Emotional interference in obsessive-compulsive disorder: a neuropsychological study using optimized emotional Stroop test

Contents related to threat and associated cognitive processes are proposed to be the central characteristic of obsessive-compulsive disorder (OCD) according to 'threat-relatedness hypothesis'. However, evidence for attention bias toward emotionally salient stimuli using the emotional Stroop test is equivocal. This discrepancy could be due to methodological issues, mainly differences in the lexical characters of words. Fifty Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) OCD patients (23 washers and 27 checkers) and 50 age-, handedness- and sex-matched healthy controls were examined with an optimized version of the emotional Stroop test (i.e., with lexically matched words) and color-Stroop test. Twenty-four patients were clinically symptomatic and 26 were remitted. OCD patients had significantly higher attention bias only for negative OCD stimuli as calculated by negatively valenced OCD interference score but not for neutral or non-OCD emotional stimuli. Symptomatic patients had significantly higher bias, but not the remitted patients. There were no significant correlations between other illness-related variables (age at onset, illness duration, and medication dose) and Stroop test performance. Study findings suggest the presence of selective emotional bias for OCD relevant stimuli in these patients and this bias is potentially related to symptomatic status. These observations are in tune with the threat-relatedness hypothesis.

Identification of discrete chromosomal deletion by binary recursive partitioning of microarray differential expression data

DNA copy number abnormalities (CNA) are characteristic of tumours, and are also found in association with congenital anomalies and mental retardation. The ultimate impact of copy number abnormalities is manifested by the altered expression of the encoded genes. We previously developed a statistical method for the detection of simple chromosomal amplification using microarray expression data. In this study, we significantly advanced those analytical techniques to allow detection of localised chromosomal deletions based on differential gene expression data. Using three cell lines with known chromosomal deletions as model system, mRNA expression in those cells was compared with that observed in diploid cell lines of matched tissue origin. Results show that genes from deleted chromosomal regions are substantially over-represented (p<0.000001 by chi2) among genes identified as underexpressed in deletion cell lines relative to normal matching cells. Using a likelihood based statistical model, we were able to identify the breakpoint of the chromosomal deletion and match with the karyotype data in each cell line. In one such cell line, our analyses refined a previously identified 10p chromosomal deletion region. The deletion region was mapped to between 10p14 and 10p12, which was further confirmed by subtelomeric fluorescence in situ hybridisation. These data show that microarray differential expression data can be used to detect and map the boundaries of submicroscopic chromosomal deletions.

Interferon-alpha induces dendritic cell differentiation of CML mononuclear cells in vitro and in vivo

The ability of interferon-alpha (IFN-alpha) to induce dendritic cell (DC) differentiation in chronic myeloid leukemia (CML) was evaluated. Peripheral blood mononuclear cells from CML patients cultured with IFN-alpha and granulocyte-macrophage colony-stimulating factor (GM-CSF) developed a dendritic morphology. Fluorescence in situ hybridization demonstrated that the DCs harbored the bcr/abl translocation. The DCs prepared with IFN-alpha/GM-CSF expressed significantly higher levels of class I and II HLA than those grown in interleukin-4 (IL-4) and GM-CSF. The DCs prepared from newly diagnosed CML patients using IFN-alpha/GM-CSF expressed immunoregulatory proteins at levels comparable to normal DCs. In contrast, DCs cultured from CML patients who did not achieve a cytogenetic response to IFN-alpha expressed significantly lower levels of class I HLA, CD40, CD54, CD80 and CD86 than normal DCs. The expression of CD86 by CML DCs was enhanced when they were cultured with IFN-alpha/IL-4/GM-CSF, or when IFN-alpha/GM-CSF-treated cells were induced to mature by CD40 ligand. The DCs from IFN-alpha failures were less stimulatory than normal DCs in the allogeneic mixed leukocyte reaction. CML patients who had a cytogenetic response to IFN-alpha initially had low numbers of bone marrow DCs that increased significantly with treatment, while nonresponders had more prevalent DCs at baseline that showed no consistent change with treatment. Therefore, IFN-alpha can induce DC differentiation from CML progenitor cells both in vitro and in vivo. The therapeutic activity of IFN-alpha in CML may be due to its ability to stimulate the generation of DCs that can present CML-specific antigens. Resistance to IFN-alpha may result when DC differentiation becomes impaired.

