Development and Validation of a Stability-indicating UV Spectroscopic Method for Candesartan in Bulk and Formulations.

A simple, specific, accurate and stability-indicating UV- Spectrophotometric method was developed for the estimation of candesartan cilexitil, using a Shimadzu, model 1700 spectrophotometer and a mobile phase composed of methanol: water in the ratio of 9:1 at wave length (λ(max)) 254 nm. Linearity was established for candesartan in the range of 10-90 µg/ml. The percentage recovery of was found to be in the range of 99.76-100.79%. The drug was subjected to acid, alkali and neutral hydrolysis, oxidation, dry heat, UV light and photolytic degradation. Validation experiments performed to demonstrate system suitability, specificity, precision, linearity, accuracy, interday assay, intraday assay, robustness, ruggedness, LOD, and LOQ. While estimating the commercial formulation there was no interference of excipients and other additives. Hence this method can be used for routine determination of candesartan cilexetil in bulk and their pharmaceutical dosage forms. The proposed method for stability study shows that there was appreciable degradation found in stress condition of candesartan.

Socio-economic inequalities in child health: recent evidence from India.

This paper analyses the Indian National Family Health Survey (2005-2006) data to present certain broad descriptive features of child health inequalities in India and their distribution across well-defined socio-economic groups classified by gender and sector-of-origin, and their dispersal across space. This study finds that poorer sections of the population are beleaguered with ill health whether in the quest for child survival or due to anxieties pertaining to child nutrition. The concentration index value for the indicators of under-five mortality, full immunisation and underweight outcomes at the national level is calculated to be -0.159, 0.204 and -0.158, respectively. The other disturbing finding here is that there are reigning regional and gender disadvantages irrespective of the developmental status of the State. This study would not only help policymakers to recognise these persistent inequalities but also would help understand health performance at the state and regional levels thus facilitating targeting intervention.

Potent bactericidal action of a flavonoid fraction isolated from the stem bark of Butea frondosa.

The flavonoid fraction isolated from the ethyl acetate fraction (BF-1) of Butea frondosa (L.) stem bark exhibited distinct antimicrobial activity when tested against 129 bacterial strains belonging to 9 different genera of both gram-positive and gram-negative types. Minimum inhibitory concentration (MIC) of the fraction BF-1 was determined following NCCLS guidelines using the agar dilution method. Twenty-four out of 36 strains of Staphylococcus aureus were inhibited by 50-200 mg/l of the fraction. This fraction also inhibited strains of Bacillus spp., Shigella spp., Salmonella spp. and even a few Pseudomonas at concentrations between 50-200 mg/l. Other bacteria including Escherichia coli, Vibrio cholerae and V. parahaemolyticus were moderately sensitive to BF-1. In the in vivo studies, this fraction offered significant protection to Swiss albino mice at a concentration of 80 microg/mouse (p<0.001) when they were challenged with 50 median lethal dose of Salmonella enteritidis NCTC 74. A fraction named BF-1 that was isolated from an ethyl acetate fraction of Butea frondosa provided protection against an infection from a Salmonella enteritidis NCTC strain.

Antibacterial Activity of Ethanol Extract of Andrographis paniculata.

In the present study the ethanol extract of the aerial part of Andrographis paniculata was prepared and evaluated for antimicrobial activity against eleven bacterial strains by determining minimum inhibitory concentration and zone of inhibition. Minimum inhibitory concentration values were compared with control and zone of inhibition values were compared with standard ciprofloxacin in concentration 100 and 200 mug/ml. The results revealed that, the ethanol extract is potent in inhibiting bacterial growth of both Gram-negative and Gram positive bacteria.

Demography of Indian aging, 2001-2051.

India is the second largest country in the world, with 72 million elderly persons above 60 years of age as of 2001, compared to China's 127 million. One of the objectives of this paper is to assess the emerging scenario of elderly for the first half of the 21st century. According to projections, the elderly in the age group 60 and above is expected to increase from 71 million in 2001 to 179 million in 2031, and further to 301 million in 2051; in the case of those 70 years and older, they are projected to increase from 27 million in 2001 to 132 million in 2051. Among the elderly persons 80 and above, they are likely to improve their numbers from 5.4 million in 2021 to 32.0 million in 2051. The increasing number and proportion of elderly will have a direct impact on the demand for health services and pension and social security payments. Mobilizing resources for geriatric care and providing sufficient maintenance for the elderly will emerge as a major responsibility for heath-care providers and pension economists.

Giant-cell tumors of the patella.

This study describes the clinical, radiographic, and histopathologic features, and discusses the management options of 11 cases of benign giant-cell tumors of the patella seen over 20 years. Fine needle aspiration cytology was a useful preoperative diagnostic tool. Ptellectomy and reconstruction of the extensor apparatus is the favored treatment option with curettage and bone grafting restricted to selected localized lesions.

Delivery-related complications and determinants of caesarean section rates in India.

