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Despite domestic violence and related homicides perpetrated by partners and/or in-laws being a significant public health problem in India, there are no reliable and valid instruments to identify and intervene with women in domestic violence relationships. Continued domestic violence can escalate to severe, near-lethal, or lethal violence or homicide. The Danger Assessment (DA) is a risk assessment instrument designed to assess the likelihood of severe, near-lethal, or lethal violence in abusive relationships. However, the DA is not designed to determine the risk of future severe, near-lethal, or lethal violence by in-laws. In-law abuse plays a significant role in domestic violence-related homicides in India and other countries with similar cultural norms. This study addressed this gap by developing the Danger Assessment for in-laws (DA-L) to assess risk from in-laws, alongside the Danger Assessment for Women in India (DA-WI) to assess risk from partners. The study also examined the psychometric properties of the DA-L and DA-WI. Longitudinal data from 150 women in India were used to measure the reliability and validity of the two versions of the DA. The original DA items and additional risk items were examined using relative risk ratios for their relationship with severe violence at three-month follow-ups. Predictive validity was tested with the receiver operating characteristic curve. The study resulted in reliable and valid measures (11 items DA-L and 26-items DA-WI) of risk. The versions of the DA can be useful for practitioners in India and those working with Indian women in the US and other countries. The DAs can be used for identifying women in domestic violence relationships who are at risk for future severe domestic violence and guide the provision of tailored safety plans., (© 2024. The Author(s).)

Background: The most frequently occurring painful and dose-limiting side effect of radiation therapy (RT) to the head and neck region is oral mucositis (OM). Several studies demonstrated that glutamine may reduce the severity and the duration of OM significantly during RT and chemo-radiotherapy in patients with head and neck cancer (HNC)., Materials and Methods: Between January 2021 and August 2022, a prospective single institutional case-control study compared the efficacy and safety of oral glutamine on radiation-induced mucositis in patients with HNC. Of 60 biopsy-proven patients with HNC, 30 patients in the study arm received oral glutamine suspension (10 g in 500 mL of water) orally once daily, 2 hours before RT, receiving definitive or adjuvant RT and chemo-radiotherapy, while as 30 patients in the control arm received placebo with the same dose and schedule (n = 30 in the study arm and n = 30 in the control arm)., Results and Analysis: A total of 27 (90%) in the glutamine arm and 28 (93.33%) patients in the control arm developed mucositis. Grade 3 mucositis (13.33%) and Grade 4 mucositis (6.66%), respectively, were significantly less ( P = .040 and P = .004) in the glutamine arm. The mean duration of grade 3 and grade 4 mucositis was significantly less in the glutamine arm (8.94 days in the study arm vs. 14.54 in the control arm; P = .0001). The mean time of onset of OM was significantly delayed in the glutamine arm in comparison to the control arm with P < .001., Conclusion: Glutamine delays the onset of OM and decreases the severity of OM in patients of HNC receiving RT with or without chemotherapy., (Copyright © 2024 Copyright: © 2024 Journal of Cancer Research and Therapeutics.)

Objective: Geriatric populations are most at risk for the tuberculosis pandemic, and as people age, the rate of infection rises steadily and drastically. Geriatric individuals frequently experience diagnostic challenges with a wide range of comorbidities, but employing all available standard and novel methods to diagnose any infection is crucial. The prophylactic and therapeutic management for the geriatric population presents a significant difficulty and challenge in assessing an appropriate and effective therapeutic outcome due to prolonged drug therapy and adverse drug reactions. The present study aims to determine the prevalence of tuberculosis in the geriatric population in the Indian subcontinent, its risk factors, clinical outcomes, and adherence to the medication., Patients and Methods: A prospective observational investigation was conducted in a tertiary care Hospital in Erode, Tamil Nadu, India, from April 2021 to September 2022. A total of 1,014 patients were screened, and 176 participants were selected. The participants were then subjected to medication adherence evaluation, and clinical data was collected.  The statistical analysis was performed using SPSS version 20.0., Results: Among 176 participants, 135 (76.70%) were old (65-74 age), 37 (21.02%) were very old (75-84 age) TB patients, and 4 (2.27%) patients were extremely old TB patients (>85). Medication adherence was improved from baseline to the end of the study (p≤0.000). 110 patients completed the treatment (62.5%). 41 patients were cured in between treatments (23.29%), 13 patients died during the treatment (7.38%), 9 patients lost their follow-up (5.11%), 3 patients failed to respond to the treatment (1.70%)., Conclusions: The effectiveness of therapy critically depends on the patient's medication adherence to anti-TB therapy. In addition to having a higher likelihood of therapy failure, elderly patients did not appropriately respond to the treatment and completely recovered from the infection even after effective pharmacotherapy.

