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PSYCHONEURO IMMUNOLOGICAL AXIS IN BREAST CANCER PATIENTS. 
SELVAMURTHY,W., SITARAM, Brindha, KILARA, G., PANDE, G., KHAR, A., 
RAMESH, B.S., GOPINATH, K.S., MALHOTRA, A.S. and SAWHNEY, R.C. 
(Defence Institute of Physiology and Allied Sciences, Delhi) 

The biochemistry of the body is a product of awareness. Beliefs, thoughts and emotions create the chemical reactions that uphold the life. Thoughts are converted into matters which are expressed by the brain as hormones or neuro-peptides which reach all 50 to 60 trillion cells of the body. The distressing negative thoughts cause sympathetic dominance and release of stress hormones which in turn increases HR and BP, stimulates generation of free radicals, and depresses immune system. These events increase allostatic load thereby cause progression of the disease or recurrence following treatment. Positive thoughts are translated by the brain not only through parasympathetic predominance and decrease in the stress hormones like catecholamines or cortisol but also increase anti-stress hormones like melatonin, DHEA (antiaging and anticancerous) and B-endorphin which in turn besides stimulating the immune system also decrease oxidative stress by acting as natural free radical scavengers. This mind-body relationship was investigated in breast cancer patients and their caregivers who are known to experience more negative events and psychological stress due to the life threatening disease. The study consisted of four groups viz., I. Breast cancer patients (n=43), II. Spouses of group I (n=3 1), III. Female care-givers of group I (n=9), and IV, Normal subjects (n=37). During the two year study, the four groups were assessed at three or more points of time (Pre-surgery, Pre-radiation and Pre-chemotherapy) using various psychological and neuro-immunological measures. Life changes, personality, coping, social supports, depression, and anxiety and neuro-immunological parameters such as plasma cortisol, NK activity, NK Cell %, T cell, CD4, CDS cells, Con A-PHA activity, B cell %, IgG levels, PWM activity and plasma IL 2 receptor levels were studied at different points during the course of the study period. The results suggested that patients experienced more negative life changes, depression, anxiety and neuroticism than spouses and normals. They were also more extroverted and expressed greater satisfaction with their social supports. Amongst the various psychological factors studied, coping emerged as the most outstanding psychological parameter that was different in patients, their husbands as well as in normals. Also, coping impacted all arms of the immune system. While surgery, radiation and cortisol levels did not seem to impact immune parameters, a definite correlation in both normals and in patients was seen between psychological factors and immune functions. Positive psychological factors enhanced NK cell activity, total T and B cell numbers and IgA levels. Likewise, negative psychological factors suppressed total immunoglobulin levels, T cell levels, CD4 and CD8 numbers, and Con A activity. NK activity and SIL 2R levels were, on the other hand enhanced by negative psychological factors. It appears that immunological performance of an individual can be impacted significantly by his/her coping strategies. Since, cognitive stress management, Yoga and Meditation have been found to be very useful in reducing the secretion of stress hormones and stimulate the immune system; stress management may play a central role in deciding the outcome of treatment and response to therapy and should be adopted as part of management in patients suffering from life threatening diseases like cancer.


FUTURE RESEARCH IN MENTAL RETARDATION IN INDIA: CHALLENGES AND OPPORTUNITIES
SEN, ARUN, K. (University of Delhi) 

According to WHO report, out of 4 billion habitants on our planet, about 3 percent are mentally retarded. They may come from any racial stock, any type of family background, any religion and creed. During the last 50 years, interest in psychological and educational research in these areas has revived and the field has expanded and encouraging results have been found. It is now clear that much can be done to use, develop and indeed sometimes to create limited assets in mentally handicapped individuals, in a way thought impossible 15 or 20 years back. However, the mental handicap issue cannot be handled as an isolated phenomenon. It is intricately associated with other factors such as the socio-economic condition of the family, the attitude of the family and neighbourhood, the resources available in the community and the political philosophy of the society. This paper summarizes the assets and deficits of the mentally handicapped, which emanated from a series of studies conducted by the author. A number of important areas are identified in which further research is called for, in the next millennium.


NUTRITIONAL AND HOME CORRELATES OF COGNITIVE FUNCTIONING AMONG DISADVANTAGED CHILDREN. 
SHARMA, Neerja (Lady Irwin College) 

This paper reports the findings of a study conducted to determine the relationship of home environment, children's nutritional status and their cognitive functioning. The subjects were 240 children (3-10 years) from a disadvantaged neighbourhood in Delhi. Their nutritional status was derived by assessing height for age. Cognitive functioning was determined using two separate Indian measures, one for 3-5 years olds and another one for.6-10 year olds. Two Home Inventories were used to study the homes. Interviews with mothers were also carried out. The results showed that 80% children were undernourished, with nearly 50% being moderately or severely malnourished. For the age-group 3-5 years, a significant positive correlation was found between home environment, nutritional status and cognitive performance. No correlation among the three variables was found for the children in the age range 6-10 years. Parental education, even if it was only upto a few years of primary school, contributed to a better quality home environment as well as higher cognitive scores of children during preschool years. The absence of a similar relationship during middle childhood has important implications for the role of extra-familial variables. A direct relationship between parental education and nutritional status of children could not be established in this study, "partly because all families were poor and hence short of resources. The findings are a pointer to the complex mediating role 'caring behaviours' at home may have in determining the health and developmental status of young children, especially if they belong to families at nutritional disadvantage.

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(SAAP-Delhi Con.-1999)
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