Hepatitis B surface antigen in blood donors. An epidemiologic study

Of 8085 volunteer donors attending the blood bank at SCTIMST screened for hepatitis B surface antigen (HBsAg) carrier state by counterimmunoelectrophoresis, 103 (1.27%) were HBsAg positive. The personal data of donors showed a higher rate of HBsAg among men than women and in the age group of 21 to 30 years than in the other age groups. A significantly higher rate was noted among donors belonging to the lower socioeconomic group (p less than 0.05).     

Consumption of coffee, but not black tea, is associated with decreased risk of premenopausal breast cancer

Caffeine has been suggested as a possible risk factor for breast cancer, potentially through its effect of facilitating the development of benign breast disease. However, coffee and tea also contain polyphenols, which exhibit anticarcinogenic properties. A hospital-based, case-control study was conducted to evaluate the role of coffee, decaffeinated coffee, and black tea in breast cancer etiology. Study participants included 1932 cases with primary, incident breast cancer and 1895 hospital controls with nonneoplastic conditions. All participants completed a comprehensive epidemiological questionnaire. Among premenopausal women, consumption of regular coffee was associated with linear declines in breast cancer risk (P for trend = 0.03); consumers of >or=4 cups/d experienced a 40% risk reduction (odds ratio = 0.62, 95% CI 0.39-0.98). No clear associations between intake of black tea or decaffeinated coffee and breast cancer risk were noted among premenopausal women, although black tea was associated with a protective effect unique to a subsample of cases with lobular histology. Among postmenopausal women, breast cancer risk was not associated with consumption of coffee, tea, or decaffeinated coffee. Results among postmenopausal women did not differ by histologic subtype. Our findings support a protective effect of coffee intake on premenopausal, but not postmenopausal breast cancer risk. Further studies are warranted to confirm these findings.     

Carrying angle in children: a normative study

Information about the carrying angle and its variations are important in the management of paediatric elbow injuries. We measured the carrying angle using bony landmarks for 300 rural South Indian children aged 5-18 years. The study confirms that the clinical carrying angle correlates best with age up to 15 years, following which there was a slight decrease in the angles. The rate of increase of the carrying angle for boys and girls is 0.42 and 0.60 degrees per year respectively. Sex differences seem to gradually increase with a maximum being around puberty. The carrying angle is greater in girls than in boys by a mean of 1.31 degrees. The carrying angle did not correlate well with height, weight, humeral length or ulnar length. The reproducibility of measuring the carrying angle by the simple technique used in our study leads us to propose that this may be used in actual clinical practice.     

Significance of silver-stained nucleolar organizer regions in early diagnosis and prognosis of oral squamous cell carcinoma: a multivariate analysis

Argyrophilic nucleolar organizer regions (AgNORs) appear to be of diagnostic and prognostic significance in different types of human tumour. The present study examined the AgNOR counts in normal, premalignant and malignant oral mucosa to evaluate their potential as a biological marker for tumour progression and a prognostic predictor for treatment outcome in oral carcinomas. The Spearmann's rank correlation analysis between AgNOR counts and various stages of tumour progression in oral mucosa exhibited a highly significant positive coefficient (r(s) = 0.7969; p < or = 0.001), thus indicating the role of AgNORs in the early diagnosis of potentially malignant oral leukoplakia. When analyzing the prognostic significance of AgNOR in oral carcinomas, mean count > 2.8 concurred with poor prognosis in both univariate and multivariate analysis. Along with AgNOR counts, the T-status of disease was also found to be an independent predictor for treatment outcome in multivariate analysis. Thus T3 and T4 tumours, with mean AgNOR counts more than 2.8, are aggressive and may exhibit resistance to current treatment protocols.     