Caesarean section rates have been increasing worldwide, raising the question of the appropriateness of the selection of cases for the procedure. This paper examines the levels and correlates of delivery-related complications and caesarean section deliveries in 18 selected states of India in terms of specific maternal and institutional factors, using data from the National Family Health Surveys, 1992-93. Goa (15.3%) and Kerala (13.7%) were the two states with relatively higher caesarean section rates. There is reason to believe that current rates are part of a rising trend. This cannot be attributed entirely to the rise in institutional deliveries alone because of the strong association between caesarean sections and private sector institutions. Apart from the fact that the states of Kerala and Goa have relatively high caesarean section rates, in Andhra Pradesh, Bihar, Gujarat, Karnataka, Punjab and Uttar Pradesh the risk of undergoing caesarean section in private sector institutions is four or more times that in the public sector. It is possible that this extremely useful surgical procedure is being misused for profit purposes in the private sector in several states. There is therefore a need to examine this phenomenon using data disaggregated by the nature of caesarean sections, i.e. whether it was an elective or an emergency caesarean section along with the reasons for the choice.

Unmet need for reproductive health in India.

Using data from the National Family Health Survey of 1992-93 and the individual reproductive histories of a cross-section of 70 women from rural Tamil Nadu, this paper exposes the limited extent to which women in India have been able to achieve their reproductive intentions and the failure of health services to meet their considerable reproductive health needs. Of the 70 women, 69 had been unable to achieve their reproductive intentions, not only non-users of contraception but also ever-users, and all 69 had an unmet need for reproductive health services. Sterilisation is often the first and only method of contraception taken up and only after a series of wanted, mistimed and unwanted pregnancies, miscarriages, induced abortions and neonatal and infant deaths. Women who wanted to have more children than they were able to were also found. Given the paradigm policy shift in India from promoting fertility reduction only to meeting women's reproductive and sexual health needs, a more useful concept for measuring 'unmet need' for services in programme planning is required, one such as the HARI index, that would capture the extent to which individual women are achieving their reproductive intentions in good health. Without this, the same problems will only recur in younger women.

Health concerns among India's elderly.

This article critically examines the health situation among elderly from two sets of independent sources. National Sample Survey in its 42 Round (July 1986-June 1987) canvassed a nationwide survey covering 50,000 households in 8312 villages and 4546 urban blocks in India to understand the socio-economic profile of aged persons. Secondly, an aging survey (1993) was conducted in Tamil Nadu, Kerala, Gujarat, and Karnataka states in India by the authors to study the elderly life in terms of general feeling, living arrangements, living support, social security, health, nutrition, their involvement in social and religious matters, views of old age homes and particularly life preparatory measures. The survey is based on interviews with about 2,253 persons aged 60 years and above, of whom 1325 are males and 928 are females. In fact, this survey is a part of a larger study conducted for the Social Development Section, Economic and Social Commission for the Asia and Pacific (ESCAP), United Nations, Bangkok, along with four other South East Asian countries-China, Korea, Singapore, and Thailand. From the survey conducted by us, we report only the health aspects of the elderly in this paper. The last section examines the major cause of death among elderly as reported from the Model Registration System of the Registrar General of India and concludes with feasible policy prescriptions.

Correlates of female sterilization regret in the southern states of India.

This study analyses factors associated with the incidence of sterilization regret in the four south Indian states of Andhra Pradesh, Karnataka, Kerala and Tamil Nadu. Using data from the National Family Health Surveys, in all four states the incidence of regret was found to be less than 10% and the factors significantly associated with it were child loss experience and quality of services. Hence, there is a need to improve the quality of services, both in terms of counselling and service provision, and women need to be counselled about the permanent nature of sterilization in order to avoid future regret.

Evaluation of formalin preserved allogeneic bone graft as a grafting material.

Formalin preserved allogeneic (FPA) bone graft was used in 18 patients with benign bone cavities, nine patients with malignant bone cavities, 12 patients with atrophic nonunion of fractures, seven with gap nonunion and 18 with comminuted fractures. The benign bone cavities were obliterated in 20 weeks and malignant cavities in 24 weeks. Union was obtained in atrophic ununited fractures in 29 weeks, in gap nonunion in 40 weeks and in comminuted fractures in 27 weeks. FPA is a simple, inexpensive and easily available alternative to autologous bone and to deep frozen bone in filling bone defects and enhancing fracture union.

Electromagnetic field in and around the campus of Jawaharlal Nehru University, New Delhi.

We have surveyed the levels of magnetic field in the open environment around the high-tension lines as well as in the domestic and laboratory environment in the JNU campus. Measurements were made in the direction of most likely access, and from the surface of the appliances. The data so obtained are analyzed and compared with some quoted in the literature. It is hoped that the results will be useful for epidemiological studies in determining the criteria for safe human exposure.

Induced abortion potential among Indian women.

Information on abortion is limited and inaccurate, especially in the developing world, which has led to speculation on the prevalence of abortion in these regions. A rise in prevalence of abortion is mostly counted in terms of increase in the prevalence of induced abortions which reflects on the reproductive health of women. With the growing concern for the reproductive health of women, the study of abortion has drawn the attention of researchers world-wide. This paper is an attempt to assess the induced abortion potential among Indian women by utilizing information on proportion of unwanted and ill-timed pregnancies obtained through National Family Health Survey, India. This exercise may facilitate a better understanding of the exact prevalence of induced abortion, which necessarily should be less than the estimated potential depending on the levels of unwanted and ill-timed fertility.

