BACKGROUND & AIMS: This paper presents and discusses selected findings from a study of health-seeking strategies in relation to sexual health among a group of female sex workers in Calcutta, India. Background information on sex work and sexually transmitted disease in Calcutta is followed by the presentation of findings pertaining to women's understandings of (sexual) health, treatment-seeking and service utilisation. In the urban context where health services are readily available, patterns of initial treatment-seeking are shown to be generally (biomedically) appropriate, but subsequent "non-compliant" therapeutic practices give cause for concern. Conventional approaches to the study of "health-seeking behaviour" are reviewed in the light of these findings and questions raised about the appropriateness of approaches that focus on initial choice of treatment type and/or assume processes of health-seeking to be determined primarily by cultural "beliefs" about illness. Inherent biomedical and culturalist biases in the orientation of such research are shown to produce an analytic neglect of the dual influences of material life conditions and people's perceptions of health, rather than illness, upon health-related strategies. Recommendations are made for operational research and policy formulation on the provision of effective sexual health services, and implications are drawn for the scope of interventions and applied research directed at improving sexual health.

背景与目标： 本文介绍并讨论了印度加尔各答一群女性性工作者中与性健康相关的健康寻求策略研究中的部分发现。在加尔各答关于性工作和性传播疾病的背景信息之后，介绍与妇女对（性）健康，寻求治疗和利用服务的理解有关的发现。在容易获得卫生服务的城市环境中，最初寻求治疗的模式已被证明通常（生物医学上）是适当的，但是随后的“不依从”治疗方法引起了人们的关注。鉴于这些发现，对“寻求健康行为”研究的常规方法进行了回顾，并提出了一些针对以治疗类型的初始选择和/或假设寻求健康的过程主要由以下因素决定的方法是否适当的问题：关于疾病的文化“信仰”。研究方向上固有的生物医学和文化主义偏见表明，人们忽视了物质生活条件和人们对健康而不是疾病的看法对健康相关策略的双重影响。为提供有效的性健康服务的运营研究和政策制定提出了建议，并对旨在改善性健康的干预措施和应用研究的范围产生了影响。

BACKGROUND & AIMS: BACKGROUND:This study aimed at analyzing different treatments of breast cancer (BC) prevalent in the region, their effect on patients' survival, and discusses the most suitable method within available resources. METHODS:The study was set up at a tertiary care hospital in north India. We retrospectively reviewed data of 473 female BC patients who attended the departments of Surgical Oncology and Radiotherapy from January 1997 to December 1999. Patients with cTNM stage IV and inoperable stage III were included; those who defaulted or were lost to follow-up were excluded. Out of 473 patients, 372 were selected. The selected patients were divided into groups on the basis of place and type of local treatment they received: (1) local excision only, (2) standard breast conservation therapy (BCT), (3) total mastectomy (TM) + axillary lymph node dissection + radiotherapy (RT), and (4) modified radical mastectomy (MRM) + RT. Data regarding recurrence and survival were analyzed in December 2005. Minimum follow-up was 6 years. RESULTS:Overall recurrence rates were significantly higher in patients operated elsewhere (P <0.0001). Of 194 operated at our Breast Unit, 25 (14.6%) of 171 MRM patients and none of 23 BCT had recurrence. Of 178 patients operated elsewhere, 44 (100%), 6 (42.9%), 41 (41%), and 8 (40%) developed recurrence in groups 1, 2, 3, and 4 respectively. Overall survival was significantly better in patients with MRM at our unit versus TM outside (93.6% vs. 80%). CONCLUSIONS:Several types of treatment from improper local excision alone, BCT, TM, to a carefully done MRM are prevalent here. Properly done, MRM yields significant local control with survival benefit and appears to remain the gold standard in management of our BC patients.

背景与目标： 背景：本研究旨在分析该地区流行的乳腺癌（BC）的不同治疗方法，它们对患者生存的影响，并在可用资源范围内讨论最合适的方法。
方法：该研究是在印度北部的一家三级保健医院进行的。我们回顾性回顾了1997年1月至1999年12月就诊于外科肿瘤和放射治疗科的473例女性BC患者的数据。那些违约或失去随访的人被排除在外。在473名患者中，选择了372名。根据所接受的局部治疗的位置和类型将选定的患者分为几类：（1）仅局部切除，（2）标准乳房保留疗法（BCT），（3）全乳房切除术（TM）腋窝淋巴结清扫术放射疗法（RT）和（4）改良根治性乳房切除术（MRM）RT。有关复发和生存的数据于2005年12月进行了分析。最低随访时间为6年。
结果：在其他地方手术的患者的总体复发率显着更高（P <0.0001）。在我们的乳房科进行的194例手术中，171例MRM患者中有25例（占14.6％），而23例BCT均未复发。在178例在其他地方手术的患者中，分别在第1、2、3和4组中复发了44例（100％），6例（42.9％），41例（41％）和8例（40％）复发。我们单位的MRM患者的总生存期明显优于室外TM（93.6％vs. 80％）。
结论：从单独的不当局部切除，BCT，TM到精心制作的MRM的几种治疗方法在这里很普遍。正确完成后，MRM可以产生明显的局部控制并具有生存获益，并且似乎仍然是我们BC患者治疗的金标准。