Body mass index: a measure of the nutritional status in Indian populations

Anthropometric data available through National Nutrition Monitoring Bureau surveys/studies conducted by the National Institute for Nutrition were analysed to study body mass index (BMI:kg/m2) profiles of adults and relate them to various parameters such as the nutritional status of preschool children, socio-economic status, low birth weight and mortality. The results show that nearly one-half (49%) of adult Indian rural population is suffering from some grade of chronic energy deficiency (CED). The adults' household BMI and child's nutritional status are associated. Mean BMI values were lower in landless agricultural occupational groups and in low per capita income group households compared with cultivators, artisan and higher income groups. Mean birth weights showed definite differences between BMI classes (2500 g in grade III CED and 2800 g in the normal BMI group). The odds ratio for low birth weight (LBW) was found to be three times more in severe CED groups compared to normal BMI groups of mothers. The influence of BMI on the incidence of LBW was evident despite the confounding factors of parity and maternal age. The frequency distribution of BMI values of adults who had been malnourished at the age of 5 years was distinctly different from that of the well-nourished group. The mean BMI of the group who were malnourished as children was 16, while those who had been well nourished was now 21 on average. Data from affluent and well-grown Indians suggests that a cut-off point of 18 rather than 18.5 would be more appropriate to distinguish the nutritionally normal groups from the energy deficient group (CED).

Nutritional status of tribal preschool children in three ecological zones of Madhya Pradesh

A health and nutrition survey was conducted on tribals in three ecological zones of Madhya Pradesh namely Jhabua (West Zone), Bastar (South Zone) and Sarguja (East Zone) taking into consideration the relative contribution of agriculture, forest and a combination of both to the economy, respectively. The consumption of both foods and nutrients appear to be worse among preschool children of Jhabua compared to Bastar and Sarguja. Clinically overt forms of Protein Energy Malnutrition and other vitamin deficiency signs were strikingly low. However, 4% of children in Sarguja exhibited signs of goitre. Both by extent and severity of malnutrition, the children of Jhabua appear to be worse followed by Bastar and Sarguja.

Nutritional anthropometry--validity of cut-off points

The present communication seeks to describe an alternate approach of arriving at cut-off levels using ratio of percentiles for (i) differentiating normal children from the undernourished ones, and (ii) identifying the severely undernourished group of children in the community on the basis of body weight and height. It also examines validity of the cut-off levels presently used of weight for age (Gomez and Indian Academy of Paediatrics classification) and height for age parameters. 1. The cut-off levels are independent of the reference standard and, as such, the same cut-off levels could be used irrespective of the standards. 2. It is desirable to have separate cut-off levels for preschool and school age groups. The use of common cut-off points for both the age groups seems to result in loss of sensitivity of the order of over 5 per cent. 3. The use of the 90 per cent cut-off level in the Gomez classification misclassifies some of the normals as undernourished, thereby tending to overestimate the problem of undernutrition in communities. 4. The body weight groups based on the suggested cut-off points do bear a relationship to the prevalence of signs of PEM--the greater the weight deficit, the higher the prevalence of signs of PEM in preschool children.

Iron fortified salt distribution through integrated child development services in Orissa - an assessment

The present study was undertaken in two backward districts namely Phulbani and Sundargarh, of Orissa State, India, to study operational aspects of the distribution programme of iron fortified salt (IFS), and the extent of any overlap with the ongoing National Nutritional Anaemia Control Programme (NNACP) and possible toxic effects thereof. All IFS samples tested showed iron levels in the range of 800-1000 mg of elemental iron per I kg of iron fortified salt. Distribution of IFS to households was irregular and only 40% of the households had stocks of IFS at the time of home visits. None of the households using IFS reported any kind of adverse effects. Prevalence of anaemia (blood haemoglobin level of less than 11 g/dl) was highest among pregnant women (90.9%) followed by lactating women (88.7%), school aged children (84.4%) and preschool children (77.9%) respectively. Folifer tablets are being distributed to pregnant, lactating women and preschool children. Adult tablets contain 60 mg of elemental iron in the form of ferrous sulphate (FeSO4) and 500 m g of folic acid. Tablets distributed to children contain 20 mg of elemental iron and 100 m g of folic acid. Enquires regarding distribution of folifer tablets showed that 71% of pregnant women, 22% of lactating women and 22% of children received the folifer tablets at sometime or other and no toxic effects were reported. These results indicate the necessity for some modifications in existing strategies for distribution of IFS in order that it be effective in the prevention of widespread anaemia.

Nutrition, health and psychosocial profile of institutionalized children

A study was undertaken to assess the health, nutrition and psychosocial profile of Institutionalized children in four States--Uttar Pradesh, Andhra Pradesh, Karnataka and West Bengal. A sample of 3,822 children from 70 institutions in 6-18 years age group formed the subjects of the study. It was observed that the destitute children were mainly taken care of in three types of institutions, viz, Voluntary, Government Aided and Government run institutions. Calorie deficiency and deficiency of Vitamins and minerals characterized the diets of these children. In general, there was no deficit of protein in their diets. Growth wise, these children were retarded both in height and weight compared to standards. However, they fared better in comparison to their age and sex counterparts in the rural and urban poor. Psychosocial profile of these children indicated that the prevailing environment in the institutions is less conducive for intellectual stimulation but not so for the development of skills of self-help, locomotion, socialization and imagery.

