungi, mycobacteria and viral pathogens using appropriate laboratory techniques. The frequencies of isolation of various organisms were calculated and associated with various demographic profiles. Results: Bacteria were isolated in 37 (35.5%) and viral RNA in 27 (29.3%) children. Pseudomonas was the most common bacteria grown in 31 (29.8%) followed by Burkholderia cepacia complex (Bcc) in three (2.8%) patients. Among viruses, Rhinovirus was the most common, identified in 16 (17.4%) samples followed by coronavirus in four (4.3%). Fungi and mycobacteria were isolated from 23 (22.1%) and four (3.8%) children, respectively. Aspergillus flavus was the most common fungus isolated in 13 (12.5%) children. Interpretation & conclusions: Pseudomonas was the most common organism isolated during exacerbation. Non-tuberculous mycobacteria were not isolated, whereas infection with Bcc and Mycobacterium tuberculosis was observed, which could probably have a role in CF morbidity. Polymicrobial infections were associated with severe exacerbations.

Comparative study of anterior support ankle foot orthosis and posterior ankle foot orthosis in foot drop patients

Background: Anterior Support Ankle Foot Orthosis (A-AFO) is a fairly recent approach. There is dearth of studies relating to comparison of metabolic efficiency of A-AFO and P-AFO. Objective was to study the efficacy of A-AFO compared to P-AFO in foot drop patients, using gait and metabolic analysis.Methods: It was a cross over study, included foot drop patients who could walk with/ without orthosis. Patients having spasticity more than grade 2 (Modified Ashworth Scale) were excluded. The metabolic parameters measured were volume of Oxygen consumed at Standard Temperature and Pressure in l/min (VO2), Dry in l/min, Rate of Oxygen consumption (MET), Volume of Carbon dioxide produced in litre/min (VCO2). Along with various gait parameters, questionnaire about patient’s preference after 4 weeks was also incorporated.Results: A-AFO was significantly better than P-AFO in terms of VO2 and VCO2 (p value = 0.02 and 0.009 respectively) as well as in terms of subjective preference.Conclusions: A-AFO is comparable to P-AFO in terms of energy efficiency, gait parameters and subjective preference, hence should also be prescribed.

Study of serum lactate dehydrogenase level as diagnostic and prognostic indicator of megaloblastic anemia

Background: Megaloblastic anaemia is the hematologic manifestation of faulty proliferation of blood cell precursors. The present study was done to facilitate the diagnosis prior to performing any bone marrow aspirate by estimation of the value of serum LDH in the diagnosis of megaloblastic anaemia.Methods: The cases were selected from patients attended the OPD and admitted in Sanjay Gandhi Memorial Hospital & Gandhi Memorial Hospital, Shyam Shah Medical College, Rewa, Madhya Pradesh. Following investigations were then done to classify anaemia and to establish the diagnosis of megaloblastic anaemia like Haemoglobin estimation by cyanmethaemoglobin method, PCV, RBC count and absolute values, general blood picture, reticulocyte count, bone marrow examination and serum LDH estimation before and after treatment.Results: Of the 100 cases, 50 cases (50%) of the cases were microcytic hypochromic anaemia. 15 cases (15%) were normocytic normochromic anaemia; 35 cases (35%) were macrocytic anaemia on the basis of general blood picture and absolute values. The incidence of megaloblastic anaemia in Indian adults was 20%. Maximum number of cases (90%) of the cases had serum LDH level of more than 1000 U/L. Range of serum LDH level was 520 U/L to 4520 U/L. Thus, there was 2 to 20-fold of highest reference value (240 U/L at37 C) rise in serum LDH level in megaloblastic anaemia.Conclusions: Megaloblasatic anaemia is not uncommon in Indian adults and serum LDH levels provide an important means of diagnosis. It is a non-invasive procedure, safe, and does not require any expertise.

