Dragon fruit (Hylocereus undatus) peel as antioxidant dietary fibre on quality and lipid oxidation of chicken nuggets.

In this study, the efficacy of dragon fruit peel (DFP) powder as antioxidant dietary fibre (ADF), at two different concentrations (T1-1.5% and T2-3.0%), on quality improvement and susceptibility to lipid oxidation of chicken nuggets during 20 days of refrigerated storage was assessed. DFP, rich in dietary fibre (56.91%) with higher insoluble dietary fibre, phenolics (36-39 mgGAE/100 g) content and possessing good radical scavenging activity as well as reducing power, contained 10.36% protein, 4.48% fat and 2.34% ash. HPLC analysis revealed presence of high concentrations of gallic and ferulic acid, among the phenolics. Incorporation of DFP in nuggets although decreased the pH but improved emulsion stability as well as cooking yield and had higher protein, ash and lower fat content. Further, the treated nuggets had significantly (p < 0.05) higher dietary fibre and total phenolics content than control. Incorporation of DFP decreased the hardness, gumminess and chewiness and improved (p < 0.05) the products' redness values. Sensory evaluation of the products revealed significant improvement in the appearance score and non-significant (p > 0.05) increase in the scores of other attributes compared to control samples. DFP significantly decreased lipid peroxidation, odour scores and microbial load in chicken nuggets during 20 days of storage period. From the study, it could be deduced that DFP rich in bioactive components had positive influence on the nutritional quality of chicken nuggets and could also be used as ADF in muscle food without affecting the quality and acceptability of products.

Planning of births and maternal, child health, and nutritional outcomes: recent evidence from India.

OBJECTIVES: In an effort to provide recommendation for maximizing synergy between maternal, infant, and young children's nutrition and family planning in India, this study makes a comprehensive assessment of the effects of the planning of births in terms of timing, spacing and limiting childbearing on maternal and child health outcomes. STUDY DESIGN: This study used the latest National Family Health Survey data of India that is globally known as the Demographic and Health Survey. A robust two-stage systematic random sampling was used for selecting representative samples for measuring demographic and health indicators. METHODS: Maternal and child health outcomes are measured by body mass index (grouped as normal, underweight, and overweight) and anemia for mothers, and stunting, underweight, anemia, and under-five mortality for the children. Logistic regression and Cox proportional hazard models were applied. RESULTS: Women with a higher number of births and among those with first-order births with fewer than 2 years between marriage and first birth, the risk of being underweight and having anemia was significantly higher compared with their counterparts. In addition, the probability of being underweight and risk of stunting, anemia, and mortality was higher among the children from women with a higher number of births and with fewer than 3 years of spacing between births than that of their counterparts. CONCLUSIONS: The findings from this study support the importance of birth planning in improving maternal, child health, and nutritional outcomes. The proper planning of births could help to achieve the Sustainable Development Goal-3 of good health and well-being for all by 2030 in India, where a significant proportion of women still participate in early marriages, early childbearing, and a large number of births with close spacing.

Changes in expression of monocarboxylate transporters, heat shock proteins and meat quality of Large White Yorkshire and Ghungroo pigs during hot summer period.

