A systematic review of ethnic disparities in the uptake of colorectal cancer screening.

AIMS: Colorectal cancer (CRC) screening reduces mortality, but variation exists in uptake. Ethnicity is suggested to play a role; however, there is no high-level evidence to support this. We aim to clarify the impact of Ethnicity on CRC screening uptake and our barriers to its understanding. METHODS: A systematic review to identify studies reporting on the participation of ethnic minorities in CRC screening worldwide was performed. MEDLINE, Embase, Scopus and Google Scholar databases up until 31 May 2019 were searched. Compliance with screening according to ethnic groups and screening modality was evaluated compared to the 'White' control group. RESULTS: Twenty-two studies were included in the review reporting on 2,084,213 patients. Substantial variation in categorisation of ethnicities (40 sub-categories), screening modality studied and confounding factors accounted for was observed. 8/15 studies for 'Blacks', 10/13 for 'Hispanics', 2/2 for 'Asians' and 1/1 for 'South East Asians' suggest a less likely or significantly decreased compliance with screening for all screening modalities (p < .05) compared to 'Whites'. Interestingly 'Japanese', 'Vietnamese' and 'Filipino' groups consistently show no difference in the uptake of CRC screening compared to the 'White' majority. CONCLUSION: This is the only systematic review on this topic. It highlights the inconsistency in screening uptake behaviour in different ethnic minority groups and identifies barriers like variation in ethnicity categorisation, screening modality and study design utilised to understanding the intricacies of this relationship. Further collaboration and action needs to be undertaken internationally to clarify and improve inequity in the uptake of screening.

Pregnancy and postpartum outcomes in a universally tested population for SARS-CoV-2 in New York City: a prospective cohort study.

OBJECTIVE: To describe differences in outcomes between pregnant women with and without coronavirus dsease 2019 (COVID-19). DESIGN: Prospective cohort study of pregnant women consecutively admitted for delivery, and universally tested via nasopharyngeal (NP) swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using reverse transcription-polymerase chain reaction. All infants of mothers with COVID-19 underwent SARS-CoV-2 testing. SETTING: Three New York City hospitals. POPULATION: Pregnant women >20 weeks of gestation admitted for delivery. METHODS: Data were stratified by SARS-CoV-2 result and symptomatic status, and were summarised using parametric and nonparametric tests. MAIN OUTCOME MEASURES: Prevalence and outcomes of maternal COVID-19, obstetric outcomes, neonatal SARS-CoV-2, placental pathology. RESULTS: Of 675 women admitted for delivery, 10.4% were positive for SARS-CoV-2, of whom 78.6% were asymptomatic. We observed differences in sociodemographics and comorbidities among women with symptomatic COVID-10 versus asymptomatic COVID-19 versus no COVID-19. Caesarean delivery rates were 46.7% in symptomatic COVID-19, 45.5% in asymptomatic COVID-19 and 30.9% in women without COVID-19 (P = 0.044). Postpartum complications (fever, hypoxia, readmission) occurred in 12.9% of women with COVID-19 versus 4.5% of women without COVID-19 (P < 0.001). No woman required mechanical ventilation, and no maternal deaths occurred. Among 71 infants tested, none were positive for SARS-CoV-2. Placental pathology demonstrated increased frequency of fetal vascular malperfusion, indicative of thrombi in fetal vessels, in women with COVID-19 versus women without COVID-19 (48.3% versus 11.3%, P < 0.001). CONCLUSION: Among pregnant women with COVID-19 at delivery, we observed increased caesarean delivery rates and increased frequency of maternal complications in the postpartum period. Additionally, intraplacental thrombi may have maternal and fetal implications for COVID-19 remote from delivery. TWEETABLE ABSTRACT: COVID-19 at delivery: more caesarean deliveries, postpartum complications and intraplacental thrombi.

Postoperative chemotherapy improves survival in patients with resected high-risk Stage II colorectal cancer: results of a systematic review and meta-analysis.