To Assess the Correlation between Bone Marrow Morphology and Immunophenotypic Findings in Patients of Chronic Lymphoproliferative Disorders (CLPD’s) and to Assess the Role of Flowcytometric Immunophenotyping in Diagnosis and Subclassification of CLPD’s

Introduction: Chronic lymphoproliferative disorderrepresent clonal proliferation of morphologically andimmunophenotypically mature B or T cells characterized by alow proliferation rate and prolonged cell survival. Study aimedto assess the correlation between bone marrow morphologyand immunophenotypic findings in patients of ChronicLymphoproliferative Disorders (CLPD’s) and to assess therole of flowcytometric immunophenotyping in diagnosis andsubclassification of CLPD’s.Material and Methods: 48 newly diagnosed cases ofCLPD were included. After complete clinical evaluation theyunderwent marrow aspiration, biopsy and immunophenotypingby flowcytometry with selected panel of monoclonalantibodies.Results: On morphology 47.9% cases were CLL. In 52.1%non CLL cases , 4.2% were PLL , 2% case as LPL and45.8% cases were CLPD-unclassifiable. Commonest patternof marrow infiltration noted on trephine biopsy was diffuse inCLL, HCL-V, B-PLL and T-CLPD. On immunophenotyping95.8% cases were B-CLPD and 4.25% T-CLPD. CD5, CD22,CD23, FMC7 and SmIg were used as first line markersfollowed by CD 10, CD 25, CD103, CD38, CD138 andCyclin D1 (on biopsy sections) as second line markers. Finalimmunophenotypic diagnosis was CLL (54.2%), B-CLPDunclassified (29.2%), 4.1% each of LPL, MCL, T-CLPD and2% each of B-PLLand HCL-V.Conclusion: Concordance rate between morphologicaldiagnosis and immunophenotypic diagnosis was 79.17%.Hence, Flowcytometry is necessary for confirmationof diagnosis and to classify the CLPD cases which areunclassifiable by morphology

Analytical Method Development And Validation For Simultaneous Estimation Of Curcumin And Cyclosporine By Rp-Hplc

Objective: The present work was undertaken with an aim to develop and validate a rapid reverse-phase high-performance liquid chromatography (RP-HPLC) method for the estimation of curcumin and cyclosporine in the capsule dosage form. Methods: The RP-HPLC method for the simultaneous estimation of curcumin and cyclosporine was developed using Agilent (Infinity 1260) HPLC system and Eclipse XDB-C18 (4.6 x 150 mm i.d., 5µ) stationary phase. The optimized mobile phase comprised of acetonitrile: water: methanol (50: 10: 40 v/v/v) pumped at a flow rate of 0.5 ml/min. Separation of drugs was achieved in an isocratic mode and elution was monitored using PDA detector at 214 nm. The method was validated as per ICH-Q2R1 guidelines. Results: Retention time of the curcumin and cyclosporine were found to be 3.073 min and 6.373 min with the correlation coefficient (R2) of 0.9993 and 0.998 respectively. The response of curcumin and cyclosporine was found linear in the concentration range of 8-48 μg/ml and 4-24 μg/ml respectively. The percent recovery values were found in the range of 97-103% indicating satisfactory accuracy of the method. The percent relative standard deviation (% RSD) values for the precision study was less than 2 which suggest that the method is precise. Conclusion: The proposed method was found accurate, precise and specific for the determination of curcumin and cyclosporine in bulk as well as in capsule dosage form. Thus, the present method can be used for routine analysis and quality control of curcumin and cyclosporine in bulk and capsule dosage form.

Is a diagnostic lumbar puncture indicated in intraocular retinoblastoma?

Background: Lumbar puncture (LP) is frequently performed in patients with advanced intraocular retinoblastoma. However, this may not be necessary in a significant proportion of patients. Materials and Methods: A file review of patients who were diagnosed with retinoblastoma over a 13-year-period was performed. Patients who underwent LP as part of staging were included in the study. Results: The study included 223 patients. One-third had bilateral retinoblastoma. The grouping was C, D, and E in 4 (2.9%), 41 (29.9%), and 92 (67.2%) patients, respectively. The stage was 0, I, II, III, and IV in 14 (6.3), 123 (55.2%), 13 (5.8%), 70 (31.4%), and 3 (1.3%) patients, respectively. Eight (3.6%) patients had a positive cerebrospinal fluid (CSF) cytology. None of the patients with intraocular disease and 7 (10%) patients with extraocular disease had a positive CSF. Conclusions: A diagnostic CSF is not indicated in patients with intraocular retinoblastoma.

