001482   Natarajan M V;Hussain S H J;Sameer M M; Shashidhar R A (NO, , 4, Lakshmi Street, Kilpauk, Chennai-600 010, Email: drmayilnatarajan@gmail.com) : Surgical management of pathological fratures of extremities in patients with myeloma using custom prosthesis. Ann Natn Acad Med Sci 2007, 43(3), 115-24.

The major clinical manifestations of Multiple Myeloma result from bone destruction. We analysed nine patients of Multiple Myeloma with pathological fractures of extremities who were surgically treated by custom prosthetic replacement in a single institution during a 14 year period (1990 - 2004). The mean age was 47.7 years and females predominated the series. Femur was the most common location. Prosthetic joint replacements were done in five patients, total bone (femur) replacement in one and intercalary prosthesis for shaft of long bones was done in 3 patients. All patients received preoperative chemotherapy. With an average follow up of 88.2 months, three patents died due to progression of the disease. Late deep infection, aseptic loosening and periprosthetic fracture occurred in one patient each. The functional outcome was excellent in three, and good in three patients. Five year Kaplan Meier survival rate of the patients was 66.7%.

3 illus, 2 table, 19 ref

001481   Nandhakumar J;Tyagi M G (Pharmacology Dep, Christian Medical College, Vellore-632 002, Email: tygi243@yahoo.co.in) : Evaluation of cyclic nucleotide phosphodieterase III inhibitors in animal models of epilepsy. Biomed Res 2008, 19(1), 13-17.

This study was conducted to investigate the role of specific phosphodiesterase-3 (PDE-3) inhibitors like amrinone and milrinone in the generation of seizures in albino Swiss mice. Generation of seizures were carried out in the animals by subjecting them to injection of a chemical convulsant, isoniazid (INH) at the dose of 500 mg/kg, s.c and by subjecting them to maximal electroshock (MES) at 60 mA for 0.2 sec. The animals were pre-treated with various dose levels of amrinone (0.5 mg/kg, 0.6 mg/kg and 0.7 mg/kg, i.p) and milrinone (50μg/kg, 100μg/kg, 200μg/kg, 300 μg/kg, i.p) 20 mins prior to the INH or MES. The control group of animals received normal saline (5 ml/kg i.p) 20 mins prior to the injection of INH, or before subjecting the animals to MES. PDE-3 inhibitors significantly enhanced the onset of seizures induced by INH and MES. In particular, milrinone potentiated the convulsive phenomenon more significantly (p<0.05 and p<0.001) when compared with amrinone.

4 tables, 24 ref

001480   Namdeo A G;Sharma A;Mahadik K R (Pharmacognosy Dep, Poona College of Pharmacy, Bharati Vidyapeeth Univ, Pune-411 038, Email: ajay_namdeo@rediffmail.com) : Some observations on Nothapodytes foetida: an overview. Pharmacog Rev 2008, 2(3), 110-15.

Nothapodytes foetida is a medium size tree distributed in Western Ghats of India, is considered to be an endangered species. Phytochemical studies of the drug revealed the presence of camptothecin, hydroxy camptothecin, acetyl camptothecin, methoxy camptothecin, steroids and fatty acids. The highest concentration of camptothecin (CRT) is found in young immature fruits. Tissue culture studies of the drug show that a lot of hormones (naphthalene acetic acid, benzyl amino purine (BAP), 2, 4-dichloro phenoxy acetic acid (2,4,0), thidiazuron (TDZ), 2, 4, 5-trichlorophenoxy acetic acid (2,4,5 T) and picloram enhance CRT content. The most important combination affect callus induction and CRT content are 2, 4-D with BAP and 2, 4, 5-T with NAA in one month old callus. At concentration (1.36 μM) TDZ simulate shoot formation (46.25%). Camptothecin and 9-methoxycamptothecin have promising anti-cancer activity. The molecular target of camptothecin is inhibiting the nuclear enzymes topoisorherase I DMA complex. Camptothecin inhibits Tat-mediated transactivation of HIV-1 LTR, a potential target for therapy of HIV-1 infection. Camptothecin itself is not used clinically due to its cytotoxicity, but its derivatives (irinotecan and topotecan) are most effective for the treatment of cancer.

11 tables, 14 ref

001479   Naik S K;Mohanty N K;Atul Murari (Forensic Medicine Dep, Lady Hardinge Medical College & Smt. S.K. Hospital, New Delhi-110 001, Email: naikshrabana@yahoo.co.in) : Sudden death form rupture of corpus luteum in pregnancy: an autopsy based study on five cases. Indian Internet J Forensic Med Toxicol 2007, 24(1), 10-14.

Sudden death most often brings curiosity in the mind of relatives, police and forensic pathologist until it is thoroughly investigated. WHO defines sudden death as death of apparently healthy individual without trauma or poisoning, which is sudden or within 24 hours from the onset of symptoms. Various causes of sudden death have been enumerated in forensic medicine literature. The present authors came across jive cases, where young, newly married women had died due to rupture of corpus luteum of pregnancy, within 24 hours from the onset of symptoms. In all those cases, causes of deaths were unknown prior to autopsy. Misdiagnosis of such natural death as blunt trauma abdomen may wrongly implicate innocent individuals. Therefore, the authors advocate inclusion of rupture of corpus luteum of pregnancy as one of the causes of sudden death in a pregnant women.

23 ref

001478   Nagaraja Puranik K;Kammar K F;Sheela Devi A (Physiology Dep, Karnataka Institute of Medical Sciences, Hubli-580 022, Email: gpuranik_nk@yahoo.com) : Efficacy of Tinospora crodifolia (Willd.) extracts on blood lipid profile in streptozotocin diabetic rats. Is it beneficial to the heart?. Biomed Res 2008, 19(2), 92-6.

Efficacy of Tinospora cordifolia (Willd.) stem extracts (both aqueous and alcoholic) in different dosages (200 and 400 mg/ kg b.w) on blood lipid profile in streptozotocin induced diabetic albino rats was investigated in this study. The drug was administered orally for 10 days in 24 rats of 4 different groups treated with Tinospora cordifolia. Similarly, in another group of study consisting of 24 rats, the drug was administered orally for 30 days. Efficacy of Tinospora cordifolia in ameliorating the metabolic derangements in lipid metabolism caused by diabetes was compared with the Lante Zinc Insulin (6 Units/kg b.w. daily, i.p.) treated diabetic rats. Plasma total cholesterol, triglycerides, free fatty acids, phospholipids and lipoproteins like high density lipoprotein, low density lipoprotein and very low density lipoprotein -cholesterol levels were measured according to the standard biochemical methods. Drug treated diabetic animals showed a significant (p< 0.05) effect of Tinospora cordifolia on all these parameters compared to untreated animals. Treatment with insulin restored all these altered parameters to near normal levels in diabetic animals. Our results indicated that Tinospora cordifolia stem extract is able to ameliorate the derangements in lipid metabolism caused by diabetes mellitus in streptozotocin induced diabetic rats towards normal level. Hence this study may reveal the usefulness and beneficial value of herbal drug Tinospora cordifolia in treating hyperlipidemia.

2 tables, 20 ref

001477   Muruganandham K;Srivastava A (Urology and Renal Transplantation Dep, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Email: anand78_uro@yahoo.co.in) : Does treatment rate impact the efficacy of extracorporeal shock wave lithotripsy for kidney or ureteral stones?. Indian J Urol 2007, 23(1), 87-8.