AIM: The aim was to assess the benefit of adjuvant chemotherapy in high-risk Stage II colorectal cancer. METHOD: A systematic literature review and meta-analysis was performed comparing survival in patients with resected Stage II colorectal cancer and high-risk features having postoperative chemotherapy vs no chemotherapy. RESULTS: Of 1031 articles screened, 29 were included, reporting on 183 749 participants. Adjuvant chemotherapy significantly improved overall survival [hazard ratio (HR) 0.61, P < 0.0001], disease-specific survival (HR = 0.73, P = 0.05) and disease-free survival (HR = 0.59, P < 0.0001) compared to no chemotherapy. Adjuvant chemotherapy significantly increased 5-year overall survival (OR = 0.53, P = 0.0008) and 5-year disease-free survival (OR = 0.50, P = 0.001). Overall survival and disease-free survival remained significantly prolonged during subgroup analysis of studies published from 2015 onwards (HR = 0.60, P < 0.0001; HR = 0.65, P = 0.0001; respectively), in patients with two or more high-risk features (HR = 0.59, P = 0.0001; HR = 0.70, P = 0.03; respectively) and in colon cancer (HR = 0.61, P < 0.0001; HR = 0.51, P = 0.0001; respectively). Overall survival, disease-specific survival and disease-free survival during subgroup analysis of individual high-risk features were T4 tumour (HR = 0.58, P < 0.0001; HR = 0.50, P = 0.003; HR = 0.75, P = 0.05), < 12 lymph nodes harvested (HR = 0.67, P = 0.0002; HR = 0.80, P = 0.17; HR = 0.72, P = 0.02), poor differentiation (HR = 0.84, P = 0.35; HR = 0.85, P = 0.23; HR = 0.61, P = 0.41), lymphovascular or perineural invasion (HR = 0.55, P = 0.05; HR = 0.59, P = 0.11; HR = 0.76, P = 0.05) and emergency surgery (HR = 0.60, P = 0.02; HR = 0.68, P = 0.19). CONCLUSION: Adjuvant chemotherapy in high-risk Stage II colorectal cancer results in a modest survival improvement and should be considered on an individual patient basis. Due to potential heterogeneity and selection bias of the included studies, and lack of separate rectal cancer data, further large randomized trials with predefined inclusion criteria and standardized chemotherapy regimens are required.

Immune thrombocytopenic purpura in a patient with disseminated tuberculosis: An unusual presentation.

Pulmonary tuberculosis can have a wide variety of presentations including hematological manifestations. We report a case of a young male patient who presented with complaints of generalized petechiae, gum bleeding, systemic lymphadenopathy, and severe thrombocytopenia. His bone marrow revealed normal megakaryocytes, and in the absence of hepatosplenomegaly, a diagnosis of immune thrombocytopenic purpura (ITP) was made. The thrombocytopenia responded to course of intravenous immune globulin. The smear made from fine-needle aspiration of cervical lymph nodes showed acid-fast bacilli. This case highlights the rare association of extrapulmonary tuberculosis with ITP.

The Banff 2017 Kidney Meeting Report: Revised diagnostic criteria for chronic active T cell-mediated rejection, antibody-mediated rejection, and prospects for integrative endpoints for next-generation clinical trials.

