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        Some terms used in the book are now out of date.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.BHATTACHAR¥YA