Diagnostic role of fibreoptic bronchoscopy in pulmonary tuberculosis

Fibreoptic bronchoscopy with bronchial aspiration* washings and biopsy was performed in 104 patients suspected clinically and radio logically of having pulmonary tuberculosis diagnostic yield in 9230% (96/104) cases. Diagnostic yield for tuberculosis was in 69.22% (72/ 104) cases, it includes positive aspiration and washings smear in 38.46%(40/l04) patients,positive mycobacteriai culture alone in 26.92% (28/104) cases and positive biopsy in 3*84% (4/ 104) patients, Non-tuberculous conditions like pneumonia and bronchogenic carcinoma were diagnosed in 19.23% (20/104) cases and 3.84% (4/104) cases respectively. These results suggest that in areas with high prevalence of tuberculosis, bronchoscopy should be performed for early diagnosis and initiation of therapy in sputum smear-negative cases of pulmonary tuberculosis.     

The utility of waist circumference in assessment of obesity

The objective of this study was to assess the correlation between waist circumference and waist hip ratio and body mass index. Also to assess if a simple measurement like the waist circumference can be used as an independent indicator for detecting health risk and management. 500 men and 500 women were included in this study from the out patient department and indoor wards of Medical College, Calcutta. Only 7% of the males and 16% of the females had body mass index > or = 25. About 50% of both males and females had waist hip ratio above the desirable range (0.80 for females and 0.95 for males). About 99% of females with, waist circumference > or = 72 cm. had either body mass index > or = 25 or high waist hip ratio > or = 0.80 or both. Similarly 99% of males with waist circumference > or = 80 cm. had either high body mass index > or = 25 or high waist hip ratio > or = 0.90 or both. Waist circumference is simple to assess and can be used as an independent measurement to identify those at risk from either increased body weight or central fat distribution or both.     

In the footsteps of "Arundhati": Asian Indian women's experience of domestic violence in the United States

This study examined the ideologies and conditions that are creating women's vulnerability to spousal abuse in the Asian Indian community in the US. The study focused on the multiple factors involved in Asian Indian women's experiences of domestic violence in the US: their minority status, life as an immigrant, and pressures to preserve a flawless public image of their community. The data were collected from interviews with 12 highly educated women from India who had sought outside help due to spousal abuse. 10 of these women were foreign born, and 2 were brought up in the US. The study revealed that the most important factor in these women's lives seemed to be childhood indoctrination into the ideals of ?good? wife and mother that include sacrifice of personal freedom and autonomy. Although majority of the women worked as professionals, economic independence did not seem to provide them with a sense of empowerment. Furthermore, they felt responsible for the reputation of their families in India, were eager not to compromise their families' honor with a divorce, and operated under the added pressures of preserving traditions and presenting an ?unblemished? image of the community to the US mainstream.     

Effects of Vibration on the Hand-Arm System of Miners in India

Sixty-six Jackhammer drillers and 35 blasters from two mineswere clinically screened for hand-arm vibration syndrome (HAVS).The screening consisted of questionnaire-based information,clinical examination including measurement of phalangeal circumferencesof fingers (FCT) and motor nerve conduction (MCV) studies. Ina warm environment, the prevalence of symptom complexes suggestedthe existence of peripheral neuropathy and musculoskeletal abnormalitiesrather than any peripheral circulatory disorders. Clinical examinationrevealed soft tissue wasting in the hands (26 cases), ulnarnerve impairment (23 cases), median nerve impairment (16 cases)and Dupuytren's contracture (4 cases). Mean motor nerve conductionvelocities of 59 out of 66 drillers who volunteered for thisassessment were not significantly different from those of the35 blasters. The results of their correlation coefficients variedconsiderably for MCVs when age and years of vibration exposureunderwent regression analysis. However, comparison of MCV andFCT of 30 drillers with 30 matched blasters revealed that themean MCV of the right median nerve in the vibration exposedgroup was significantly decreased (<0.01) and for the meanFCT, the proximal phalanxes of the right index finger, leftthumb and left ring fingers were thinner in the vibration exposedgroup (<0.05). Received        1 November 1994 Accepted       29 September 1995     

