The prevalence of behavioral disorders among children under parental care and out of parental care: A comparative study in India.

BACKGROUND: Children may suffer from a wide range of behavioral problems, but children living under conditions of perpetual stress and trauma and experiencing breakdown of family structures are tremendously affected. This study was adopted to identify the prevalence of behavioral disorders among children under parental care and out of parental care. METHODS: A cross-sectional comparative descriptive study was conducted among 300 children of age 6-12 years from a pediatric outpatient department of a selected hospital and 300 children from selected orphanages in Kolkata to compare the prevalence of behavioral disorders in children under parental care and out of parental care using Strengths and Difficulties Questionnaire (SDQ). RESULTS: Total difficulty was more prevalent in children out of parental care (220 children) than in children under parental care (128 children). Conduct problem was the most prevalent behavioral disorder among all the subscales of SDQ with 48.70% and 84.30% of children, respectively. This was followed by peer problem (44.60% and 48.30%), emotional problem (33.70% and 55.60%), and hyperactivity problem (26.70% and 32.30%), respectively. There was significant difference in total difficulty, all subscales, externalizing score, internalizing score, and impact score between the two groups. Regression analysis showed significant relationship of selected variables such as the child's favorite hobbies and number of close friends the child has using total difficulty score in both the groups. Significant correlation was found among subscales in both the groups. CONCLUSION: Family-based care and improvised institutional care should be emphasized to reduce the burden of behavioral problem in children.

Profile of pediatric dengue cases from a tertiary care hospital in Kolkata.

A study was conducted on the 52 serologically positive cases of dengue, admitted to the Dept. of Paediatrics, R.G. Kar Medical College & Hospital, from an outbreak in Kolkata. The most unusual feature observed in this study was that the rash in some cases was urticarial and intensely pruritic. The shock appeared early in the course of the disease and it was less commonly associated with bleeding (22%). One out of three dengue cases was a severe disease. It was not possible to predict a severe disease from the early symptomatology.

The effects of estrogen and progesterone on corticotropin-releasing hormone and arginine vasopressin messenger ribonucleic acid levels in the paraventricular nucleus and supraoptic nucleus of the rhesus monkey.

Ovarian steroids increase hypothalamic-pituitary-adrenal (HPA) axis activity and sensitize the hypothalamic-pituitary-ovarian (HPO) axis to stress-induced inhibition. The present study investigated the effect of ovarian steroids on CRH and arginine vasopressin (AVP) messenger RNA (mRNA) levels in the rhesus monkey hypothalamus, as both neuropeptides have been shown to stimulate the HPA axis and inhibit the HPO axis in this species. This was accomplished by measuring CRH and AVP mRNA in the paraventricular nucleus (PVN) and supraoptic nucleus (SON) by in situ hybridization histochemistry. Menstrual cycles were simulated in ovariectomized (OVX) rhesus monkeys by sequential addition and removal of SILASTIC brand (Dow Corning Corp.) tubing containing either 17beta-estradiol (E2) or progesterone (P4). On the morning of day 11 of the simulated follicular phase (E2 alone) or day 21 of the luteal phase (E2 + P4), animals were anesthetized, and the brains were perfused with paraformaldehyde via the carotid artery. Coronal sections (30 microm) were cut, and mRNA for CRH and AVP in the paraventricular nucleus (PVN) and supraoptic nucleus (SON) were semiquantified by in situ hybridization. CRH mRNA in the PVN of E2-replaced OVX animals (n = 7) was 2-fold greater than that in untreated OVX controls (n = 4), whereas CRH mRNA after E2 + P4 (n = 4) was no different from that in controls (optical density + SEM, 0.38 +/- 0.06, 0.13 +/- 0.08, and 0.14 +/- 0.09 for OVX + E2, OVX + E2 + P4, and OVX, respectively; P = 0.02). CRH in the SON was undetectable. In contrast to CRH, AVP mRNA in the PVN and the SON was similar in the three treatment groups. We conclude that E2 and E2 + P4 replacement to OVX monkeys exert different effects on CRH and AVP gene expression, as estrogen stimulation of CRH mRNA in the PVN was abrogated by progesterone, whereas no effect of ovarian steroids on AVP mRNA in either the PVN or SON was observed. We postulate that ovarian steroid regulation of CRH synthesis and release may in part explain the central nervous system mechanisms by which ovarian steroids affect the HPA and HPO axes during basal and stress conditions.

