OBJECTIVE: We examined serum in patients of liver injury to explore the possible clinical application of abnormal micrometabolites as a marker of liver injury and severity in cases of traumatic liver damage. METHODS: Serum were screened by proton nuclear magnetic resonance spectroscopy in 96 patients with varying degree of liver injury and compared with concentrations in healthy control volunteers. RESULTS: Large quantities of phenylalanine and tyrosine were detected by spectroscopic analysis in patients with liver injury but not in those without liver injury (P < 0.001). Proton nuclear magnetic resonance spectroscopy revealed two unique amino acids, phenylalanine and tyrosine, in the sera of the subjects with liver injury, irrespective of the extent and type of injury gauged by radiology or laparotomy. Phenylalanine spectrum was obtained in all 84 patients with liver injury (100% sensitivity) whereas tyrosine spectrum was present in 83 out of 84 patients (98.8% sensitivity) suggesting that these amino acids were specifically released in the patients of liver injury. Significant correlations were observed between phenylalanine and tyrosine concentrations and total bilirubin levels and albumin levels. Serum phenylalanine and tyrosine concentrations correlated well with imaging and laparotomy findings of liver injury. CONCLUSION: Phenylanaline and tyrosine appear to be specific and new markers of liver injury.

The accidents on the roads are mainly, if not exclusively, (apart from many other causes), are due to excessive number of vehicles on the roads.

This excessive number is due to increase in demand of small vehicles and two wheelers. This is due to 1) inadequate production and promotion of vehicles of mass transport such as buses, 2) Artificial creation of felt status need 3) Aggressive marketing 4) excessive production and supply of private cars, auto-rickshaws and two wheelers and 5) Easily available low interest (easily affordable for a certain class of people) loans for purchase of private cars, rickshaws and two wheelers.

Ideally the government should have proper policies, rules and regulations for rectification of this aberration, in terms of excessive production. In addition, the government should also make it mandatory for the banks to give substantially lower interest loans for the purchase of buses as compared to and in preference to private cars, rickshaws and two wheelers.

But even if government fails to do so, the banks can volunteer and take initiative and lead to provide substantially lower interest loans for purchases of buses as compared to and in preference to the loans for cars, rickshaws and two wheelers.

This can have some rectifying influence in terms of preferential purchase of buses and running public undertakings and businesses of mass (bus) transport.

The persons in the money lending sectors such as banks, and especially those in decision making position, have to realize that their concern for the prevention or reduction in the number and severity of road accidents can be effectively expressed to the satisfaction of their conscience, through such a bank policy and its implementation. This is because even though, this measure obviously can not prevent the road accidents completely, it would certainly tackle one of the major causes of road accidents, viz. easy financing and thereby unabated increase in the number of vehicles on the roads. This would surely reduce the number and severity of accidents.

This point certainly does not undermine the importance of the individual precautions. But it is important to realize that this measure is not merely complementary to all the precautions the car owners, drivers, pedestrians and the traffic police should take, but its impact, like that of any accurate decision, is far more effective, widespread and on massive scale than any individual or institutional precautions, taken in isolation.

Sudden cardiac arrest is rapidly becoming the leading cause of death in in world. Once the heart ceases to function, a healthy human brain may survive without oxygen for up to 4 minutes without suffering any permanent damage. Unfortunately, a typical EMS response may take 6, 8 or even 10 minutes.

It is during those critical minutes that CPR can provide oxygenated blood to the victim's brain and the heart, dramatically increasing his chance of survival. And if properly instructed, almost anyone can learn and perform CPR.

CPR may not save the victim even when performed properly, but if started within 4 minutes of cardiac arrest and defibrillation is provided within 10 minutes, a person has a 60% chance of survival.