OBJECTIVE: Present study explores the effect of hot summer period on the glycolytic rate of early post-mortem meat quality of Ghungroo and Large White Yorkshire (LWY) pig and comparative adaptability to high temperature between above breeds by shifting the expression of stress related genes like mono-carboxylate transporters (MCTs) and heat shock proteins (HSPs). METHODS: Healthy pigs of two different breeds, viz., LYW and Ghungroo (20 from each) were maintained during hot summer period (May to June) with a mean temperature of about 38°C. The pigs were slaughtered and meat samples from the longissimus dorsi (LD) muscles were analyzed for pH, glycogen and lactate content and mRNA expression. Following 24 h of chilling, LD muscle was also taken from the carcasses to evaluate protein solubility and different meat quality measurements. RESULTS: LWY exhibited significantly (p<0.01) higher plasma cortisol and lactate dehydrogenase concentration than Ghungroo indicating their higher sensitivity to high temperature. LD muscle from LWY pigs revealed lower initial and ultimate pH values and higher drip loss compared to Ghungroo, indicating a faster rate of pH fall. LD muscle of Ghungroo had significantly lower lactate content at 45 min postmortem indicating normal postmortem glycolysis and much slower glycolytic rate at early postmortem. LD muscle of LWY showed rapid postmortem glycolysis, higher drip loss and higher degrees of protein denaturation. Ghungroo exhibited slightly better water holding capacity, lower cooking loss and higher protein solubility. All HSPs (HSP27, HSP70, and HSP90) and MCTs (MCT1, MCT2, and MCT4) in the LD muscle of pigs inclined to increase more in Ghungroo than LWY when exposed to high temperature. CONCLUSION: Effect of high temperature on the variation of HSPs and MCTs may play a crucial role in thermal tolerance and adaptation to different climatic conditions, pH regulation, muscle acidification, drip loss, protein denaturation and also in postmortem meat quality development.

Gamma knife capsulotomy for intractable OCD: Neuroimage analysis of lesion size, location, and clinical response.

Obsessive-compulsive disorder (OCD) affects 2-3% of the population. One-third of patients are poorly responsive to conventional therapies, and for a subgroup, gamma knife capsulotomy (GKC) is an option. We examined lesion characteristics in patients previously treated with GKC through well-established programs in Providence, RI (Butler Hospital/Rhode Island Hospital/Alpert Medical School of Brown University) and São Paulo, Brazil (University of São Paolo). Lesions were traced on T1 images from 26 patients who had received GKC targeting the ventral half of the anterior limb of the internal capsule (ALIC), and the masks were transformed into MNI space. Voxel-wise lesion-symptom mapping was performed to assess the influence of lesion location on Y-BOCS ratings. General linear models were built to compare the relationship between lesion size/location along different axes of the ALIC and above or below-average change in Y-BOCS ratings. Sixty-nine percent of this sample were full responders (≥35% improvement in OCD). Lesion occurrence anywhere within the targeted region was associated with clinical improvement, but modeling results demonstrated that lesions occurring posteriorly (closer to the anterior commissure) and dorsally (closer to the mid-ALIC) were associated with the greatest Y-BOCS reduction. No association was found between Y-BOCS reduction and overall lesion volume. GKC remains an effective treatment for refractory OCD. Our data suggest that continuing to target the bottom half of the ALIC in the coronal plane is likely to provide the dorsal-ventral height required to achieve optimal outcomes, as it will cover the white matter pathways relevant to change. Further analysis of individual variability will be essential for improving targeting and clinical outcomes, and potentially further reducing the lesion size necessary for beneficial outcomes.

The current practice for cocaine-associated chest pain in the Netherlands.

INTRODUCTION: Cocaine is considered a cardiovascular risk factor, yet it is not included in the frequently used risk stratification scores. Moreover, many guidelines provide limited advice on how to diagnose and treat cocaine-associated chest pain (CACP). This study aimed to determine the current practice for CACP patients in emergency departments and coronary care units throughout the Netherlands. METHODS: An anonymous online questionnaire-based survey was conducted among Dutch emergency physicians and cardiologists between July 2015 and February 2016. The questionnaire was based on the American Heart Association CACP treatment algorithm. RESULTS: A total of 214 subjects were enrolled and completed the questionnaire. All responders considered cocaine use a risk factor for developing acute coronary syndrome (ACS), nevertheless 74.4 % of emergency physicians and 81.1 % of cardiologists do not always question chest pain patients about drug use. Of all responders, 73.6 % never perform toxicology screening. Most responders (60 %) observe patients with CACP according to the European Society of Cardiology ACS guideline, and 24.3 % give these patients ß-blockers. CONCLUSION: The current practice for CACP patients in most emergency departments and coronary care units in the Netherlands is not in line with the AHA scientific statement. Emergency physicians and cardiologists should be advised to routinely question all chest pain patients on drug history and be aware that the risk stratifications scores are not validated for CACP. Despite the AHA scientific statement of 2008, many respondents utilize ß-blockers for CACP patients, which is supported by published evidence since the statement appeared.

