Detection of Chlamydia trachomatis cervical infection: a comparison of Papanicolaou and immunofluorescent staining with cell culture

We compared tissue culture with Papanicolaou-stained cervical smears, endocervical cytologic smears stained with immunofluorescent monoclonal antibody, and a direct immunofluorescent stain of cervical specimens (MicroTrak) for detection of Chlamydia trachomatis in cervical specimens. Fifty-one (21%) of 245 women had positive cultures for C. trachomatis, 14 (27%) of whom had clinical evidence of cervicitis. With the criteria of intracytoplasmic coccoid inclusion bodies within metaplastic cells, 45 (34%) of 130 Papanicolaou smears were read as suggestive for C. trachomatis. Seventeen of the 45 positive Papanicolaou smears were positive on culture and 28 were negative (sensitivity 54%, specificity 71%). In contrast, 48 of 51 women with positive cultures and one woman with a negative culture had positive immunofluorescent-stained cytologic smears (sensitivity 94%, specificity 99%, with positive predictive value of 98%). Similarly, 47 of 51 women with positive cultures also had positive results with MicroTrak direct immunofluorescent stain, with only one positive specimen in 196 women with negative cultures (sensitivity 92%, specificity 99%, with positive predictive value of 98%). This study demonstrates that immunofluorescent staining of cervical specimens or of cytologic smears is a more sensitive and specific method than routine Papanicolaou smear for detection of chlamydia infection in a high-prevalence population.     

Knowledge and attitudes of rural health personnel regarding infant feeding

The knowledge and attitudes regarding infant feeding practices were studied among those health personnel (doctors, nurses and dais) who were delivering M.C.H. services in the peripheral areas of Barmer District (W. Rajasthan). The study revealed that the health personnel under study are not fully aware of the correct infant feeding practices and thus their incorrect knowledge and attitudes when put into practice can have detrimental effects. This study highlights the need of continuing medical education and stepping up of pediatric training in undergraduate courses.     

Subcutaneous bioabsorbable pellets of norethindrone for contraception in women: Phase I. Clinical study

Ten healthy, normally menstruating female volunteers participated in a 1-year phase I clinical study in which subcutaneous pellet implants of norethindrone (NET) were employed as a low-dose and long-acting potential contraceptive. Two NET pellets were implanted subcutaneously by the aid of a trocar in the forearm of each volunteer on the fifth day after the start of menstrual bleeding. Serum levels of NET, follicle-stimulating hormone, luteinizing hormone, 17 beta-estradiol, and progesterone were determined weekly by radioimmunoassay. The daily NET release from the pellets, based on mean values (+/- standard error of the mean) in five subjects was 79.4 +/- 7.6 micrograms. The mean serum NET level was initially 1.0 +/- 0.34 ng/ml; thereafter, it gradually lowered during the 343 days of the study period to the level of 0.43 +/- 0.09 ng/ml. The ovarian response, days of bleeding, and cycle lengths with continuously sustained release of NET from the pellets were similar to those observed in women taking the daily oral "minipill" of 300 micrograms NET. The results of the phase I study suggest that NET pellet implants may provide a simple and acceptable approach to long-term contraception in women.     

Two siblings with unilateral renal agenesis

Family with two consecutive brothers with unilateral aplasia of the kidney are reported. Role of genetic inheritance and defects in embryogenesis of familial renal aplasia are discussed.     

An experience with measles vaccine

A study was conducted in Simla town to know the effectiveness and reactions of measles vaccine. One hundred and eight children in the age group of 9–23 months were immunized with measles vaccine and followed over a period of 2 years. Eighty nine children were also followed up as controls. The difference in the attack rate of measles in these two groups was highly significant. Mild fever was found to be a significant side effect. No other reaction like rash or convulsions was observed.     

Intravitreal pefloxacin therapy in postoperative endophthalmitis

Purpose : To study the efficacy of intravitreal pefloxacin in the management of suspected bacterial endophthalmitis. Methods : Twenty eyes with suspected postoperative bacterial endophthalmitis were given an intravitreal injection of pefloxacin (200 μg in 0.1 mL). If required the injection was repeated after 24 h. The main parameters evaluated were visual acuity, response to intravitreal therapy and any complications due to intravitreal pefloxacin. Results : Fourteen eyes (70%) responded to intravitreal pefloxacin therapy alone, while an additional pars plana vitrectomy was required in six eyes (30%). Nineteen eyes retained a visual acuity of 6/60 or better at 3 months after the initiation of therapy. A retinal detachment developed in one of the eyes which received intravitreal therapy. Conclusions : Intravitreal pefloxacin may be a useful alternative therapy in bacterial endophthalmitis.     

Leiomyoma of the palate

Leiomyoma, a benign neoplasm of smooth muscle cell origin, has been documented infrequently in the oral cavity. It may arise wherever unstriated muscle is present including the arterial wall (Cherrick et al., 1973). The most common site is the uterus, followed by the wall of the alimentary canal and in subcutaneous tissue (McCaffrey et al., 1978). A search of the literature revealed 51 cases of oral leiomyomas. Cherrick et al. (1973) reviewed 35 cases, including seven of their own. Galili and Shteyer (1974) summarized the clinical data of 42 cases of oral leiomyomas reported since 1884. We can find only nine more reported cases of leiomyoma in the oral cavity: one each by Rhatigan and Kim (1976), Shirota et al. (1976), Kelly and Harrigan (1977), Schweigel (1980), Davis (1980) and Mechlin et al. (1980); and three cases by Damm and Neville (1979). The common sites in the oral cavity are the tongue and cheek but its occurrence on the palate is rare for out of the 51 cases of oral leiomyomas, only 10 involved the palate (one case each was reported by Fein, 1905; Kist and Bhaskar, 1964; Garrett, 1969; Galili and Shteyer, 1974; Rhatigan and Kim, 1976; and Davis, 1980; and four cases by Cherrick et al., 1973). Its rarity and large size make the tumour worth reporting.