The kidney sessions of the 2017 Banff Conference focused on 2 areas: clinical implications of inflammation in areas of interstitial fibrosis and tubular atrophy (i-IFTA) and its relationship to T cell-mediated rejection (TCMR), and the continued evolution of molecular diagnostics, particularly in the diagnosis of antibody-mediated rejection (ABMR). In confirmation of previous studies, it was independently demonstrated by 2 groups that i-IFTA is associated with reduced graft survival. Furthermore, these groups presented that i-IFTA, particularly when involving >25% of sclerotic cortex in association with tubulitis, is often a sequela of acute TCMR in association with underimmunosuppression. The classification was thus revised to include moderate i-IFTA plus moderate or severe tubulitis as diagnostic of chronic active TCMR. Other studies demonstrated that certain molecular classifiers improve diagnosis of ABMR beyond what is possible with histology, C4d, and detection of donor-specific antibodies (DSAs) and that both C4d and validated molecular assays can serve as potential alternatives and/or complements to DSAs in the diagnosis of ABMR. The Banff ABMR criteria are thus updated to include these alternatives. Finally, the present report paves the way for the Banff scheme to be part of an integrative approach for defining surrogate endpoints in next-generation clinical trials.

Quality indicators in pediatric colonoscopy: an Australian tertiary center experience.

OBJECTIVES: Quality indicators for colonoscopy in adults are largely driven by colorectal cancer screening, and include cecal intubation rates, with rates of >90% recommended. In contrast, colorectal cancer is rare in childhood, with paucity of data on relevant quality indicators for pediatric colonoscopy. It is also unclear whether high rates of cecal intubation are achievable in small children. Our aim was to audit all colonoscopies performed in a tertiary pediatric center to examine clinical indications for procedure, completeness of examination with cecal and ileal intubation, significant findings, and complications. METHODS: Retrospective review of colonoscopies performed between November 2011 and October 2015 was undertaken. RESULTS: Total colonoscopy was performed in 652 patients, 53% male, with median age 13.0 (range 0.4-18.2) years. The most common indications for colonoscopy were assessment of inflammatory bowel disease (IBD) 57.9% (378/652), rectal bleeding 10% (68/652) and abdominal pain 10% (68/652). Trainees performed 69.8% (452/652) of procedures. Quality of bowel preparation was mentioned in 63% (410/652), of which 22% (90/410) were considered inadequate. Cecal intubation rate was 96.3% (628/652) and ileal intubation rate was 92.4% (603/652). Extent of procedure was confirmed in 99.2% of patients with photographs and/or ileal biopsy. Poor quality of bowel preparation (p = .001) and age <5years (p = .007) were inversely related to successful ileal intubation. CONCLUSIONS: High rates of cecal and ileal intubation are achievable in pediatric colonoscopy. Ileal intubation should be considered a quality indicator since the main indicator for pediatric colonoscopy is to investigate IBD.

BK Polyomavirus Genomic Integration and Large T Antigen Expression: Evolving Paradigms in Human Oncogenesis.

Human polyomaviruses are ubiquitous, with primary infections that typically occur during childhood and subsequent latency that may last a lifetime. Polyomavirus-mediated disease has been described in immunocompromised patients; its relationship to oncogenesis is poorly understood. We present deep sequencing data from a high-grade BK virus-associated tumor expressing large T antigen. The carcinoma arose in a kidney allograft 6 years after transplantation. We identified a novel genotype 1a BK polyomavirus, called Chapel Hill BK polyomavirus 2 (CH-2), that was integrated into the BRE gene in chromosome 2 of tumor cells. At the chromosomal integration site, viral break points were found, disrupting late BK gene sequences encoding capsid proteins VP1 and VP2/3. Immunohistochemistry and in situ hybridization studies demonstrated that the integrated BK virus was replication incompetent. We propose that the BK virus CH-2 was integrated into the human genome as a concatemer, resulting in alterations of feedback loops and overexpression of large T antigen. Collectively, these findings support the emerging understanding that viral integration is a nearly ubiquitous feature in polyomavirus-associated malignancy and that unregulated large T antigen expression drives a proliferative state that is conducive to oncogenesis. Based on the current observations, we present an updated model of polyomavirus-mediated oncogenesis.

The Banff 2015 Kidney Meeting Report: Current Challenges in Rejection Classification and Prospects for Adopting Molecular Pathology.