BACKGROUND & AIMS: BACKGROUND:Epidemiological studies have shown significant ethnic differences in coronary heart disease death rates with South Asians showing significantly greater coronary heart disease mortality than other groups. PURPOSE:This research examined ethnic differences in cardiovascular reactivity (CVR) among Chinese, Malays and Indians in Singapore as well as a sample of Indians living in India. METHODS:Experiment 1 examined differences across 303 Chinese, Malay and Indian undergraduates in Singapore, while Experiment 2 looked at differences in CVR between Indian participants from Singapore, and 145 Indians living in India. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), cardiac index (CI) and total peripheral resistance index (TPRI) were measured during baselines and five laboratory tasks. RESULTS:Ethnicity main effects for SBP and CI reactivity were obtained in Experiment 1, with Indians showing significantly lower BP and CI reactivity than the Chinese and Malays. Significant main effects for sex were found with females showing lower reactivity than males for TPRI, and greater reactivity than males for HR and CI. Experiment 2 found that participants from India showed higher reactivity for SBP, HR and CI, while Indian participants from Singapore showed higher TPRI reactivity. These differences, however, often varied by task. CONCLUSIONS:These results point to differences in CVR among ethnic groups in Singapore as well as between Indians living in India and those living in Singapore. These differences may reflect cultural differences and need to be explored further with respect to their relationship to different rates of coronary heart disease among these groups.

背景与目标： 背景：流行病学研究表明，冠心病死亡率的种族差异显着，南亚人显示冠心病死亡率明显高于其他人群。
目的：本研究调查了新加坡华人，马来人和印第安人以及生活在印度的印第安人样本中心血管反应性（CVR）的种族差异。
方法：实验1研究了303名新加坡华裔，马来裔和印度裔本科生之间的差异，而实验2研究了新加坡的印度裔参与者与145名居住在印度的印度人之间CVR的差异。在基线和五个实验室任务期间测量了收缩压和舒张压（SBP，DBP），心率（HR），心脏指数（CI）和总外周阻力指数（TPRI）。
结果：种族对SBP和CI反应性的主要影响是在实验1中获得的，印度人的BP和CI反应性明显低于华人和马来人。发现性别具有重大的主要影响，女性对TPRI的反应性低于男性，而对HR和CI的反应性则高于男性。实验2发现印度参与者对SBP，HR和CI的反应性更高，而新加坡印度参与者对TPRI的反应性更高。但是，这些差异通常因任务而异。
结论：这些结果表明，新加坡各族裔之间以及居住在印度的印度人与居住在新加坡的印度人之间的CVR差异。这些差异可能反映了文化差异，因此需要进一步探讨这些差异与这些人群中冠心病发病率的关系。

BACKGROUND & AIMS: :Limb-girdle muscular dystrophies (LGMDs) are common in India. Information on LGMDs has been gradually evolving in the recent years. This information is scattered in case series and case studies. The aim of this study is to collate available Indian information on LGMDs and put it in perspective. PubMed search using keywords such as limb-girdle muscular dystrophies in India, sarcoglycanopathies, dysferlinopathy, calpainopathy, and GNE myopathy was carried out. The published information on LGMDs in Indian context suggests that dysferlinopathy, calpainopathy, sarcoglycanopathies, and other myopathies such as GNE myopathy are frequently seen in India. Besides these, anecdotal reports of many other forms are available, some with genetic support and others showing immunocytochemical defects. The genotypic information on LGMDs is gradually evolving and founder mutations have been detected in selected populations. Further multicenter studies are necessary to document the incidence and prevalence of these common conditions in India.