Implementing unified municipal solid waste management (MSWM) is often difficult due to socio-economic variables. However, spatial GIS models and statistical analysis of solid waste characterized by the weekdays, weekends, and festivals can somewhat mitigate the variance and assist with selecting suitable waste management methods. This paper presents the example of Rajouri, India, to propose a suitable MSWM based on Inverse Distance Weighted (IDW) intensity maps and statistical findings. The considered region was divided into different sample sites based on the local population density, and Municipal Solid Waste (MSW) was collected from four locations in each site on weekdays, weekends, and festivals. Compositional analysis of the MSW was then used to generate spatial IDW models in QGIS 3.22.7 to interpolate MSW generation over the entire area. Finally, statistical analysis was conducted to gain insight into the waste generation and accumulation trends. The results show that Rajouri produces 245 tonnes of waste daily (per capita: 0.382 kg/day) with a large organic fraction compared to other waste categories. Besides, waste generation is observed to increase over weekends and festivals due to increased consumption of material goods. Composting could serve as a vector for municipal solid waste because of its increased organic component and cost constraints. However, further research on the potential segregation techniques for the organic fraction of solid waste is needed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Groundwater is a primary natural water source in the absence of surface water bodies. Groundwater in urban environments experiences unprecedented stress from urban growth, population increase, and industrial activities. This study assessed groundwater quality in terms of arsenic and heavy metal contamination in three industrial areas (Shahdara, Jhilmil, and Patparganj), Delhi, India. The water quality was assessed over a 3-year time interval (i.e., 2015 and 2018). The groundwater constituents investigated were As, Fe, Cr, Cd, Ni, Zn, Mn, Cu, and Pb. Metal index and heavy metal pollution indexes were estimated to assess groundwater pollution. The health risk was evaluated in terms of non-carcinogenic and carcinogenic risk assessment. Patparganj industrial area saw increment in concentration for Cu 0.23 mg/L (2015)-0.85 mg/L (2018), Zn 0.51 mg/L (2015)-7.2 mg/L (2018), Fe 0.32 mg/L (2015)-0.9 mg/L (2018), Cr 0.21 mg/L (2015)-0.26 mg/L (2018), Mn 0.14 mg/L (2015)-0.25 mg/L (2018), Ni 0.04 mg/L (2015)-0.34 mg/L (2018), and As 0.01 mg/L (2015)-0.18 mg/L (2018). Cd and Pb concentrations were observed to decrease by 40-90 % and 85-99% for all the three industrial areas. Metal index and heavy metal index values were found to be >1 for all locations. The risk quotient value > 1 was observed for all locations in the year 2015 but was found to increase further to a range of RQ 10-62 in the year 2018, inferring increased non-carcinogenic risk to consumers. The carcinogenic risk was significant with respect to Fe (0.2-0.7), Zn (0.001-0.007), and As (0.002-0.003) for all locations in the year 2015. This study concludes that groundwater in the three industrial areas is highly polluted and is not fit for human consumption. Further studies are required to explore possible control measures and develop methods to mitigate groundwater pollution, sustainable management, and optimized use to conserve it for future generations., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Noise monitoring and mapping is the critical processes to ensure that the noise level does not reach the harmful levels and provides noise exposure level details. 2-D and 3-D noise mapping has been carried out at pre-selected critical locations of major roads passing through densely populated residential areas, namely, Mathura Road, Lodhi Road, Lala Lajpat Rai Road, and Ring road, along with significant intersections, viz. Moolchand, Ashram, Sabz Burj, and Lodhi road. The monitoring has been performed during the day and night's peak traffic hours using Sound Level Meter (SLM) Larson & Davis 831as per standard procedure. Then after, 2-D and 3-D noise maps have been prepared, visualized, and analyzed by soundPLAN (acoustic) and MapInfo Pro (Desktop GIS). The maximum noise level is observed at Ashram Chowk [81.1 dB (A)] at 8 pm; however, the minimum noise level is found to be at Lala Lajpat Rai Road [76.4dB (A)] at 7 pm. Monitoring results of noise level show non-compliance of regulatory standards for day time and night time. 2-D noise maps revealed that the noise level is maximum at the centerline of the road and decreases either side with the distance, and remains above the permissible limits at all locations. However, the 3-D noise maps show horizontal as well as vertical noise levels at all locations. The 3-D noise maps also revealed a noise level of 70 dB (A) up to a height of 6.096m at the Ashram Chowk and Moolchand intersection. However, a noise level of 65 dB (A) has been observed at the height of 5.486m at Lala Lajpat Rai Marg and Sabz Burj. This study will explore noise levels in both horizontal and vertical directions near roads surrounded by high-rise buildings. It will help the decision-makers take remedial measures., Competing Interests: The authors have declared that no competing interests exist.

