Plasma levels of Rifampicin and Pyrazinamide with pre and post meal administration in tuberculosis patients

CONTEXT

Various factors affect plasma concentrations of antitubercular drugs in different populations so dosing schedule should be adjusted after therapeutic drug monitoring.

AIMS

To study variability in plasma concentrations of Rifampicin and Pyrazinamide with pre and post-meal administration of drugs in tuberculosis patients.

METHODS AND MATERIAL

52 patients of pulmonary tuberculosis, divided in to two groups, pre and post-meal through systemic randomization. After taking pre-dose sample, drugs were administered according to the group. Samples were withdrawn at 2, 4, 6, and 10h after drug administration. Analysis of samples was done using HPLC.

RESULTS

Mean±1SD of C_max of Rifampicin was 7.75±2.82μg/ml, mean±1SD of AUC_0-10 was 42.17±17.25μgh/ml, adjusted T_max was 4.25h. In pre-meal samples, the corresponding values were 7.75±2.88μg/ml, 42.83±18.47μgh/ml, 3.76h and in post-meal samples 8.03±2.30μg/ml, 41.56±16.46μgh/ml and 4.75h. Mean±1SD of C_max levels of Pyrazinamide was 54.49±21.86μg/ml, mean±1SD of AUC_0-10 was 337.94±124.28μgh/ml and adjusted T_max was 3.49h. In pre-meal samples the corresponding values were 52.00±19.13μg/ml, 329.96±112.11μgh/ml, 3.23h, and in post-meal samples 57.43±23.61μg/ml, 345.58±136.99μgh/ml, 3.54h.

CONCLUSION

There is huge variability in the plasma levels of Rifampicin and Pyrazinamide in population of this sub-himalayan region.

A prospective cohort study assessing the appearance of retrieved aesthetic orthodontic archwires

OBJECTIVES

To investigate the appearance of three esthetic nickel titanium (NiTi) wires after 6 weeks of intra-oral cycling and to determine the association between objective and subjective measures of esthetics.

SETTING AND SAMPLE POPULATION

A prospective cohort study was undertaken involving participants undergoing upper fixed orthodontic appliance treatment with ceramic brackets.

MATERIALS AND METHODS

Fifty participants were assigned to one of three groups of NiTi esthetic wires (American Orthodontics Ever White™, Forestadent Biocosmetic™ and GAC High Aesthetic™), with wires retrieved after 6 weeks in situ. Participants completed a bespoke questionnaire exploring perceptions of wire esthetics. Objective measurement of coating loss was undertaken using a custom arch wire jig.

RESULTS

American Orthodontics Ever White™ had the greatest mean coating loss (50.7%) followed by Forestadent Biocosmetic™ (6%), with GAC High Aesthetic TM undergoing minimal loss (0.07%) (P < .001). The majority of coating loss with the American Orthodontics Ever White™ wires arose in the anterior region while Forestadent Biocosmetic™ wires and GAC High Aesthetic™ wires exhibited coating loss posteriorly (P < .001). These findings were reflected in the subjective assessment with a negative correlation found between coating loss and final Visual Analogue Scale scores (P < .001).

CONCLUSIONS

Considerable esthetic variation between arch wires following 6 weeks of intraoral cycling was identified in this prospective cohort study. Intraoral cycling has a negative impact on participant perception of arch wire esthetics, and objective and subjective assessment of wire esthetics appears to be consistent.

