Use of propofol as an induction agent in the acutely injured patient.

PURPOSE: Etomidate is a commonly used agent for rapid sequence induction (RSI) in trauma due to its limited hemodynamic effects. Given a recent nationwide shortage of etomidate, alternative induction agents may be required. Propofol is a frequent substitute; however, concern exists regarding its potential hypotensive effects. The study attempts to determine the hemodynamic effects of propofol and etomidate following RSI in trauma bay. METHODS: A retrospective study was performed on 76 consecutive trauma patients requiring RSI at a single academic medical center. Patients were stratified by age, gender, mechanism of injury, Injury Severity Score (ISS), and Glasgow Coma Scale (GCS). Pre-induction and post-induction hemodynamic parameters were evaluated, and a multivariate regression analysis was performed. RESULTS: The mean age was 42, ISS was 13, and GCS was 9.8. The mean dose of propofol was 127 ± 5 mg and the mean dose of etomidate was 21 ± 6 mg. Patients who received propofol were younger and had a lower ISS. The etomidate group had significantly increased post-induction systolic blood pressure but no difference in mean arterial pressure or heart rate when compared to pre-induction parameters. The propofol group had no significant changes in any post-induction parameter compared to pre-induction parameter. CONCLUSION: RSI with propofol did not result in hypotension in our patient population, suggesting that a reduced dose of propofol may represent a reasonable alternative to etomidate in hemodynamically stable trauma patient. Further research is warranted to assess the safety of propofol in the acutely injured patient.

Y-STR haplotypes from eight south Indian groups based on five loci.

Five Y-chromosome short tandem repeat (STR) loci (DYS389I, DYS389II, DYS390, DYS391, and DYS393) were typed in 81 males from seven tribal populations of south India, including 30 Koragas, 23 Yeravas, 5 Mullukurunan, 2 Mullukurumba, 4 Paniya, 3 Kuruchian and 3 Bettakurumba; and 11 south Indian caste individuals of mixed origins.

Independent origins of Indian caste and tribal paternal lineages.

The origins of the nearly one billion people inhabiting the Indian subcontinent and following the customs of the Hindu caste system are controversial: are they largely derived from Indian local populations (i.e. tribal groups) or from recent immigrants to India? Archaeological and linguistic evidence support the latter hypothesis, whereas recent genetic data seem to favor the former hypothesis. Here, we analyze the most extensive dataset of Indian caste and tribal Y chromosomes to date. We find that caste and tribal groups differ significantly in their haplogroup frequency distributions; caste groups are homogeneous for Y chromosome variation and more closely related to each other and to central Asian groups than to Indian tribal or any other Eurasian groups. We conclude that paternal lineages of Indian caste groups are primarily descended from Indo-European speakers who migrated from central Asia approximately 3,500 years ago. Conversely, paternal lineages of tribal groups are predominantly derived from the original Indian gene pool. We also provide evidence for bidirectional male gene flow between caste and tribal groups. In comparison, caste and tribal groups are homogeneous with respect to mitochondrial DNA variation, which may reflect the sociocultural characteristics of the Indian caste society.

Mitochondrial DNA analysis reveals diverse histories of tribal populations from India.

We analyzed 370 bp of the first hypervariable region of the mitochondrial DNA (mtDNA) control region in 752 individuals from 17 tribal and four nontribal groups from the Indian subcontinent, to address questions concerning the origins, genetic structure and relationships of these groups. Southern Indian tribes showed reduced diversity and large genetic distances, both among themselves and when compared with other groups, and no signal of prehistoric demographic expansions. These results probably reflect enhanced genetic drift because of small population sizes and/or bottlenecks in these groups. By contrast, northern groups exhibited more diversity and signals of prehistoric demographic expansions. Phylogenetic analyses revealed that southern and northern groups (except northeastern ones) have related mtDNA sequences albeit at different frequencies, further supporting the larger impact of drift on the genetic structure of southern groups. The Indian mtDNA gene pool appears to be more closely related to the east Eurasian gene pool (including central, east and southeast Asian populations) than the west Eurasian one (including European and Caucasian populations). Within India, northeastern tribes are quite distinct from other groups; they are more closely related to east Asians than to other Indians. This is consistent with linguistic evidence in that these populations speak Tibeto-Burman languages of east Asian origin. Otherwise, analyses of molecular variance suggested that caste and tribal groups are genetically similar with respect to mtDNA variation.

The 9-bp deletion between the mitochondrial lysine tRNA and COII genes in tribal populations of India.

A 9-base-pair (bp) deletion located between the lysine tRNA (MTTK) and COII (MTCOX*2) genes in the human mitochondrial genome is a valuable marker for tracing population relationships. Previous research has shown that the 9-bp deletion is associated with two major clusters of control region sequences; one occurs in sub-Saharan Africa, while the other is associated with Asian populations and populations of Asian origin. We surveyed 898 individuals from 16 tribal populations in India and found 6 individuals with the 9-bp deletion. Sequences of the first hypervariable segment (HV1) of the mtDNA control region from these 9-bp deletion-bearing mtDNAs were compared to those previously reported from Asian and African populations. Phylogenetic analysis indicates three distinct clusters of tribal Indian 9-bp deletion mtDNA types. One cluster, found in northeast India, includes southeast Asian and Indonesian mtDNA types. The remaining two clusters appear to have unique origins in southern India. These data provide further evidence of past migrations from Asia into the northeast corner of the Indian subcontinent.

Population structure of the Chenchu and other south Indian tribal groups: relationships between genetic, anthropometric, dermatoglyphic, geographic, and linguistic distances.

We describe the genetic structure and interrelationships of nine south Indian tribal groups (seven from Andhra Pradesh and two from the adjoining states of Tamil Nadu and Kerala) using seven polymorphic loci (ABO, MN, RH, PGM, ACP, PGD, and LDH). R matrix analysis indicates that the Andhra Pradesh tribes are clustered and that the Kadar and Irula are genetically isolated from them. This dispersion of populations has been explained by the combination of relatively high frequencies of the alleles RH D and MN M in the Kadar and the relatively high proportions of the allele PGM*2 in the Irula. The Mahaboobnagar Chenchu subgroup is isolated from other Telugu-speaking groups because of high frequencies of the PGM*1 and ACP*A alleles. The regression of mean per locus heterozygosity (H) on distance from the gene frequency centroid (rii) reveals considerable levels of external gene flow among the Lambadi, the Yerukula, and the two Chenchu subgroups and more homogeneity in the Kolam, Koya, Yanadi, Irula, and Kadar. Mantel statistics were used to assess the relative effects of nonbiological processes (i.e., language and geography) on the morphological and genetic patterns of these subdivided populations. The significance of correlations was determined between different data sets (genetic, dermatoglyphic, anthropometric, geographic, and linguistic) at three levels involving nine, six, and five populations. Although multiple correlation analysis reveals significant combined effects of geography and language on genetics, anthropometrics, and dermatoglyphics, highly significant partial correlations suggest strong effects of geography on both anthropometry and genetics. Our analysis indicates that geographic factors have an overwhelming effect on the genetic differentiation of the south Indian tribal groups.