In a retrospective study Chacko, Moore era/have examined the impact of treatment rate on the efficacy of extracorporeal shock wave lithotripsy (ESWL) for solitary stones less than 2 cm located in the kidney and stones in the proximal ureter, with a stone surface area (SSA) between 30 and 90 mm². Confounding variables like stone location, stone radio-opacity, anesthesia type, stone size and machine type were controlled. From May 2002 to August 2004, 439 patients underwent ESWL for a solitary kidney stone between 1 and 2 cm or for stones with an SSA of 30 to 90 mm² located in the kidney or proximal ureter. Adequate follow-up was available for 349 patients (80%) of which 135 had renal stones between 1 and 2 cm, 137 had renal stones less than 1 cm (SSA between 30 and 90 mm²) and 77 had a proximal ureteral stone with an SSA of between 30 and 90 mm². Patients were subjected to ESWL using either Fast Rate (120 shocks/min, FR) or Slow Rate (between 70 and 80 shocks/min, SR). Parameters that were studied were the total number of shock waves, power index, fluoroscopy time, treatment time and stone-free rate (SFR). Stone characteristics and SSA were similar in the two groups for all three stone categories. About 40% of stones between 1 and 2 cm and 52% of stones between 30 and 90 mm² were in the lower pole. There were no statistical differences between the FR and SR groups with respect to stone location. The average number of shocks and power indices in the FR group were significantly higher compared to the SR group for each stone category (P=0.05). Average fluoroscopy time in the FR group was less for renal stones but more for ureteral stones compared to the SR group but the difference was not statistically significant. The ESWL treatment time was slightly less in the FR group across all stone categories compared to that in the SR group but only statistically significant for renal stones between 30 to 90 mm². Slower treatment rate resulted in improved SFRs compared to the faster rate. Difference in the SFR was only statistically significant for the 1 to 2 cm renal stone category. For renal stones between 1 and 2 cm the SFR was 67% in the SR group but 46% in the FR group (P=0.05). There were no differences in outcome based on renal stone location.

7 ref

001476   Murty O P;Tyng C C B;Kalimuthu M;Bun T S;Dany O C (Forensic Medicine and Toxicology Dep, All India Institute Medical Sciences, New Delhi-110 029, Email: opmurty@ yahoo.co.in) : Fatality due to rupture of aneurysms : autopsy review of ten years at UMMC Malaysia (1996-2005). Indian Internet J Forensic Med Toxicol 2007, 24(1), 39-44.

Aneurysm, especially aortic and intracranial anenrysms, account for diseases affecting blood vessels which cause significant mortality due to hemorrhage following its rupture. The objective of the study was to determine the number of fatalities due to rupture of aortic and intracranial aneurysms in autopsies in UMMC, thus to determine the pattern of deaths relating to ethnicity, age group, sex and correlation with its known risk factors and medical history. A total of 29 deaths were found due to rupture of aneurysms in autopsies performed in the Department of Forensic Pathology, Faculty of Medicine, University of Malaya from 1st January 1996 to 31st December 2005. Over the stated period, aneurysm contributes to 0.005% of deaths. It generally affected the middle age groups (60%) with sex ratio of M:F = 3:1. Chinese contributed 69% of cases, followed by Malay (17%), Indian (7%) and others (7%). Atherosclerosis was noted in 57% and obesity in 59% of cases, thus depicting a satisfactory correlation. 47% of the total cases had possessed one or more risk factors such as hypertension, obesity, alcohol consumption and smoking.

8 illus, 2 tables, 21 ref

001475   Muniandy S;Yaiw K C;Chook J B;Rayappan A V; Wong K T;Ismail I S;Qvist R (Molecular Medicine Dep, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia, Email: sekaran@um.edu.my) : Quantification of Zonula occludens-1 mRNA expression in cultured bovine retinal endothelial cells, using Sybr green real-time pcr. Biomed Res 2008, 19(2), 117-24.

A simple and rapid real-time reverse transcription-PCR (RT-PCR) technique using SYBR green fluorescence was developed to quantify Zonula Occludens-1 (ZO-1) mRNA expression in histamine-treated cultured bovine retinal microvessel endothelial cells. There was no difference between the quantity of ZO-1 mRNA expression in histamine-treated (10^-7M to 10^-9 M) and untreated bovine retinal endothelial cells at high magnesium levels. Immunohisto-chemistry staining and western blot assay unequivocally demonstrated the approximately similar levels of ZO-1 protein in both histamine-treated and non-treated endothelial cells at high magnesium concentrations.

4 illus, 2 tables, 25 ref

001474   Mukhopadhyay A K;Patnaik S K;Satya Babu P (National Institute of Communicable Diseases, RFT & RC, Weavers Colony, Rajahmundry) : Status of lymphatic filariasis in parts of east Godavari district of Andhra Pradesh, India. J Vector Borne Dis 2007, 44(1), 72-4.

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001473   Modi P (Urology and Transplantation Surgery, Institution of Kidney Diseases and Research Centre and Institute of T, Civil Hospital Campus, Ahmedabad-380 016, Email: dr_pranjal@yahoo.com) : Pertinent issus in pretransplant recipient workup. Indian J Urol 2007, 23(3), 278-85.

Renal transplantation is recognized as the treatment of choice in most patients with end-stage renal disease. The evaluation of the candidate for kidney transplantation has been the recent subject of clinical practice guidelines published by the European Renal Association- European Dialysis Transplant Association and the American Society of Transplantation. The purpose of this article is to review the current literature for urological evaluation and treatment of patients prior to renal transplantation. In India, urologists are involved in evaluating not only the genitourinary problems but also vascular access and, vascular anatomy and pathology especially related to major pelvic vessels. Hence, evaluation of the transplant recipient should include assessment of vascular access for hemodialysis, access for peritoneal dialysis, assessment of pelvic vessels to which renal allograft vessels need to be anastomosed and genitourinary system. In addition, review of the serological tests for infective viral diseases like hepatitis and human immunodeficiency viruses should always be done before starting clinical evaluation. A note of the evaluation performed by other specialists like nephrologist, cardiologist, endocrinologist, pulmonologist, anesthetist etc. should always be reviewed.

2 tables, 82 ref

001472   Mishra S K;Muthu V;Rajapurkar M M;Desai M R (Urology Dep, Muljibhai Patel Urologies Hospital, Nadiad-387 001, Email: mrdesai@mpuh.org) : Kidney transplantation in abnormal bladder. Indian J Urol 2007, 23(3), 299-304.

Structural urologic abnormalities resulting in dysfunctional lower urinary tract leading to end stage renal disease may constitute 15% patients in the adult population and up to 20-30% in the pediatric population. A patient with an abnormal bladder, who is approaching end stage renal disease, needs careful evaluation of the lower urinary tract to plan the most satisfactory technical approach to the transplant procedure. Past experience of different authors can give an insight into the management and outcome of these patients. This review revisits the current literature available on transplantation in abnormal bladder and summarizes the clinical approach towards handling this group of difficult transplant patients. We add on our experience as we discuss the various issues. The outcome of renal transplant in abnormal bladder is not adversely affected when done in a reconstructed bladder. Correct preoperative evaluation, certain technical modification during transplant and postoperative care is mandatory to avoid complications. Knowledge of the abnormal bladder should allow successful transplantation with good outcome.

45 ref

001471   Mishra S (Home Sciences (Nutrition) Dep, V.K.M. Banaras Hindu Univ, Varanasi-221 005) : Safety aspects of street foods: a case study of city of Varanasi. Indian J Prev Soc Med 2007, 38(1-2), 32-5.