Parenteral immunization of fish, Labeo rohita with Poly D, L-lactide-co-glycolic acid (PLGA) encapsulated antigen microparticles promotes innate and adaptive immune responses.

Immunogenicity of different antigen preparations of outer membrane proteins (OMP) of Aeromonas hydrophila such as Poly d, l-lactide-co-glycolic acid (PLGA) microparticles, oil emulsion, neat OMP and bacterial whole cells were compared through intra-peritoneal injection in fish, Labeo rohita. Among these preparations, PLGA encapsulated antigen stimulated both innate and adaptive immune parameters and the immunogenicity exhibited by PLGA microparticles was significantly higher (p < 0.05) at both 21 and 42 days post-immunization suggesting that the above delivery system would be a novel antigen carrier for parenteral immunization in fish, Labeo rohita.

Knowledge of human monkeypox viral infection among general practitioners: a cross-sectional study in Indonesia.

After the first, imported, laboratory-confirmed case of monkeypox in human was reported in Singapore on May 2019, countries in Asia started to strengthen disease surveillance systems. One challenge in preventing monkeypox is a lack of knowledge, particularly among healthcare workers. The aim of this study was to assess the knowledge of monkeypox among general practitioners (GPs) in Indonesia. A cross-sectional online survey was conducted. The survey collected participants' knowledge on a 21-item scale and explanatory variables. A two-step logistic regression analysis was employed to assess the predictors of knowledge of monkeypox. A total of 432 GPs were included; 10.0% and 36.5% of them had a good knowledge using an 80% and 70% cutoff point for knowledge domain, respectively. No explanatory variables were associated with knowledge when using 80% cutoff point. Using the lower cutoff, there was lower knowledge among GPs who graduated from universities located in Sumatra or other islands versus Java (adjusted odds ratio (aOR): 0.53; 95%CI: 0.28-0.97, p = 0.041) and among those were older than 30 years compared to younger GPs (aOR: 0.61; 95%CI: 0.39-0.96, p = 0.033). GPs working in private clinics had less knowledge compared to GPs in community health centers (aOR: 0.55; 95%CI: 0.31-0.99, p = 0.047). In conclusion, knowledge of monkeypox among GPs in Indonesia is relatively low in all groups. Increasing knowledge of monkeypox will be key to improving the capacity of GPs to respond to human monkeypox cases and to report into a disease surveillance system.

Confidence in managing human monkeypox cases in Asia: A cross-sectional survey among general practitioners in Indonesia.

The current re-emergence of human monkeypox (HMPX) is a global concern for endemic and non-endemic countries, but healthcare workers in some regions, like Asia, have less experience with identifying and treating HMPX cases. This study aimed to assess the confidence and its predictors in HMPX case management among general practitioners (GPs), the frontline doctors in Indonesia, and to explore their perspectives on HMPX. Between May and July 2019, GPs in Indonesia completed an online-based survey. The questionnaire collected information on GPs' confidence, perspective, sociodemographic, workplace and professional characteristics, exposure to HMPX information and knowledge on HMPX. A logistic regression analysis was employed to explore the explanatory variables influencing the confidence and the perspective. We included 395 GPs in our analysis (77.4% out of 510 responses received) of which 10.1% and 34.9% were classified having good confidence using an 80% and 70% cut-off for confidence score, respectively. In the adjusted analysis, receiving information about HMPX during medical training was the only variable significantly associated with good confidence (adjusted odds ratio 2.74, 95% confidence interval 1.57 to 4.78 and p < 0.001). Approximately 73.6% and 77.9% of GPs agreed that HMPX is an important infectious disease and it has potential to detrimentally impact the Indonesian economy, respectively. In addition, 88.8% of GPs suggested that the disease should be incorporated into the National Medical Curriculum of Indonesia. In conclusion, in case of HMPX outbreak, majority of the GPs in Indonesia seem to be less confident in diagnosing and treating cases, using their current knowledge, skills and their workplace facilities. Therefore, a systematic strategy to improve their confidence in managing HMPX is required.