The XIII Banff meeting, held in conjunction the Canadian Society of Transplantation in Vancouver, Canada, reviewed the clinical impact of updates of C4d-negative antibody-mediated rejection (ABMR) from the 2013 meeting, reports from active Banff Working Groups, the relationships of donor-specific antibody tests (anti-HLA and non-HLA) with transplant histopathology, and questions of molecular transplant diagnostics. The use of transcriptome gene sets, their resultant diagnostic classifiers, or common key genes to supplement the diagnosis and classification of rejection requires further consensus agreement and validation in biopsies. Newly introduced concepts include the i-IFTA score, comprising inflammation within areas of fibrosis and atrophy and acceptance of transplant arteriolopathy within the descriptions of chronic active T cell-mediated rejection (TCMR) or chronic ABMR. The pattern of mixed TCMR and ABMR was increasingly recognized. This report also includes improved definitions of TCMR and ABMR in pancreas transplants with specification of vascular lesions and prospects for defining a vascularized composite allograft rejection classification. The goal of the Banff process is ongoing integration of advances in histologic, serologic, and molecular diagnostic techniques to produce a consensus-based reporting system that offers precise composite scores, accurate routine diagnostics, and applicability to next-generation clinical trials.

Fe3C-filled carbon nanotubes: permanent cylindrical nanomagnets possessing exotic magnetic properties.

The present study aims to deduce the confinement effect on the magnetic properties of iron carbide (Fe3C) nanorods filled inside carbon nanotubes (CNTs), and to document any structural phase transitions that can be induced by compressive/tensile stress generated within the nanorod. Enhancement in the magnetic properties of the nanorods is attributed to tensile stress as well as to compression, present in the radial direction and along the nanotube axis, respectively. Finally, the growth of permanent cylindrical nanomagnets has been optimized by applying a field gradient. Besides presenting the growth model of in situ filling, we have also proposed the mechanism of magnetization of the nanotubes. Magnetization along the tube axis has been probed by confirming the pole formation. Fe3C has been selected because of its ease of formation, low TC and incompressibility.

Yield loss assessment due to Alternaria blight and its management in linseed.

Field experiments were conducted during 2010-11 and 2011-12 to assess the yield losses due to Alternaria blight disease caused by Alternaria lini and A. linicola in recently released cultivars and their management with the integration of Trichoderma viride, fungicides and plant extract. Disease severity on leaves varied from 41.07% (Parvati) to 65.01% (Chambal) while bud damage per cent ranged between 23.56% (Shekhar) to 46.12% (T-397), respectively in different cultivars. Maximum yield loss of 58.44% was recorded in cultivar Neelum followed by Parvati (55.56%), Meera (55.56%) and Chambal (51.72%), respectively while minimum loss was recorded in Kiran (19.99%) and Jeevan (22.22%). Minimum mean disease severity (19.47%) with maximum disease control (69.74%) was recorded with the treatment: seed treatment (ST) with vitavax power (2 g kg(-1) seed) + 2 foliar sprays (FS) of Saaf (a mixture of carbendazim+mancozeb) 0.2% followed by ST with Trichoderma viride (4g kg(-1) seed) + 2 FS of Saaf (0.2%). Minimum bud damage (13.75%) with maximum control (60.94%) was recorded with treatment of ST with vitavax power+2 FS of propiconazole (0.2%). Maximum mean seed yield (1440 kg ha(-1)) with maximum net return (Rs. 15352/ha) and benefit cost ratio (1:11.04) was obtained with treatment ST with vitavax power + 2 FS of Neem leaf extract followed by treatment ST with vitavax power+2 FS of Saaf (1378 kg ha(-1)).

High prevalence of type 2 diabetes mellitus in affluent urban Indians.

The highest prevalence of type 2 diabetes mellitus in developing countries occurs in the upper socio-economic group, but this has not been well documented in Indians. The age and sex standardized prevalence of diabetes in 1112 affluent adult Indian subjects was 21.1%. This is the highest prevalence of diabetes reported from India.