Safety of the street foods is an important aspect in the field of nutrition security. A study was conducted in the city of Varanasi, UP. It was observed that about 42% of the working man and women in the age group of 25-45, and 61% of the students in the age group of 14-21, consume foods from the street vendors in the day at least once. About 23% of working women prefer to have food from street vendors' rather carrying food from home to the work place. About 82% of people of all age groups prefer to go to street vendors against only 18% only who prefer to go to the restaurant in the evening. About 57% working man and women are concerned about the cleanliness and hygiene of the vendors while the rest are not concerned about these aspects.

6 tables, 8 ref

001470   Mishra R N;Tripathi C B;Mishra C P;Shukla H S (Community Medicine Dep, Institute of Medical Science, Banaras Hindu Univ, Varanasi-221 005) : Duration of post partum amenorrhoea: short in breast cancer. Indian J Prev Soc Med 2007, 38(1-2), 53-6.

Objective of the study is to assess association between duration of post partum amenorrhoea (PPA) and occurrence of breast carcinoma. Clinically and histopathologically proved hundred incident cases of breast carcinoma in premenopausal age group, hundred matched controls suffering form some other disease during the same period, were the subjects of study. Adjusted Odd's Ratio (AOR) and Confidence Intervals (Cl) for various risk factors for breast carcinoma focused in present research revealed increased risk of cancer breast associated with taller women (p= 0.02, AOR= 2.14 Cl =1.10-4.14). Irregular menstrual cycles were associated with increased breast malignancy (p= 0.03, AOR= 3.16, Cl= 1.14-8.77). Decreased proportion of lactational amenorrhoea to total menstrual duration was associated with increased breast carcinoma (p= 0.01, AOR = 3.23, Cl = 1.38-7.59). Results: Logistic regression analysis carried out on some modifiable and non- modifiable risk factors for carcinoma breast revealed that if duration of PPA was than 33% of their total reproductive period from first full term delivery, there was 3.23 times more risk of developing breast cancer. The risk of carcinoma breast gets reduced in those cases where the period of post partum amenorrhoea is increased.

1 table, 11 ref

001469   Mishra J;Mishra A;Talukdar A;Boruah P;Sheela (Cardiology Dep, NEIGRIHMS, Mawdiangdiang, Shillong-12) : Patho-physiological changes in cardiovascular aging. Indian J Cardiol 2006, 9(3-4), 48-9.

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001468   Mishra C P;Tiwari I C;Mishra R N (Community Medicine Dep, Institute of Medical Sciences, Banaras Hindu Univ, Varanasi) : Work performance of primary health centres in Varanasi district. Indian J Prev Soc Med 2007, 38(1-2), 96-103.

The key infrastructure to deliver primary health care, in rural areas, is a network of health centers and sub-centers. They are reporting their performance to the District Health Organization month-wise. Considering the work load on the staff of these centers and their level of technical competence, it will be not appropriate to give survey work for primary health care evaluation to the staff of PHCs. However if this work is done through external evaluators, a considarable amount of fund is likely to be consumed for this purpose only and because of time constraints, such evaluators will find it difficult to do a comprehensive assessment. Therefore, need for assessing performance of PHCs by utilizing existing service parameters is currently being emphasized. Besides financial and operational feasibility, such approach gives an insight to the persons who are directly managing PHC programmes. As PHCs have many function to perform, Programme managers are likely to give more emphasis on those programmes on which their performance are assessed and may show less concern for other activities which are also cost effective and have long lasting implications form public health point of view. With his background, this study was carried out in two Block level PHCs of Varanasi District. Comprehensive scoring system of assessing work performance of PHCs was evolved on the basis of PEER opinion and its application was demonstrated by computing various parameters and allotting scores to them for different components of care on the basis of data collected from the two PHCs ever a period of three years. Overall Monthly performance score was 40.19 ± 8.90 (Range 26-57) against a maximum possible score of 100. Year wise performance were similar (F_2.30=0.73; P> 0.05). However, compared to quarter I (28 per month), performance of PHCs studied were significantly (F_2.30= 30.52; P < 0.01) higher in other quarters due to varied emphasis on different components of care in different quarters of the year.

3 tables, 10 ref

001467   Mishra B N;Sinha N D;Vinu V S;Soodan A S (PSM Dep, Rural Medical Coolege; Pravara Rural Univ, Maharashtra) : Epidemiology of childhood surgical admissions in a teriary care hospital in Nepal. Indian J Prev Soc Med 2007, 38(1-2), 80-7.

The study includes all children aged <15yrs who were admitted to a medical college teaching hospital in mid western Nepal from 15th July 2003 to 14th April 2004. During the study period total of 1541 children were admitted to KTH with an admission rate of 3.8%. Surgical patients accounted for 10.6% of all pediatric admissions and total of 5453 days of hospital inpatient stays. The most common diagnostic category were trauma & burns (33.2%) followed by congenital anomalies (18.8%) and surgical infections (14%). The total hospital days for 542 patients was 5453 out of which 1009 (18.5%) was for fracture and 803 (14.7%) for hernia & hydrocele. 10.5% of all pediatric surgical hospital days were due to burn & injuries. Nepali children were rarely admitted for appendicitis and hypertrophic pyloric stenosis. Prevention of child hood injuries, better trauma care and prompt referral of acute cases, especially at the primary and secondary health care levels, should be the priorities for improving pediatric surgical care in Nepal. Surgical care of children which is a non-priority area at present should be considered as an essential component of child health programmes in south East Asian region.

2 tables, 11 ref

001466   McMahon C G (Australian Centre For Sexual Health Suit 2-4, , Berry Road, Medical Centre 1a Berry Rd St Leonards, Australia, Email: cmcmahon@acsh.com.au) : Premature ejaculation. Indian J Urol 2007, 23(2), 97-108.

Premature ejaculation (PE) is a common male sexual disorder. Recent normative data suggests that men with an intravaginal ejaculatory latency time (IELT) of less than 1 minute have "definite" PE, while men with lELTs between 1 and 1.5 minutes have "probable" PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (5-hydroxytryptamine, serotonin) receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors is well tolerated and offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains. Investigational drugs such as the ejaculo-selective serotonin transport inhibitor, dapoxetine represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control and sexual satisfaction with minimal adverse effects.

8 illus, 129 ref

001465   Manjunath S;Ramachandra C;Murthy V;Murthy P S;Prabhakaran P S;Satya Suresh Attili V (NO, , No. 2, 9th cross, ISRO layout, Bangalore-560 078) : Surgical resection for locally invasive renal cell carcinoma: is it worthwhile?. Indian J Urol 2007, 23(3), 246-9.

Many patients with renal cell carcinoma (RCC) present with disease involving the adjacent viscera. Although survival in such patients is poor, surgery remains the only proven modality of treatment. Describes experience with radical nephrectomy for locally invasive RCC over a five-year period. A retrospective analysis of the records of all patients who had undergone surgery for locally invasive RCC between January 1999 and December 2004 at our institute. During the study period, 102 patients with RCC underwent surgery at our institute, out of which 18 (17.6%) patients had adjacent organ involvement. The survival and outcomes in terms of symptom relief are described, The survival rates were calculated by the Kaplan-Meier method using EGRET statistical software package. Of the 18 patients, two patients had inoperable disease. Fifteen out of the 18 patients succumbed to their disease after a median period of 7.5 months. Three patients are still alive, having survived for 13, 16 and 25 months. Most patients derived considerable benefit with respect to relief of symptoms, which was long-lasting. Conclusion: For selected patients with locally invasive RCC, radical nephrectomy with en bloc resection of involved organs may provide the opportunity for long-term survival. In others, it may provide considerable symptomatic relief.