Hospital wastewater are a lurking threat to environment and human health security for any given moment of time owing to its complexity and high vulnerability to cause disease outbreak. Though there are a number of treatment process for wastewater., there is a high need for employing cost-efficient and sustainable method of treatment. Hence a pilot scale horizontal surface flow Constructed Wetland (HSFCW) coupled with Tubesettler was installed at New Delhi, India (February to may 2019). This study reports comparative pollutants removal from hospital wastewater using Constructed Wetlands and associated tubesettler dosed with Hospital wastewater. A pilot scale CW system was used for treating 10m 3 /day of hospital wastewater. The system was tested for 3 Months to evaluate its performance for removing pollutants from the wastewater. The HSFCW coupled with tubesettler achieved over all removal efficiency of 94% (COD), MLSS (97%), TSS (98%), BOD 5 (96%), Phosphate (79%). However, process of nitrification was not observed and accumulation of Nitrate up to 197% was observed. The study concluded that it may be due to the presence of pharmaceuticals and other elements present in hospital wastewater. This conclusion was based on the fact that Alkalinity increased by 52% in effluent and pH value also exhibited an average increase of 12%. Further research studies are required to investigate effect of pharmaceutical originating from hospital on treatment efficiency, to incorporate anaerobic setup to complete denitrification-nitrification process and also to determine efficiency of thermophilic, mesophilic, and psychrophilic bacteria with respect to climate and temperature., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Purpose: To report the spectrum of chest computed tomographic (CT) imaging findings in coronavirus disease-19 (COVID-19) infected Indian patients., Methods: This was a prospective descriptive study comprising 147 consecutive reverse transcriptase polymerase chain reaction (RT-PCR) positive patients who underwent CT chest. Prevalence, distribution, extent and type of abnormal lung findings were recorded., Results: Among the total study cohort of 147 patients, 104 (70.7 %) were males and 43 (29.3 %) were females with mean age of 40.9 ± 17.2 years (range 24-71 years). We observed lung parenchymal abnormalities in 51 (34.7 %) cases whereas 96 (65.3 %) RT-PCR positive cases had a normal chest CT. Only 12.2 % of the patients were dyspneic, 6.1 % had desaturation, 7.4 % had increased respiratory rate and 10.9 % had comorbidities. Among the patients with abnormal CT findings bilateral 39/51 (76.5 %), multilobar (88.2 %) lung involvement with a predominant peripheral and posterior distribution was commonly observed. With regards to the type of opacity, ground glass opacity (GGO) was the dominant abnormality found in all 51 (100 %) cases. Pure GGO was observed in 15 (29.4 %), GGO with crazy paving pattern was seen in 15 (29.4 %) and GGO mixed with consolidation was noted in 21(41.2 %). Peri-lesional or intralesional segmental or subsegmental pulmonary vessel enlargement was observed in 36 (70.6 %) cases., Conclusion: In this study population predominantly with mild symptoms and few comorbidities, two-thirds of RT-PCR positive patients had a normal chest CT; whereas the remaining patients showed typical findings of predominant GGOs with a bilateral distribution and peripheral predominance., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Leptospirosis is a zoonotic disease caused by the pathogenic helical spirochetes, Leptospira. Symptoms include sudden-onset fever, severe headaches, muscle pain, nausea and chills. Leptospirosis is endemic in developing countries such as Malaysia, India, Sri Lanka, and Brazil where thousands of cases are reported annually. The disease risk factors include the high population of reservoirs, environmental factors, recreational factors, and occupational factors. To end the endemicity of leptospirosis, these factors need to be tackled. The management of leptospirosis needs to be refined. Early diagnosis remains a challenge due to a lack of clinical suspicion among physicians, its non-specific symptoms and a limited availability of rapid point-of-care diagnostic tests. The purpose of this review is to provide insight into the status of leptospirosis in developing countries focusing on the risk factors and to propose methods for the improved management of the disease., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objectives: Guidelines recommend ACE inhibitors (ACEi), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs) and diuretics in all patients with diabetes mellitus. However, the effectiveness of these agents in South Asian and Chinese populations is unknown. We sought to determine whether ACEi, ARB, CCB and diuretics are associated with reduced mortality in South Asian, Chinese and other patients with diabetes., Design: Population-based cohort study using administrative health databases., Setting: Province of British Columbia, Canada (2006-2013)., Participants: Patients aged ≥35 years with incident diabetes., Primary and Secondary Outcome Measures: Primary outcome was all-cause mortality for each medication class compared with untreated patients within each ethnicity. Treatment effect was assessed using inverse probability of treatment weighted Cox proportional hazards models. Medication adherence effect on mortality was also evaluated., Results: 208 870 patients (13 755 South Asian, 22 871 Chinese, 172 244 other Canadian) were included. ACEi reduced mortality in other patients (HR=0.88, 0.84-0.91), but power was insufficient to evaluate for benefit in Chinese and South Asian patients. ARB and diuretics reduced mortality in Chinese (ARB HR=0.64, 0.50-0.82; diuretics HR=0.77, 0.62-0.96) and other patients (ARB HR=0.69, 0.64-0.74; diuretics HR=0.66, 0.63-0.69) compared with untreated patients. No mortality benefit was observed among South Asians for any drug class or for CCB among all ethnicities. Higher medication adherence was associated with lower mortality for other patients only (HR=0.79, 0.72-0.86)., Conclusions: Effectiveness of cardiovascular risk reduction therapy on mortality varies considerably by ethnicity. Further study is needed to evaluate the mortality benefit of antihypertensive agents in South Asians. Inclusion of these ethnic groups in future clinical trials is essential to examine for differential responses., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Purpose: Leber's hereditary optic neuropathy (LHON; OMIM 535000) is one of the most common maternally inherited mitochondrial disorders. Three mitochondrial DNA point mutations-m.3460G>A (MT-ND1), m.11778G>A (MT-ND4), and m.14484T>C (MT-ND6)-account for the majority of reported LHON cases. Only approximately 50% of males and approximately 10% of females carrying these mutations develop optic neuropathy and blindness. Additional factors, such as mtDNA/nuclear genetic background and environmental modifiers, are likely to contribute toward the observed incomplete penetrance and gender bias. We aimed to investigate whether mtDNA haplogroup influences LHON clinical expression in Indian patients harboring the m.11778G>A mutation., Methods: Detailed clinical assessment and complete mitochondrial genome sequencing was undertaken in 64 LHON families harboring the m.11778G>A mutation. Mitochondrial haplogroup was assigned based on evolutionarily conserved mtDNA variations., Results: A total of 543 individuals (295 male, 248 female) from 64 unrelated families harboring the m.11778G>A mutation were recruited to the study. The overall disease penetrance was 27.07% (146 of 543) and higher in males (37.9%; 112 of 295) than females (13.7%; 34 of 248). The mtDNA haplogroup analysis revealed that all affected probands belonged to different mtDNA haplogroups. No association between the m.11778G>A mutation and the background mtDNA haplogroup was detected., Conclusions: The first detailed study of Indian LHON patients confirm that the m.11778G>A-related LHON in India coexists with multiple different mtDNA haplogroups, unlike the preferential association of west Eurasian haplogroup J and the reported increased clinical penetrance with the J2 subhaplogroup. However, we observed variable penetrance of LHON in different Indian mtDNA haplogroup backgrounds, indicating their possible influence on clinical expression. These data suggest that a similar heterogeneity, resulting from the mtDNA haplogroup, might also exist in other mitochondrial diseases among Indian populations.