Acceptance and willingness to pay for a hypothetical vaccine against monkeypox viral infection among frontline physicians: A cross-sectional study in Indonesia.

BACKGROUND: A clinical trial is ongoing to evaluate the safety and efficacy of a monkeypox vaccine among healthcare workers (HCWs). The critical question that needs to be addressed is whether HCWs are willing to accept and purchase this vaccine. The objective of this study was to evaluate the acceptance and willingness to pay (WTP) for the vaccine among HCWs. METHODS: From May to July 2019, a cross-sectional study was conducted among registered general practitioners (GPs) in Indonesia. A contingent valuation method was employed to evaluate the WTP. Besides acceptance and WTP, various explanatory variables were also collected and assessed. A logistic regression and a multivariable linear regression were used to explore the explanatory variables influencing acceptance and WTP, respectively. RESULTS: Among 407 respondents, 391 (96.0%) expressed acceptance of a free vaccination. The mean and median WTP was US$ 37.0(95%CI:US$ 32.76-US$ 41.23) and US$ 17.90(95%CI:US$ 17.90-US$ 17.90), respectively. In an unadjusted analysis, those 30 years old or younger had 2.94 times greater odds of vaccine acceptance compared to those who were older (95%CI: 1.07-8.08). Location of alma mater, type of workplace, length of individual medical experience, and monthly income of GPs were all significantly associated with WTP. CONCLUSION: Although the vast majority of GPs would accept a freely provided vaccine, they were also somewhat price sensitive. This finding indicates that partial subsidy maybe required to achieve high vaccine coverage, particularly among GPs at community health centres or those with a shorter duration of medical practice.

Physicians' willingness to be vaccinated with a smallpox vaccine to prevent monkeypox viral infection: A cross-sectional study in Indonesia.

Background: Although there is no licensed vaccine for monkeypox, smallpox vaccine has been shown to be 85% effective in preventing the monkeypox. This study was conducted to assess the willingness of frontline healthcare providers to be vaccinated with smallpox vaccine to prevent monkeypox. Methods: A cross-sectional study was conducted in Indonesia. The willingness was assessed under two scenarios: fully subsidized and non-subsidized vaccine. Explanatory variables such as sociodemographic profile, workplace and professional characteristics, and knowledge of monkeypox were collected. A logistic regression assessed the influence of these explanatory variables on participants' willingness. Results: Out of 510 received participants' responses, 407 (79.8%) were analyzed. With a fully subsidized vaccine scenario, 381 (93.6%) of the participants were willing to be vaccinated and in an unadjusted analysis, gender, education, monthly income, and type of workplace were associated with willingness. With a non-subsidized vaccine (i.e. the vaccine price was US$ 17.9), the proportion who were willing to be vaccinated decreased to 71.9%. In adjusted analyses for both scenarios, gender was the only independent predictor for willingness; men were less willing to be vaccinated than women, adjusted odds ratio (aOR): 0.37; 95% confidence interval (CI): 0.16, 0.87 and aOR: 0.42; 95%CI: 0.27, 0.67, respectively for subsidized and non-subsidized scenario. Conclusion: Vaccine price and gender are important factors for physicians' willingness to be vaccinated for smallpox vaccine prevent monkeypox in Indonesia. These findings indicate that achieving high vaccine converge may require partially or fully subsidized vaccines, along with a clear guideline and recommendation from authorities.

Trends of greenhouse gas emissions from the road transport sector in India.