Synthesis antimicrobial and anticancer activity of N′-arylmethylidene-piperazine-1-carbothiohydrazide

Ten newly synthesized thiosemicarbazones of piperazine (3a–3j) were evaluated for their antibacterial and antifungal activity against non-pathogenic strains of Escherichia coli (NCIM 2068), Klebsiella pneumonia (NCIM 2957), Staphylococcus aureus (NCIM 2079), and Bacillus subtilis (NCIM 2921); pathogenic strains of Vibrio cholerae, protease, Candida albicans and Aspergillus niger. All the 10 compounds (3a–3j) were found to be better than Ciprofloxacin against B. subtilis and four molecules (3c, 3d, 3e, and 3h) against S. aureus. Compound 3j, a derivative of benzophenone, has been identified as a potent and promising candidate against C. albicans. The compounds were also evaluated for their anticancer activity against HBL-100 and HL60 cell lines. Compound 3a, a p-hydroxy benzaldehyde derivative, has been identified as a potent and promising candidate.     

Gap in the prevalence of neutralising antibodies to polioviruses in antenatal women in southern India

With the disappearance of circulating wild poliovirus and improved sanitation, protective antibody levels may wane over time following oral poliovirus vaccine (OPV) administration. This study evaluated the seroprevalence of neutralising antibodies to vaccine polioviruses among young Indian women who had received at least three doses of OPV as primary immunisation. Of 60 women studied, 27 (45%) had antibody titres of <1:8 to one or more polioviruses, with the lowest levels for poliovirus types 3 and 1. These findings represent a possible immunity gap and this needs to be confirmed with further studies, which could include a challenge with vaccine virus.     

Decrease in pulmonary artery pressure after administration of thoracic epidural anesthesia in a patient with Marfan syndrome awaiting aortic valve replacement procedure

Thoracic epidural anesthesia is an adjunct to general anesthesia in cardiac surgery. Decrease in heart rate and blood pressure are frequently seen beneficial effects. There are several other hemodynamic effects of thoracic epidural anesthesia such as decrease in systemic vascular resistance, cardiac index, left ventricular stroke work index among others. However, the effect of thoracic epidural anesthesia on pulmonary artery pressure (PAP) has not been studied extensively in humans. Thoracic epidural anes-thesia decreased pulmonary artery pressure in experimen-tally induced pulmonary hypertension in animals. The mechanisms involved in such reduction are ill understood. We describe in this report, a significant reduction in PAP in a patient with Marfan’s syndrome scheduled to under-go aortic valve replacement. The possible mechanisms of decrease in pulmonary artery pressure in the described case are, decrease in the venous return to the heart, decrease in the systemic vascular resistance, decrease in the right ventric-ular function and finally, improvement in myocardial contraction secondary to all the above. The possibility of Marfan’s syndrome contributing to the decrease in PAP appears remote. The authors present this case to generate discussion about the possible mechanisms involved in thoracic epidural anesthesia producing beneficial effects in patients with secondary pulmonary hypertension. Thoracic epidural anesthesia appears to decrease pulmonary artery pressure by a combination of several mechanisms, some unknown to us. This occurrence, if studied and understood well could be put to clinical use in pulmonary hypertensives.     

Efficacy of Endoscopic Ultrasound-Guided Drainage of Pancreatic Pseudocysts in a Pediatric Population

Background  

While pancreatitis is uncommon in children, pseudocyst development can be a serious complication. Endoscopic drainage of pseudocysts is well established in adults. However, there are limited data regarding this procedure in a pediatric population. The objective of this study is to determine the safety and efficacy of endoscopic ultrasound-guided pseudocyst drainage in children.     

Effect of thoracic epidural anesthesia on oxygen delivery and utilization in cardiac surgical patients scheduled to undergo off-pump coronary artery bypass surgery: a prospective study

To evaluate the effect of thoracic epidural anesthesia (TEA) on tissue oxygen delivery and utilization in patients undergoing cardiac surgery. This prospective observational study was conducted in a tertiary referral heart hospital. A total of 25 patients undergoing elective off-pump coronary artery bypass surgery were enrolled in this study. All patients received thoracic epidural catheter in the most prominent inter-vertebral space between C7 and T3 on the day before operation. On the day of surgery, an arterial catheter and Swan Ganz catheter (capable of measuring cardiac index) was inserted. After administering full dose of local anesthetic in the epidural space, serial hemodynamic and oxygen transport parameters were measured for 30 minute prior to administration of general anesthesia, with which the study was culminated. A significant decrease in oxygen delivery index with insignificant changes in oxygen extraction and consumption indices was observed. We conclude that TEA does not affect tissue oxygenation despite a decrease in arterial pressures and cardiac output.