Mitochondrial oxidative phosphorylation (OXPHOS) disorders account for a variety of neuromuscular disorders in children. In this study mitochondrial respiratory chain enzymes were assayed in muscle tissue in a large cohort of children with varied neuromuscular presentations from June 2011 to December 2013. The biochemical enzyme deficiencies were correlated with the phenotypes, magnetic resonance imaging, histopathology and genetic findings to reach a final diagnosis. There were 85 children (mean age: 6.9±4.7years, M:F:2:1) with respiratory chain enzyme deficiency which included: isolated complex I (n=50, 60%), multiple complexes (n=24, 27%), complex IV (n=8, 9%) and complex III deficiencies (n=3, 4%). The most common neurological findings were ataxia (59%), hypotonia (59%) and involuntary movements (49%). A known mitochondrial syndrome was diagnosed in 27 (29%) and non-syndromic presentations in 57 (71%). Genetic analysis included complete sequencing of mitochondrial genome, SURF1, POLG1&2. It revealed variations in mitochondrial DNA (n=8), SURF1 (n=5), and POLG1 (n=3). This study, the first of its kind from India, highlights the wide range of clinical and imaging phenotypes and genetic heterogeneity in children with mitochondrial oxidative phosphorylation disorders., (Copyright © 2016 Elsevier B.V. and Mitochondria Research Society. All rights reserved.)

