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THE NATIONAL MEDICAL JOURNAL OF INDIA VOL. 3, NO.2 95 Book Reviews Clinical Dietetics and Nutrition. F. P. Antia. Oxford mation isprovided on the prevalence of obesity nor about University Press, Bombay, 1989.438pp, Rs 250. the relation between obesity and other diseases such as hypertension and diabetes. This book continues to be a useful source of information The Indian height-weight tables given in the book about dietetics and nutrition in India. The present edition should have been best omitted because they do not have was published in 1989but was obviously prepared much any scientific basis. The metropolitan height-weight earlier as the references are only up to 1986. Even the tables are provided in feet and inches and pounds for small, author's preface to the book isdatelined October 1986. It medium and large 'frames', without actually defining the is stated that the book will be useful to a wide range of basis for the classification. Such definitions are now avail- readers from postgraduate students to lay persons and able and should have been given. General usetables derived housewives-a rather tall claim! from metropolitan data should have been independent of Some terms used in the book are now out of date. It is body frame asthese are now internationally accepted and too late in the day to include in chapter headings 'Filtrate included in current medical textbooks. Factor' and 'Adermin' as alternate names for pantothenic The descriptive section of the book isdivided into three acid and pyridoxine respectively. The Indian Council of parts. The first deals with individual nutrients, the second Medical Research (ICMR) dietary recommendations are with different foods and the third with clinical dietetics. given according to old guidelines in several places. The The book would have been much more useful if it had ICMR data provided in the 'Recommended Dietary included sections on clinical nutrition and community Intakes for Indians, 1981' and 'Nutrient Composition of nutrition. A few illustrations should also have been Indian Foods, 1989' should have been used instead. For included. example, the ICMR standard man and woman now weigh The printing and appearance are good. The price of 60 and 50 kgrespectively and not 55 and 45 kgasmentioned Rs 250 might appear a bit high, but this is probably in the book. Similarly, the recommended daily allowance unavoidable in these days of rising costs. Overall, I think (RDA) of vitamin C has been mentioned to be 30 to 100 this is a good and useful book in spite of its limitations. mg. The RDA recommended in the USA for various M. C. GUPTA age and sex groups has been given in detail in the chapter on vitamin C but the daily allowance recommended bythe ICMR (40 mg) has not been mentioned. While describing Bcomplex vitamins, insufficient attention has been given to riboflavin-the commonly deficient vitamin in the B The Short Textbook of Pediatrics. Suraj Gupte. Jaypee complex group. Brothers Medical Publishers, New Delhi. 1989. 419pp, The book does not provide information regarding the Rs 100. extent to which various nutritional deficiences are found. For example, prevalence figures are not given even for The fact that six editions have been published in 12 years common conditions such as protein energy malnutrition is an indication of the popularity and usefulness of this (PEM) , anaemia, xerophthalmia and iodine deficiency textbook. The latest edition with its broad page-size and disorders. It is surprising that only three pages have been improved print is a refreshing change from the thick, devoted to PEM (found in 75% of preschool children) somewhat stubby earlier editions. But the cutting and against four pages each to thiamine and vitamin C defi- binding should have been more carefully done; some pages ciency and sixpages to sodium deficiency, which are rare. have been carelessly cut, leaving irregular margins and The possible association between a high copper 'intake slanting tables. The price has increased from Rs 65 to and Indian childhood cirrhosis (ICC), observed by many Rs 100. paediatricians in India, is mentioned neither in the Though the title makes no such claim, this is indeed a chapter on copper nor in the discussion on ICc. Similarly, textbook suited to Indian students. A commendable breast milk and breast feeding do not find a mention any- thread of Indianness runs through the entire work. This where in this book; these topics deserve a whole chapter. has been effectively accomplished in several ways. The The least that could have been expected was a paragraph black and white pictures of children in typical rural inthe chapter on milkor inthe chapter on diet forchildren. settings add to the impact of the text. 'Indian' diseases A book on clinical nutrition should also have carried a have received the space they warrant. Both the introduc- chapter on the assessment of nutritional status in patients tory chapter and the one on Community Paediatrics have and its effects upon the course and prognosis of diseases been thoughtfully compiled and this is the only Indian as much work has been done in this area. The chapter on paediatrics textbook to include an informative chapter on obesity is also incomplete. There isno mention ofskinfold child labour. thickness as a method of assessing body fat and no infor- The chapters are well written and interesting though 96edcbaZYXWVUTSRQPONMLKJIHGFEDCBA THE NATIONAL MEDICAL JOURNAL OF INDIA VOL. 3, NO.2 one may question the large number of footnotes on almost The arrangement of the book is similar to that of every page. Harrison's Principles of