背景与目标： ：四肢肌营养不良症（LGMD）在印度很常见。近年来，有关LGMD的信息已逐渐发展。此信息分散在案例系列和案例研究中。这项研究的目的是整理有关LGMD的印度可用信息，并加以透视。使用关键词进行了PubMed搜索，例如印度的四肢肌肉营养不良，肌糖蛋白病，dysferlinopathy，钙蛋白酶病和GNE肌病。关于在印度背景下的LGMD的公开信息表明，在印度经常见到神经纤维异常，钙蛋白酶病，肌糖蛋白病和其他肌病，例如GNE肌病。除此之外，还有许多其他形式的轶事报道，其中一些具有遗传支持，而另一些则显示出免疫细胞化学缺陷。关于LGMD的基因型信息正在逐步发展，并且在选定的人群中发现了创始人突变。有必要进行进一步的多中心研究，以证明印度这些常见疾病的发生率和流行率。

BACKGROUND & AIMS: :To quantify the economic burden of maternal health care services on Indian households and examine the levels of expenditure incurred in public and private health care institutions at the national, state and community levels. Cross-sectional population data from the 2004 National Sample Survey Organisation were used, which considered 9,643 households for the analysis where at least one woman received maternal health care services during the year preceding the survey. Multilevel linear regression techniques were used to estimate the effect of household, cluster and state characteristics on the proportion of maternal health care expenditures over total household expenditures. Over 80 % of households reported paying for maternal health care services, with those using private care facilities paying almost 4 times more than those using public facilities. Multilevel analyses show evidence of high burden of maternal health care expenditures, which varied significantly across states according to the level of health care utilisation, and with considerable heterogeneity at the household and community levels. Maternal health care services in India are offered free at the point of delivery, yet many families face significant out-of-pocket expenditures. The recent governmental policy interventions to encourage institutional births by providing nominal financial assistance is a welcome step but this might not help to compensate mothers for other indirect expenditures, especially those living in rural areas and poorer communities who are increasingly seeking care in private facilities.

背景与目标： ：量化印度家庭中孕产妇保健服务的经济负担，并检查国家，州和社区各级公共和私人保健机构的支出水平。使用了2004年国家样本调查组织的横断面人口数据，该组织考虑了9,643户家庭进行分析，其中在调查前一年中至少有一名妇女接受了孕产妇保健服务。多级线性回归技术用于估计家庭，集群和州特征对孕产妇保健支出占家庭总支出的比例的影响。超过80％的家庭报告为产妇保健服务付费，使用私人护理设施的家庭支付的费用是使用公共设施的家庭的近4倍。多级分析表明，孕产妇医疗保健支出负担沉重，根据医疗保健利用水平的不同，各州之间差异很大，并且在家庭和社区层面存在很大的异质性。印度的产妇保健服务在分娩时是免费提供的，但是许多家庭面临大量的自付费用。最近的政府通过提供名义上的财政援助来鼓励机构生育的政策干预措施是可喜的一步，但这可能无助于补偿母亲的其他间接支出，特别是生活在农村地区和越来越多地在私人机构中寻求照料的贫困社区的母亲。

BACKGROUND & AIMS: OBJECTIVES:There is paucity of data on Primary immunodeficiency disorders (PID) from India. Here we describe the frequency of different primary immunodeficiency disorders, their clinical features and disease complications of 159 patients with PID diagnosed in a tertiary care center from India over the last 3 years. METHODS:We retrospectively reviewed the records of all the patients identified to have specific PID from 2008 to 2011. The diagnosed patients were classified according to guidelines of International Union of Immunological Society (IUIS) into eight different sub groups. RESULTS:The distribution pattern was as follows: diseases of immune dysregulation (29 %), phagocytic defects (29 %), predominant antibody deficiency (13 %), combined T and B cell deficiency (19 %) and other well defined diseases (10 %). CONCLUSION:The distribution pattern of PID varied significantly from those reported by western studies. This study highlights the need for development of more advanced facilities for diagnosis and management of PID in India and also the need for establishing population and hospital based registries.

背景与目标： 目的：印度缺乏有关原发性免疫缺陷疾病（PID）的数据。在这里，我们描述了过去3年间在印度三级护理中心诊断的159例PID的不同原发性免疫缺陷疾病的发生率，其临床特征和疾病并发症。
方法：我们回顾性回顾了2008年至2011年所有被鉴定为具有特定PID的患者的记录。根据国际免疫学会联合会（IUIS）的指南，将诊断出的患者分为八个不同的亚组。
结果：分布模式如下：免疫失调疾病（29％），吞噬缺陷（29％），主要抗体缺乏症（13％），T和B细胞联合缺乏症（19％）和其他明确疾病（10） ％）。
结论：PID的分布模式与西方研究报道的存在显着差异。这项研究突出了在印度开发用于PID诊断和管理的更先进设施的需求，以及建立以人口和医院为基础的注册表的需求。

BACKGROUND & AIMS: :A 58 year old male, chronic smoker, with diabetes mellitus (Type II), residing in Madhya Pradesh presented with dysphagia, hoarseness, odynophagia and significant weight loss. Microlaryngoscopy showed reddish ulcerated area involving valleculae, and pharyngo-epiglottic fold. Histopathological examination showed foamy macrophages containing Histoplasma capsulatum. Patient initially responded to Azoles, relapsed three months after stopping the treatment and presented with oral lesions. Biopsy showed H. capsulatum, histologically as well as on culture. The mycelial phase converted to yeast phase on B.H.I.A. at 37 degrees C confirming the isolate as H. capsulatum. The patient responded well to amphotericin B.