Condition factor and organosomatic indices of parasitized Rattus rattus as indicators of host health

This study describes the influence of parasitism (Trypanosoma lewisi and Cysticercus fasciolaris) on the condition factor, hepato and splenosomatic indices of the common house rat, Rattus rattus Linnaeus, 1758 from Rohilkhand, Uttar Pradesh, India. Examination of R. rattus (n = 389) revealed T. lewisi (prevalence 12.40 %; intensity14 parasites/1000 RBC) from the blood and C. fasciolaris (larval Taenia taeniaeformis) (prevalence 46.70 %; intensity 2-4 par/host) from the liver. Condition factor (K) and organosomatic indices [hepatosomatic index, spleenosomatic index (SSI)] were evaluated in two groups (Group I non pregnant, Group II pregnant) of female rats which were further subdivided into four subgroups each (a Uninfected, b T. lewisi infected, c C. fasciolaris infected, d T. lewisi and C. fasciolaris infected) belonging to three weight groups (A 50-100 g; B 100-150 g; C 150-200 g). The results indicated that reduction in K-factor was more apparent in young rats, Group Ic (weight category A) showing the maximum depletion (21.62 %), hepatomegaly and splenomegaly were frequent outcomes of parasitic infection and maximum change (50 %) was recorded in dual-infected pregnant rats (Group IId) expressed as SSI of the infected rat. The abnormal condition factor and organosomatic indices indicate perturbations in the biological systems at the organismal level. Thus, the information generated through this piece of work is a warning of an incipient or impending problem.

Antitubercular therapy induced liver function tests abnormalities in human immunodeficiency virus infected individuals

BACKGROUND

Both antitubercular therapy (ATT) and antiretroviral therapy (ART) can cause drug induced liver injury (DILI) in tuberculosis (TB) and human immunodeficiency virus (HIV) coinfection. The aim of this research was to study ATT-induced liver function test (LFT) abnormalities in HIV-infected patients.

METHODS

HIV-infected patients diagnosed with TB were evaluated with baseline LFT and CD4 counts. ATT regimen was modified if baseline LFT was significantly abnormal. Patients on protease inhibitors were given rifabutin instead of rifampicin. In patients on nevirapine-based ART, efavirenz was substituted for nevirapine. In ART-naive patients, the timing of introduction of ART was according to CD4 cell counts. LFT were repeated fortnightly or as clinically indicated for 10 weeks.

RESULTS

We studied 100 patients with HIV ([M - 67, F - 23], mean age: 40.05 ± 10.75 years, mean CD4 cell count: 239.157 ± 228.49 cells/dL). Sixty-one patients were on ART prior to diagnosis of TB. Baseline LFT abnormalities (n = 40) were similar in ART and non-ART group (28/61 vs 12/39, p = 0.13). After starting ATT, derangement of LFT was observed in majority of patients (99/100). However, liver sparing ATT was required only in 15 patients. Bilirubin >2.5 mg/dL was seen only in 9 patients. Significant rise in transaminases was commoner in patients on concurrent ART and ATT (p = 0.044) and with baseline LFT abnormalities (p = 0.00016). There was no case of acute liver failure or mortality.

CONCLUSION

Mild LFT abnormalities are common in HIV-infected individuals on ATT. Concomitant use of ATT and ART and baseline LFT abnormalities increase the risk of significant DILI. However, with closer follow-up, serious liver injury can be prevented.

Observations on traditional usage of ethnomedicinal plants in humans and animals of Kangra and Chamba districts of Himachal Pradesh in North-Western Himalaya, India

ETHNOBOTANICAL RELEVANCE

Medicinal plants are frequently used by Gaddi and Gujjar tribes of Kangra and Chamba districts of Himachal Pradesh, India to cure various ailments in humans and livestock. Therefore, extensive field work was conducted to document the traditional use of ethnomedicinal plants by these tribes.

MATERIALS AND METHODS

Direct interviews of 208 informants were conducted. The data generated through interviews was analysed using quantitative tools such as use-value (UV), factor informant consensus (Fic) and fidelity level (Fl).

