Introduction: The study aimed to analyse the nutritional quality, antioxidant components and activity of three varieties of corn based ready-to- eat (RTE) breakfast cereals (BFC) enriched with strawberry, banana and mango. Methods: Fruit-enriched corn based breakfast cereals manufactured in India were purchased and ground to obtain homogeneous samples for analysis. The contents of moisture, protein, total fat, dietary fibre, iron, phosphorous, calcium, vitamin C, total carotene, thiamine, riboflavin, in vitro digestible protein, bioaccessible calcium and iron, and digestible starch fractions were determined. The antioxidant components namely, polyphenols, flavonoids and antioxidant activity in different extracts were also determined using total antioxidant, free radical scavenging(2,2-diphenyl-1-picrylhydrazyl) and reducing power assays. Results: The protein and dietary fibre contents in all samples ranged between 4.0-4.6 and 6.4-7.6 g/100g respectively. Total iron and vitamin C ranged between 10.7-13.3 mg and 33.2-43.6 mg/100g respectively. Cereals with mango had high total carotene in comparison with other samples. In vitro digestible protein of the processed cereals was low, while bioaccessible calcium (50.2-59.5%) and iron (8.5-15.1%) levels were high due to low oxalates and phytic acid contents. The starch profiles of the breakfast cereals showed high rapidly available glucose and starch digestibility index. Fruit-enriched breakfast cereals showed high polyphenol content in methanol extract (48.6-71.3 mg/100g) and high total antioxidant activity in aqueous extracts. Free radical scavenging and reducing power assay showed high activity in 80% methanol extract. Conclusion: Fruit-enriched breakfast cereals have the potential to be a good source of iron, dietary fibre, vitamin C and total carotene. The fruit-enriched cereals also had high bioaccessible iron and antioxidant activity.

The Infant Mortality Rate defined as the risk for a live born child to die before its first birthday, is known to be one of the most sensitive and commonly used indicators of the social and economic development of a nation. This paper investigates the causal relationship between infant mortality rate, economic growth and private health expenditure [% Gross Domestic Product (GDP)] in India using the co-integration and Granger causality frameworks for the period from 1995 to 2013 using secondary data from various sources. We have examined the presence of a long-run equilibrium relationship using the bounds testing approach to co-integration within the Unrestricted Error- Correction Model (UECM). We have also examined the direction of causality between infant mortality rate, economic growth and private health expenditure (% GDP) in India using the Granger causality test within the Vector Error-Correction Model (VECM). As a summary of the empirical findings, we find the Infant Mortality Rate (IMR), Per-Capita Gross Domestic Product (PCGDP) and private health expenditure (% GDP) are co-integrated. The results of Granger Causality suggested that no short-run effect was existing between all the three variables. The error-correction term implies that the variable is non-explosive and long-run equilibrium relationship is attainable.​​

Objective: To perform the pharmacognostic study of Pongamia pinnata (L.) Pierre (P. pinnata) stem bark. Method: The pharmacognostic studies were carried out in terms of organoleptic, macroscopic, microscopic, fluorescence analysis and physicochemical parameters. Results: The bark consisting of channelled, recurved, slightly quilled, usually 0.2-1 cm thick, lenticellate pieces with outer surface ash-grey to greyish-brown and internal surface yellowish-white to cream coloured having unpleasant odour and bitter taste. The main microscopic characterstics of the bark include phellem (5-20 or more layers of cork), phellogen (2-3 layered) followed by 10-15 layered phelloderm. Among other microscopic components were phloem parenchyma, phloem fibre and stone cells, traversed by wavy medullary rays. Further, physicochemical analysis of the bark power showed total ash, water soluble ash, acid insoluble ash and sulphated ash as 10.94, 1.96, 1.47 and 15.8 % w/w respectively. The alcohol and water soluble extractives values of the stem bark were 9.6 and 18.4 %w/w respectively. Conclusions: Various pharmacognostic characters observed in this study helps in botanical identification and standardization of P. pinnata L. in crude form.