Effect of 5-aminolevulinic acid dose and estrogen on protoporphyrin IX concentrations in the rat uterus.

OBJECTIVES: To determine the in vivo dose-response relation between administered 5-aminolevulinic acid (ALA) and the concentration of protoporphyrin IX (PpIX) produced in rat uterine tissue, to determine the effect of estrogen on ALA-induced PpIX production in the rat endometrium and myometrium, and to determine the selectivity of ALA-induced PpIX production in uterine tissue. METHODS: Ovary-intact female rats (n = 53) received a subcutaneous estradiol-17 beta (E2) implant. Three days later, ALA dissolved in saline (0, 1, 2.5, 10, 25, or 50 mg/100 microL) was injected into one uterine horn. Three hours after ALA administration, the uterus was removed and the endometrium was scraped from the myometrium. In a second study, rats (n = 35) were ovariectomized and 8 days later given either an E2 or sham implant. After 3 days of hormonal or sham priming, ALA (10 or 25 mg) was injected into the uterine horn 3 hours before hysterectomy. In both studies, PpIX was extracted in a methanol/ perchloric acid (1:1) solution and quantified spectrofluorometrically. RESULTS: Five-aminolevulinic acid increased PpIX concentrations in the endometrium and myometrium in a dose-dependent fashion. Twenty-five milligrams of ALA produced maximum PpIX concentrations in both the endometrium and myometrium. In the second study, sham-implanted ovariectomized rats had endometrial PpIX concentrations approximately two times higher than those in the estrogen-primed rats after doses of either 10 or 25 mg ALA. In the third study, the endometrium had two to three times higher PpIX concentrations than the myometrium at 1, 10, 25, and 50 mg of ALA. CONCLUSIONS: An in vivo dose-response relation was demonstrated between ALA and uterine production of PpIX, with maximum PpIX concentrations occurring after 25 mg of intrauterine ALA. Because estrogen was not required to convert ALA to PpIX, complete endometrial ablation may best be achieved with an unstimulated endometrium.

Photodynamic endometrial ablation in the nonhuman primate.

OBJECTIVE: To test the effectiveness of 5-aminolevulinic acid (ALA)-induced photodynamic endometrial ablation in the rhesus monkey under varying conditions of light delivery (fractionated versus continuous) and steroid priming. METHODS: Photodynamic endometrial ablation was carried out in 17 rhesus monkeys that were either postmenopausal or in the early proliferative phase. Four hours after intralumenal injection of ALA (250 mg in 1 mL hyskon), a quartz fiber with a diffusing tip was inserted. A KTP tunable dye laser delivered 300 mW of light (635 nm) for 60 minutes in either continuous or fractionated fashion (20 minutes on, 5 minutes off, and 40 minutes on). In some experiments, thermistors were used to monitor temperature in the lumen and myometrium during light treatment. Hysterectomy was performed 3 or 4 days after treatment, and endometrial damage was assessed histologically. Two additional monkeys (one rhesus and one cynomolgus monkey) were exposed to the same protocol, except hyskon was substituted for ALA to control for potential ablative effects due to light treatment alone. RESULTS: Endometrial ablation was evident in all ALA-photosensitized specimens. The degree of ablation around the light fiber ranged from moderate to complete. The depth of ablation ranged from 1.14 +/- 0.54 to 2.15 +/- 1.62 mm (mean +/- standard deviation). Ablation was most complete in uteri of menopausal monkeys. Light treatment after ALA increased lumenal temperature from 36 C to 50 C, whereas temperature was not significantly increased by light treatment in the controls. CONCLUSION: This is the first report of endometrial destruction in the primate using a photodynamic approach. Whereas clinical application of photodynamic therapy (PDT) requires complete endometrial ablation to produce long-lasting amenorrhea, our results suggest that PDT may offer a simple office-based approach to endometrial ablation.