RESULTS

A total of 73 plant species in 67 genera and 40 families were observed to be medicinal and used to cure 22 ailment categories. The highest number of ethnomedicinal plants was recorded from the family Asteraceae followed by Lamiaceae, Apiaceae, Acanthaceae, Caesalpiniaceae, Polygonaceae, Ranunculaceae, Rosaceae and Rutaceae. Leaves were the most frequently used plant part used to treat various ailments followed by whole plant and roots or rhizomes. Ajuga parviflora, Berberis lycium, Viola canescens, Vitex negundo and Zanthoxylum armatum were the most important medicinal plants used for treating human diseases, whereas Achyranthes bidentata, Aloe sp., Cassia fistula, Podophyllum hexandrum and Pogostemon benghalensis were the most important medicinal plants used for treating animal diseases as per use value. The important ailment categories classified on the basis of factor informant consensus were gastrointestinal and respiratory disorders.

CONCLUSION

The present study revealed that people of the study area are extensively using the ethnomedicinal plants to cure various ailments. Plants with high use value and fidelity level should be subjected to pharmacological investigation for scientific validation.

A Traditional NSAID Aspirin along with Clofazimine in Erythema Nodosum Leprosum Reaction: Study of Six Cases

Six male patients of lepromatous leprosy with erythema nodosum leprosum reaction (ENL) reactions diagnosed clinically and by slit skin smear were treated with aspirin and clofazimine. Aspirin was given in the daily dosage of 75mg/kg body weight up to a maximum of 2.8 grams in four divided doses, along with daily 300mg clofazimine in three divided doses and dapsone 100mg daily with rifampicin 600mg once a month. Aspirin was continued in the same dosage for a month before being tapered and stopped at the end of third month when clofazimine was also reduced to 50 mg daily. All the six cases had an excellent response in 15 days.

In Vitro and In Vivo Evaluation of Niosomal Formulation for Controlled Delivery of Clarithromycin

The present study was focused on formulating and evaluating clarithromycin (CLR) containing niosomal formulation for in vitro and in vivo pharmacokinetic behavior. Niosomal formulations (empty and drug loaded) were prepared by using different ratio of surfactant (various Span grades 20, 40, 60, and 80) and cholesterol by thin film hydration method and were evaluated for in vitro characteristics, stability studies, and in vivo study. Dicetyl phosphate (DCP) was added to the niosomal formulation. Various pharmacokinetic parameters were determined from plasma of male SD rats. Span 60 containing niosomal formulation NC2 (cholesterol to surfactant ratio 1 : 1) displayed highest entrapment efficiency with desired particle size of 4.67 μm. TEM analyses showed that niosomal formulation was spherical in shape. Niosomes containing Span 60 displayed higher percentage of drug release after 24 h as compared to other formulations. NC2 formulation was found to be stable at the end of the study on storage condition. Various pharmacokinetic parameters, namely, AUC, AUMC, and MRT of niosomal formulation, were found to be 1.5-fold, 4-fold, and 3-fold plain drug, respectively. The present study suggested that niosomal formulations provide sustained and prolonged delivery of drug with enhance bioavailability.

Current Developments in Antimicrobial Surface Coatings for Biomedical Applications

Bacterial adhesion and subsequent biofilm formation on material surfaces represent a serious problem in society from both an economical and health perspective. Surface coating approaches to prevent bacterial adhesion and biofilm formation are of increased importance due to the increasing prevalence of antibiotic resistant bacterial strains. Effective antimicrobial surface coatings can be based on an anti-adhesive principle that prevents bacteria to adhere, or on bactericidal strategies, killing organisms either before or after contact is made with the surface. Many strategies, however, implement a multifunctional approach that incorporates both of these mechanisms. For anti-adhesive strategies, the use of polymer chains, or hydrogels is preferred, although recently a new class of super-hydrophobic surfaces has been described which demonstrate improved anti-adhesive activity. In addition, bacterial killing can be achieved using antimicrobial peptides, antibiotics, chitosan or enzymes directly bound, tethered through spacer-molecules or encased in biodegradable matrices, nanoparticles and quaternary ammonium compounds. Notwithstanding the ubiquitous nature of the problem of microbial colonization of material surfaces, this review focuses on the recent developments in antimicrobial surface coatings with respect to biomaterial implants and devices. In this biomedical arena, to rank the different coating strategies in order of increasing efficacy is impossible, since this depends on the clinical application aimed for and whether expectations are short- or long term. Considering that the era of antibiotics to control infectious biofilms will eventually come to an end, the future for biofilm control on biomaterial implants and devices is likely with surface-associated modifications that are non-antibiotic related.