Internal Medicine. The book has There are some peculiar juxtapositions. A paragraph eight parts and is very well organized. Part one deals with on clinical statistics is found in the middle of a discussion clinical and biological considerations in the approach to on epiphyseal development. The section on anaerobic tropical medicine. It has four sections: clinical (fevers, infections is included in the miscellaneous section when it diarrhoea, malabsorption, pneumonia, skin disorders, should have been included in the chapter onbacterial eye manifestations, neoplasms, anaemia and eosinophilia), infections. The table on page 70is incomprehensible. genetics (factors modifying tropical disorders and common This edition is generally wen illustrated although -the disorders in the tropics), parasitism (the host-parasite chapter on practical procedures would have benefited if interface, membranes, biochemistry, immunology, more illustrations had been used. The numerous line dia- evasion, the immunocompromised host, ecology, popula- grams are an effective adjunct to the text. But the colour tion biology, insect vectors and snail intermediate hosts) pictures and the reproduction of charts and nomograms and nutrition (nutritional needs and evaluation, nutritional from other sources are fuzzy and dim. Poor proofreading, epidemiology, nutrition and infection and nutrition and a national disease, has affected this volume as well. The immune function). author has an idiosyncratic writing style. He has a penchant Other parts deal with protozoan diseases, metazoan for emotional asides like 'How sad!', 'And yes, rightly so!' diseases, viral and chlamydial diseases, bacterial, and 'True, very true indeed'. But since Dr Gupte is also a spirochaetal and rickettsial diseases, fungal diseases, prize-winning novelist, these digressions may be forgiven. nutritional diseases and epidemiology and health care Medical students and residents will like the textual con- (estimating the burden of illness in the tropics, social tent and its easy readability. Others who are interested in determinants in tropical diseases, relative risks, benefits Indian paediatrics will find this a useful reference work. and costs of intervention, organizing principles for effec- G. G. CHRISTO tive health care systems and tropical diseases of travellers and migrants). In a multi-author book such as this the main problem is to maintain uniformity in the writing style and organize various subjects in their order of importance. While the Tropical and Geographical Medicine. Kenneth S. Warren, writing is clear, there will be differences of opinion about Adel A. F. Mahmoud. McGraw-Hill Book Company, the utilization of 1175 pages. Parasitism and the host- New York, International Student Edition, 1985. 1175pp, parasite interface and general immunology related to $27.00. parasitism have been dealt with in too much detail occupying asmuch as86pages. At places, specialist infor- Tropical countries have health problems related partly to mation on abstruse subjects isincluded which willinterest their climates but mainly to underdevelopment. These only a few readers. Topics such as the malabsorption 'tropical diseases' occur in one half of the world's land syndrome, genetic disorders in the tropics and nutritional area and affect three-quarters of the world's population. epidemiology are particularly well covered, the material Curiously, the major part of the research and teaching in presented being adequate and practical. In the discussion tropical diseases has been done in the developed countries, on acute diarrhoea the emphasis has been placed on the earlier in Europe and now in the USA. Thus the available bacterial causes, less importance has been given to others. textbooks and reference books on tropical diseases have The role of intestinal stasis in the pathogenesis of sprue been produced in the developed world. Advances in and in initiating bacterial contamination has not been immunology and therapy and the changing. spectrum of adequately discussed. The chapter on malaria describes diseases have resulted in an increasing need for the proper parasite biology, intracellular physiology and biochemistry, study of drugs and vaccinesinthe treatment and prevention parasite genetics and epidemiology, giving much useful of tropical diseases. The present volume is a multi-author information not generally available in many standard general reference book. There are 153contributors from textbooks. The descriptions of taxonomy, morphology 21 countries-the majority from the United States and a and ultrastructure of the parasites causing kala-azar are few from the developing countries. The book is 'intended detailed yet concise. Other aspects of kala-azar which are for all those who are studying, researching or practising also well written include its immunology, the use of animal tropical medicine. It has been planned to provide an models to study the mechanism of glomerulonephritis and adequate and balanced guide for the student, the scientist delineation of genes and the use of lymphokines in and the clinician. increasing resistance against kala-azar. 'The basicstructure ofthe book reflects an understanding The printing isclear and the price moderate. The volume of all infectious agents as parasites in the broad sense of willserve as a useful reference book for students of tropical . the term. It presents three crucial facets of the relation- medicine, especially postgraduates, researchers and ship between the infectious agent and host: the parasite, teachers. the patient and the population.' A.K.BHATTACHARÂ¥YA
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