Prevalence & risk factors of pre-hypertension & hypertension in an affluent north Indian population.

BACKGROUND & OBJECTIVES: Urban Indians have a high prevalence of insulin resistance, hypertension and cardiovascular disease. We studied the prevalence of pre-hypertension and hypertension, as well their association with cardiovascular risk factors, in a north Indian upper socio-economic population. METHODS: A total of 1746 adults (age >or=30 yr) residing in an urban colony of high-income group residents in the city of Lucknow, north India, were invited to be enrolled for the study. The response rate was 64 per cent (n=1112). Blood pressure, anthropometry, plasma glucose in response to oral glucose tolerance test and lipids were measured. The variables contributing significantly to pre-hypertension and hypertension were analyzed by multiple logistic regression analysis. RESULTS: The age and sex adjusted prevalence of hypertension was 32.2 per cent and pre-hypertension was 32.3 per cent. In contrast to hypertension, which was highest in the age group 60-69 yr (64%), prehypertension was highest (36%) in the group 30-39 yr. There was a high prevalence of cardiovascular risk factors in the general population [central obesity (86.7%), elevated LDL cholesterol (22.8%), abnormal glucose tolerance (41.6%) and smoking (20.3% of males)]. Two or more of the cardiovascular risk factors were present in a higher proportion of hypertensive [66%, odds ratio (OR) 3.0, P<0.0001] and pre-hypertensive, (56%, OR 2.0, P<0.0001) compared to normotensive subjects (39%). Subjects with pre-hypertension had body mass index, waist-hip ratio and frequency of glucose intolerance, which was intermediate between normotensive and hypertensive subjects. In multiple logistic regression analysis, increasing age, body mass index, waist hip ratio and impaired glucose tolerance/diabetes were independent risk factors for both hypertension and pre-hypertension. INTERPRETATION & CONCLUSION: A high prevalence of pre-hypertension and hypertension were noted in affluent urban north Indians. Increasing age, body mass index, central obesity and impaired glucose tolerance/diabetes were significantly associated with both hypertension and pre-hypertension. Pre-hypertension was associated with an increased prevalence of cardiovascular risk factors.

Low field magnetotransport in manganites.

The perovskite manganites with generic formula RE(1-x)AE(x)MnO(3) (RE = rare earth, AE = Ca, Sr, Ba and Pb) have drawn considerable attention, especially following the discovery of colossal magnetoresistance (CMR). The most fundamental property of these materials is strong correlation between structure, transport and magnetic properties. They exhibit extraordinary large magnetoresistance named CMR in the vicinity of the insulator-metal/paramagnetic-ferromagnetic transition at relatively large applied magnetic fields. However, for applied aspects, occurrence of significant CMR at low applied magnetic fields would be required. This review consists of two sections: in the first section we have extensively reviewed the salient features, e.g. structure, phase diagram, double-exchange mechanism, Jahn-Teller effect, different types of ordering and phase separation of CMR manganites. The second is devoted to an overview of experimental results on CMR and related magnetotransport characteristics at low magnetic fields for various doped manganites having natural grain boundaries such as polycrystalline, nanocrystalline bulk and films, manganite-based composites and intrinsically layered manganites, and artificial grain boundaries such as bicrystal, step-edge and laser-patterned junctions. Some other potential magnetoresistive materials, e.g. pyrochlores, chalcogenides, ruthenates, diluted magnetic semiconductors, magnetic tunnel junctions, nanocontacts etc, are also briefly dealt with. The review concludes with an overview of grain-boundary-induced low field magnetotransport behavior and prospects for possible applications.

Heterogeneous photocatalysed degradation of 4-chlorophenoxyacetic acid in aqueous suspensions.