Comparative study between liquid-based cytology & conventional Pap smear for cytological follow up of treated patients of cancer cervix

Background & objectives: Cancer cervix is one of the most common forms of genital malignancy among Indian women. Recurrence is seen in a significant number of cases. The conventional cervical smear technique has inherent problems and screening and interpretation errors. This study was undertaken to assess the efficacy of liquid-based cytology (LBC) as a method for cytological follow up and detection of recurrence in treated cases of cancer cervix and to compare it with conventional Pap smear technique to find the best screening method for detection of recurrence in these patients. Methods: This cross-sectional study was conducted over a period of one year. Patients attending Gynecology and Radiotherapy outpatient departments for follow up after treatment of cancer cervix were included. Pap smear and LBC were taken in all cases. Colposcopy and biopsy were done for those having epithelial cell abnormality in cytology report. Colposcopy and biopsy were taken as gold standard for diagnosis of cancer cervix recurrence. Results: Ninety four treated patients of carcinoma cervix were studied. The diagnostic accuracy for detection of recurrence of conventional Pap smear was 79.16 per cent, and that of LBC was 97.6 per cent. The difference between the two methods was significant (P<0.001). Interpretation & conclusions: Our findings showed that LBC performed better than the conventional method of cytology to detect recurrence of squamous cell carcinoma. Its sensitivity, specificity as well as accuracy were much higher than conventional method. LBC can be a better method of cytological follow up of post-treated patients of cancer cervix.

Energy and Protein Intake During Pregnancy in Relation to Preterm Birth: A Case Control Study.

Objective: To find the association of maternal energy and protein intake with preterm birth. Design: Case-control study. Setting: Two hospitals at Lucknow in Northern India. Participants: Cases (n=350) were defined as mothers (age 18-40 y) of singleton live preterm (<37 wks) neonates. Controls (n=350) were mothers who delivered a singleton neonate, consecutive to enrolled case, after completing 37 weeks of gestation. Results: There was a statistically significant lower mean (SD) energy intake [cases 1624 (249) Kcal vs. controls 1911 (341) Kcal; P<0.001] and protein intake [cases 32.1 (6.1) vs. controls 37.2 (7.0); P<0.001] among women who delivered preterm neonates. Maternal energy and protein intake had significant positive correlation with neonatal weight, length, foot length, head circumference and chest circumference. Conclusion: Lower energy and protein intake during pregnancy is possibly associated with preterm birth.

Prevalence of tuberculosis in Faridabad district, Haryana State, India.

Background & objectives: Epidemiological information on tuberculosis (TB) has always been vital for planning control strategies. It has now gained further importance for monitoring the impact of interventions to control the disease. The present study was done to estimate the prevalence of bacillary tuberculosis in the district of Faridabad in Haryana State of India among persons aged older than 15 years. Methods: In this cross-sectional study, residents of Faridabad district were assessed for the prevalence of tuberculosis. Twelve rural and 24 urban clusters with estimated populations of 41,106 and 64,827 individuals were selected for the study. Two sputum samples were collected from individuals found eligible for inclusion. The samples were also cultured by modified Petroff’s method and were examined for growth of Mycobacterium tuberculosis once a week for eight weeks. A person found positive by smear and/or culture was identified as sputum-positive pulmonary TB positive. Results: A total of 105,202 subjects were enumerated in various clusters of the Faridabad district. There were 50,057 (47.58%) females and 55,145 (52.42%) males. Of these 98,599 (93.7%) were examined by the study group (47,976 females; 50,623 males). The overall prevalence of sputum smear or culture positive pulmonary tuberculosis in our study was found to be 101.4 per 100,000 population. Interpretation & conclusions: The present results showed that the prevalence of sputum positive pulmonary tuberculosis was higher in Faridabad district than the notification rates recorded by the World Health Organization for the contemporary period, a disparity that could be explained by a difference in case detection strategy employed for the study.

Association of mycobacterium tuberculosis in the causation of Eales' disease: An institutional experience.

