Body weight, exercise and menstrual status among ballet dancers in training

Summary. A prospective study of the menstrual pattern and weight changes was made in the first year of training of 29 new female entrants to a professional ballet school. Seventy-nine per cent of the student girls had menstrual disturbances at entry: primary amenorrhoea, four; secondary amenorrhoea, 11; irregular menses, eight. The incidence of secondary amenorrhoea increase substantially by the end of the year (20), but was not associated with any significant change in body weight. Only three students menstruated regularly during the year. Menstrual regularity improved during periods of injury and long vacation and it appears that deterioration of the menstrual pattern during dancing periods was related to strenuous physical exercise rather than to any change in body weight.     

The place of premedication in pediatric practice

Behind the multiple arguments for and against the use of premedication, sedative drugs in children is a noble principle that of minimizing psychological trauma related to anesthesia and surgery. However, several confounding factors make it very difficult to reach didactic evidence-based conclusions. One of the key confounding issues is that the nature of expectations and responses for both parent and child vary greatly in different environments around the world. Studies applicable to one culture and to one hospital system (albeit multicultural) may not apply elsewhere. Moreover, the study of hospital-related distress begins at the start of the patient's journey and ends long after hospital discharge; it cannot be focused completely on just the moment of anesthetic induction. Taking an example from actual practice experience, the trauma caused by the actual giving of a premedication to a child who absolutely does not want it and may struggle may not be recorded in a study but could form a significant component of overall effect and later psychological pathology. Clearly, attitudes by health professionals and parents to the practice of routine pediatric premedication, vary considerably, often provoking strong opinions. In this pro–con article we highlight two very different approaches to premedication. It is hoped that this helps the reader to critically re-evaluate a practice, which was universal historically and now in many centers is more selective.     

Pathogenesis of Acute Porphyria

The pathogenesis of the clinical manifestations of acute porphyriahas been considered in the light of their pathological changesand their aberrations of the heam biosynthetic pathway. Thesemanifestations may be explained almost entirely upon a neurogenicbasis. A number of hypotheses have been considered to explainthe clinical, pathological and biochemical features. Of thesehypotheses two seem more impressive: (i) the neurological manifestationsmay be explained by a deficiency of haem in neural tissues;(ii) the porphyrin precursor 5-aminolaevulinic acid (ALA) mayhave in addition specific pharmacological activity.     

The teaching of behavioural sciences

Summary. Medical science over the last few decades has undergone vast changes. Technologically it has advanced at a rapid pace. There has been a realization as well that the behaviour of individuals and communities also influences the occurrence of disease. Medical schools around the globe have realized the need for incorporating behavioural sciences as an integral part of the basic sciences taught to medical students.
This paper presents the experience of Christian Medical College, Veilore in teaching behavioural sciences. Students are taught sociology, psychology and medical anthropology through a community-based, problem-oriented teaching programme. The students have first-hand experience of living in a community and learn by observation and interaction. Pre- and post-assessment has shown a significant improvement of their knowledge and attitude. Feedback from students also indicates that they find this programme relevant and interesting.     

IL-12 eliminates the Th-2 dependent protective immune response of mice to larval Strongyloides stercoralis

The goal of the present study was to determine if immune-mediated killing of S. stercoralis L3 in mice could be modulated by shifting from a Th-2 to a Th-1 type immune response. L3 killing in immunized mice was ablated in CD4⁺ T cell-depleted animals, but not in CD8⁺ T cell-depleted or β2-microglobulin-deficient mice. Treatment of immunized mice with IL-4 or IL-5 neutralizing MoAb significantly reduced the protective effects of vaccination against S. stercoralis , while protective immunity was unimpaired in IFN-γ knockout mice. Recombinant IL-12 was administered to infected mice to switch the immune response from a Th-2 to a Th-1 type response. Protective immunity was ablated in immunized mice that received IL-12 therapy. Eosinophil numbers, eosinophil peroxidase levels, and parasite-specific IgG1 levels were lowered in IL-12 treated immunized animals, and parasite-specific IgG2a levels were increased in these animals. The data indicate that eosinophils are important as mediators of larval killing, and that the establishment of Th-2 type immunity results in killing of infective S. stercoralis L3, while a shift to Th-1 type immunity abrogates protective responses.     

Aneurysm of the Left Main Coronary Artery

Aneurysms of the left main coronary artery are rare; the estimated incidence is < 0.1%. They are usually associated with atherosclerotic coronary artery disease, and are incidental discoveries at the time of cardiac catheterization for the evaluation of cardiac symptoms. This report describes the clinical course of a patient with an isolated left main coronary artery aneurysm and generalized atherosclerosis.