To design and implement a prescription writing teaching module for second professional medical students

Context:

There is ample evidence to prove that medical graduates are not prescribing rationally and this can be improved by proper training.

Aims:

To design and implement a prescription writing teaching module for second professional medical students.

Subjects and Methods:

A module of 3 h duration consisting of didactic lecture, interactive audiovisual small group session, and evaluation method was framed for every disease and implemented. Completeness of the prescriptions was evaluated on a scale of 1–4. Appropriateness of the prescription, knowledge about the rationale behind the drugs used and adverse events related to the drugs used was judged in three categories, that is, appropriate and complete; appropriate but insufficient; and inappropriate.

Results:

One thousand six hundred and seven response sheets to 24 health problems were collected. Completeness score of 18% was 2, 59% was 3% and 24% was 4.41% prescriptions were appropriate and complete, 58% appropriate but insufficient and 1% inappropriate. The rationale behind the drugs used was appropriate and complete 24%, appropriate but insufficient 68%, inappropriate 8%. Documentation of adverse events was appropriate and complete 23%, appropriate but insufficient 49%, inappropriate 28%. All facilitators were satisfied with the duration, contents and conduct of the sessions.

Conclusions:

A module is an effective tool for teaching prescription writing to undergraduate students; modifications required in contents and strategy to emphasize the need of complete documentation.

Awareness, Practices and Treatment Seeking Behavior of Type 2 Diabetes Mellitus Patients in Delhi

Background:

Type 2 diabetes mellitus is a multisystem disorder that is associated with number of complications. Patient's awareness and practices are crucial components in reducing the burden of diseases and its complications.

Aim:

To assess patient's knowledge about their disease and its complications, practices, treatment seeking behavior and average expenditure incurred by its management.

Subjects and Methods:

A community based cross-sectional study was conducted in rural and urban slum areas of Delhi selecting a total of 98 diabetic patients diagnosed during the two community surveys and interviewed using pretested and predesigned questionnaire. Data were analyzed using SPSS software, version 17 (Chicago II, USA). Chi-square, fisher or Mann–Whitney tests were used for test of significance and considered statistically significant at P < 0.05.

Results:

Of 98 participants, 31.6% (31/98) were from urban slum area, and 68.4% (67/98) were from the rural area. In both urban and rural areas, majority were Hindu, married, literate and unemployed. Significantly less subjects (61.3%, 19/31) of urban slum area than of rural area (85.1%, 57/67) could name at least one complication of DM (P < 0.01, odds ratio [OR] =3.6, 95% confidence interval [CI] =1.3–9.6). Majority of participants in both urban slum and rural area have knowledge about at least one component of management but significantly lesser in urban (83.9%, 26/31) than rural area (97.0%, 65/67) were reported (P = 0.02, OR = 6.2, 95% CI = 1.1–34.2). Significantly more subjects (29.0%, 9/31) in urban slum area than rural areas (7.5%, 5/67) reported that they were not taking any treatment for DM (P < 0.01, OR = 0.2, 95% CI = 0.1–0.6). In urban area, 32.2% (10/31) patients told that it is a burden on their family while in rural area 44.7% (30/67) of the patients told that they have to squeeze money from the family expenditure to afford drugs.

Conclusion:

Patients need to be made aware of the asymptomatic phase of DM and its long term complications. At the same time, efforts should be made to sensitize them about the importance of taking regular treatment and management.