PIP: An increase in the prevalence of abortion is mainly counted in terms of an increase in the prevalence of induced abortions which, in turn, reflects the status of women's reproductive health. The growing concern for women's reproductive health has fueled the study of abortion among researchers worldwide. The authors assess the induced abortion potential among women in India by using information on the proportion of unwanted and ill-timed pregnancies obtained through the National Family Health Survey, India. The number of births reported as ill-timed and unwanted was used to calculate potential abortion rates by age for the 15 major states in India. The distribution of ill-timed and unwanted births indicates that unwanted births occur mainly among women over age 30 years, while ill-timed births are concentrated more among younger women. The total potential for abortion is highest in Uttar Pradesh and lowest in Gujarat. The peak ages for abortion potential is 20-24 years in 10 of the 14 major states, while that peak is at ages 25-29 years in Assam, Bihar, Madhya Pradesh, Orissa, and Uttar Pradesh. The potential for induced abortion is expected to decline with improved access to limiting services and overall improvement in the quality of family planning services for birth spacing.

Psychosocial aspects of amputation.

Twenty-five subjects were studied who had undergone amputation 6 months to 2 years prior to the time of assessment. The sample was divided into sick (those having psychiatric illness) and non-sick (those without any psychiatric illness) groups, and then compared for various life events following the amputation. It was seen that those who were labelled as psychiatrically sick had more work impairment, change in job, socioeconomic difficulties and social avoidance. The latter two factors were also significantly more in right upper limb amputees than the left upper limb amputees; no such difference existed between the upper and lower limb amputees.

Psychiatric sequelae of amputation : I immediate effects.

Twenty-five subjects, who had undergone amputation within last 6 weeks, were studied for psychiatric complications, including phantom limb phenomena. The patients were interviewed on SCID, HRSD and HARS. Out of a total of 25 subjects, 8 (34.6%) developed psychiatric disorders - PTSD and major depression. The whole sample was thus divided into 2 groups-sick and nonsick. Phantom limb was seen in 88% subjects. No significant difference was present between the two groups with regard to presence of phantom, its associated phenomena of pain, telescopy and movement. A statistically significant difference was seen in psychiatric sickness in relation to upper and lower limb.

Psychiatric sequelae of amputation : ii long term effects.

Psychiatric sequelae present after 6 months to 2 years following amputation were studied in a group of 25 subjects. The subjects were screened on SCID, HRSD and HARS. The most common diagnoses were depressive disorder NOS (20.6%) and major depressive disorder (10.3%). Patients having right sided amputation were more psychiatrically ill than those with loss of a left limb. Phantom limb was seen in about two-thirds of the total sample-more in the sick group (about 88%) than in the non-sick group (about 55%). Pain in the phantom limb was seen more in the sick group, but telescopy and movement were more frequently complained of by subjects of the non-sick group.

On estimating current levels of fertility and child mortality from the data on open birth interval and survival status of the last child.

PIP: A steady state model was described for estimating fertility and child mortality simultaneously from data on open birth interval and survival status of the last child. The estimation of risks of mortality and fertility were period specific, and child mortality risk was estimated with a Weibull distribution function. The model was applied to 1981 census data for India on observed childhood mortality and age specific fertility rates. The life table approach of Pandey and Suchindran was used to generate a period specific distribution of open birth intervals from age specific marital fertility rates (ASMFR). Sprague multipliers were used to obtain ASMFR by single years of age and then to generate the open birth intervals of women aged 15-49 years. The survival status of the last born child during the preceding 5 years of the census was simulated by applying the observed mortality pattern for India. The final set of estimates with a minimum value of Chi-square was m=0.23, a=0.134, b=0.261 and an assumed value of h=1.25.^ieng

Childlessness and fertility.

PIP: Data on childlessness may be utilized to understand the fertility behavior of women. This paper describes the age pattern of childlessness by a mathematical model. The model gives the starting age of fecund married life, which is an important indicator of fertility patterns. The relationship of childlessness with age at 1st marriage, total fertility rate and contraceptive prevalence can also be studied with the help of the proposed model. Age at marriage is often taken to be the beginning age of childbearing. But, in fact, the pace and age pattern of natural fertility is largely characterized by the age at which childbearing starts. This model was developed in India using World Fertility Survey data from 6 countries.^ieng

Intertrochanteric displacement osteotomy in the treatment of femoral neck fractures.

A total of 51 patients with displaced femoral neck fractures of Garden grade III or IV was treated by intertrochanteric displacement osteotomy. Of these, 42 patients had complete follow-up and 31 fractures (73.8%) united. The results were satisfactory in 66.6% and poor in 33.4%. The poor results were mainly due to non-union, chronic osteomyelitis and stiffness of the hip or knee. A high intertrochanteric osteotomy with adequate displacement is recommended in fresh, displaced femoral neck fractures.