1 illus, 1 tables, 17 ref

001464   Manjula bai K H ;Santosh (Forensic Medicine & Toxicology Dep, J.N. Medical College Belgaum, Karnataka) : Autopsy suite, mobile sutopsy suite and biosafety. Indian Internet J Forensic Med Toxicol 2007, 24(1), 31-5.

The autopsy room is regarded as a special place for gathering scientific knowledge by conducting autopsy. The dead body for autopsy is a big sized good culture media, contaminated with microorganisms, explosives or evidence material, and so on. So, it needs lot of watchfulness, chain of custody & a bio-containment area -Autopsy suit. Water, air, people, bodies, samples, scientific equipment, gurneys, information, and disposables, all must be decontaminated before safely removed from the containment area. There must be awareness about bio-safety application in dissection/autopsy room. To start with, including the same in the UG curriculum/syllabus and awareness programs for doctors who already engaged in the autopsy work. A pilot survey results authenticate the deficiency in autopsy facilities and the open space autopsy in nearly 50% of PHCs level. It is time for the department of inquest- Ministry of home affairs, to implement mobile autopsy unit/suite to avoid the heinous open space autopsy. However, Construction of autopsy suite and implementation of mobile autopsy suite with the consideration of biosafety, is must and is to be proceeded in consultation with experts in the subject.

4 illus, 5 tables, 12 ref

001463   Mandal P K;Sardar J C;Chatterjee C;Lahiri S K;Ghosh P (Community Medicine Dep, Medicine, Medical College, Kolkata) : Breast feeding practices among infants in a rural area of west Bengal. Indian J Prev Soc Med 2007, 38(1-2), 28-31.

A longitudinal observational study was undertaken in a rural block of a district in West Bengal state to assess the breast feeding practices among infants. Study revealed that exclusive breast feeding was persistently lower compared to national values. It also showed a steady decline with age and dropped to 10% at 6 months of age. 15% were predominantly breast fed and 75% were partially breast fed at that age. All the infants continued breast feeding till the observation period. 93.3% infants received colostrums.71.7% newborns received pre-lacteal feeds and honey was the commonest prelacteal feed offered. Mothers stated that lactation failure was the reason behind early initiation of complementary feeding.

4 tables, 10 ref

001462   Mallick S;Ray C;Bhattacharjee S (NO, , K/31, Kharkai Road, P.O. Golmuri, Nildih, Jamshedpur-831 003, Email: dr_smallick@rediffmail.com) : Postabortal hematometra. J Obstet Gynec India 2007, 57(3), 257-8.

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001461   Majumder B;Ashutosh Kumar (Cardiology Dep, I.P.G.M.E., Kolkata-700 020) : Non coronary indications of statins. Indian J Cardiol 2006, 9(3-4), 38-46.

2 illus, 1 table, 68 ref

001460   Mahajan S;Ramasethu R;Bhowmik D;Tiwari S C (Nephrology Dep, All India Institute of Medical Sciences, New Delhi-110 029, Email: sctiwari@hotmail.com) : Spectrum of chronic kidney disease in the elderly and factors governing in-hospital mortality in a tertiary care hospital in India. Ann Natn Acad Med Sci 2007, 43(3), 125-33.

With increasing geriatric population in India more number of elderly patients with chronic kidney disease (CKD) are now requiring hospitalization and renal replacement therapy (RRT). However, no study has specifically looked at the etiology of CKD and factors determining in-hospital mortality among these patients. Identifying these factors can help in planning strategies for management of these cases and a more rational use of expensive therapeutic modalities. Retrospectively analyzed data of 158 patients aged ^{3 60 years admitted with CKD in a tertiary care super-specialty hospital in North India from July 2003 - December 2004. Data regarding their demographic profile, renal diagnosis, associated co-morbidities, requirement and type of RRT given were retrieved. The study parameters between survivors and non-survivors were analyzed by univariate and multivariate analysis. Type of RRT opted for by the patient at discharge was also noted. Average age of study population was 67.09 years (60-88 years) with 69% being males. Diabetic nephropathy was the commonest cause accounting for 41.8% cases followed by hypertensive nephrosclerosis (24.1%) and obstructive nephropathy (16.3%). 21 patients (13%) had acute on chronic renal failure with volume depletion being the most common acute insult followed by infection. 77.7% patients required RRT at admission due to uremic complications. Acute peritoneal dialysis was the most frequent initial dialysis given (62%). Only 18 (14.5%) patients had a prior follow-up with a nephrologist of 33 months and only 10 had an arteriovenus fistula. 60.8% had one or more co-morbidity with infection and cardiovascular disease being most common while 17.6% patients were requiring inotropic/ventilatory support. Authors had an in-hospital mortality of 22.2%. On univariate analysis age 380 years, diabetic nephropathy, late referral, presence of infection, need for inotropic/ventilatory support and need for RRT were found to be significantly associated with increased mortality. On multivariate analysis however, only diabetic nephropathy and need for inotropic/ventilatory support were found to be significant. Of the 78 patients who were discharged requiring long-term dialysis, 42 (53.7%) opted out of RRT due to financial constraints and lack of social support. To conclude, diabetic nephropathy is the commonest cause of CKD among our hospitalized elderly patients. Most of our patients present to referral hospital in advanced azotemia and with significant co-morbidities. They have a high in-hospital mortality that correlates with presence of diabetic nephropathy and cardiovascular or respiratory failure.}

3 tables, 12 ref

001459   Lemack G E (NO, , 5323 Harry Hines Blvd, Dallas, TX 75390-9110, USA, Email: gary.lemack@utsouthwestern.edu) : Use of urodynamics prior to surgery for urinary incontinence: how helpful is preoperative testing. Indian J Urol 2007, 23(2), 142-7.

It has not yet been definitively demonstrated that preoperative evaluation of women with stress urinary incontinence with urodynamic testing enhances presurgical counseling, more effectively models patients' expectations or improves postoperative outcome. Nonetheless, urodynamic testing is frequently utilized in the assessment of women with stress urinary incontinence and clearly accomplishes a number of goals when utilized for this purpose. For example, there are data to suggest that the risk of voiding dysfunction can be mitigated by utilizing data obtained from urodynamic testing to identify women more likely to void ineffectively after conventional stress incontinence procedures. Furthermore, it has been suggested though not proven, that patients with more severe forms of stress incontinence as identified by urodynamic testing, might be less likely to improve after surgery compared to others with more modest degrees of incontinence. Since urodynamic testing is invasive, costly and not always available, it is imperative that the usefulness of such testing be carefully explored and its utility appropriately defined. Discusses urodynamic techniques to assess stress urinary incontinence, particularly focusing on the ability of leak point pressure testing and urethral pressure profilometry to predict which patients would most likely benefit from surgery and which might be more likely to experience adverse events following surgery.

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001458   Lallemand B;Busard P;Leduc F;Vaesen R (NO, , Rue de Hollenfels 7a, 7481 TUNTANGE, Luxembourg, Email: lallemandbernard@hotmail.com) : Laparoscopic resection of a leiomyoma of the seminal vesicle. Indian J Urol 2007, 23(1), 70-1.