Development and validation of different ultraviolet-spectrophotometric methods for the estimation of besifloxacin in different simulated body fluids

In the present study a simple, accurate, precise, economical and specific UV-spectrophotometric method for estimation of besifloxacin in bulk and in different pharmaceutical formulation has been developed. The drug shows maximum λ_max289 nm in distilled water, simulated tears and phosphate buffer saline. The linearity range of developed methods were in the range of 3-30 μg/ml of drug with a correlation coefficient (r²) 0.9992, 0.9989 and 0.9984 with respect to distilled water, simulated tears and phosphate buffer saline, respectively. Reproducibility by repeating methods as %RSD were found to be less than 2%. The limit of detection in different media was found to be 0.62, 0.72 and 0.88 μg/ml, respectively. The limit of quantification was found to be 1.88, 2.10, 2.60 μg/ml, respectively. The proposed method was validated statically according to International Conference on Harmonization guidelines with respect to specificity, linearity, range, accuracy, precision and robustness. The proposed methods of validation were found to be accurate and highly specific for the estimation of besifloxacin in different pharmaceutical formulations.

Indigenous traditional knowledge and usage of folk bio-medicines among Rongmei tribe of Tamenglong district of Manipur, India

BACKGROUND

Rongmei tribe (Kooki), are inhabitant of the Charoi Chagotlong village, Tupul, Tamenglong district of Manipur have the traditional knowledge of folk bio-medicine based on diverse plant species for the prevention and cure of certain chronic diseases. The aim of this study was to document and preserve the indigenous knowledge of the Rongmei tribe on folk medicines.

MATERIAL AND METHODS

The present work was based on methodical field survey conducted between 2010, to 2013. Local people of within 30-70 age groups of both sexes were interviewed and a group discussion (using a structured interview schedule), was held to know about the type of plant parts used in folk bio-medicines, and their mode of use. The interviewers were drawn from a wide array of disciplines (Vendors, Farmers club, NGO's, scientific societies, etc.), to obtain maximum information in relation to folk bio-medicine.

RESULTS

A total of 60 species belonging to 36 different families (ranging from gymnosperm to angiosperm with medicinal benefits), were discussed briefly with significant emphasis on their local name, scientific name, family, parts used; they claimed to cure various ailments from these plants in this mode of folk bio-medicine. The different plant parts used were leaves, fruits, bulbs, bark, roots, seeds, tuber, trunk, flower, shoot, whole plant, rhizome, stem, wood and berries. Based on a life form of the reported plants comprise herbs, shrubs, trees, grasses, bulb, vine, climber, tuber and succulent.

CONCLUSION

Efforts should be made to promote the use of traditional biomedicines within rural communities to preserve the traditional knowledge.

Neuroimaging features and predictors of outcome in eclamptic encephalopathy: a prospective observational study

BACKGROUND AND PURPOSE

Posterior reversible encephalopathy syndrome is associated with eclampsia. We assessed the distribution and nature of typical and atypical cranial MR imaging findings in these patients and their correlation with clinical and laboratory data and predictors of outcome.

MATERIALS AND METHODS

Forty-five clinically confirmed cases of eclampsia were included in this prospective observational study. Subjects with hemolysis, elevated liver enzymes, and low platelets syndrome (n = 9) and pre-existing neurologic conditions (1 with cerebral solitary cysticercus granuloma) were excluded. Patients underwent blood investigations and cranial MR imaging.

RESULTS

Twenty-seven patients had abnormal while 8 had normal MR imaging findings. Involvement of brain regions was as follows: frontal, 88.89%; temporal, 44.44%; parietal, 100%; occipital, 100%; deep gray matter, 29.63%; cerebellum, 22.22%; brain stem, 14.81%. Cytotoxic edema was present in 33.33% of cases; 66.67% of patients had mild posterior reversible encephalopathy syndrome; 25.92% had moderate posterior reversible encephalopathy syndrome; and 7.41% had severe posterior reversible encephalopathy syndrome. Abnormal neuroimaging findings were significantly associated with altered sensorium; visual disturbances; status epilepticus; and elevated serum creatinine, uric acid, and lactate dehydrogenase (P=.006, P=.018, P=.015, P=.019, P=.003, and P=.001, respectively). Serum creatinine, uric acid, and lactate dehydrogenase values and the presence of moderate or severe posterior reversible encephalopathy syndrome were significantly associated with mortality (P<.001, P<.001, P=.009, and P=.027, respectively).