Intrauterine 5-aminolevulinic acid induces selective endometrial fluorescence in the rhesus and cynomolgus monkey.

OBJECTIVES: To evaluate the selectivity of endometrial photosensitization after intrauterine 5-aminolevulinic acid administration in nonhuman primates, and to assess acute and chronic systemic toxicity after intravenous (i.v.) delivery of 5-aminolevulinic acid. METHODS: Ovariectomized cynomolgus monkeys (n = 19) aged 6-18 years and ovariectomized rheusus monkeys (n = 3) aged 9-14 years were used in these studies, 5-aminolevulinic acid at various doses was administered by a transfundal (n = 8), transcervical (n = 3), or i.v. (n = 11) route. Spectrophoto-fluorometric readings and fluorescence microscopy were used to assess 5-aminolevulinic acid-induced photosensitization of uterine tissues; respiration, heart rate, blood biochemistry, and behavior were used to evaluate potential acute and delayed systemic toxicity. RESULTS: Endometrial fluorescence was achieved in all animals after administration of 5-aminolevulinic acid. Characteristic spectrophotofluorescence peaks of protoporphyrin IX (PpIX) in the endometrium but not myometrium confirmed selective endometrial PpIX production from 5-aminolevulinic acid. A transient (less than 1 week) increase in serum aspartate aminotransferase was observed after systemic instillation of 5-aminolevulinic acid in dosages 24-50-fold greater than that required to induce endometrial photosensitization after intrauterine injection. CONCLUSIONS: The endometrium but not myometrium in nonhuman primates is capable of converting 5-aminolevulinic acid into protoporphyrin IX. At large doses, systemic 5-aminolevulinic acid causes a transient increase in the serum aspartate aminotransferase level. No other evidence of acute or delayed systemic toxicity was observed.

In vitro induction of tetraploidy in mulberry (Morus alba L.).

A high frequency of tetraploidy was induced in mulberry (Morus alba L.) through apical bud treatment under in vitro conditions. Apical buds from in vitro-grown plants were treated with three different concentrations (0.05, 0.1 and 0.2%) of colchicine in MS medium for 24 h. Tetraploidy at a frequency of 39.4±4.8% was obtained using 0.1% colchicine, whereas the frequency of tetraploidy was significantly reduced to 16.7±2.3% when 0.2% colchicine was used. Morphological, histological and cytological evidence indicated a phenotypic and genomic similarity of in vitro- with ex vitro-induced tetraploids. Rooting of tetraploids was on basal medium containing 2.6 µM NAA. The recovery of tetraploids was 80.8% more efficient using the in vitro method instead of the ex vitro method. The use of the same colchicine medium for up to 4 weeks with additional explants was found to be equally effective for the induction of tetraploidy.

Effect of continuous and multiple doses of 5-aminolevulinic acid on protoporphyrin IX concentrations in the rat uterus.

The objective of the present study was to determine if the concentration of protoporphyrin IX (PpIX) in the rat endometrium could be increased by administering 5-aminolevulinic acid (ALA) in multiple doses or by continuous infusion. The effect of pH, temperature and time in solution on the stability of ALA were also investigated. Estrogen-filled silastic capsules were implanted subcutaneously into ovary intact female rats (200-225 g) (n = 66). On the third day of hormonal priming, ALA (10 mg or 25 mg) dissolved in saline and adjusted to a pH of 5-5.5 was administered intrauterine either as a single bolus or as two injections 3 hours apart (n = 10). A fifth group of rats was infused with 25 mg ALA over a 12 hour period using an osmotic minipump (n = 6). In a second experiment, ALA (25 mg) was injected immediately after being dissolved in saline (pH 2) (n = 16) or after incubation at 37 degrees C for 12 hour (pH 2) (n = 7). PpIX was then extracted from the endometrium and myometrium using a 1:1 methanol/perchloric acid solution and quantified spectrofluorometrically. A dose-response relationship was observed between 10 and 25 mg of ALA and endometrial PpIX concentrations. However, no differences in endometrial PpIX concentrations were detected between rats administered ALA either as a single bolus or as two doses. Continuous infusion of 25 mg of ALA resulted in statistically lower endometrial PpIX concentrations compared to 25 mg ALA injected either as a single bolus or as two injections. Neither pH, temperature, nor time in solution affected ALA-induced PpIX accumulation. We conclude that the simplest way of achieving the highest PpIX concentration in the rat endometrium in vivo is to administer a bolus injection of 25 mg of ALA.