Background: Eales’ disease is an idiopathic retinal vasculitis characterized by retinal infl ammation, ischemia, and neo-vascularisation. It frequently causes massive vitreous haemorrhage and retinal detachment leading to blindness. Although the exact etiology is unknown, this condition is considered to be a consequence of hypersensitivity reaction to tubercular protein due to previous Mycobacterium tuberculosis (M. tuberculosis) infection. This study is aimed at the detection of association of M. tuberculosis in patients with Eales’ disease. Materials and Methods: A prospective case-control study was undertaken in 65 clinically diagnosed cases of Eales’ disease. Patients with proliferative diabetic retinopathy, neo-vascular proliferation, macular oedema, premacular fi brosis and tractional retinal detachment were taken as controls. M. tuberculosis DNA was detected (MPT64 gene by polymerase chain reaction, PCR) in patients with Eales’ disease. Clinical symptoms along with tuberculin skin test (TST) and erythrocyte sedimentation rate (ESR) were used as gold standard for comparing results of PCR. Result: PCR positivity was found in 12 (38.7%) patients with Eales’ disease. The PCR positivity was signifi cantly associated with the patients with high TST reading and high ESR values. Conclusion: Patients with a high TST reading and ESR value and a positive PCR in vitreous samples have a high likelihood of having M. tuberculosis as an etiology.

Declining trend of resistance to first-line anti-tubercular drugs in clinical isolates of Mycobacterium tuberculosis in a tertiary care north Indian hospital after implementation of revised national Tuberculosis control programme.

Trends showing drug‑resistance pattern are needed to understand direction of tuberculosis (TB) control programme. The drug‑resistance pattern in state of Uttar Pradesh, India, is not documented. Here we are reporting the prevalence of multi‑drug‑resistant (MDR) and drug‑resistant TB in previously treated cases of pulmonary tuberculosis following launch of revised national TB control programme (RNTCP) in whole of Uttar Pradesh. Isolates of Mycobacterium tuberculosis, from patients of pulmonary tuberculosis, who were treated with antitubercular drugs for more than 4 weeks, were tested for resistance to first‑line drugs; streptomycin (S), Ethambutol (E), Rifampicin (R) and isoniazid (H) over a period of 4 years, 2009‑2012. Total 2496 isolates of M. tuberculosis were tested, of which 1139 isolates (45.6%) were pan‑sensitive and 370 (14.8%) were pan‑resistant. Total 695 isolates (27.8%) were MDR. Maximum resistance was with Isoniazid (n = 1069, 42.8%) followed by streptomycin (n = 840, 33.7%), rifampicin (n = 742, 29.7%), and ethambutol (n = 613, 24.6%). A decline in number of MDR strains and individual drug resistance was seen. Total MDR strains in the year 2009, 2010, 2011 and 2012 were 35.6%, 30.8%, 26.7% and 22.8% respectively. The drug resistance pattern reported from time to time may vary substantially. The decline in drug resistance visible over last four years, after implementation of DOTS, appears promising.

Pain Management By Who Step Ladder Pattern Protocol In Cases Of Cervical Cancer

To assess pain in cases of cancer cervix and to evaluate the response to pain management according to WHO step ladder pattern in cases of cancer cervix, total 209 carcinoma cervix diagnosed and admitted case were recruited in the study. Baseline pain score was measured for each patient. For mild to moderate pain (VAS ≤ 7) , step 1 analgesic, NSAID, diclofenac sodium (50 mg TDS) was prescribed. Pain scores were reevaluated after 48 hrs and change of score was recorded. If pain persisted (same score), worsened (score increased) or score decreased but with a VAS score of > 4 , case was considered as non responder and patient was switched to step 2 analgesic. Step 2 was also applied directly to patients presenting with severe pain ( VAS >7) at the time of recruitment. Drugs used in step 2 was oral tramadol (50 mg QID ) along with Diclofenac ( 50 mg TDS) . VAS Score was reevaluated after 48 hrs. If score still remained above 4; adjuvant analgesics (Amitryptiline 25-75 mg OD, Prednisolone 5mg BD – 10 mg/day) were added to step 2. Step 2 non responders were treated with step3 protocol. In step 3, tab morphine (10 mg BD upto maximum 30 mg BD) was given after stopping all other drugs . After 48 hrs, scores were re evaluated; if scores remained >4; adjuvant analgesics ( Amitryptiline 25-75 mg OD, Prednisolone 5mg BD – 10 mg/day ) were added. After 48 hrs if still pain scores did not decrease to <4, case was declared as failure . The WHO algorithm was followed as per the response of the patients. Outcome showed decrease in pain score using Visual Analogue Scale Score. 209 patients were enrolled in the study. 60 patients had no pain at baseline. Out of 149 patients with pain, 44.9 % (67) patients achieved complete pain relief at step 1. Out of the remaining 82 patients , 5 were lost to follow up. 49.3 % (38) achieved complete relief at step 2 . Only 39 patients did not reach score of zero after step 2 but 35 (89.7%) out of them achieved complete relief after step 3. Out of 142 patients ( excluding lost to follow up ), 2 cases were declared as failure. Among these failure cases, one of them had metastasis of femur and symphysis pubis; bisphosphonates were started. Other patients had bladder and bowel involvement diagnosed on repeat cystoscopy. This WHO guideline implementation study supports use of algorithm in decision making for cancer pain management. Following the same we were able to achieve effective pain relief in 96% of our patients with failure rate of only 4%. It further helped to reduce patient’s agony and improved the quality of life.