The photocatalysed degradation of 4-chlorophenoxyacetic acid (4-CPA, 1) has been investigated in aqueous suspensions of titanium dioxide under a variety of conditions. The degradation was studied by monitoring the change in substrate concentration employing UV spectroscopic analysis technique and depletion in total organic carbon (TOC) content as a function of irradiation time. The influence of various parameters such as, different types of titanium dioxide (TiO2) powders, pH, catalyst and substrate concentrations, and in the presence of electron acceptor such as hydrogen peroxide (H(2)O(2)) besides molecular oxygen has been investigated. The effects of these parameters on the degradation rates were found to be significant. The volatile degradation product 4-chlorophenol was analyzed by GC-MS technique and probable pathways for the formation of product has been proposed.

Heterogeneous photocatalyzed degradation of uracil and 5-bromouracil in aqueous suspensions of titanium dioxide.

Photocatalyzed degradation of uracil (1) and 5-bromouracil (2) has been investigated in aqueous suspensions of titanium dioxide under a variety of conditions. The degradation was studied by monitoring the change in substrate concentration employing UV spectroscopic analysis technique and depletion in total organic carbon (TOC) content as a function of irradiation time. The degradation of the compounds under investigation was studied using various parameters such as, different types of TiO2 powders, pH, catalyst concentration, substrate concentrations, and in the presence of electron acceptors like hydrogen peroxide (H(2)O(2)) and potassium bromate (KBrO(3)) besides molecular oxygen. Photocatalyst Degussa P25 was found to be more efficient for the degradation of both compounds as compared with other TiO2 powders such as UV100, PC500 and TTP.

Is fluoroscopy essential for retrieval of lower ureteric stones?

INTRODUCTION: The aim of this study was to assess the efficacy of ureteroscopy for lower ureteric stones without the use of fluoroscopy. PATIENTS AND METHODS: Between June 2001 and January 2005, a total of 110 patients with a mean age of 33.5 years (range 12-65) suffering from of lower ureteral calculi (below the upper margin of the sacroiliac joint) prospectively underwent ureteroscopic removal. Retrograde pyelography was avoided, and no safety guidewire was placed. Whenever required, the ureteric meatus was dilated with a ureteric balloon under direct vision. Double-J stent placement was done with the aid of ureteroscopy. A fluoroscope was kept standby. The patients had a postoperative X-ray of the kidney-ureter-bladder region to document the stone clearance. RESULTS: The mean stone size was 8.7 mm (range 6-15). Complete clearance without the use of fluoroscopy was achieved in 99 patients (94.2%). Fluoroscopy was required in 6 patients (4%) for calcified stricture (n = 1), duplex system (n = 1), narrow and tortuous meatus causing difficulty in passing the 5-Fr balloon dilator (n = 3), and confirmation of spontaneous passage of the stone (n = 1). Of the 13 patients who required balloon dilatation it was successfully achieved without fluoroscopy. Double-J stenting was done due to mucosal ulceration (n = 3), polypoid reaction (n = 2), and perforation (n = 1). All these patients had correct placement of the stent, as confirmed by X-ray of the kidney-ureter-bladder region postoperatively. CONCLUSIONS: To uphold the notion for radiation exposure to be as low as reasonably achievable, ureteroscopic stone retrieval can safely be done without the use of fluoroscopy in a significant number of patients.

Cell-cycle regulatory proteins in the podocyte in collapsing glomerulopathy in children.