背景与目标： ：一位居住在中央邦的58岁男性，慢性吸烟者，患有糖尿病（II型），表现为吞咽困难，声音嘶哑，吞咽困难和体重减轻。微喉镜检查显示溃疡区带红色的溃疡区域，并有咽咽部褶皱。组织病理学检查显示泡沫状巨噬细胞含有荚膜组织胞浆。患者最初对Azoles有反应，在停止治疗后三个月复发，并出现口腔损伤。活检组织学和培养均显示荚膜H.。菌丝体相在B.H.I.A.上转化为酵母相。在37℃下确认该分离物为荚膜H.。该患者对两性霉素B反应良好。

BACKGROUND & AIMS: BACKGROUND:Tuberculosis is curable, but community surveys documenting epidemiological impact of the WHO-recommended DOTS strategy on tuberculosis prevalence have not been published. We used active community surveillance to compare the impact of DOTS with earlier programmes. METHODS:We conducted tuberculosis disease surveys using random cluster sampling of a rural population in South India approximately every 2.5 years from 1968 to 1986, using radiography as a screening tool for sputum examination. In 1999, DOTS was implemented in the area. Prevalence surveys using radiography and symptom screening were conducted at the start of DOTS implementation and after 2.5 years. RESULTS:From 1968 to 1999, culture-positive and smear-positive tuberculosis declined by 2.3 and 2.5% per annum compared with 11.9 and 5.6% after DOTS implementation. The 2.5 year period of DOTS implementation accounted for one-fourth of the decline in prevalence of culture-positive tuberculosis over 33 years. Multivariate analysis showed that prevalence of culture-positive tuberculosis decreased substantially (10.0% per annum, 95% CI: 2.8-16.6%) owing to DOTS after only slight declines related to temporal trends (2.1% annual decline, 95% CI: 1.1-3.2%) and short-course chemotherapy (1.5% annual decline, 95% CI: -9.7% to 11.5%). Under DOTS, the proportion of total cases identified through clinical care increased from 81 to 92%. CONCLUSIONS:Following DOTS implementation, prevalence of culture-positive tuberculosis decreased rapidly following a gradual decline for the previous 30 years. In the absence of a large HIV epidemic and with relatively low levels of rifampicin resistance, DOTS was associated with rapid reduction of tuberculosis prevalence.

背景与目标： 背景：结核病是可以治愈的，但尚未发表证明WHO推荐的DOTS策略对结核病患病率的流行病学影响的社区调查。我们使用了主动社区监视，将DOTS与早期计划的影响进行了比较。
方法：我们采用射线照相作为痰液检查的筛查工具，从1968年至1986年大约每2.5年对印度南部农村人口进行随机整群抽样调查，进行了结核病调查。 1999年，在该地区实施了DOTS。在DOTS实施之初和2.5年后，进行了放射照相和症状筛查的患病率调查。
结果：从1968年到1999年，培养阳性和涂片阳性的结核病每年下降2.3％和2.5％，而DOTS实施后分别下降11.9％和5.6％。实施DOTS的2.5年时间占了33年来培养阳性结核病患病率下降的四分之一。多因素分析表明，仅因与时间趋势相关的轻微下降（每年下降2.1％，95％CI：1.1-），DOTS导致培养阳性结核病的患病率大幅下降（每年10.0％，95％CI：2.8-16.6％）。 3.2％）和短程化疗（每年下降1.5％，95％CI：-9.7％至11.5％）。在DOTS中，通过临床护理发现的病例总数从81％增加到92％。
结论：在实施DOTS之后，在过去30年中，培养阳性结核病的患病率迅速下降。在没有艾滋病毒大流行且对利福平耐药性相对较低的情况下，DOTS与结核病患病率的快速降低有关。