Presents a case of a leiomyoma of the seminal vesicle that occurred in a 52-year-old man who presented with symptoms f of bladder outlet obstruction. Prostate-specific antigen was within normal limit. Computed tomography scan and magnetic resonance imaging revealed a mass in the patient's right seminal vesicle. Laparoscopic excision of the seminal vesicle tumor was performed successfully. The patient was discharged from the hospital on the fourth postoperative day.

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001457   Kurien A;Thomas J (Pathology Dep, Melake Manipal Medical College, Manipal, Email: drannammakurien@yahoo.co.in) : Can reflex uro vysion fluorescence in situ hybrridization predict tumor recurrence during follow-up?. Indian J Urol 2007, 23(3), 333-4.

The primary aim of this study was to demonstrate the usefulness of multitarget fluorescence in situ hybridization (FISH UroVysion) testing in the early detection of recurrent urothelial carcinoma (UC). The study population comprised patients with bladder tumor on follow-up, who had negative or atypical urine cytology with no evidence of recurrence by cystoscopy. Some of these patients had positive UroVysion FISH in the urine cell sample. The paper looks at the course of these "anticipatory positive" cases with special reference to the recurrence and the time to tumor recurrence. Fifty-six (26.5%) of the 211 patients with negative cystoscopy and negative or atypical cytology had positive FISH results. This group formed the anticipatory positive subset of patients. Recurrent urothelial carcinoma developed in 35 (62.5%) of these 56 patients. Of these recurrent tumors 22 were high-grade UC and 12 low-grade UC. In about 65% of this anticipatory positive group, recurrent bladder UC bladder developed within 29 months. The recurrence rate was 48% in six months and 54% within 10 months of the positive FISH result. In contrast recurrent UC developed in only eight (5.2%) of the 155 cystoscopically negative, cytologically negative or atypical and FISH negative cases.

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001456   Kulkarni S K (University Institute of Pharmaceutical Sciences, Panjab Univ, Chandigarh-160 014, Email: skpu@yahoo.com) : Revisiting gaba receptor pharmacology. Ann Natn Acad Med Sci 2007, 43(2), 23-34.

γ-Amino butyric acid (GABA) is the major inhibitory neurotransmitter in the mammalian central nervous system. Almost 80-75 % of the neurons in the central nervous system are GABAergic in nature and they are virtually absent outside the brain and the spinal cord. GABA produces inhibitory hyperpolarizing response by increasing the chloride (Cl^-) conductance of the neuronal membrane. Increased GABAergic activity produces CNS depression, sedation, ataxia and amnesia. Any loss in GABAergic tone would lead to arousal response, insomnia and excitation. GABA is known to act on three distinct receptor subtypes, of which GABA_A receptors are widely studied. The GABA_A receptor is a ligand gated ion channel receptor and is influenced by diverse chemical ligands. Many drugs including benzodiazepines, alcohol, neurosteroids and inverse agonists modulated GABA_A receptor mediated physiological functions.

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001455   Kuldip Singh;Amandeep Singh (NO, , House No. 4319, Word No.13, Near Punjab Hindutan Combine G T Road, Bara-Sirhind, Fategarh Sahib 140 406, Email: kuldip70@rediffmail.com) : Changes in plasma fibrinogen, homocysteine and lipid profile in coronary artery disease patients of north Indian (Punjab) population. Biomed Res 2008, 19(2), 125-8.

Conventional risk factors such as age, smoking, hyperlipidemia and hypertension do not explain all the mortality and morbidity due to coronary artery disease. Novel factors like plasma fibrinogen, homocysteine, C - reactive protein have been recently recognized as independent risk factors for coronary artery disease. The objective of the present study was to examine the change in plasma fibrinogen, homocysteine along with lipid profile in the pathogenesis of angiographically established coronary artery disease. 75 male patients in the age range of 30-60 years with angiographically established coronary artery disease and equal number of age and sex matched normal healthy subjects were recruited in the present study. Coronary artery disease patients had significant high plasma fibrinogen, homocysteine, total cholesterol, triglyceride and LDL-cholesterol levels whereas the level of HDL-cholesterol significantly decreased in them as compared to normal healthy subjects (control). Elevated levels of plasma fibrinogen, homocysteine contribute significantly to the risk of coronary artery disease and might be considered in screening program to identify individuals at increased thrombotic risk.

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001454   Kshirsagar N A (Clinical Pharmacology Dep, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai-400 012) : Infectious diseases control : from product development to public health. Ann Natn Acad Med Sci 2007, 43(2), 65-74.

There are difficulties in controlling environment conditions and preventing vector breeding and propagation. New drugs, drug combinations and regimens and vaccines need to be developed and tested. However, it is also of great importance to note that concerted efforts of various healthcare workers from different disciplines and administrations are needed to control tropical diseases.

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001453   Kotila R;Okesola A;Makanjuola O (Haematology Dep, Medical Microbiology & Parasitology, College of Medicine, Ibadan Univ, Nigeria) : Asymptomatic malaria parasitaemia in sickle-cell disease patients: how effective is chemoprophylaxis?. J Vector Borne Dis 2007, 44(1), 52-5.

Sickle-cell trait confers protection against malaria while homozygote sickle-cell disease (SCD) patients are at greater risk of malaria infection, hence the use of malaria chemoprophylaxis in SCD patients. The use of malaria chemoprophylaxis and asymptomatic parasitaemia were studied in SCD and non-SCD patients. A semi-structured questionnaire was administered to both patients and controls; a thick blood film was also examined in both the groups. Sixty-nine percent of patients use proguanil, 22% do not use any form of chemoprophylaxis, while 9% use pyrimethamine. There was no significant difference between level of parasitaemia in patients and controls (p = 0.1), a positive smear was found in equal numbers of patients on chemoprophylaxis and those not on chemoprophylaxis (p = 0.3). In the month preceding the study, 31% of patients vs 18% of controls had received treatment for malaria. There were no significant differences between patients and controls in frequency of malaria attacks (p = 0.06), last episode of malaria (p = 0.2). Ten percent of patients and 2% of controls use bednets. study did not find any advantage in the use of malaria chemoprophylaxis in SCD patients over controls or SCD patients not on chemoprophylaxis. Vector control should also be considered in the fight against malaria. There is a need to look into why both patients and controls fail to use bednets in a malaria endemic country.

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001452   Khurana N;Srivastava A (Urology and Renal Transplant Dep, SGPGIMS, Lucknow, Email: drrgoyal@yahoo.com) : Which one is better, wallace or bricker?. Indian J Urol 2007, 23(2), 216-17.

This is a retrospective study in 198 patients who underwent radical cystectomy in carcinoma urinary bladder from July 1997 to July 2003. Eighty-six patients underwent Bricker ureterointestinal anastomosis (UIA) and 112 underwent Wallace UIA. Bricker UIA was considered two anastomotic units while Wallace UIA was considered a single unit. Therefore, there were 162 (59%) total Bricker UIA compared to 112 (41%) Wallace UIA. There were three strictures (1.85%) in the Bricker group and five strictures (4.46%) in the Wallace group (statistically insignificant). A total of 33 patients (17%) in the study received neoadjuvant radiation, salvage radiation or prior radiation. Of the 33 radiated cases (48 anastamosis) there were three strictures. Although the stricture rate between radiated (6.25%) and nonradiated (2.21%) anastomosis was considerable, this was not statistically significant. There was no statistically significant difference between stricture rates in small bowel vs. large bowel diversions or in the groups comparing 5Fr feeding tubes to 7Fr single J stents.