Total anomalous pulmonary venous connection: a case report.

Total anomalous pulmonary venous connection is a rare congenital heart disease in which the pulmonary veins drain anomalously into the right atrium or its tributaries. The condition manifests from infancy and has a high mortality rate in infancy and childhood.

Plant regeneration from leaf explants of mulberry: influence of sugar, genotype and 6-benzyladenine.

A protocol for plant regeneration from leaf explants was developed for tropical mulberry varieties. Effect of sugars, 6-benzyladenine and genotype on shoot regeneration was studied. Highest percentage of shoot regeneration (80 +/- 6) was obtained with genotype S799 on medium containing glucose and 8.9 microM 6-benzyladenine. Genotypes Mandalaya and MIHP, having thicker leaves with waxy cuticle, showed poorer regeneration ability than S799 and Sujanpur-5, which have thinner leaves and cuticle. Histological studies revealed that shoots regenerated from sub-epidermal cells.

Stabilization of quinapril by incorporating hydrogen bonding interactions.

In the present study stability of various known solvates of quinapril hydrochloride has been compared with nitromethane solvate. Nitromethane solvate was found to be more stable compared to other known solvates. Single crystal X-ray diffraction analysis of quinapril nitromethane solvate shows intermolecular hydrogen bonding between quinapril molecule and nitromethane. Stabilization of quinapril by forming strong hydrogen bonding network as in case of co-crystals was further studied by forming co-crystal with tris(hydroxymethyl)amino methane. Quinapril free base forms a stable salt with tris(hydroxymethyl)amino methane not reported earlier. Quinapril tris(hydroxymethyl)amino methane salt found to be stable even at 80 degrees for 72 h i.e. hardly any formation of diketopiperazine and diacid impurity. As expected single crystal X-ray diffraction analysis reveals tris(hydroxymethyl)amino methane salt of quinapril shows complex hydrogen bonding network between the two entities along with ionic bond. The properties of this stable salt - stable in solid as well as solution phase, might lead to an alternate highly stable formulation.

Health for all by the year 2000: the countdown has begun.

PIP: In 1977 the World Health Assembly launched the movement for "Health for all by the year 2000." The 1st step was taken at the International Conference on Primary Health Care in Alma Alta, USSR, in 1978. The conference declared that primary health care (PHC) was the key to realizing the goal of health for all by 2000. It also emphasized the need for urgent and effective national and international action to develop and implement a PHC program throughout the world. A general review of the progress in terms of the indicators will facilitate tracing the progress and realizing the magnitude of the tasks ahead. In terms of the 1st 2 indicators, the target has been endorsed at the highest official level by parliaments or governments in most countries and the mechanism has been strengthened in most of the developing countries to involve people in the implementation of the health development programs. The trouble begins with the 3rd indicator which requires countries to spend at least 5% of the gross national product (GNP) on health. For most of the developing countries where health development is inextricably linked with socioeconomic development, investing 5% of the GNP on health is difficult. It is almost an impossibility for the least developed countries (LDCs). The position of the developing countries like India, though somewhat better than that of the LDCs, is not very encouraging either. In India's 6th Plan the allocation on health as percentage of total allocation in the budget was 2.40 in 1978-79 and 2.10 in 1979-80. India's position with regard to the 4th global indicator, requiring that a reasonable percentage of national health expenditure be devoted to the local health care, is not yet satisfactory though considerable efforts have been made in this area. In regard to the 5th indicator, namely, equitable distribution of resources on various population groups or geographical areas, the desired standard has not been achieved. A most important indicator, indicator 7, set by the WHO for monitoring the progress of the global strategy is that PHC should be available to the entire population. About 361 million of India's rural population do not have adequate drinking water facilities and sanitation facilities. In respect to the drug requirement of indicator 7, only a few of the essential drugs of the 20 required, are available. About 50% of the children live in conditions of poverty, deprivation, and malnutrition, and about 40% of all deaths in the country occur among children below age 5 and 10% of all children born do not live to celebrate their 1st birthday. Despite the conditions, child care continues to receive low priority from the government of India. Nutrition programs have been launched, but most of these programs have only touched on the problem.^ieng