The road transport sector is the largest consumer of commercial fuel energy within the transportation system in India and accounts for nearly 35% of the total liquid commercial fuel consumption by all sectors. Gasoline and diesel consumption for road transportation have quadrupled between 1980 and 2000 due to about nine times increase in the number of vehicles and four-fold increase in freight and passenger travel demands. The paper elaborates the trends of energy consumption and consequent emissions of greenhouse gases such as CO(2), CH(4) and N(2)O and ozone precursor gases like CO, NO(x) and NMVOC in the road transport sector in India for the period from 1980 to 2000. For the first time, efforts have been made to apportion the fuels, both diesel and gasoline, across different categories of vehicles operating on the Indian roads. In order to generate more comprehensive and complete emission estimates, additionally, other minor fuel types like light diesel oil and fuel oil along with lubricants have also been taken into account. Emission estimates have revealed that nearly 27 Mt of CO(2) were emitted in 1980, increasing to about 105 Mt in 2000. Similar trends have also been observed for other gases. Further scope for improvements in emission estimation is possible by generating country specific emission factors for different vehicle categories and improvement in documentation of fuel consumption at segregated levels by fuel types and vehicle types.

Awareness and Practices Relating to Zoonotic Diseases Among Smallholder Farmers in Nepal.

Increasing livestock production to meet growing demands has resulted in greater interactions at the livestock-wildlife-human interface and more opportunities for zoonotic disease spread. Zoonoses impose enormous burdens on low-income countries like Nepal, where populations are largely dependent on livestock production and access to shared grazing lands, often near protected areas, due to population pressures. Several livestock-associated zoonoses have been reported in Nepal; however, little is known regarding Nepali farmers' knowledge of zoonoses and opportunities for disease management. We conducted a cross-sectional study to investigate Nepali farmers' awareness of zoonoses, assess current health challenges, and evaluate disease prevention and control practices. We found that awareness of zoonotic pathogens was limited, especially in informally educated and illiterate farmers; the majority of which were women. Further, farmers' preventive herd health, food safety, and sanitation practices were not associated with their awareness. Several farmers reported high-risk practices despite being aware of zoonotic diseases, suggesting a disconnect between the farmers' awareness and practice. Our study highlights the need for improving Nepali farmers' knowledge of zoonoses and disease prevention measures. Closing these awareness-practice gaps will require an improved understanding of risk and effective drivers of behavior change, alongside engagement of farmers in development of zoonotic disease prevention programs that encourage participation of both male and female farmers across all levels of education.

Molecular signature of extended spectrum ß-lactamase producing Klebsiella pneumoniae isolated from bovine milk in eastern and north-eastern India.

The present study reports on 23 extended spectrum ß-lactamase producing Klebsiella pneumoniae (KP), isolated from milk samples (n=340) of healthy cows (n=129) and cows with subclinical (n=159) and clinical (n=52) mastitis, from three different states of India viz. West Bengal, Jharkhand and Mizoram. Seven of them were AmpC type ß-lactamase producers, as well. The ESBL producing KP were significantly (P=0.006, χ2=10.04, df=2) and more frequently detected in milk samples of mastitic cows than healthy ones. The ß-lactamase genes - blaCTX-M, blaTEM and blaSHV were detected in 19, 8 and 3 isolates, respectively. In all but one CTX-M positive isolates, the genetic platform - ISEcp1-blaCTX-M-orf477 was detected. Ten of the isolates carried plasmid mediated quinolone resistance gene - qnrS and 1 isolate possessed qnrB. Again 11 of them were found to have sulfonamide resistance gene - sul1 and 12 possessed class I integron. Sequencing of the class 1 integron revealed the presence of dfrA12/dfrA17 and aadA2/aadA5 gene cassettes conferring resistance to trimethoprim and aminoglycosides, respectively. All the isolates, characterized by enterobacterial repetitive intergenic consensus (ERIC) PCR, yielded distinct fingerprinting profile. However, most of the isolates from Jharkhand were clustered along with two isolates each from West Bengal and Mizoram indicating their clonal relatedness even though isolated from geographically different areas. Isolation of ESBL producing KP from bovine milk samples implies its public health significance; as such pathogens may enter the human food chain causing severe health hazards.

Docosahexaenoic acid-containing phosphatidylcholine affects the binding of monoclonal antibodies to purified Kb reconstituted into liposomes.