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001451   Khurana N;Srivastava A (Urology and Renal Transplant Dep, SGPGIMS, Lucknow, Email: drrgoyal@yahoo.com) : Search for new αla-adrenoceptor-selective antagonist for treating lower urinary tract symptoms associated with benign prostatic hyperplasia. Indian J Urol 2007, 23(2), 215-16.

This phase III randomized, multicentric, double-blind, placebo-controlled, study in Japanese men has shown the clinical efficacy of silodosin, a new α_1A -adrenoceptor-selective antagonist for treating lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). The change in the total International prostatic symptom score (IPSS) from baseline in the silodosin, tamsulosin and placebo groups was -8.3, -6.8 and -5.3, respectively. There was a significant decrease in the IPSS vs. placebo in the silodosin group from one week. In the early-stage comparison, silodosin showed a significant decrease in IPSS vs. tamsulosin at two weeks. The change in QoL from baseline was -1.7, -1.4 and -1.1 in the silodosin, tamsulosin and placebo groups, respectively. Silodosin showed a significant improvement in the QoL score vs. placebo. In the subgroup of patients with severe symptoms (IPSS ≥ 20) silodosin also gave a significantly better improvement than placebo (-12.4 vs. -8.7). The incidence rates of adverse events and drug-related adverse events were, respectively, 88.6%, 82.3% and 71.6% and 69.7%, 47.4% and 36.4%, respectively. The most common adverse event in the silodosin group was abnormal ejaculation, which occurred more often in the silodosin than in the tamsulosin group (22.3% vs. 1.6%).

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001450   Khurana N;Agarwal S;Srivastava A (Urology and Renal Transplant Dep, SGPGIMS, Lucknow, Email: drrgoyal@yahoo.com) : Are we along the path for laparoscopic partial nephrectomy?. Indian J Urol 2007, 23(2), 217.

This is the first study addressing five-year outcomes of laparoscopic partial nephrectomy (LPN) in 56 patients, each of whom has completed a minimum of five years of follow-up. Ninety-one per cent of patients had incidentally discovered renal masses with a mean tumor size of 2.9 cm, which were benign in 34% and malignant in 66% and pathological tumor stage was pT1a in 32 (86%). Final surgical margin was positive for cancer in one patient. Median serum creatinine preoperatively and postoperatively was 0.9 and 1.0 mg/dl, respectively. No patient with normal baseline serum creatinine undergoing elective laparoscopic partial nephrectomy had postoperative chronic renal insufficiency (serum creatinine more than 2 mg/dl). At a median follow-up of 5.7 years (range 5.0 to 6.9) no distant recurrence (0%) and a single local recurrence (2.7%) were detected. Overall and cancer-specific survival was 86% and 100%, respectively, at five years.

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001449   Khochikar M V (Uro-oncology Dep, Siddhi Vinayak Ganapati Cancer Hospital, Miraj, Email: khochikar@rocketmail.com) : Prostate cancer treatment does not increases the risk of cardiovascular events. Indian J Urol 2007, 23(1), 83-4.

This paper is aimed at studying the risk of cardiovascular disease mortality in patients with prostate cancer and to compare this with the risk in the general population. The study population consisted of participants of the Rotterdam section of the ESRPC trial (European Randomized Study of Screening for Prostate cancer). Standardized mortality ratios (SMRs) of cardiovascular mortality for 2221 prostate cancer patients has been calculated in this study including the analysis for the treatment subgroups-radical radiotherapy (RT), radical surgery, watchful waiting and hormonal therapy. Cardiovascular mortality was defined as any deaths from cardiovascular disease, coronary artery disease, acute myocardial infarction, other diseases of the heart and cerebrovascular accidents. The treatment received by the prostate cancer patients was in the form of radical RT in 40.2%, radical prostatectomy in 30.3%, watchful waiting in 14.9% and hormonal therapy in 5.4% (unknown in 9.2%). At mean follow-up of 5.5 years 12% of prostate cancer patients (258) had died. The SMRs for prostate cancer patients were found to be low in the range of 0.37-0.49 as compared to 0.90 in the general population. This low SMR was found in all patients irrespective of the treatment they had received. Therefore the authors have concluded that less emphasis should be put on risk of cardiovascular events as a contraindication for aggressive, especially surgical treatment for prostate cancer patients.

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001448   Khochikar M V (Uro-oncology Dep, Siddhi Vinayak Ganapati Cancer Hospital, Miraj, Email: khochikar@rocketmail.com) : Neoadjuvant androgen suppression in patients treated with high-intensity focused ultrasound therapy. Indian J Urol 2007, 23(1), 83.

The authors have performed this study to explore the effectiveness of neoadjuvant androgen suppression in patients of localized prostate cancer treated with high-intensity focused ultrasound (HIFU). From January 1999 to January 2005, they had treated 250 patients with HIFU. One hundred and fifty-four patients received neoadjuvant hormonal therapy and 96 were not treated with androgen suppression. Treatment failure was defined by presence of prostate cancer on biopsy taken six months after HIFU. In this unrandomized trial, the authors found a slightly lower treatment failure rate in patients who received neoadjuvant androgen suppression (31% vs. 34%), but this was not statistically significant (P=0.119).

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001447   Khochikar M V (Uro-oncology Dep, Siddhi Vinayak Ganapati Cancer Hospital, Miraj, Email: khochikar@rocketmail.com) : Is incidence of prostate cancer higher in patients with end stage renal disease?. Indian J Urol 2007, 23(1), 82.

Studying the usefulness of prostate-specific antigen (PSA) screening for patients with end-stage renal disease (ESRD) and also to assess if the incidence of prostate cancer is higher in this group of patients. The authors screened 1250 men with ESRD aged >50 years for prostate cancer and compared 1007 healthy men aged >55 years in the community who also underwent prostate cancer screening. Prostate-specific antigen > 4 ng/ml was taken as significant and further evaluation including prostate biopsy was done in these cases. The authors found a statistically significant increase in the PSA in the ESRD group than in healthy controls. Thirteen patients in the ESRD group and five in the healthy control men were found to have prostate cancer and were treated as per their staging. The authors conclude that higher levels of PSA are found in ESRD patients and there is higher incidence of prostate cancer in the ESRD group as compared to healthy men.

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001446   Khochikar M V (Uro-oncology Dep, Siddhi Vinayak Ganapati Cancer Hospital, Miraj, Email: khochikar@rocketmail.com) : Treatment algorithm in hormone-resistant prostate cancer: practical guidelines. Indian J Urol 2007, 23(1), 67-9.

Treatment of hormone-resistant prostate cancer can be a challenging situation. The first important step in treating this condition is to assess if one has achieved the castrate level or not. If the castrate levels are not achieved, attempt should be made to achieve so. If the castrate level is achieved, then androgen withdrawals may be of help. Supportive care, care of the clinical problems forms an integral part of the treatment. Cancer-specific chemotherapy is certainly an option in progressive disease.

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001445   Khemchandani S;Devra A;Gupta S (NO, , 401, Sudarshan flats, 13, Shantinagar Society, Usmanpura, Ahmedabad-380 016, Email: dr_sajni@rediffmail.com) : Unusual case of urinary tract obstruction due to imperforate hymen in an 11-month-old infant. Indian J Urol 2007, 23(2), 198-9.