Anemia and physical fitness of school children of rural Hyderabad

Physical fitness status of 119 school children was assessed by administering a simple field level 'running test' without any sophisticated equipment. Moderately anemic children had taken significantly longer time (6.25 min) to complete the 'running test' distance of 1.6 Km. Children with normal hemoglobin (Hb) values and those with higher level normal Hb values took shorter times (7.42 and 7.06 min) to complete the test distance. Deficits of weight for age, height for age and weight for height did not exert independent influence on the 'running time'. Anemic children in the sub-groups of each category of nutritional anthropometric indicator, performed poorly. Anemia proved to be a handicap either in the presence or absence of anthropometric deficits. Mild and moderate anemia imposed handicaps on physical endurance and fitness of school children irrespective of other nutritional deficits.

Sister chromatid exchanges in congenital cataracts

A total of 25 patients with bilateral congenital cataracts, from three aetiological groups i.e. rubella (6 patients) hereditary (6 patients) and undetected aetiology (13 patients) were studied for sister chromatid exchanges (SCE). SCEs were markedly raised in the rubella groups as compared with age sex matched controls. The other two groups also showed raised SCE, more so in hereditary group.

Dermatoglyphic profile in congenital cataracts

Forty-five children with congenital cataract cases were studied for patterns and compared with age sex matched controls. The patients showed marked differences in different dermatoglyphic traits. The intra uterine aetiological groups i.e. rubella, hereditary and undetected aetiology, showed variations in mainline terminations. Rubella group showed increased angle atd.

Evaluation of national nutritional anemia prophylaxis programme

An evaluation of the National Nutritional Anemia Prophylaxis Program was carried out in Andhra Pradesh. About 8,000 respondents from about 5,754 households were interviewed and 487 pregnant women were covered for haemoglobin estimation in six selected districts. Nearly 19 per cent of the pregnant women had received folifer tablets, while about 1 per cent of child beneficiaries were receiving the tablets. The acceptance of the programme by the community appeared to be satisfactory. The reasons for poor coverage were reported to be inadequate and irregular supplies. Results indicated that the health functionaries were not properly oriented towards the programme, as many of them were not aware of all the beneficiaries under the programme. Chemical analysis of the tablets indicated that about 30 per cent of the tablet samples had iron content less than the expected levels, and none of them had expected levels of folic acid content.

Primary school teacher as a primary health care worker

School children (1608) were examined for three items (nails, scalp hairs and teeth) relating to personal hygiene and relevant infective conditions from two sets of villages i.e. one set where primary school teacher was working as primary health care worker (Group I) and the other set where Community Health Volunteer (CHV) was delivering primary health care (Group II). The objective was to evaluate the efficiency of school teachers' role vis-a-vis CHVs' in imparting health education to school children. Out of 1608 school children, 801 belonged to Group I villages and the remaining 807 to Group II villages. From the results, it was evident that children of Group I villages were better with respect to all the items related to personal hygiene and infective conditions excepting scalp infections, where difference was not statistically significant, indicating teachers' superiority over the CHVs' in imparting health education to school children.

Indian preschool children--a profile of stunting and wasting

Anthropometric data collected on 18,938 preschool children (1-5 years) by the National Nutrition Monitoring Bureau (NNMB) in 10 states of the country were analysed for assessing growth status in terms of 'stunting' and 'wasting'. The results showed that the prevalence of stunting, reflective of chronic malnutrition, is of higher magnitude compared to wasting (considered to be an outcome of current acute malnutrition), as well as wasting and stunting. The stunting increased with increasing age of children. The data also suggested that over the period, the prevalence of stunting declined from 58 per cent in 1974 to 45 per cent in 1980. A corresponding increase in normals from 35 to 50 per cent has also been noticed during the same period.

The adolescent growth spurt of height among rural Indian boys in relation to childhood nutritional background: an 18 year longitudinal study

The Adolescent Growth Spurt (AGS) was studied in rural Hyderabad boys of 5+ years of age with known childhood nutritional background. Longitudinal data on height measurements of pre-school children available for 13 to 16 points of follow-up, during an 18 year period of study (i.e., from 1965-66 to 1983-84) were utilized for this purpose. A Preece and Baines model 1 (PB 1) function was fitted for height measurements of 323 boys aged 19-24 years in 1984. The boys were classified into three groups according to degree of under-nutrition at the age of 5+ years, using Boston reference values for height. Boys with severe height deficit at age 5+ were considered to have had a background of severe undernutrition and were referred as Group III. Boys with normal range height measurements at age 5+ were considered to have a normal nutritional background and were referred to as Group I. Group II boys had height deficits in between the above two groups and were considered to have milk to moderate undernutrition backgrounds. Group I boys had similar timing, intensity, duration of Adolescent Growth Spurt Period (AGSP) and gained a similar amount of height during puberty as did British boys. Group III boys differed significantly from British boys for AGS. They entered late into puberty, with significantly depressed intensity, but gained a similar amount of height, as a result of prolonged AGSP, which continued till 19.2 years. Thus a childhood background of undernutrition did not lead to any additional deficit in height during puberty. However, pre-pubertal height deficits were carried into adult height. The growth curves of rural Hyderabad children were parallel to the British distance height curve after 12 years of age. The mean constant height velocity curve of group I boys was superimposable on the British curve during puberty.