Class I major histocompatibility complex (MHC I) molecules are transmembrane proteins that bind and present peptides to T-cell antigen receptors. The role of membrane lipids in controlling MHC I structure and function is not understood, although membrane lipid composition influences cell surface expression of MHC I. We reconstituted liposomes with purified MHC I (Kb) and probed the effect of lipid composition on MHC I structure (monoclonal anti-MHC I antibody binding). Four phospholipids were compared; each had a phosphocholine head group, stearic acid in the sn-1 position, and either oleic, alpha-linolenic, arachidonic, or docosahexaenoic acid (DHA) in the sn-2 position. The greatest binding of monoclonal antibody AF6-88.5, which detects a conformationally sensitive epitope in the extracellular region of the MHC I alpha-chain, was achieved with DHA-containing proteoliposomes. Other epitopes (CTKb, 5041.16.1) showed some sensitivity to lipid composition. The addition of beta2-microglobulin, which associates non-covalently with the alpha-chain and prevents alpha-chain aggregation, did not equalize antibody binding to proteoliposomes of different lipid composition, suggesting that free alpha-chain aggregation was not responsible for disparate antibody binding. Thus, DHA-containing membrane lipids may facilitate conformational change in the extracellular domains of the alpha-chain, thereby modulating MHC I function through effects on that protein's structure.

Effects of lithium on cortical thickness and hippocampal subfield volumes in psychotic bipolar disorder.

Relative to healthy controls, lithium free bipolar patients exhibit significant gray matter abnormalities. Lithium, the long-time reference standard medication treatment for bipolar disorder, has been proposed to be neuro-protective against these abnormalities. However, its effects on cortical thickness and hippocampal subfield (HSF) volumes remain unstudied and unclear, respectively, in bipolar disorder. This study included 342 healthy controls (HC), 51 lithium free PBD patients (NoLi), and 51 PBD patients taking lithium (Li). Regional gray matter thickness and HSF volume values were extracted from 3T MRI images. After matching NoLi and Li samples, regions where HC differed from either Li or NoLi were identified. In regions of significant or trending HC-NoLi difference, Li-NoLi comparisons were made. No significant HC-Li thickness or HSF volume differences were found. Significantly thinner occipital cortices were observed in NoLi compared to HC. In these regions, Li consistently exhibited non-significant trends for greater cortical thickness relative to NoLi. Significantly less volume was observed in NoLi compared to both HC and Li in right HSFs. Our results suggest that PBD in patients not treated with Li is associated with thinner occipital cortices and reduced HSF volumes compared with HC. Patients treated with Li exhibited significantly larger HSF volumes than NoLi, and those treated with Li were no different from HC in cortical thickness or hippocampal volumes. This evidence directly supports the hypothesis that Li may counteract the locally thinner and smaller gray matter structure found in PBD.

A comparative study on the expression profile of MCTs and HSPs in Ghungroo and Large White Yorkshire breeds of pigs during different seasons.

Thermal stress has a significant adverse effect on commercial swine production but it is not easy to measure. Animals may adapt to stress conditions by an alteration in the expression of stress-related genes such as heat shock proteins (HSPs) and monocarboxylate transporters (MCTs). The present study presents a comparative analysis of seasonally varied effects on the expression profiles of HSPs (27, 70, and 90) and MCTs (1, 2, and 4) transcripts in thigh muscle and colon tissue of Ghungroo and Large White Yorkshire (LWY) breeds of pig. By real-time polymerase chain reaction, the mRNA expression of HSP27 and HSP90 genes was found to be higher in both thigh muscle and colon tissue in Ghungroo compared to Large White Yorkshire pigs during the summer. However, the relative expression of HSP70 was significantly higher (P < 0.01) in Ghungroo compared to Large White Yorkshire pigs during both seasons in both thigh muscle and colon tissue. The expression of HSP90 was higher in Ghungroo when compared to LWY though the variation was non-significant (P > 0.05) in the colon during different seasons. However, in Ghungroo, the mRNA expression of MCT1 was found to be significantly (P < 0.05) higher in thigh muscle and colon regions during the summer compared to LWY, whereas MCT2 was expressed more in the colon in LWY compared to Ghungroo during the summer. The relative expression of mRNA of MCT4 was found to be significantly (P < 0.05) higher in thigh region in both summer and winter in Ghungroo compared with LWY. Thus, the study demonstrated that both HSPs and MCTs gene expression during thermal stress suggests the possible involvement of these genes in reducing the deleterious effect of thermal stress, thus maintaining cellular integrity and homeostasis in pigs. These genes could be used as suitable markers for the assessment of stress in pigs.