The present study aimed to design a sitting stool for fish processing worker to reduce the postural stress during work. The study was conducted on 74 male and female fish processing workers selected randomly. The Musculoskeletal Disorder (MSD) of the subjects was assessed by the modified Nordic Questionnaire method. The body joint angles were measured by a digital goniometer. The results revealed that MSD was highly prevalent in lower back region in both male (78.57%) and female (93.47%) workers. The results of body joint angles suggested a high degree of forward bending during work. Efforts were made to design a sitting stool considering the human factors of the users to reduce the postural problems. The stool was designed by considering 5th and 95th percentile values of different anthropometric dimensions of the male and female workers. Paired comparison tests were employed to determine optimum dimensions of the stool for ensuring the compatibility of the physical characteristics of the stool with human body. From the results of paired comparison test and anthropometric characteristics of the users, physical dimensions of the sitting stool were settled for final designing. From the results, the height of the stool was determined separately for male and female workers. In the suggested design the height of the seat was 25cm for male and 20cm for female where the length and depth of the seat were 40cm and 32cm respectively for both sexes.A mechanical system was incorporated in the design so that the same stool could be used by the male and female workers. Subjective evaluation indicated that most of the subjects (>75%) rated the seat as good or very good. The joint angle study with suggested seat showed improved working posture.

Haemodialysis associated amyloidosis (HAA) is a complication of long-term haemodialysis caused by deposition of β2- microglobulin in tissues that most often presents clinically at osteoarticular sites. However, in very rare circumstances, patients do present initially with oral manifestations of HAA. In a normally functioning kidney, β2- microglobulin is cleared by glomerular filtration and is catabolized in the proximal tubules. This article describes a patient with oral manifestation of haemodialysis associated amyloidosis with an unusual presenting complaint of lingual dysaesthesia.

Objective:To evaluate the antimicrobial potential of fresh water microalgae viz., Oscillatoria sancta (O. sancta) (Kuetz) Gomont., Lyngbya birgei (L. birgei) Smith G.M., Oedogonium echinospermum (O. echinospermum), Spirogyra decimina (S. decimina) (Muller) Kuetz., Spirogyra grantiana (S. grantiana) Transeau., Spirogyra crassa (S. crassa), Spirogyra biformis (S. biformis) Jao. and Spirogyra condensata (Vaucher) Kuetz against human bacterial pathogens. Methods:Antimicrobial study was carried out by disc diffusion method against the pathogens viz., Escherichia coli (E. coli) (ATCC 35218), Staphylococcus aureus (S. aureus) (ATCC 6538), Salmonella typhi (S. typhi) (MTCC 733), Proteus vulgaris (P. vulgaris), Proteus mirabilis (P. mirabilis) and Streptococcus pyogenes. Results: The methanolic extract of O. sancta showed the antibacterial activity against three pathogens viz., P. mirabilis, P. vulgaris and S. aureus with the inhibition zones of 10, 8 and 8 mm, respectively. The methanolic and ethanolic extracts of L. birgei exhibited the antibacterial activity against two pathogens i.e. P. mirabilis and P. vulgaris with the maximum zone of inhibition of 8 and 8 mm, respectively. The ethanolic extracts of O. echinospermum displayed the antibacterial activity against S. typhi and P. mirabilis with the maximum of zone of inhibition (7 mm). The methanolic extracts of S. decimina exhibited the antibacterial activity against S. aureus and P. mirabilis with the maximum zone of inhibition of 12 and 9 mm, respectively. The ethanolic extracts of S. grantiana showed the anti-bacterial activity against three organisms i.e. E. coli, P. vulgaris and P. mirabilis with the zone of inhibition of 9, 10 and 9 mm, respectively. The methanolic extracts of S. crassa exhibited the antibacterial activity against P. mirabilis with the maximum zone of inhibition (9 mm). The methanolic extracts of S. biformis exhibited the antibacterial activity against P. vulgaris with the maximum zone of inhibition (8 mm). Conclusions: These results give an indication of the presence of promising antibacterial compounds in the plants under studied. Further phytochemical studies are needed to elucidate the components responsible for antibacterial activity of these extracts against bacteria.

