Cardiovascular diseases like hypertension, hyperlipidemia, diabetes mellitus and obesity are the important predictors of erectile dysfunction (ED). Endothelial dysfunction is proposed to be the underlying cause of ED, just like coronary artery disease. Sildenafil was originally developed to treat angina pectoris but later on was recognized as novel treatment option for impotence. To date, sildenafil has been the most extensively studied PDE (phosphodiesterase)-5 inhibitor. Currently two more PDE-5 inhibitors, tadalafil and vardenafil, are under study. Newer compounds have certain advantages over sildenafil, including greater selectivity for PDE-5 compared with other isoenzymes, absence of effect of food on absorption, faster onset and longer duration of action. PDE-5 inhibitors are emerging as novel therapeutic tools with a potential to protect or enhance endothelial function in humans and to selectively improve regional blood flow. The FDA has recently approved a reformulation of sildenafil for the treatment of pulmonary arterial hypertension. Raynaud's phenomenon, respiratory disorders with ventilation/ perfusion mismatch, congestive cardiac failure, hypertension and stroke are the other conditions in which PDE-5 inhibitors are being tried. It is hoped that this group of drugs will soon emerge as a novel weapon in the armamentarium against various cardiovascular and pulmonary diseases.

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Background: Almost 10% of school-going children have specific learning disability (SpLD) in the form of dyslexia, dysgraphia and/ or dyscalculia. Attention-deficit hyperactivity disorder (ADHD) occurs as a comorbidity in about 20% of these children. Aims: To document the clinical profile and academic history of children with SpLD and co-occurring ADHD. Settings and Design: Prospective observational study conducted in our clinic. Materials and Methods: From August to November 2004, 50 consecutively diagnosed children (34 boys, 16 girls) were included in the study. SpLD was diagnosed on the basis of psychoeducational testing. Diagnosis of ADHD was made by DSM-IV-revised criteria. Detailed clinical and academic history and physical and neurological examination findings were noted. Statistical Analysis : Chi-square test or unpaired student's t-test was applied wherever applicable. Results: The mean age of children was 11.4 years (±SD 2.5, range 7-17.1). Fifteen (30%) children had a significant perinatal history, 12 (24%) had delayed walking, 11 (22%) had delayed talking, 5 (10%) had microcephaly, 27 (54%) displayed soft neurological signs and 10 (20%) had primary nocturnal enuresis. There were no differentiating features between the two gender groups. Their academic problems were difficulties in writing (96%), inattentiveness (96%), difficulties in mathematics (74%), hyperactivity (68%) and difficulties in reading (60%). All children had poor school performance, 15 (30%) had already experienced class retention and 20 (40%) had developed aggressive or withdrawn behavior. Conclusion: Children with SpLD and co-occurring ADHD need to be identified at an early age to prevent poor school performance and behavioral problems.

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[FULL TEXT]  [PDF] [CITATIONS]  [PubMed]

[FULL TEXT]  [PDF] [CITATIONS]  [PubMed]

Background: Injuries are now a major cause of death and disability among the adolescents in the world. Road accidents are the main cause of death of young men worldwide. Objective : To study health-risk behavior related to road safety amongst adolescent students in south Delhi and its epidemiological correlates. Study Design : Cross-sectional study. Setting : Three schools and two colleges in south Delhi. Participants: Five hundred fifty adolescent students aged 14-19 years selected by cluster sampling. Statistical Analysis : Proportions, Chi-square test, multivariate logistic regression. Results : More than half (52.4%) reported 'not always' wearing a seat belt. About 72.1% (300) of two-wheeler riders reported 'not always' and 23.3% (97) reported 'never' wearing a helmet. Nearly 20% (91) students rode with a driver who had alcohol before driving, and 37.3% (185) subjects had driven with a driver not possessing a driving license, in the past 30 days. Such 'road-hazard' behaviors were found to be significantly more in males and in lower-age groups. Logistic regression analysis revealed that the significant correlates of such behaviors were gender of the respondent and living status of the parents. Almost 77.5% (426) of the respondents were 'at risk' as far as behaviors related to safety on roads are concerned. Conclusion : The results should evoke earnest responses from the government, policy makers and all personnel concerned with adolescent welfare on how best to reduce the extent of this preventable problem.

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Background : Specific infectious agents have been found to be related to the pathogenesis of coronary atherosclerosis. Aims : We assessed the possible association between angiographically proven coronary artery disease (CAD) and hepatitis B surface antibody (HBS Ab) seropositivity in a population with relatively high prevalence of hepatitis B virus (HBV) infection. Setting and Design : This was a cross-sectional study. Materials and Methods : We analyzed data from 830 consecutive subjects undergoing coronary angiography, including angiographic results reported by two cardiologists for inter-observer reliability and assessment of HBS Ab status determined by enzyme-linked immunosorbent assay (ELISA). Statistical Analysis Used : Chi-square test or Fisher's exact test, independent two-sample t test and the Pearson's Correlation Coefficient test were used, as required. Statistics were performed using SPSS software version 13 (SPSS, Chicago, IL). Results : Two hundred forty-nine (30%) subjects had normal angiogram or minimal CAD, and 581 (70%) had significant CAD in at least one major coronary artery. In patients with CAD and in patients without angiographic evidence of significant atherosclerosis, 28.7% and 28.9% respectively were positive for HBV (P = 0.954). Mean C-reactive protein levels in subjects with positive and negative HBS Ab were 10.77 ± 8.37 mg/L versus 10.33 ± 7.64 mg/L respectively (P = 0.465). However, C-reactive protein levels in CAD group were significantly higher (P < 0.001). Conclusions : Our results suggested hepatitis B surface antibody seropositivity has no relationship with coronary artery disease. Moreover, no significant linear correlation exists between HBS Ab and C-reactive protein levels. However, as previously shown, C-reactive protein level in patients with coronary artery disease is significantly higher than in patients with normal coronary arteries.

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