Relationship between body weight and the incidence of positive axillary nodes at mastectomy for breast cancer

The question, whether obesity is associated with an increased incidence of positive axillary nodes at mastectomy for breast cancer, was studied in two quite different hospital populations; one from a large urban teaching hospital (Montefiore) and one from a medium-sized Air Force medical center (Malcolm Grow). In the Montefiore population, the answer was "yes"; 67% of the node-positive patients, but only 31% of the node-negative patients were obese (20% or more above ideal weight) (p less than 0.05). In the Malcolm Grow population, the answer was "no"; 20% of the node-positive and 20% of the node-negative patients were obese. The different answers, we believe, are due to the biological differences between the populations; the Montefiore population was shorter (by an average of 1.7 inches), heavier (by an average of 20 lbs), and more obese. The incidence of obesity was about three times as high in the Montefiore population (52% versus 20%; p less than 0.02) and it contained a statistically distinct subpopulation of obese patients, while the few obese patients in the Malcolm Grow population constituted merely the upper tail of a unimodal log-normal distribution of weight in that population. We propose that it is possible to demonstrate a relationship of obesity to node-positivity in the Montefiore population but not in the Malcolm Grow population because obesity was highly prevalent in the former and almost nonexistent in the latter. It seems self-evident that it is not possible to demonstrate an effect of obesity in a population if that population manifests no significant obesity, statistically speaking, but disregarding this principle, we believe, may account for the controversy in the literature about whether obesity is a risk factor in breast cancer.     

Effect of a selective cyclooxygenase-2 inhibitor, nimesulide, on the growth of lung tumors and their expression of cyclooxygenase-2 and peroxisome proliferator- activated receptor-gamma.

PURPOSE: The objectives of this study were to evaluate the effect of a cyclooxygenase (COX)-2 inhibitor, nimesulide, on the growth inhibition of s.c. human lung A549 adenocarcinoma tumors and to assess the effect of nimesulide on the expression of COX-2 and peroxisome proliferator-activated receptor (PPAR)-gamma in lung tumors harvested from mice. EXPERIMENTAL DESIGN: Female nu/nu mice were xenografted with s.c. A549 lung tumors, and 1 day after tumor implantation, the mice were fed with a diet containing nimesulide at 250-1500 ppm doses. Tumor dimensions were monitored twice weekly, and tumor samples isolated from mice were used to determine prostaglandin E(2) (PGE(2)) levels by enzyme immunoassay, expression of COX-2 and PPAR-gamma by Western blotting and immunohistochemistry. Furthermore, the induction of apoptosis in tumor specimens was determined by terminal deoxynucleotidyl transferase-mediated nick end labeling staining. RESULTS: Nimesulide treatment showed a dose-dependent growth-inhibitory effect of A549 tumors with a maximum of 77.7% inhibition at 1500 ppm of nimesulide. Western blotting experiments showed similar expression of COX-2 in both control and nimesulide (250-1500 ppm)-treated mice tumor tissues. PPAR-gamma was found to be overexpressed as a result of 1500 ppm nimesulide treatment and was not detected in tumors from control or 250-1000 ppm nimesulide-treated mice. Nimesulide (1500 ppm) significantly reduced intratumor PGE(2) levels (P < 0.001) and induced apoptosis in 25% of tumor cells as compared with control tumors. CONCLUSIONS: Nimesulide (1500 ppm) induced growth inhibition of A549 lung tumors is associated with the reduction of intratumor PGE(2) levels but without affecting the expression of COX-2. Nimesulide-induced enhancement of the expression of PPAR-gamma may also contribute to its antitumor effect, which needs to be further investigated.