BACKGROUND & AIMS: UNLABELLED:Pure red cell aplasia (PRCA) is an uncommon disorder, characterized by transfusion dependent anemia, reticulocytopenia with selective aplasia or paucity of erythroid cells in bone marrow. There are only a few large series of PRCA reported in literature. This is the largest single center series of PRCA from India. OBJECTIVE:To evaluate the utility of Immunohistochemistry with Glycophorin A on bone marrow biopsies in quantitating the cut-off percentage of erythroid blasts required for diagnosis, as the upper cut-off percentage of erythroblasts for establishing a diagnosis of PRCA is still not clear. METHODS:The clinical data were obtained from patients' case files. Immunohistochemistry with Glycophorin A was performed using an immunoperoxidase technique and percentage of Glycophorin A positive cells of all nucleated cells was calculated by two independent observers. RESULTS:In our study, bone marrow aspirates showed a variable percentage of erythroblasts ranging from 2 to 12% (mean 6.3%) in children and from 1 to 8% (mean 4.6%) in adults on Giemsa smears. Immunohistochemistry (IHC) with Glycophorin A showed a mean positive cell % of 8.2 (range 2-16%) and 6.8 (1-9%) in pediatric and adult respectively against a mean of 28% (range 21-39%) in idiopathic thrombocytopenia (ITP) cases. Treatment with prednisone showed good response in a majority of both adults and childhood PRCA. Cyclosporine was found to be a good alternative in prednisone non-responders. Thymectomy was beneficial in patients with thymoma. CONCLUSION:A higher percentage of erythroid cells (>5%) does not exclude a diagnosis of PRCA in an appropriate clinical setting and therefore can be managed as PRCA.

背景与目标： 纯净红细胞发育不全（PRCA）是一种罕见疾病，其特征为输血依赖性贫血，网状细胞减少伴选择性增生或骨髓中的红系细胞稀少。文献中仅报道了一些大型的PRCA系列。这是印度最大的PRCA单中心系列。
目的：评估糖蛋白A的免疫组织化学在骨髓活检中定量诊断所需要的红系胚细胞的截止百分比的实用性，因为尚无法确定诊断PRCA的红细胞的最高截止百分比。
方法：临床资料来自患者的病例档案。使用免疫过氧化物酶技术用糖蛋白A进行免疫组织化学，并由两名独立的观察员计算所有有核细胞中糖蛋白A阳性细胞的百分比。
结果：在我们的研究中，在Giemsa涂片上，骨髓抽吸物显示儿童中成纤维细胞的百分比可变，成人为2％至12％（平均6.3％），成人为1％至8％（平均4.6％）。糖皮质激素A的免疫组织化学（IHC）显示，儿科和成人的平均阳性细胞百分比分别为8.2（范围为2-16％）和6.8（1-9％），而特发性疾病的平均阳性细胞率为28％（范围为21-39％）血小板减少症（ITP）病例。泼尼松治疗在大多数成人和儿童PRCA中均显示出良好的反应。在强的松无反应者中发现环孢菌素是一个很好的选择。胸腺切除术对胸腺瘤患者有益。
结论：较高比例的红系细胞（> 5％）不能排除在适当的临床环境中诊断出PRCA，因此可以作为PRCA进行管理。

BACKGROUND & AIMS: BACKGROUND & OBJECTIVES:The relevance of the gut microbiota to human health is increasingly appreciated. The objective of this study was to compare the gut microbiota of a group of adult tribals with that of healthy adult villagers in Tamil Nadu, India. METHODS:Faeces were collected from 10 healthy tribal adults (TAs) in the Jawadhi hills and from 10 healthy villagers [rural adults (RAs)] in Vellore district, Tamil Nadu. DNA was extracted, and 456 bp segments comprising hypervariable regions 3 and 4 of the 16S rRNA gene were amplified, barcoded and 454 sequenced. RESULTS:Totally 227,710 good-quality reads were analyzed. TAs consumed a millets-based diet, ate pork every day, and did not consume milk or milk products. RAs consumed a rice-based diet with meat intake once a week. In both groups, Firmicutes was the most abundant phylum, followed by Proteobacteria, Bacteroidetes and Actinobacteria. The median Firmicutes-to-Bacteroidetes ratio was 34.0 in TA and 92.9 in RA groups. Actinobacteria were significantly low in TA, possibly due to non-consumption of milk. Clostridium constituted the most abundant genus in both groups, but was significantly more abundant in TAs than RAs, while Streptococcus was significantly more abundant in RA (P<0.05). Analyses of genetic distance revealed that the microbiota were distinctly different between TA and RA, and principal component analysis using 550 distinct taxonomically identifiable sequences revealed a clear separation of microbiota composition in the two groups. Phylogenetic analysis of major microbiota indicated clustering of microbial groups at different major branch points for TAs and RAs. INTERPRETATION & CONCLUSIONS:Phylum Firmicutes and genus Clostridium constituted the bulk of the faecal microbiota, while significant differences in composition between the groups were probably due to differences in diet and lifestyle.