Variations in the anatomy of the hymen are common and imperforate hymen is an extreme manifestation. In spite of the recommendations for early inspection of the external genitalia, hymenal malformations escape diagnosis until the time of menarche. Rarely, female infants with imperforate hymen present with urologic complications. We would like to present an unusual case of urinary retention in an 11-month-old female infant due to imperforate hymen. This infant was successfully treated surgically.

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001444   Khattar N;Dorairajan L N;Santosh Kumar (Urology Dep, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry-605 006, Email: dorairajan_in@hotmail.com) : Role of simultaneous fine needle aspiration cytology of palpable inguinal lymph node and primary tumor biopsy in carcinoma of the penis. Indian J Urol 2007, 23(2), 290-1.

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001443   Khan M A;Khan A A;Faruqi N A (Anatomy Dep, J N Medical College, Aligarh Muslim Univ, Aligarh-202 002) : Effect of monocular encleation on the superior colliculus of adult rabbit-a light microscopic study. Biomed Res 2008, 19(1), 27-31.

Monocular enucleation induced changes in the visual system in neonates have been reported by many workers but information regarding its effects in adults remains scanty. Present study is an attempt to find out the latter in rabbits. 25 adult rabbits of either sex were subjected to monocular enucleation under general anaesthesia. A similar number of nonenucleates served as controls. Animals were sacrificed after post lesion-survival periods ranging from 2 weeks to 4 months. Brains were fixed by trans-cardiac perfusion of 10% formalin. Superior colliculi were removed from midbrain and processed for paraffin embedding. 10μ thick sections were stained with Hae-matoxylin and Eosin, Cresyl violet and Luxol fast blue and Thionin as well as Kluver Barrera and Glees and Marshland stains. To access the deafferentation-induced changes in the contralateral (with respect to enucleation), sections from superior colliculi were observed under light microscope. Morphological changes were in the form of vacuolation in the neuropil, fascicular disorganization and fragmentation of myelin, cytoplasmic and nuclear disintegration of neurons and glial cell aggregation. It was concluded that though the deafferentation-induced changes were not dramatic at any point of time during study, yet its extent could be correlated with duration of post-experimental survival period of the animal.

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001442   Karande V C;Klipstein S;Birkenkamp T;Melone K E;Meyer L R;Hazlett W D (NO, Suit 406, Karande and associates for fertility 1585 North Barrington Road, Email: vkarande@aol.com) : Comparison of NuvaRing and desogen in IVF cycles with ganirelix acetate. J Obstet Gynec India 2007, 57(3), 234-9.

To compare NuvaRing with Desogen for cycle pretreatment prior to controlled ovarian lyperstimulation (COH) in vitro fertilization (IVF) cycles. In this prospective randomized study conducted from May 2003 to August 2004, 79 patients undergoing COH for IVF cycles were included and randomized to received pretreatment with or Desogen estradiol (n=40) or NuvaRing (n=39) for 12-21 days starting from day 3 of their cycle. Cycle monitoring was done by transvaginal ultrasound or estradiol (E₂) levels. The main outcome measure was ovarian suppression. Chi square test and t test were used for statistical analysis. Ovarian volumes and antral follicle counts were similar before and after hormonal manipulation. E₂ levels before and after contraceptive use were similar in both the groups. The luteinizing hormone (LH) level after contraceptive use was significantly suppressed in both the groups. The NuvaRing group required less total dose of follitropin β. Pregnancy and implantation rates were similar in both the groups. Both NuvaRing and the oral contraceptive Desogen are good and comparable choices for cycle pretreatment prior to IVF.

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001441   Kar S;Surekha Kishore;Semwal J (NO, Himalayan Institute of Medical Sciences, Swami Rama Nagar, Jolly Grant, Dehradun) : Quality of care of acute resipratory tract infections in under five under primary health care in Dehradun district. Indian J Prev Soc Med 2007, 38(1-2), 47-52.

The study assesses the quality of care in Acute Respiratory Tract infections under primary health care in the various centers of both urban and rural Dehradun. Clients coming to the health facilities to seek care for their under five were observed during service delivery, according to the checklist devised by Aga Khan Foundation Module 6. Prior consent was taken from the centre authorities as well as the guardian. Ten such beneficiaries were observed in 14 centres selected by stratified multistage random sampling, the total being 140 children. The centres were also observed for their logistic support in terms of availability of septran and equipments needed to assess the child for ARI. It was observed that though the availability of the drug was satisfactory, the quality of the management was poor in all centres-both urban and rural Dehradun.

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001440   Kapoor R;Singh K J;Suri A;Singh P;Mandhani A (Urology Dep, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Email: rkapoor@sgpgi.ac.in) : Prolene (mesh) bulbourethral sling in male incontinence. Indian J Urol 2007, 23(1), 29-32.

Presents our preliminary results of bulbar urethral sling (single bolster) in treatment of postprostatectomy urinary incontinence (PPUI). From May 2003 to June 2005, six patients with postprostatectomy urinary incontinence (transurethral resection of prostate in five patients and after open prostatectomy in one patient) underwent prolene mesh bulbar urethral sling surgery. Preoperative evaluation included physical examination, neurological assessment, stress cystogram and urethrocystoscopy. Urodynamic evaluation was done in all patients for abdominal leak point pressure and ruling out bladder pathology. Urodynamic studies did not demonstrate bladder instability in any patient. Mean abdominal leak point pressure was 43cm of water (range 26-80 cm of water). Mean duration of hospital stay was 3.2 days. Follow-up ranged from 6-22 months. Four patients out of six patients were completely dry till their last follow-up. One patient developed mild stress incontinence after one year of the surgery and required use of one to two pads per day. Mean pad use after surgery was 0.6 pads per day in comparison to mean pad usage of 6.4 pads per day preoperatively. One patient was over-continent after the procedure and required clean intermittent catheterization till last follow-up (six months). Mean cost of the procedure was $ 350+15. Prolene bulbar urethral sling (single bolster) is an economically effective option in patients with postprostatectomy urinary incontinence.

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001439   Kapoor R;Agrawal S (Urology Dep, Sanjay Gandhi Post Graduate Institute of Medical Science, Lucknow-226 014, Email: rkapoor@sgpgi.ac.in) : Meningomylocele: An update. Indian J Urol 2007, 23(2), 181-6.

Therapy-resistant overactivity of detrusor or small capacity and poor compliance, will usually need to be treated by bladder augmentation. Heal or colonic patches are used frequently for augmenting the bladder, with either intestinal segment appearing to be equally useful. Stomach is rarely used because of the associated complications, but it is the only available intestinal segment for patients with impaired renal function. Concerns regarding long-term effects of associated metabolic acidosis, including abnormalities in linear growth and bone metabolism are misplaced. Ureterocystoplasty offers an attractive urothelium-preserving alternative, avoiding the metabolic complications, mucus production and cancer risk of heterotopic epithelium associated with enterocystoplasty. Though ideal for patients with dilated ureter and nonfunctioning kidney, in patients with functioning kidney it carries added risks associated with transuretero-ureterostomy, mainly obstruction. Ureteral dilatation in meningomyelocele patients is avoidable with proper follow-up and treatment. Therefore they rarely should be candidates for this operation. Alternative urothelium-preserving techniques, such as auto augmentation and seromuscular cystoplasty, have not proven to be as successful as standard augmentation with intestinal segment. Work is in progress on various bioengineering techniques to culture and combine bladder cells in tissue culture for regeneration. Early efforts are exciting, but preliminary.