Podocyte is a terminally committed cell in G1 arrest of cell cycle, and is unable to overcome G1/S transition phase in children with minimal change disease (MCD) and classic focal segmental glomerulosclerosis (FSGS), in contrast to dysregulated proliferative phenotype of idiopathic collapsing glomerulopathy (CGN) in adults. Forty-two kidney biopsies, MCD (14), FSGS (12), CGN (4), and normal (CON) (12), were evaluated by immunohistochemistry using dual staining for expression of p27, p21, and p57, and cyclins D and A, in podocytes of children with CGN. On light microscopy, all podocytes expressed p27, whereas p21 and p57 expression was seen in a portion of podocytes in normal kidney biopsies. Cyclin D was expressed in a small percentage of podocytes. Cyclin A expression was absent in normal biopsies. The staining for p27 decreased significantly, in order, from normal (100%) to MCD (45.8%) to CGN (24.2%) to FSGS (16.6%). p21 staining was significantly decreased from normal (69.8%) to CGN (15.5%) to MCD (2.2%) to FSGS (0.6%), and the difference between CGN and MCD and FSGS was also significant. There was no significant difference in staining of p57. Cyclin D staining was significantly increased in CGN (26.8%) compared to normal (7.2%), MCD (1.6%), and FSGS (0.0%), and the difference between CGN and MCD and FSGS was also significant. De novo cyclin A staining was only observed in children with CGN. Thus, p27 and p21 but not p57 was decreased in CGN, as in FSGS when compared to normal. Both cyclins D and A staining were increased in CGN. The staining pattern in CGN would suggest that podocyte is able to overcome G1/S transition phase, and has a proliferative phenotype. We propose, based on the significant contrast observed in podocytes injury response between CGN (proliferative) and classic FSGS (non-proliferative), that CGN not be considered as a morphological variant of FSGS.

Validation and reproducibility of a food frequency questionnaire to assess energy and fat intake in affluent north Indians.

BACKGROUND: India is currently witnessing a sharp rise in noncommunicable disorders such as obesity, diabetes, hypertension and cardiovascular diseases. This rise can be related in part to dietary changes such as increased intake of calories, fat (especially saturated fat) and cholesterol. A simple, accurate and reproducible method to measure these nutrients is essential to study the role of diet in these diseases in epidemiological studies. We aimed to develop and validate a food frequency questionnaire that could be used for this purpose. METHODS: Thirty urban north Indian subjects (age 23-64 years, 16 men) belonging to a high socioeconomic group were studied. The subjects were selected consecutively over a period of 3 weeks from among those participating in an epidemiological survey on cardiovascular risk factors in an affluent population. A 102-item food frequency questionnaire was developed to capture the intake of calories, fat, saturated fat and cholesterol. The results obtained by the food frequency questionnaire were compared with a 5-day diet record. To assess the reproducibility of the food frequency questionnaire, it was re-administered after 3 months to the 23 subjects available. RESULTS: It took the dietician 20 minutes or less to administer the questionnaire. There was good correlation between the nutrient values as calculated by the food frequency questionnaire and 5-day diet record. The correlation for energy intake was 0.80, and varied between 0.55 and 0.69 for unadjusted intake of other nutrients. After adjusting for calories, the correlation varied between 0.45 and 0.68. In general, the food frequency questionnaire overestimated the energy-adjusted nutrient intake by 6%-17%. When intake was classified into quartiles, there was good agreement between the two methods: 43%-100% for calories; 29%-86% for other nutrients for unadjusted intake; 29%-71% for nutrients after energy adjustment. On calculation of intake after re-administration of the food frequency questionnaire, there was a moderate to strong correlation (energy adjusted r=0.49-0.90) between the two evaluations for various nutrients. CONCLUSION: The food frequency questionnaire developed for the assessment of nutrient intake in a north Indian population was easy to administer, showed moderate to good correlation with the 5-day diet record and was reproducible.

A new dimension of 1H-NMR spectroscopy in assessment of liver graft dysfunction.

High-resolution 1H-NMR spectroscopy of serum and urine samples of an 11-year-old male living related orthotopic liver transplant recipient is reported. Serum glutamine increased to abnormal levels along with simultaneous abnormal excretion of urinary glutamine post-transplantation. High levels of glutamine in both blood and urine and concomitant reduced urea levels in urine were found to be evidence of impairment in urea cycle and compatible with persistently abnormal graft function. Thus glutamine levels in serum and urine, and urea in the urine as observed by 1H-NMR spectroscopy highlight their important roles in monitoring liver graft function; increased glutamine levels lead to brain damage, if untreated.