No abstract

It is hoped that this series of images will increase the accuracy and safety of needle placement for spasticity injections in the forearm.

Background Multinutrient insufficiencies as a consequence of nutritional and economic factors are common in India and other developing countries. We have examined the impact of multi-nutrient insufficiency on markers of one carbon metabolism in the blood, and response to a methionine load in clinically healthy young women. Design & Methods Young women from Pune, India (n=10) and Cleveland, USA (n=13) were studied. Blood samples were obtained in the basal state and following an oral methionine load (50mg/kg of body weight in orange juice). Plasma concentrations of vitamin B12, folate and B6 were measured in the basal state. The effect of methionine load on the levels of methionine, total homocysteine, cysteine, glutathione and amino acids was examined. Results Indian women were significantly shorter and lighter compared with the American women and had lower plasma concentration of vitamins B12, folate and B6, essential amino acids and glutathione, but higher concentration of total homocysteine. The homocysteine response to methionine load was higher in Indian women. The plasma concentrations of glycine and serine increased in the Indian women after methionine (in juice) load. A significant negative correlation between plasma B6 and homocysteine (r= −0.70), and plasma folate and glycine and serine levels were observed in the Indian group (P<0.05) but not in the American group. Conclusion Multi-nutrient insufficiency in the Indian women caused unique changes in markers of whole body protein and one carbon metabolism. These data would be useful in developing nutrient intervention strategies.

It is hoped that this series of images will increase the accuracy and safety of needle placement for spasticity and nerve block injections in the proximal upper arm.