Epidermoid cyst of the brain stem--a case report.

Epidermoid cysts occurring within the brain stem are extremely rare and only nine such cases are reported in the literature. In this report, we report a case of Intrapontine epidermoid cyst in a young female patient.     

Dietary adequacy of Indian rural preschool children--influencing factors

The dietary adequacy (qualitative and quantitative) of preschool children residing in rural areas near Mysore (a district in south India) was assessed by the 'Food frequency method' and '24-h recall method'. Food intake assessed in three different seasons revealed that their diets were predominantly cereal based with negligible quantity of protective foods. The overall nutrient intake was found to be inadequate, irrespective of the seasons. The adequacy level of the nutrients (cereal dependence) was found to be comparatively better in monsoon and winter seasons because of better labour opportunities and availability. Food consumption pattern showed no gender differences. The nutrient adequacy also varied by the age of the children. The influence of 'food expenditure' on the nutrient adequacy was not statistically significant. Nutritional status was found to be a factor influencing nutrient intake. Apart from age, nutritional status and food availability, feeding practices may also influence the nutrient intake of the preschool children.     

Closing the theory-practice gap: intrapartum midwifery management of planned homebirths

In the United States, access to qualified homebirth providers varies by state, city, and community, and consistent, evidence-based guidelines for intrapartum management at home are not available. This article examines the similarities and differences in midwifery management of the intrapartum, postpartum, and neonatal course between planned homebirths and planned hospital births. Characteristics of qualified attendants, essential medical supplies and equipment, methods for maternal and fetal surveillance, and common intrapartum indications for transfer are discussed. Unique features of management of the healthy woman and baby in the home are described, as well as the process of consultation and/or referral for collaborative or medical management. Current evidence for the management of fetal intolerance of labor, meconium stained amniotic fluid, prolonged labor, postpartum hemorrhage, and the unstable newborn is discussed in the context of homebirth practice. Aspects of homebirth care that require cultural competency and affect the informed consent process are included. Homebirth practice may provide opportunities to increase the congruence between espoused midwifery philosophy and actual practice.     

Development of food frequency questionnaires and a nutrient database for the Prospective Urban and Rural Epidemiological (PURE) pilot study in South India: methodological issues

PURPOSE: To develop Food Frequency Questionnaires (FFQs) and nutrient databases for urban and rural Indian populations with diverse dietary habits for the PURE (Prospective Urban and Rural Epidemiological) pilot study. PROCEDURE: 24 hour dietary recalls were obtained from 84 rural and 60 urban subjects. From a comprehensive food list, separate FFQs were developed for the two groups. Nutrient analysis of the FFQ required the selection of foods, development of recipes and application of these to cooked foods to develop a nutrient database. The FFQs were piloted in 80 urban and 77 rural subjects. Separately for each group, a stepwise regression method was used to identify foods contributing to a cumulative 90% of variance to total energy intake. Nutrient and food group intakes were compared using an independent t-test. MAIN FINDINGS: The urban and the rural FFQs contained 129 and 102 foods respectively, of which 82 foods were common to both. Fourteen urban foods and eight rural foods explained a cumulative 90% of variance for total energy intake. Daily intakes for most nutrients and food groups were two to three fold higher in the urban than in the rural group. CONCLUSIONS: In Indian populations with diverse dietary habits, using standard methods to develop separate FFQs can capture dietary intakes adequately. To develop nutrient databases, substitution of local food composition tables with data from other sources using standard methods to match foods can be adopted.     

Late dislocation of intrastromal corneal ring segment into the anterior chamber

We describe the case of a 53-year-old woman with keratoconus who presented with a dislocated intrastromal corneal ring segment (ICRS) (Intacs) in the anterior chamber 3 weeks after surgery. To our knowledge, this is the first report of a late occurrence of postoperative anterior chamber dislocation of an ICRS and illustrates the need to consider the potential for such a complication.