Nutritional profile of preschool children of armed forces families around Hyderabad

Three hundred and fifty three preschool children (1 to 5 years) belonging to armed forces families of non-officers (who often come from rural background) stationed at Military Station, Golconda, Hyderabad were studied for their clinical examination and anthropometric status. Diet survey by oral questionnaire was also carried out on a sub-sample of 48 children. The heights and weights of children from families of armed forces were far superior to those of rural Indian preschool children, but they were marginally shorter and lighter than those of well-to-do Hyderabad children. About 92% of the children had weights above 80% of Harvard median. The practical implication of these findings is that the children of rural families, with the usual socioeconomic constraints, when provided with steady income and comprehensive health care can be expected to achieve a growth status which is almost comparable to that of well-to-do children.

Diet and Nutrition during Drought-An Indian Experience

In 1987 India experienced one of the century's worst droughts with two-thirds of its sown area receiving 'scanty' or 'deficient' rainfall. Delayed rains in some parts, though to some extent they relieved the water scarcity, did not brighten the prospects of agricultural production. In order to assess the diet and nutritional situation of the vulnerable population in the severely affected areas, rapid surveys were undertaken by the National Institute of Nutrition, Hyderabad, in five States of the country, namely Andhra Pradesh, Tamil Nadu, Karnataka, Orissa and Gujarat, during the months of October-December 1987. Results obtained during the current surveys are compared with the dietary situation observed in earlier droughts in the 1960s and 1970s, and it is concluded that the widespread hunger and its consequences encountered in earlier droughts could be averted, due mainly to the better food security and distribution mechanisms now available in the country.

Impact of massive doses of vitamin A on incidence of nutritional blindness

In a longitudinal study designed to assess the impact of a massive-dose vitamin A programme on the incidence of keratomalacia, 50 000 preschool children in 450 slum areas in Hyderabad city (India) were given 200 000 IU of vitamin A once every 6 months. During the study period, the incidence of keratomalacia in areas covered by the programme decreased by about 80%, while in control areas the reduction was of the order of 20%. To test whether large doses of vitamin A supplements prevented keratomalacia, a case-control analysis was done, with patients with severe protein-energy malnutrition being used as controls. The high odds ratio clearly indicated that keratomalacia was more likely to occur in children not receiving supplements.

A simple method to evaluate the massive dose vitamin A prophylaxis program in preschool children

A massive dose vitamin A prophylaxis program is currently in operation in several States of India. Evaluation of this program on a large scale has so far been difficult due to lack of baseline data on the prevalence of vitamin A deficiency in children. In this study, a simple evaluation method which makes use of the linear relationship that exists between age on one hand and prevalence of ocular signs of vitamin A deficiency (Bitot's spots) on the other is described. Regression coefficients between age and prevalence of vitamin A deficiency of areas not covered by the program (control areas) were found to be significantly different both from zero and from regression coefficients of regularly covered areas (experimental areas). Also, all regression lines of control areas were found to be above the regression zone of experimental areas. These differences between the experimental and control areas which were significant, indicate the impact of the program in areas where the program is in operation. The regression coefficient calculated for one area where the program was discontinued after some time was found to be significantly different from zero, also it was different from the regression zone of the experimental areas. However, the regression coefficient of the discontinued area was found to be significantly different from the experimental areas only at 10% level, indicating a lesser degree of efficiency of the program in this area as compared to regularly fed areas. It is, therefore, suggested that evaluation of the massive dose prophylaxis program be done against the null hypothesis beta = 0.0065--the regression coefficient achievable under field conditions.

Association of growth status and the incidence of nutrition deficiency signs

The validity of using the index weight--height in the assessment of nutritional status was evaluated. The suitability of the index and its relation to growth status and nutritional deficiency signs were assessed through the: 1) comparison of incidence rates of nutrition deficiency signs and growth rates by scales of overall weight--height values less than or above 0.15; 2) comparison of growth rates and incidence of nutrition deficiency signs by classification of children depending on the frequency with which they maintained the index above or below 0.15; and 3) intercorrelations between growth rates, incidence rates of PCM, and absolute values of weight--height index.