背景与目标： 背景与目的：肠道菌群与人类健康的关系日益受到人们的重视。这项研究的目的是比较一群成年部落的肠道菌群与印度泰米尔纳德邦健康成年村民的肠道菌群。
方法：从贾瓦迪山的10个健康的部落成年人（TA）和泰米尔纳德邦韦洛尔区的10个健康的村民[农村成年人（RA）]收集粪便。提取DNA，扩增包含16S rRNA基因的高变区3和4的456 bp片段，进行条形码编码和454测序。
结果：总共分析了227,710次高质量阅读。 TAs消费以粟为基础的饮食，每天吃猪肉，不消费牛奶或奶制品。类风湿性关节炎每周食用一次以米为基础的饮食，并摄入肉类。在这两组中，Firmicutes是最丰富的门，其次是Proteobacteria，Bacteroidetes和Actinobacteria。 TA组中硬菌与拟杆菌的中位数比为34.0，RA组中值为92.9。放线菌的TA含量很低，可能是由于不食用牛奶造成的。梭菌是两组中最丰富的属，但是TA中的RA比RA中的丰富得多，而链球菌在RA中的含量明显更高（P <0.05）。遗传距离分析显示，TA和RA之间的菌群明显不同，使用550种不同的生物分类学可识别序列进行的主成分分析表明，两组中菌群的组成明显分离。主要微生物群的系统发育分析表明，TA和RA的不同主要分支点处的微生物群聚集。
解释与结论：Phylum Firmicutes和梭状芽胞杆菌属构成了粪便微生物群的主体，而各组之间组成的显着差异可能是由于饮食和生活方式的差异所致。

BACKGROUND & AIMS: BACKGROUND:Road traffic injuries contribute substantially to the disease burden in India. This paper describes the road safety issues discussed by members of the Indian Parliament, and highlights the gaps that need to be addressed to make road safety visible as a public health problem to policy-makers in India. METHODS:All questions asked to and information provided by the Ministry of Road Transport and Highways, and questions relating to accident asked to the Ministry of Health and Family Welfare of the Government of India were reviewed for the two Houses of the Indian Parliament for the years 2002 to 2004. RESULTS:Of the 1529 questions asked to the Ministry of Road Transport and Highways, only 140 (9.1%) were related to road safety, whereas 1076 (70.5%), 181 (11.8%), 51 (3.3%) and 81 (5.3%) were related to other aspects of the national highways, state roads, vehicles and other issues, respectively. Data on the magnitude of road crashes dealt only with the number of crashes and fatalities and not with the age, sex and type of road users affected by road traffic injuries. The parliamentarians were informed that human error was the main cause of road crashes in India; however, the robustness of this information is questionable. Strategies to prevent road crashes focused mainly on training of drivers with little attention to other factors that cause road crashes. The discussion on legislations also focused on drivers, ignoring other road users. Ten of the 4741 questions (0.2%) asked to Ministry of Health and Family Welfare were related to accident, the majority of which were about the setting up of trauma care services. CONCLUSION:An appropriate policy and intervention response by policy-makers is not possible with data that are presented in a manner that do not highlight the true nature of the problem, and are neither comprehensive nor robust. Majority of the proposed road safety interventions by the Ministry of Road Transport and Highways are based on the traditional view of human error as a major cause of road crashes highlighting the lack of a scientific public health approach towards prevention of road crashes. It would be useful to build the technical capacity of the Ministry of Road Transport and Highways in road safety to use the available data more effectively, and to facilitate generation of further relevant data about the magnitude, underlying causes and impact of road traffic injuries, for policy-makers to better understand the critical issues for planning effective road safety policies and interventions to reduce the high burden of mortality and morbidity due to road crashes in India.