Objectives: Optimal control of type 2 diabetes is challenging in many patient populations including in South Asian patients. We systematically reviewed studies on the effect of diabetes management interventions targeted at South Asian patients with type 2 diabetes on glycaemic control., Design: Systematic review of MEDLINE, EMBASE and CINAHL databases for randomised controlled trials (RCTs) and pre-post-test studies (January 1990 to February 2014). Studies were stratified by where interventions were conducted (South Asia vs Western countries)., Participants: Patients originating from Pakistan, Bangladesh or India with type 2 diabetes., Primary Outcome: Change in glycated haemoglobin (HbA1c). Secondary end points included change in blood pressure, lipid levels, anthropomorphics and knowledge., Results: 23 studies (15 RCTs) met criteria for analysis with 7 from Western countries (n=2532) and 16 from South Asia (n=1081). Interventions in Western countries included translated diabetes education, additional clinical care, written materials, visual aids, and bilingual community-based peers and/or health professionals. Interventions conducted in South Asia included yoga, meditation or exercise, community-based peers, health professionals and dietary education (cooking exercises). Among RCTs in India (5 trials; n=390), 4 demonstrated significant reductions in HbA1c in the intervention group compared with usual care (yoga and exercise interventions). Among the 4 RCTs conducted in Europe (n=2161), only 1 study, an education intervention of 113 patients, reported a significant reduction in HbA1c with the intervention. Lipids, blood pressure and knowledge improved in both groups with studies from India more often reporting reductions in body mass index and waist circumference., Conclusions: Overall, there was little improvement in HbA1c level in diabetes management interventions targeted at South Asians living in Europe compared with usual care, although other outcomes did improve. The smaller studies in India demonstrated significant improvements in glycaemic and other end points. Novel strategies are needed to improve glycaemic control in South Asians living outside of India., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Hypertrophic cardiomyopathy (HCM) is a primary disorder, characterized by unexplained hypertrophy of the left ventricle that frequently involved in the inter-ventricular septum. Mitochondrial DNA (mtDNA) mutations and haplogroups have been found to be associated with several diseases. Therefore, in the present study, we have sequenced the complete mtDNA of 114 clinically well-characterized HCM patients to look for the role of mtDNA variations and haplogroups in HCM phenotype among Indian patients. Complete mtDNA analysis revealed 28 novel variations, 25 disease-associated and 50 private mutations. We found 13 (11.40%) HCM patients having novel non-synonymous and/or MT-tRNA variations, of which two (m.4797C>M and m.8728T>Y) were in heteroplasmic condition. In silico prediction showed that a few mutations are pathogenic, which may affect the energy production in the heart. Unlike some of the other studies, we did not find association of mitochondrial haplogroup with HCM., (Copyright © 2013 © Elsevier B.V. and Mitochondria Research Society. All rights reserved. Published by Elsevier B.V. All rights reserved.)

