Vitamin A deficiency is a major cause of childhood mortality and morbidity in India and other developing countries. The ocular manifestations of vitamin A are collectively called xerophthalmia and range from conjunctival xerosis to severe blinding complications such as keratomalacia. Vitamin A deficiency exists as a major public health nutrition problem among preschool-aged children, especially in the South East Asian region, as well as among the pregnant and lactating women. Deficiency can be diagnosed by the ocular manifestations such as Bitot's spots, serum retinol levels, and conjunctival impression cytology (CIC). Improving vitamin A status in the diet or by periodic administration of vitamin A to children can reduce both mortality and blindness. This review is an attempt to highlight the ocular manifestations of vitamin A deficiency, its prevalence, treatment, and preventive strategies.

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Nutritional needs in patients with chronic kidney disease are different from those of the normal population. As such, estimation of these nutritional requirements mandates a thorough understanding of the various physiologic and pathologic processes related to renal system. Many of these patients get admitted in intensive care and dialysis units at some stage of life for one indication or the other. Intensivists also have to update their knowledge when it comes to providing nutrition to these patients during their intensive care unit (ICU) stay. Majority of these patients are on chronic dialysis and this aspect has to be taken care of while they are treated in ICU. The assessment of nutritional needs and the various dietary modifications requires the services of a nephrologist on patient-to-patient basis depending upon the underlying co-morbid diseases. Majority of the studies involving patients with renal disease have been carried out in normal population, and as such, data is lacking from ICU and dialysis units. The present article is an attempt to discuss various aspects of patients with chronic kidney disease and their nutritional needs and the relevant dietary modifications and is an extrapolation of the present evidence of normal population to the patients admitted in ICU and dialysis units.

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With the ever increasing epidemic of obesity, diabetes and hypertension among young adults, the risk of mortality and morbidity due to atherosclerotic heart disease is gradually increasing. Dyslipidemia is an additional risk factor for cardiovascular disease. Nutraceutical supplements can provide valid alternate to patients who are intolerant to statins or patients preferring alternative treatments. The combination of a lipid lowering diet and scientifically proven nutraceutical supplements can significantly reduce low density lipoprotein (LDL) cholesterol, increase LDL particle size, decreased LDL particle number decreased triglycerides and increased high density lipoprotein (HDL) particles. In addition, they address lipid induced vascular damage by suppressing inflammation, oxidative stress and immune response leading to additional antihypertension, antidiabetic properties. The current article reviews the evidence in support of different dietary supplements and their lipid lowering beneficial effects.

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Male sexual dysfunction (MSD) is a common and distressful condition which is often amenable to counseling and other non pharmacological therapy. These ALLIANCE guidelines are an exhaustive coverage of the counseling and related non-pharmacological methods used for management of MSD. The guidelines discuss various concepts of medical care, including the bio-psychosocial model, patient centered care, couple centered care, therapeutic patient education, shared decision making, minimizing the discomfort of change, and coping skills training, as related to MSD. They go on to describe the ideal environment and prerequisites in which a proper history should be elicited, and physical examination performed. Counseling related to investigations, physical activity and yoga is described. Specific examples of psychotherapy for various sexual disorders are presented to illustrate the usage of counseling. The guidelines discuss cognitive behavioral therapy, couple centered therapy, family therapy, and use of religion in detail. Counseling regarding pharmacological, device and invasive therapy is also covered. The guidelines conclude with a call to enhance community awareness of MSD

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The prevalence of overweight and obesity has increased to epidemic proportion across the globe. With it the prevalence of metabolic syndrome and type diabetes mellitus has also increased tremendously. Hyperglycemia as a consequence of associated type 2 diabetes mellitus, or stress response facilitated by counter-regulatory hormone surge is encountered quite commonly in obese patients during pre-operative assessment. There are reports of increased peri-operative complications with higher glucose levels in some studies, while evidence derived from some other studies are inconclusive. There are conflicting data regarding the benefit of a very tight intra-operative glucose control. There is clinical trial evidence that should help the operative team to develop some locally derived threshold near a reasonable blood glucose cut-off; for e.g., blood glucose level of 180 mg/dL for an elective major (i.e., requiring general anesthesia) procedure and 250 mg/dL for an emergency major or any sort of minor (not requiring general anesthesia) procedure.

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Background: Pregnancy is characterized by generation of reactive species and reduction in immune functions of the woman, exposing her to oxidative stress and infections/infestations. In developing countries, pregnant women seldomly seek antenatal care early in their pregnancies, exposing them to pregnancy complications. Aim: The aim of this study is to measure the levels of anti-infective antioxidant minerals – selenium and zinc, in rural pregnant women who are on their first antenatal visits, to know their status before routine antenatal supplements are commenced. Materials and Methods: Serum selenium and zinc concentrations were determined using atomic absorption spectrophotometer, in 181 apparently normal pregnant rural women aged between 18 and 40 years, who were on first antenatal visits. They were first grouped according to trimesters and later according to parity. Controls were 50 age-matched, non-pregnant women who were not in their menstrual periods at the time of the study. Results: Results showed that serum selenium and zinc in pregnant women were significantly lower (P < 0.001) than values obtained from non-pregnant women (controls). However, there was no significant difference between the values from the controls and first trimester in both elements (P = 0.964 and 0.974, respectively), but thereafter, the elements became significantly lower (P < 0.001) and remained so throughout gestation. Though both elements showed significantly lower value in each parity group when compared with the control (P < 0.001), selenium did not show significant difference (P = 0.066) between one parity group and another, while zinc showed significantly higher value (P < 0.001) in high multiparas over preceding parity group. Conclusion: Our results suggest that pregnant women in the rural areas are prone to oxidative stress and infections ever before they seek for antenatal care. Public health education should be organized regularly in these rural areas to highlight the dangers of late antenatal registration, while the need for consumption of local foods that contain these trace elements by pregnant women should be emphasized on antenatal days.

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