Objective: The present study was carried out to investigate the antidiabetic and hypolipidemic activities of bioactive fraction (ethyl acetate fraction) of Dillenia indica methanolic extract in experimental diabetic Wistar rats. Methods: Type-1 diabetes was induced by single intraperitoneal injection of streptozotocin (60 mg/kg body weight), and type-2 diabetes was induced by single intraperitoneal injection of streptozotocin (60 mg/kg body weight), 15 min after the intraperitoneal injection of 120 mg/kg nicotinamide. The rats were treated by administering graded oral doses of isolated ethyl acetate fraction of methanolic extract of D. indica (DIEE), 200 and 400 mg/kg body weight, respectively, for 21 d. The blood glucose level was estimated at weekly intervals by glucometer. Serum cholesterol, triglycerides and high-density lipoprotein cholesterol (HDL-C) were also evaluated in normal and diabetic rats by an autoanalyzer. Results: In both experimental models, daily oral treatment with DIEE for 21 d resulted in a significant reduction in blood glucose (P<0.01), serum cholesterol (P<0.05) and triglycerides (P<0.05) levels whereas HDL-C level was found to be increased (P<0.05) as compared with the diabetic control group. Conclusion: DIEE at 400 mg/kg body weight has prominent antidiabetic effect in experimental type-1 and type-2 diabetes models in rats. It may therefore be used as an alternative remedy for the treatment of diabetes mellitus.

OBJECTIVES: Hydroxychloroquine (HCQ) 400 mg is approved by the Drug Controller General of India (DCGI) and recommended by the Research Society for the Study of Diabetes in India (RSSDI) clinical practice recommendations 2017 as add-on therapy after metformin and sulfonylurea in Type 2 Diabetes (T2DM) patients. The aim of this observational study is to compare the efficacy and safety of hydroxychloroquine 400 mg and teneligliptin 20 mg when used as add-on therapy in Indian Type 2 DM patients who were inadequately controlled (HbA1c ?7.5%) with metformin 1000 mg and glimepiride 2 mg combination.

METHODOLOGY: This study is a prospective observational study to be conducted in 2 diabetic centres of Patna city between October 2017 and May 2018 involving 180 patients followed up for 6 months. One group (N=90) of patients received hydroxychloroquine 400 mg + metformin 1000 mg + glimepiride 2 mg, the other group (N=90) received teneligliptin 20 mg + metformin 1000 mg + glimepiride 2 mg. Efficacy was assessed by fasting blood glucose (FBG), post prandial blood glucose (PPBG) and glycated haemoglobin (HbA1c) reduction. Safety was evaluated by the number of hypoglycaemic events and changes in serum creatinine levels. Home based glucose monitoring was used to detect the hypoglycaemic events. Patients who had any type of retinopathy/maculopathy were excluded.

RESULTS: Mean age of entire population was 66 ± 8 years with mean 6 ± 2 years of DM with 102 males. Mean body weight was 71 ± 12 kg. Baseline HbA1c was 8.1 ± 0.3 in the hydroxychloroquine group and 8.2 ± 0.2 in the teneligliptin group.

At 24 weeks there were statistically significant reductions in mean HbA1c in the hydroxychloroquine group (1.1 ± 0.3) as compared to the teneligliptin group (0.82 ± 0.3) (P?0.001). The mean FBG and PPBG was 169 ± 18 mg/dl and 232 ± 18 mg/dl respectively in hydroxychloroquine group which was reduced to 121 ± 15 mg/dl and 161 ± 19 mg/dl at the end of 24 weeks. In the teneligliptin group, FBG and PPBG was 171 ± 16 mg/dl and 239 ± 21 mg/dl at baseline, which was reduced to 121 ± 15 mg/dl and 161 ± 19 mg/dl respectively in same period of time (P? 0.005). There were 4 incidences of hypoglycaemic events in the hydroxychloroquine group (4.4%) and 6 in the teneligliptin group (6.67%). No patients required medical assistance for hypoglycaemic events. There was no statistically significant change in body weight in both the groups. No marked changes in creatinine levels were found in patients in both the groups.