Background: An assessment of cancer incidence in population is required for prevention, early diagnosis, treatment and resource allocation. This will also guide in the formation of facilities for diagnosis, treatment, rehabilitation and follow-up for these patients. The demographic trend of cancer will help to identify common types and etiological factors. Efforts at clinical, research and administrative levels are needed to overcome this problem., Settings and Design: Present retro prospective study was conducted in regional cancer center of a tertiary care hospital., Materials and Methods: After permission from ethics committee, a retro prospective study of 1 year duration was undertaken to study the profile of cancer patients and to compare it with other cancer registries in India., Statistical Analysis: Pearson's Chi-square test and simple linear regression were used. Statistical Package for the Social Sciences version-16 (University of Bristol information services (www.bristol.ac.uk/is/learning/resources) was used., Results: The overall incidence of cancer in Kashmir is on the increase and common sites of cancer are esophagus and gastroesophageal (GE) junction, lung, stomach, colorectal, lymphomas, skin, laryngopharynx, acute leukemias, prostate and brain in males.In females common sites are breast, esophagus and GE junction, ovary, colorectal, stomach, lung, gallbladder, lymphomas, acute leukemias and brain., Conclusion: Cancers of esophagus, stomach and lungs have a high incidence both in men and women in Kashmir. Future studies on sources and types of environmental pollution and exposures in relation to these cancers may improve our understanding of risk factors held responsible for causation of these malignancies in this region. This will help in the allocation of available resources for prevention and treatment strategies.

Background: Mitochondrial DNA (mtDNA) mutations are known to cause Leber hereditary optic neuropathy (LHON). However, the co-occurrence of double pathogenic mutations with different pathological significance in pedigrees is a rare event., Methods: Detailed clinical investigation and complete mtDNA sequencing analysis was performed for two Indian families with LHON. The haplogroup was constructed based on evolutionarily important mtDNA variants., Results: We observed the existence of double pathogenic mutations (m.11778G>A and m.1555A>G) in two Indian LHON families, who are from different haplogroup backgrounds (M5a and U2e1), with different clinical penetrance of the disease (visual impairment). The m.11778G>A mutation in the MT-ND4 gene is associated primarily with LHON; whereas, m.1555A>G in the 12S rRNA gene has been reported with aminoglycoside-induced non-syndromic hearing loss., Conclusions: The absence of hearing abnormality and widely varying clinical expression of LHON suggest additional nuclear modifier genes, environmental factors, and population heterogeneity might play an important role in the expression of visual impairment in these families.

Purpose: To investigate the clinical and mitochondrial DNA (mtDNA) haplogroup background of Indian Leber hereditary optic neuropathy (LHON) patients carrying the m.14484T>C mutation., Methods: Detailed clinical investigation and complete mtDNA sequencing analysis was carried out for eight Indian LHON families with the m.14484T>C mutation. Haplogroup was constructed based on the evolutionarily important mtDNA variants., Results: In the present study, we characterized eight unrelated probands selected from 187 LHON cases. The overall penetrance of the disease was estimated to be 19.75% (16/81) in eight pedigrees with the m.14484T>C mutation and showed substantially higher sex bias (male: female = 13:3). The mtDNA haplogrouping revealed that they belong to diverse haplogroups; i.e., F1c1, M31a, U2a, M*, I1, M6, M3a1, and R30a. Interestingly, we did not find an association of the m.14484T>C mutation with any specific haplogroup within the Indian population. We also did not find any secondary mutation(s) in these pedigrees, which might affect the clinical expression of LHON., Conclusions: Contrary to earlier reports showing preferential association of the m.14484T>C mutation with western Eurasian haplogroup J and increased clinical penetrance when present in J1 subhaplogroup background, the present study shows that m.14484T>C arose independently in a different mtDNA haplogroup and ethnic background in India, which may influence the clinical expression of the disease.