Rapid identification of clinical mycobacterial isolates by protein profiling using matrix assisted laser desorption ionization-time of flight mass spectrometry.

Purpose: The purpose of this study was to evaluate the identification of Mycobacterium tuberculosis which is often plagued with ambiguity. It is a time consuming process requiring 4-8 weeks after culture positivity, thereby delaying therapeutic intervention. For a successful treatment and disease management, timely diagnosis is imperative. We evaluated a rapid, proteomic based technique for identification of clinical mycobacterial isolates by protein profiling using matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Materials and Methods: Freshly grown mycobacterial isolates were used. Acetonitrile/trifluoroacetic acid extraction procedure was carried out, following which cinnamic acid charged plates were subjected to identification by MALDI-TOF MS. Results: A comparative analysis of 42 clinical mycobacterial isolates using the MALDI-TOF MS and conventional techniques was carried out. Among these, 97.61% were found to corroborate with the standard methods at genus level and 85.36% were accurate till the species level. One out of 42 was not in accord with the conventional assays because MALDI-TOF MS established it as Mycobacterium tuberculosis (log (score) >2.0) and conventional methods established it to be non-tuberculous Mycobacterium. Conclusions: MALDI-TOF MS was found to be an accurate, rapid, cost effective and robust system for identification of mycobacterial species. This innovative approach holds promise for early therapeutic intervention leading to better patient care.

Morphological traits association with fodder and seed yield in Vigna unguiculata (L.).

In cowpea, dual purpose plant types are more preferable for cultivation. Therefore, exotic and indigenous cowpea germplasm lines were evaluated in augmented design to study estimates of the correlation coefficients and path analysis of morphological as well as fodder and grain yield attributes. The present study showed a high impact of direct effects of correlation (0.9714**) and suggested that going for plant types with higher biomass per plant (0.8856**), dry weight per plant (0.4598), stem girth (0.2336) number of secondary branches (0.2788), leaves per plant (0.3251), pods per plant (0.9059) and pod clusters per plant (0.7718) would be effective for improving both fodder and seed yield in cowpea.

Assessment of Health-Related Quality of Life in school-going adolescents: Validation of PedsQL instrument and comparison with WHOQOL-BREF

Background. Health-Related Quality of Life (HRQoL) studies are gaining importance. Yet there is a dearth of crossculturally validated generic HRQoL instruments for Indian adolescents. Two HRQoL instruments, namely World Health Organization Quality of Life-Brief (WHOQOL-BREF) and Pediatric Quality of Life inventoryTM 4.0 (PedsQL), are widely used internationally, with both measuring four domains (physical, psychological/emotional, social relations and environment/school) but each having different questions with 26 in the former and 23 in the latter. This study was done among adolescents in the city of Lucknow to evaluate the psychometric properties of PedsQL and compare its performance with previously validated and culturally revised WHOQOL-BREF. Methods. This cross-sectional study was conducted in February 2010 after institutional ethical approval. Data were collected by a self-administered, predesigned questionnaire in which items of PedsQL and revised WHOQOL-BREF were intermingled. Reliability, content and construct validity were evaluated for PedsQL. Convergent validity of PedsQL with revised WHOQOL-BREF was calculated for domains with similar questions. Results. Parents of 76.5% adolescents (385/503) provided consent. Mean age of adolescents was 13.6 years (1.6 SD and 44.7% were girls). PedsQL showed substantial reliability (Cronbach alpha=0.82, p<0.00001) but poor to fair validity as compared to revised WHOQOL-BREF. Conclusions. For Indian adolescents, PedsQL is a reliable and valid instrument. However, on comparison with revised WHOQOL-BREF, PedsQL has poor to fair validity. We conclude that revised WHOQOL-BREF is a better HRQoL instrument for Indian adolescents.