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001438   Kapoor P;Kapoor A K;Sinha U S (Forensic Medicine Dep, M.L.N. Medical College, Allahabad-211 001) : Drug abuse: its clinico-pharmacologic and management aspects. Indian Internet J Forensic Med Toxicol 2007, 24(1), 19-25.

Of late, drug abuse is spreading like a wild fire to almost every part of the globe. 'Drugs' entice, captivate and ultimately cripple abusers from all walks and strata of life. No population or group is spared off the scourge of drug abuse and no one is immune by virtue of age, sex, class, and educational or economic status. World over millions of individuals particularly young adults and students are 'hooked' on dependence producing drugs. Thus, 'drug culture' is fast making inroads in the lives of young people from all walks of life. Indeed, this social scourge not only ruins the addict physically and mentally but also his familv physiologically, socially and economically to the extent of causing disruption of peace, harmony and happiness apart from creating apprehension in the minds of peace loving citizens too.

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001437   Kannur D M;Kulkarni A A;Paranjpe M P;Navangul M V (MAEERS, Maharashtra Institute of Pharmacy, MIT Canpus, Paud Road, Kothrud, Pune-411 038, Email: dinkannur@rediffmail.com) : Screening of antistress properties of herbal extracts and adaptogenic agent-a review. Pharmacog Rev 2008, 2(3), 95-101.

Stress is a daily phenomenon faced by every human, normal functioning of every individual is dependent on optimum levels of stress; it is very vital that stress is kept under control and normal functioning is not hampered due to excess of stress. Adaptogens are such herbal agents, which help the body to overcome excess stress even in chronic cases. Many marketed formulations claim to possess antistress actions, but still many herbs which have claims to be general tonics as well as wonder drugs need to be investigated and there claims be authenticated. In recent era there is a great thrust on screening of herbal extracts and formulations for Adaptogenic action. In this article efforts have been taken to list as well as discuss various models and parameters used for antistress activity. The motto is to discuss the models, to bring them under one title, which would surely prove to be some help to the researchers.

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001436   Kandpal S D;Srivastava A K;Negi K S;Singhal A;Aggarwal P (Community Medicine Dep, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dolwala, Dehradun) : Mental health profile of medical students of HIMS, Dehradun. 0000, , (NULL).

Objective of the study to assess the mental health profile of medical students. To identify the factors associated with the poor mental health profile. To suggest appropriate methods of intervention in consultation with the department of Holistic Medicine. The study was conducted at Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun. Maximum number of the study subjects (35.1%) were studying in MBBS 2nd Professional followed by 1st Professional (26.3%). Majority of the students with mental health score of ≥ 2 were found in IInd Professional (32.1%) closely followed by Ist Professional (31.5%). 39.5% of males having mental health score of ≥ 2 were found in Ist Professional. 79.6% of the medical students who had a mental health score of ≥ 2 belonged to nuclear family. Maximum number of male as well as female students (43.0%) having mental health score of ≥ 2 belonged to the age group of 20-22 years.

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001435   Kamath A;Yavaraja T B;Tongaonkar H B;Kane S (TB Dep of Genitourinary Oncology, Tata Memorial Hospital, Parel, Mumbai, Email: uroraj@redmail.com) : Carcinoma penis: how late can inguinal nodal metastases occur?. Indian J Urol 2007, 23(3), 321-2.

Inguinal nodal metastasis is the single most important prognostic factor for survival in a patient with carcinoma penis. In patients without inguinal lymph nodal metastasis at presentation, options include close surveillance or prophylactic inguinal lymph nodal dissection. The majority of patients on surveillance who develop inguinal nodal metastases do so within two to three years of treatment of the primary. Here we report a case who developed inguinal nodal metastasis 10 years after the treatment of primary. This raises questions about the natural history and biology of the disease, the optimum surveillance and whether a patient of carcinoma penis can ever be considered risk-free for metastasis.

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001434   Joshi S M;Patil S B (Preventive Social Medicine Dep, Padmashree Dr. D.Y. Patil Medical College, Nerul, Navi Mumbai-400 706) : Knowledge and practices of family planning in an urban slum of Mumbai. Indian J Prev Soc Med 2007, 38(1-2), 1-4.

Objective of the study is to find out the distribution of family planning practices with respect to socio-demographic factors like religion, education, age of the mother, family structure and parity. The study was conducted in urban slum field practice area under the Urban Health Centre, Tilak Nagar, Mumbai. Married women in the age group 15-44 years living with their spouses and residents of the slum. Socio-demographic variables like religion, Education, Age of the mother, Family structure, number of living children and contraceptive use. 44.5 % of the women were acceptors. Among the acceptors, 52.8 % were using spacing methods and 47.19 % had used terminal methods. Use of contraception increased with increase-in age and literacy. Family planning acceptance was found to be greater in nuclear families (48.1%) than joint families (40.2%). The percentage of acceptance increase with an increase in the number of living children, especially male children. Age of the mother, Literacy and living male children are strong incentive for family planning.

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001433   Joshi H;Jagadeesh P;Parle M (Pharmacognosy and Phytomedicine Dep, Soniya Education Trust's College of Pharmacy, S R Nagar, Dharwad, Karnataka, Email: amanjoshi17@yahoo.com) : Potential of phytochemical in management of cognitive disorders- an update. Pharmacog Rev 2008, 2(3), 54-60.

Memory function is vulnerable to a variety of pathologic processes including neurodegenerative diseases, strokes, tumors, head trauma, hypoxia, cardiac surgery, malnutrition, attention-deficit disorder, depression, anxiety, the side effects of medication, and normal ageing. Normal ageing is known to deteriorate memory in human beings. Oxygen free radicals, the harmful byproducts of oxidative metabolism are known to cause organic damage to the living system, which may be responsible for the development of Alzheimer's disease (AD) in elderly. AD is a progressive neurodegenerative brain disorder that occurs gradually and results in memory loss, unusual behavior, personality changes and ultimately death. It is the most common form of onset of adult dementia and attention deficit disorders. Nootropics represent a new class of psychotropic agents with selective facilitatory effect on integrative functions of the central nervous system, particularly on intellectual performance, learning capability and memory. AD begins as a deficiency in the production of the neurotransmitter acetylcholine. The National Institute of Health predicts, if the current trend continues, there will be more than 8.5 million AD patients by the year 2030 in USA alone. Amnesic mild cognitive impairment represents a transitional state between the cognitive changes of normal ageing and the earliest critical features of Alzheimer's disease. Although there is no cure for dementia of AD type at present, alternative pharmacologic treatment modalities can reduce the symptoms of cognitive impairment and slow disease progression. Presently, the allopathic system of medicine principally relies on nootropic agents, such as piracetam, aniracetam, fosracetam, nefiracetam, etc., and anticholinesterases, such as Donepezil and tacrine which are cpmmonly used for improving mood and behavior. However the Donepezil have adverse side effect on cholinergic symptoms particularly gastrointestinal symptoms like nausea, vomiting and diarrhea. Tacrine has adverse effect on liver toxicity, as shown by elevated serum amino transferases. Since allopathic system of medicine is yet provide a radical cure of AD, it is worthwhile to look for new direction, which would minimize the memory loss of patients with neuropsychiatric disorder. The utility of traditional medicines may be explored for treating patient with dementia. The phytochemicals proved to be of potential in the modulation of cognitive dysfunctions particularly Alzheimer's related disorders, have been discussed with special reference to their possible mechanism of action.

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