Background and Objective: To study the incidence and pattern of gastro-oesophageal reflux disease (GORD) in patients with mild-to-moderate chronic obstructive pulmonary disease (COPD) using dual-probe 24-h oesophageal pH recording., Methods: This was a prospective study of 50 patients with mild-to-moderate stage COPD based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. A detailed history of illness along with spirometry was done in all patients. In the study group, reflux symptoms were measured using a validated scoring system. All the patients underwent oesophageal manometry and dual-probe 24-h oesophageal pH recording., Results: Symptoms of gastro-oesophageal reflux were present in 38 patients. Twenty-four-hour oesophageal pH monitoring revealed pathological reflux in 31 out of 38 symptomatic and 8 out of 12 asymptomatic patients. The overall rate of GORD was 78% in our study. Only distal GORD was observed in 11 (28.9%), and both distal and proximal GORD was observed in 20 (52.6%) out of the 38 symptomatic subjects. In the remaining 12 asymptomatic patients, eight had GORD. Distal GORD was present in six (50%) patients, and two (16.6%) had both distal and proximal GORD in this group. Isolated proximal GORD was not observed in any patient., Conclusions: There is an increased occurrence of GORD in patients with even mild-to-moderate COPD., (© 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.)

Background/objective: Esophageal cancer has a peculiar geographical distribution and shows marked differences in incidence within a particular geographical region. Presently, as there seems little prospect of early detection of this cancer, an understanding of the etiological factors may suggest opportunities for its primary prevention. In this paper, we have tried to determine the role of diet and other life-style related factors in the etiology of cancer of esophagus., Material and Methods: A total of 100 confirmed squamous cell carcinoma of esophagus patients were enrolled for the study (Group A). 100 healthy subjects were included as controls (Group B). A predesigned questionnaire dealing with the basic patient data, dietary and smoking habits etc. was distributed among the cases in both groups. The data was thoroughly analyzed to define an association with the development of cancer of esophagus., Results: Group A patients included 71 males and 29 females in the age range of 40-70 years. Majority 37% were farmers, 29% house wives. Of the 72% smokers, 66% smoked hookah. 29% had positive family history. More than 90% took salt-tea at breakfast. Meat consumption was low, 44% took it weekly and 42% on monthly basis. 69% took fish yearly. Group B included 75 males and 25 females of which 35.7% were hookah smokers., Conclusion: Poor socio-economic status resulting in fewer intakes of fresh fruits, vegetables and fish in addition to heavy hookah smoking are suspected to be the major risk factors for the development of esophageal cancer.

Aim: To study the clinico-pathological aspects of lung cancer, and the outcome of various treatment modalities., Methods: A retrospective review of histopathologically confirmed lung cancer patients who were registered and treated at our institution over a period of five years was carried out., Results: A total of 321 patients were studied. There was a preponderance of males (91.9%) as compared to females (8.1%). Smoking history was present in 88% of the male patients. Cough was the main presenting feature in 71.6% of patients. Diagnosis was established by bronchoscopy in 94% of cases. Squamous cell carcinoma was observed in 77.3%, while 17.1% had small cell carcinoma. Radiotherapy formed the main treatment modality alone (22.4%) and in combination (27%). Out of the 321 patients, 206 were evaluable on follow-up. Local failure and distant metastasis were seen in 9.2% and 19.9% of cases, respectively. The overall survival rate of 2, 3 and 5 years was 19.9%, 13.59% and 6.79%, respectively., Conclusions: . The outcome of lung cancer is poor. Increased survival is possible if the disease is detected early, treated adequately with multi modality approach.

A number of drugs, both single and compound preparations are used widely in Tibb-e-Unani (Unani medicine) in the management of renal diseases. But such drugs mostly, have not been investigated for their described effects. Jawarish Zarooni Sada (JZS) is one such polyherbal preparation containing 15 ingredients, mainly described to be diuretic and nephroprotective. Therefore, in the present study ethanol and water extracts of JZS (300 mg each) were investigated for diuretic activity by measuring the total urine output over a period of 6h. Sodium and potassium level in urine sample was also estimated. Nephroprotective activity of JZS against gentamicin-induced nephrotoxicity was investigated by administering JZS along with high dose of gentamicin (40 mg/kg) and elevation of serum urea and serum creatinine was taken as the index of nephrotoxicity. JZS showed significant diuretic and nephroprotective effect.