CONCLUSION: In conclusion, treatment with hydroxychloroquine 400 mg for 24 weeks reduces glycaemic parameters more aggressively than teneligliptin 20 mg in Indian type 2 diabetes patients.

AlM: To study the pattern/distribution of retinal vascular diseases in the hilly terrain of Himachal Pradesh (altitude ranging from 500-4500m above sea level).
METHODS: lt is a retro/prospective study of patients with retinal diseases attending the general ophthalmology clinic of a tertiary care facility at Shimla from August 2008 to April 2013. Out of 5600 subjects, 4323 were taken as a sample. The data were taken from the hospital records and thereafter analyzed to determine their age, sex distribution and diagnosis. All patients underwent visual acuity, refraction, slit lamp examination and fundus evaluation. The diagnosis was confirmed from fundus clinic records and evaluation of fundus photographic records retro/prospectively. The photographs were taken on the fundus camera (Kowa Fundus Camera VX-10) and fundus fluorescein angiography done where ever indicated.
RESULTS:Out of the 4323 patients, there were more males 2563 ( 59. 29%) than females 1760 ( 40. 71%) with retinal diseases. Out of the 525 ( 12. 14%) diabetic retinopathy ( DR) subjects, mild non-proliferative diabetic retinopathy was present in 133 (3. 08%), moderate non-proliferative diabetic retinopathy in 156 (3. 60%), severe non-proliferative diabetic retinopathy in 120 (2. 78%) and proliferative diabetic retinopathy in 116 (2. 68%) subjects. Amongst the 393 (9. 10%) subjects of hypertensive retinopathy, hypertensive retinopathy-grade 1 ( was present in 130 ( 3. 01%) , hypertensive retinopathy - grade 2 in 111 (2. 57%), hypertensive retinopathy-grade 3 in 131 (3. 03%) and hypertensive retinopathy - grade 4 in 21 ( 0. 49%) subjects. Of all the 660 (15. 27%) subjects of other retinal vascular disorders, branch retinal vein occlusion ( BRVO) was present in 229 (5. 30%), central retinal vein occlusion (CRVO) in 55 (1. 27%), hemi central vein occlusion in 8 (0. 19%), central retinal artery occlusion ( CRAO) in 20 (0. 46%), branch retinal artery occlusion in 4 (0. 09%), ocular ischaemic syndrome in 1 (0. 02%), retinopathy of prematurity in 9 (0. 21%), retinal artery macroaneurysm in 5 (0. 12%), juxtafoveal telangiectasia in 6 (0. 14%), anaemic retinopathy in 16 (0. 37%), leukemic retinopathy in 10 (0. 23%), preretinal haemorrhage in 52 (1. 20%), Coats disease in 8 (0. 19%), cilioretinal artery occlusion in 1 (0. 02%), Eales disease in 10 (0. 23%), vasculitis in 17 (0. 39%) and clinically significant macular edema in 209 (4. 83%) subjects.
CONCLUSlON: DR was the most common retinal vascular disorder. Retinal disorders appear to be a major public health problem in lndia. The present study shall help us in planning the management of such disorders in the hilly state of Himachal Pradesh to reduce the visual morbidity arising out of such disorders.

Primary intra-osseous squamous cell carcinoma (PIOSCC) is a rare tumour which occurs centrally within the jaws. It is believed to arise from odontogenic epithelial remnants or from pre-existing odontogenic cysts/tumours. A case of PIOSCC arising from an odontogenic cyst in a 57-year-old female is discussed. Initial clinical and radiographic examination was suggestive of an odontogenic cyst / cystic tumour. The lesion was enucleated and sent for diagnostic histopathology which revealed the presence of an invasive carcinoma arising from the walls of the odontogenic cyst. The patient then underwent right mandibular resection and reconstruction as well as right supra-omohyoid neck dissection. Long standing odontogenic cysts have the potential to undergo malignant transformation though this may not always be the case. Relying only on radiographic findings for the management of cyst-like lesions without obtaining histopathological diagnosis is extremely ill-advised.
Carcinoma, Squamous Cell