Hepatopathy in complicated falciparum malaria: report from eastern India.

A prospective study done in 216 children with complicated falciparum malaria showed hepatopathy in 33.3% of cases with a higher incidence in children aged above five years. Bilirubin and alanine aminotransferase were moderately raised in most cases. No significant association with other common complications and no higher risk of mortality was observed.

Severe falciparum malaria.

Falciparum malaria affect all ages with multiple-systemic complications which varies in different age group. We studied 242 children with complicated Falciparum malaria with a median age of 6.5 years to look for occurrence of different complications in younger and older age groups and overall mortality picture. Unarousable coma (40.5%), severe anemia (26.03%), repeated seizures (46.2%) and hepatopathy (32.2%) were commonest complications. Under five children had higher risk of development of cerebral malaria (P<0.01), severe anemia (P<0.05) and seizures (P<0.001); whereas above five children had higher risk of acute renal failure (P<0.05) and malarial hepatopathy (P<0.02). Over all mortality was 9.9%, cerebral malaria being the commonest cause (6.6%). Multi-system involvement was seen in 58.4% cases of death. Children having pulmonary edema, shock and cerebral malaria had high case fatality rate.

Immediate effect of tobacco chewing in the form of 'paan' on certain cardio-respiratory parameters.

Immediate effect of tobacco in the form of chewing was evaluated in 40 healthy males (mean age 26.27 yrs.) not habituated to tobacco, who were given paan containing 200 mg of tobacco to chew (group T). Heart rate (HR), blood pressure (BP), forced vital capacity (FVC), FEV1 and peak expiratory flow rate (PEFR) were measured twice for each subject, once before chewing and again immediately after completion of chewing. Another 24 age and sex matched controls (group C) were given paan without tobacco to chew and cardiorespiratory parameters were recorded as for group T subjects. Electrocardiography was recorded in 10 group T and 10 group C subjects. Effect of tobacco chewing was also evaluated in 10 habitual tobacco chewers. Results showed statistically significant increments in HR and BP as well as a decline in T wave amplitude in ECG following tobacco chewing (group T subjects). The changes in HR and BP lasted for 15-30 mins, as observed in 10 of group T subjects. The FVC, FEV1 and PEFR showed marginal, though non-significant, increments after tobacco chewing. No significant difference in the cardiorespiratory responses to tobacco chewing could be seen between habitual and nonhabitual (group T) tobacco chewers. The changes in cardiovascular and respiratory parameters following paan (without tobacco) chewing in the control subjects were negligible and nonsignificant.

FEF200-1200, FEF25-75% and FEF75-85% in non-smokers of either sex and in male smokers residing at an altitude of 2150 M above MSL in Himachal Pradesh.

Forced expiratory flow (FEF) rates were determined for 170 (130 males and 40 females) healthy adults of Himachal Pradesh in the age group of 19-26 years for males and 19-22 years for females. The subjects had been staying at an altitude of 2150 M above mean sea level (MSL) for at least three years prior to the conduct of the study. FEF200-1200, FEF25-75% and FEF75-85% were found to be high as compared to those reported from most other parts of the country. The results were found comparable with those reported from certain populations in U.S.A. Further, the flow rates of the non-smoker males were compared with those of the male smokers. FEF75-85% in smokers was significantly less than that of non-smokers, whereas the differences in FEF200-1200 and FEF25-75% were found to be nonsignificant.