CONCLUSIONS

Neuroimaging in eclampsia demonstrates a higher incidence of atypical distributions and cytotoxic edema than previously thought. Altered sensorium; visual disturbances; status epilepticus; and elevated serum uric acid, lactate dehydrogenase, and creatinine are associated with abnormal neuroimaging findings. Higher serum creatinine, uric acid, and lactate dehydrogenase levels and moderate and severe forms of posterior reversible encephalopathy syndrome are possible predictors of poor outcome.

Students’ Reflections on Teaching Methodology in Anatomy

Objective: With technological evolution, use of power point presentation has been increased tremendously for classroom teachings in medical education. There is dearth of information that whether this technology is really liked by the students in anatomy or not. Therefore present study was conducted to assess which methodology of teaching anatomy was preferred by students: traditional (chalk & black-board), computer assisted or both when combined. Methods: A questionnaire based study was conducted that involved 250 1st year MBBS students. Students were asked to fill semi structured questionnaire that contained closed and open ended questions regarding teaching methodology. Results & Conclusion: 70.37% students favored combination of power point presentations along with traditional method, 25.93% preferred chalk and blackboard method and only 3.7% students opined that power point presentations should be the sole method of teaching. Therefore the study concludes that traditional method of lecture delivery in anatomy should be carefully amalgamated with power point presentations to meet the aspirations of students and to combat the limitations of chalk and board method. DOI: http://dx.doi.org/10.3126/ajms.v5i1.8039 Asian Journal of Medical Science Vol.5(1) 2014 pp.47-51

Apatite accumulation enhances the mechanical property of anammox granules

The strength of granular sludge is essential for the mechanical stability of the granules. Inorganic precipitants form a major factor influencing the strength of the granules. To check the possibility of apatite accumulation in anammox granules, and study its contribution to the mechanical strength of granules, anammox granular sludge was collected from Dokhaven municipal wastewater treatment plant, the Netherlands. Mineral precipitation inside the granules was visualized by micro-computed tomography, and apatite was identified by electron probe microanalysis and X-ray powder diffraction. The mechanical strength of anammox granules was measured by a low load compression tester. The contribution of apatite to the mechanical strength was evaluated by the generalized Maxwell model. Ca-PO4 minerals are reported to accumulate in anammox granules. A transformation of Ca-PO4 happens, and apatite is the final stable form. The accumulation of apatite increases the mechanical strength of anammox granules. A fast method to monitor and evaluate the accumulation of minerals in anammox granules was proposed.

Meta-analysis: serological markers and the risk of acute and chronic pouchitis

BACKGROUND

Serological markers such as anti-neutrophil cytoplasmic antibody (ANCA) and anti-Saccharomyces cerevisiae antibody (ASCA) may be associated with pouchitis after ileal pouch-anal anastomosis (IPAA).

AIM

To perform a systematic review with meta-analysis of studies evaluating the association of ANCA and ASCA status with risk of acute and chronic pouchitis after IPAA.

METHODS

We searched multiple databases (upto September 2012) for studies reporting ANCA and/or ASCA status along with risk of acute or chronic pouchitis after IPAA in adults with ulcerative colitis (UC). We abstracted odds ratio (OR) or raw data from the individual studies to calculate summary OR estimates with 95% CIs using random-effects model.