背景与目标： 背景：道路交通伤害在印度大大增加了疾病负担。本文介绍了印度国会议员所讨论的道路安全问题，并着重指出了需要解决的差距，以使道路安全成为印度决策者的公共卫生问题。
方法：多年来，印度议会两院均审查了道路运输和公路部向印度政府提出的所有问题和提供的信息，以及向印度政府卫生和家庭福利部提出的与事故有关的问题。 2002年至2004年。
结果：在向公路交通和公路部提出的1529个问题中，只有140个（9.1％）与道路安全有关，而1076个（70.5％），181个（11.8％），51个（3.3％）和81个（5.3） ％）分别与国道，国道，车辆和其他问题有关。关于道路交通事故严重程度的数据仅涉及道路交通事故和死亡人数，而不涉及受道路交通伤害影响的道路使用者的年龄，性别和类型。议员们获悉，人为错误是印度道路交通事故的主要原因。但是，此信息的鲁棒性值得怀疑。预防道路交通事故的策略主要集中在对驾驶员的培训上，而很少注意引起道路交通事故的其他因素。有关立法的讨论也集中在驾驶员身上，而忽略了其他道路使用者。向卫生和家庭福利部提出的4741个问题中有10个（占0.2％）与事故有关，其中大多数与建立创伤护理服务有关。
结论：政策制定者不可能采取适当的政策和干预措施，而所提供的数据不能突出问题的真实本质，而且既不全面也不可靠。公路运输和公路部拟议的大多数道路安全干预措施均基于传统的人为失误观点，认为人为失误是造成道路交通事故的主要原因，这突出表明缺乏科学的公共卫生方法来预防道路交通事故。建设公路运输和公路部在道路安全方面的技术能力，以便更有效地利用现有数据，并有助于生成有关道路交通伤害的程度，根本原因和影响的进一步相关数据，对于以下方面将是有益的：政策制定者可以更好地了解规划有效的道路安全政策和干预措施的关键问题，以减少印度道路交通事故造成的高死亡率和高发病率负担。

BACKGROUND & AIMS: :Venoms of Russell's vipers (genus Daboia) are known for their deadly coagulopathic and other effects. We herein studied various isoforms of venom phospholipases A(2) (PLAs) from two Daboia species at their geographic boundary. From Myanmar Daboia siamensis venom (designated as DsM), four PLAs (designated DsM-aI, aI', aII' and bI') were purified, and the cDNAs encoding two acidic (DsM-aI and aII) and two basic PLAs (DsM-bI and S1) were also cloned from its venom-glands. DsM-S1 is identical to the major venom PLA of southern India Daboia russelii, but the protein is absent from the venom. Additionally, four PLAs (designated DrK-aI, aII, bI and bII) were cloned from cDNA obtained from venom glands of a Kolkata D. russelii, and the PLAs were purified from the pooled venom (designated as DrK). The acidic DrK-aI is the most neurotoxic and lethal among these PLAs; DsM-aI which differs from DrK-aI by only the Phe2 substitution shows greatly reduced enzymatic activity and lethality. Both acidic PLAs do not form dimeric complex with basic PLAs in the same venoms. DsM-bI' is neurotoxic and lethal but its orthologous DrK-bI (97% identical to DsM-bI') is a much weaker toxin. Given the fact that most of the orthologous PLAs of DrK and DsM share 97-100% sequence identity, Daboia vipers of Myanmar and Kolkata must be closely related. Molecular phylogenetic analyses on 30 venom PLAs of Eurasian vipers' revealed co-evolution of five subtypes of venom PLAs in both Daboia and Vipera genera. Our results shed light on the intra- and inter-species variations and structure-function relationships of viperid venom PLAs.

背景与目标： ：Russell的毒蛇（Daboia属）的毒液以致命的凝血病和其他功效而闻名。我们在这里研究了来自两个Daboia物种在其地理边界处的毒性磷脂酶A（2）（PLA）的各种同工型。从缅甸Daboia siamensis毒液（称为DsM）中，纯化了四个PLA（分别称为DsM-aI，aI'，aII'和bI'），并编码了两个酸性（DsM-aI和aII）和两个碱性PLA（DsM）的cDNA。 -bI和S1）也从其毒腺中克隆得到。 DsM-S1与印度南部Daboia russelii的主要毒液PLA相同，但该毒液中不存在该蛋白质。另外，从得自罗氏加尔各答蛇毒腺的cDNA克隆了四个PLA（命名为DrK-aI，aII，bI和bII），并从合并的毒液（命名为DrK）中纯化了PLA。在这些PLA中，酸性DrK-aI具有最高的神经毒性和致死性。 DsM-aI与DrK-aI的不同之处仅在于Phe2取代，显示酶活性和杀伤力大大降低。两种酸性PLA在同一毒液中均不会与碱性PLA形成二聚体复合物。 DsM-bI'具有神经毒性和致死性，但其直系同源的DrK-bI（与DsM-bI'97％相同）是一种弱得多的毒素。鉴于大多数DrK和DsM的直系同源PLA拥有97-100％的序列同一性，因此缅甸和加尔各答的Daboia蛇蝎必须紧密相关。对欧亚vi蛇的30种毒液PLA进行分子系统发育分析，揭示了Daboia和Vipera属中5种亚型毒液PLA的共同进化。我们的研究结果揭示了蛇毒PLA的种内和种间变异以及结构与功能的关系。

