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This article discusses the changing systems of food production among Garhwali resettlers who were forcibly displaced due to the construction of the Tehri Dam in North India. Resettling to a drastically new environment affected their traditional food production strategies and rendered them vulnerable to the vagaries of transition, including the forced adaptation to new cash crop-based farming systems, restricted hunting and fishing areas, and limited access to dairy products. These changes led to an inadequate supply of food and nutrients, especially protein, for these resettlers. Using ethnographic methods, this study illustrates that resettling an agrarian community to a new ecological area significantly changes their food production practices in ways that leave them vulnerable to the potential risk of an impoverished diet.  相似文献   
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ABSTRACT An unusual presentation of acute lymphoblastic leukaemia (ALL) in a 6-year-old girl is reported. She presented with unilateral cervical lymphadenopathy, a mixed obstructive/cholestatic jaundice and a progressive pancytopenia. Ultrasound examination revealed an obstructed common bile duct with gross thickening of the wall of the duct and intrahepatic bile duct dilatation. The jaundice resolved with high dose intravenous (i.v.) methylprednisolone. It is postulated that this was due to infiltration of the common bile duct, given the failure to demonstrate any other cause for the bile duct pathology.  相似文献   
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Rotational atherectomy has long been regarded as contraindicated for stenotic lesions within the body of saphenous vein grafts. So far, reports of rotational atherectomy in vein grafts have been concerned with ostial and distal anastomotic lesions. We report the first two cases of the successful use of the Rotablator for discrete lesions of mid-saphenous vein grafts. No complications were encountered. One patient is doing well 6 months after the procedure, and the other patient continues to do well more than 1 yearlater.  相似文献   
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Detailed invasive haemodynamic studies were performed in 27of 32 patients with severe tetanus. Nineteen had severe uncomplicatedtetanus and eight had associated major complications, chieflyinfection and pulmonary complications. The results were comparedwith those obtained from 15 healthy male volunteers who servedas controls. There were two deaths in 32 patients (mortality6.25 per cent). Severe tetanus without major complications wascharacterized by a high output hyperkinetic circulatory statewith tachycardia (heart rate 131 (19.2) beats/minute), increasedstroke volume index (43.1 (10.7) ml/m2), increased cardiac index(5.48 (0.94)1/min/m2) and a normal left ventricular stroke workindex (60.5 (15.9) g/m/m2). Volume loading demonstrated a significanthaemodynamic response and increased vascular capacitance. Evenso the maximum percent rise from baseline values of these indicesafter volume load was significantly higher in controls (p <0.001). Autonomic cardiovascular disturbances affected bothsympathetic and parasympathetic activity. Hypertension and tachycardiaalternating with hypotension and bradycardia were related tosudden fluctuations in systemic vascular resistance. Our studiessuggested some degree of myocardial dysfunction in patientswith severe uncomplicated tetanus. The haemodynamics of severetetanus were masked and altered by complicating infection, pneumonia,and atelectasis.  相似文献   
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Cancer is one of the dreadful diseases of 20th century and moving vastly towards 21st century. According to the studies, world wide about 6 million new incidences are reported every year. It is the second major cause of death after cardiovascular diseases. Lung, colon, prostate and breast cancer account for more than half of the cancer deaths. Nature has given us a variety of useful medications to cure number of diseases. The role of natural products as a source of remedies for diseases can be dated back to 1500 BC.  相似文献   
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During a balloon pericardial window formation we experienced a fracture of the balloon catheter causing dislodgment of the balloon. The balloon remained in the pericardial space. We describe a case report of this uncommon complication and a method for retrieval of the balloon.  相似文献   
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ABSTRACT. Gastrointestinal manifestations of Henoch-Schönlein purpura (HSP) commonly include abdominal pain and gastrointestinal bleeding. Hypoproteinemia and edema could be related to renal involvement. We report a 14-year-old boy with classical features of HSP manifestated with edema due to severe intestinal protein loss, measured by elevated fecal alpha 1 antitrypsin secretion. The protein losing enteropathy subsided with corticosteroid therapy.  相似文献   
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