RESULTS

Eight studies reporting 184 cases of acute pouchitis and six studies reporting 151 cases of chronic pouchitis were included. The odds of chronic pouchitis were 76% higher in ANCA-positive patients than ANCA-negative (six studies; OR: 1.76; 95% CI: 1.19-2.61; P < 0.01). ASCA-positivity was not associated with the risk of chronic pouchitis (three studies; OR: 0.89; 95% CI: 0.49-1.59; P = 0.68). Neither ANCA (eight studies; OR: 1.54; 95% CI: 0.79-3.02; P = 0.21) nor ASCA-positivity (two studies; OR: 1.28; 95% CI: 0.25-6.54; P = 0.77) were associated with the risk of acute pouchitis.

CONCLUSIONS

The risk of chronic pouchitis after IPAA is higher in ANCA-positive patients, but the risk of acute pouchitis is unaffected by ANCA status. ASCA status was not associated with the risk of acute or chronic pouchitis. This information may be used to counsel UC patients regarding their risk of pouchitis after IPAA.

Studies on salinization in Haryana soils on free-living nitrogen-fixing bacterial populations and their activity

A total of 26 soil samples from saline soils of Haryana were collected. Based on their electrical conductivity (EC) values, which varied from 1.04 to 21.00 dS m(-1), the soils were categorized into non-saline soils (EC 0-2 dS m(-1)), weakly saline soils (EC 2-4 dS m(-1)), saline soils (EC 4-8 dS m(-1)), strongly saline soils (EC 8-16 dS m(-1)), and very strongly saline soils (EC >16 dS m(-1)). The pH values of these soil samples ranged from 6.03 to 8.62, while organic C, total N, and available P were in the range of 0.06-0.94%, 0.07-0.15%, and 0.11-0.29 μg g(-1) soil, respectively. As a measure of the impact of salinity on free-living N(2) fixers and their activity, the total bacterial populations on four media (Jensen's nitrogen-free medium, malate medium, Burk's medium, and soil extract agar medium) decreased from 6.12 to 3.70 log CFU g(-1) soil with increasing salinity level. PCR amplification of the nifH region of the DNA from 234 selected morphotypes from all the media showed the presence of nifH in 71 isolates. Out of these, 37% of the isolates were obtained using Jensen's medium; 35, 28, and 21% of the isolates were obtained using soil extract medium, Burk's medium, and malate medium, respectively. The majority of the free-living N(2) fixers (67%) were Gram negative. Apart from the acetylene reduction assay (ARA) activity in these isolates, other beneficial traits like ammonia excretion and indole acetic acid (IAA) production were also present. A decreasing trend in the activities was observed with increasing salinity levels. Isolates JN6, BP8, and MJ4 showed the highest ARA activity, ammonia excretion, and IAA production. The performance of isolates like BNC2 with good ARA activity, ammonia excretion, and IAA production and isolated from a very strongly saline soil should be further evaluated under high-saline conditions.

Profile of lung cancer in predominantly Bidi smoking rural population of northern Himachal Pradesh

BACKGROUND

Lung cancer is a leading cause of morbidity and mortality among both genders. The histopathological patterns of lung cancer in different parts of India appear to be variable.

OBJECTIVE

To study the profile of lung cancer in northern Himachal Pradesh.

METHODS

Patients of all age groups and either gender with history and complaints suggestive of lung cancer were subjected to further investigations to study the histopathological types of lung cancer over a period of 14 months.

RESULTS

Out of 105 histopathologically confirmed patients with lung cancer (mean age 62.7 +/- 11.6 years; 96 males), 89.5% were "ever smokers" and 82.9% were "current smokers"; 92% of current smokers were bidi smokers. Most common presenting complaints were chest pain (46.7%) and cough (35.2%). Mean duration of longest presenting complaint was 64 days. The histopathological types included squamous cell carcinoma (37.1%), adenocarcinoma (36.2%), small cell carcinoma (8.6%), un-classifiable (16.2%), and other types (1.9%).

CONCLUSIONS

Majority of the lung cancer patients in northern Himachal Pradesh were bidi smoking males from rural areas and the incidence of adenocarcinoma and squamous cell carcinoma is almost equal.