BACKGROUND & AIMS: BACKGROUND & OBJECTIVE:Estimation of maternal mortality has been difficult because of large sample size requirement. A study using snowball technique for identification of households where maternal death has taken place and its related causes was conducted. We present here the feasibility of carrying out the snowball technique for capturing maternal deaths as against house-to-house survey and to obtain the estimates of maternal mortality ratio (MMR) in some selected States of India. METHODS:Five states representing high MMR (Uttar Pradesh), medium MMR (Maharashtra, Karnataka, Uttranchal) and low MMR (Delhi) were selected. A total of 8 PHCs and 3 (UFS) were covered. Study used both house-to-house survey and snowball technique to enumerate the maternal deaths in the selected PHCs in rural area and urban frame survey (UFS) in urban area. RESULTS:In all, 94 maternal deaths were captured through snowball technique as against 83 through house-to-house survey. The estimate of MMR for the five States combined was 356 per 100,000 live births, as compared to assumed 400 per 100,000 live births for the country as a whole. The relative standard error of the estimate of MMR was about 10 per cent. INTERPRETATION & CONCLUSION:Snowball technique captured more maternal deaths than those in house-to-house survey particularly in rural areas. The estimates also indicated the feasibility of replicating the proposed methodology for estimation of MMR as a time and cost-effective methodology.

背景与目标： 背景与目的：由于样本量大，难以估计产妇死亡率。进行了一项使用雪球技术来识别已发生产妇死亡及其相关原因的家庭的研究。我们在这里介绍了进行雪球技术来捕获孕产妇死亡的可行性，而不是逐户进行调查，并获得了印度某些选定国家的孕产妇死亡率（MMR）的估计值。
方法：选择代表高MMR（北方邦），中等MMR（马哈拉施特拉邦，卡纳塔克邦，北方邦）和低MMR（德里）的五个州。总共涵盖了8个PHC和3个（UFS）。该研究使用逐户调查和滚雪球技术来枚举农村部分重点城市的孕产妇死亡人数，以及城市地区的城市框架调查（UFS）。
结果：通过滚雪球技术共捕获了94名孕产妇死亡，而通过逐户调查获得了83名孕产妇死亡。五个国家的MMR估算合计为每100,000例活产356例，而整个国家的假设为每100,000例活产400例。 MMR估计值的相对标准误差约为10％。
解释与结论：雪球技术捕获的孕产妇死亡人数比逐户调查的死亡人数高，尤其是在农村地区。估算还表明，将拟议的MMR估算方法复制为一种既省时又具有成本效益的方法是可行的。

BACKGROUND & AIMS: :Neuroimaging after a first unprovoked seizure may show significant abnormalities. In our study, 32% of all children with a first apparent unprovoked seizure had an abnormal CT scan result. Most of these were ring-enhancing lesions of cysticercal or tubercular origin.

背景与目标： ：首次无故癫痫发作后的神经影像检查可能显示明显异常。在我们的研究中，有32％的首次明显无故癫痫发作的儿童具有异常的CT扫描结果。这些大多数是囊性或结核性起源的环状增强病变。

BACKGROUND & AIMS: :The authors present a case series of 54 subjects of Rhinosporidium. They were reported in two years at a tertiary care hospital of Western Orissa. The clinically diagnosed cases by ophthalmologists were confirmed by histopathological samples following surgery. In our series, we noted Rhinosporidium seeberi organisms as the main causative agent. Males were affected three times more than females. Children less than 10 years of age comprised more than 50% of our series. In 91% of cases, the conjunctiva was the site of this infection. Total excision of fungal mass was carried out in all cases and two cases had recurrence between 9 and 12 months following intervention. Although this is an endemic area for such infestation, unilateral manifestation observed in all cases is interesting to note. Low recurrence rate in limited follow-up period could be due to early detection and standard management.

背景与目标： ：作者介绍了54个犀牛孢子虫的病例系列。据报道，他们在西奥里萨邦的一家三级医院就读了两年。眼科医生的临床诊断病例由手术后的组织病理学样本证实。在我们的系列文章中，我们注意到鼻孢子虫菌是主要的病原体。男性受到的影响比女性多三倍。 10岁以下的儿童占我们系列的50％以上。在91％的病例中，结膜是该感染的部位。所有病例均行真菌肿块全切术，其中2例在干预后9至12个月内复发。尽管这是此类病的流行地区，但在所有情况下观察到的单侧表现都值得一提。在有限的随访期内复发率低可能归因于早期发现和标准管理。