National health policy.

PIP: The Indian Medical Association's demand for a National Health Policy has been met in the form of a Draft National Health Policy, which is inadequate. The Draft emphasizes increasing medical and paramedical manpower and overlooks the conditions of development necessary to good health. The Draft offers no guarantee that the State would protect, prevent, and promote people's health care. Instead, the Draft encourages self-medication and individual responsibility. This approach contradicts the Declaration of the Alma-Ata Conference, which states that primary health care is an integral part of the socioeconomic development process and that health sector activities must be coordinated with nutrition improvement, increases in production and employment, a more equitable distribution of income, antipoverty measures, and protection of the environment. The Draft pleads for utilization of traditional knowledge with modern practice in a synthesized "Indian" medicine. Modern medicine has proven its acceptability in its effectiveness; traditional medicine is acceptable because it is cheaper. The cost of modern medicine is not the fault of the system of medicine; it is costly because the government has failed to establish a real health movement in the country. Rather than cleaning the water system and preventing disease, the government presents alibis.^ieng

Maximum permissible weight to be carried on the head by a male worker from eastern India.

Six healthy adult male Indian workers whose physical characteristics resembled those of the average worker from eastern India, were required to carry compact loads of 20, 30, 40, and 50 kg at a speed of 5 km/h on separate days. From observations on energy expenditures, of peak pulse rates, and of the patterns of recovery pulse rates, it was decided that for the average eastern Indian male worker the permissible weight of a compact load for manual carriage on a hard, level terrain should not ordinarily be more than 30 kg.

Progesterone, estradiol, and prolactin involvement in lactation, including lactation following a postpartum mating, in the Djungarian hamster (Phodopus campbelli).

The endocrinology of lactation in the Djungarian hamster was investigated through once-daily sampling of females on Days 0, 3, 6, 9, 12, 15, and 18 postpartum. Serum prolactin (PRL) was elevated during early lactation but declined with time. Serum progesterone (P4) levels were uniformly low, and serum estradiol (E2) levels increased after Day 9. New CL were formed after the postpartum ovulation and persisted throughout lactation. During the first 9 days, the CL had the high P4 content typical of pregnancy. After Day 9, each individual CL decreased in P4 content and increased in E2 content. As evidenced by the reappearance of large antral follicles, lactating females probably returned to ovulatory cycles at about that time. The Djungarian hamster has a postpartum estrus and is capable of delivering a second litter without a diapause (18 days), although the majority of second litters are delayed. Mating during the postpartum estrus had no detected effect on growth or survival of the first litter. Second pregnancies were developmentally delayed by 3 to 7 days. P4 was effectively absent from serum for the first 12 days after mating. Although CL contained high levels of P4, the CL remained small and poorly vascularized. Mated females did not have higher serum P4 levels than nonpregnant, lactating females until Day 18. In response to the competing demands of lactation and concurrent gestation, the endocrine conditions associated with pregnancy were the most affected.

Performance evaluation of BK amputees through graded load carrying tests.

The ergonomic approach to performance evaluation in orthopaedic rehabilitation presents problems because of the cumbersome and time-consuming measurement and test procedures involved. This paper describes a method of performance evaluation through graded load carrying tests which makes it possible to set up regression equations which can be used in routine clinical practice for prediction of the performance of below-knee amputees.