Physical growth of primary school children of Lucknow

Conclusion From the above consideration we conclude that the stature of the boys and girls in all the age groups grew more rapidly than the other body segments under consideration. On the other hand, the arm girth grew very slowly. The mean values were progressively higher while the rate of growth and growth velocities were different in different age groups. The mean values of the lower extremity and biacromial indices were nearly constant in all the age groups which showed relatively equal growth of the stature in relation to lower extremity and shoulder breadth. From the Department of Anthropology, Lucknow University, Lucknow-226001.     

Laparoscopic and ultrasound-guided transcervical evacuation of cornual ectopic pregnancy: an alternative approach.

Conventional treatment of cornual ectopic pregnancy carries significant morbidity and may compromise future fertility. We present a minimal access technique for the treatment of cornual ectopic pregnancies which we believe carries a reduced morbidity and may be less likely to compromise future reproductive function.     

Risk factors for the development of acute lung injury in patients with infectious pneumonia

ABSTRACT: INTRODUCTION: Although pneumonia has been identified as the single most common risk factor for acute lung injury (ALI), we have a limited knowledge as to why ALI develops in some patients with pneumonia and not in others. The objective of this study was to determine frequency, risk factors, and outcome of ALI in patients with infectious pneumonia. METHODS: A retrospective cohort study of adult patients with microbiologically positive pneumonia, hospitalized at two Mayo Clinic Rochester hospitals between January 1, 2005, and December 31, 2007. In a subsequent nested case-control analysis, we evaluated the differences in prehospital and intrahospital exposures between patients with and without ALI/acute respiratory distress syndrome (ARDS) matched by specific pathogen, isolation site, gender, and closest age in a 1:1 manner. RESULTS: The study included 596 patients; 365 (61.2%) were men. The median age was 65 (IQR, 53 to 75) years. In total, 171 patients (28.7%) were diagnosed with ALI. The occurrence of ALI was less frequent in bacterial (n = 99 of 412, 24%) compared with viral (n = 19 of 55, 35%), fungal (n = 39 of 95, 41%), and mixed isolates pneumonias (n = 14 of 34, 41%; P = 0.002). After adjusting for baseline severity of illness and comorbidities, patients in whom ALI developed had a markedly increased risk of hospital death (ORadj 9.7; 95% CI, 6.0 to 15.9). In a nested case-control study, presence of shock (OR, 8.9; 95% CI, 2.8 to 45.9), inappropriate initial antimicrobial treatment (OR, 3.2; 95% CI, 1.3 to 8.5), and transfusions (OR, 4.8; 95% CI, 1.5 to 19.6) independently predicted ALI development. CONCLUSIONS: The development of ALI among patients hospitalized with infectious pneumonia varied among pulmonary pathogens and was associated with increased mortality. Inappropriate initial antimicrobial treatment and transfusion predict the development of ALI independent of pathogen.     

Prevalence of asthma in urban school children in Jaipur, Rajasthan

A cross sectional survey of 3321 school going children (5–15 years) using modified ISAAC questionnaire in Jaipur city showed 7.59% children to have asthma (in last 12 months) and 8.4% wheezing in last 12 months. Only 5.3 % children had “physician diagnosed asthma ever” suggesting under diagnoses.     

Decrease in the Frequency of Circulating CD56+CD161+ NK Cells in Human Visceral Leishmaniasis

Background: Natural Killer (NK) cell plays an important role in the innate immune system and is known to produce IFN-γ at an early stage of infection that is essential to eliminate intracellular infection like Leishmania spp. It is already established that Leishmania parasite inhibits the activity of NK cells, avoiding the encounter with the early innate immune response. This, in turn, favors establishment and further dissemination of the infection. Methods: In the present study, we have tried to measure the frequency of different phenotypic subsets of NK cells among visceral leishmaniasis (VL) patients. Results: We have phenotyped three distinct three distinct subsets (CD56^–CD161⁺, CD56⁺CD161^–, and CD56⁺CD161⁺) of NK (CD3^–) cell using their specific markers CD161 and CD56. Conclusion: Interestingly, we observed selective loss of CD56⁺CD161⁺ subset of circulating NK (CD3^–) cells. Importantly, the other subsets (i.e., CD56^?CD161⁺ and CD56⁺CD161^–) of circulating NK cells remain unaffected as compared with healthy subjects.     

Manoeuvres to Improve Endoscopic Visualization of Hypopharynx

The more progress achieved in endoscopy, the more superficial cancers in head and neck region have been diagnosed. There are, however, some areas difficult to observe, particularly the hypopharynx, due to closure of this space. Examination of hypopharynx form an essential part of head and neck examination especially in the suspected malignancies as well as in the cases with unknown primary. As the flexible fiber-optic nasopharyngolaryngoscopy forms an essential part of examination of hypopharynx, the present study aims to evaluate the effectiveness of various manoeuvres devised to aid in better visualization of the hypopharynx. The present prospective study is an observation carried out on 30 patients, which had been followed up for hypopharyngeal or laryngeal disease, in the OPD of the department of Otorhinolaryngology and head and neck surgery in Gandhi Medical College and associated hospital, Bhopal, M.P. In the present study, authors compared the visibility of subsites of hypopharynx in 30 patients undergoing trans nasal flexible fibre optic endoscopy in normal seated position and with head torsion, valsalva manoeuvre and the Killian position. The authors concluded that the above mentioned manoeuvres facilitated the visualization of the entire circumference of the hypopharynx during endoscopic examination, are non invasive and easy to perform and so should be included as a part of routine examination while performing flexible fibre optic endoscopy.     

Primary ovarian insufficiency in classic galactosemia: current understanding and future research opportunities

Classic galactosemia is an inborn error of the metabolism with devastating consequences. Newborn screening has been successful in markedly reducing the acute neonatal symptoms from this disorder. The dramatic response to dietary treatment is one of the major success stories of newborn screening. However, as children with galactosemia achieve adulthood, they face long-term complications. A majority of women with classic galactosemia develop primary ovarian insufficiency and resulting morbidity. The underlying pathophysiology of this complication is not clear. This review focuses on the reproductive issues seen in girls and women with classic galactosemia. Literature on the effects of classic galactosemia on the female reproductive system was reviewed by an extensive Pubmed search (publications from January 1975 to January 2017) using the keywords: galactosemia, ovarian function/dysfunction, primary ovarian insufficiency/failure, FSH, oxidative stress, fertility preservation. In addition, articles cited in the search articles and literature known to the authors was also included in the review. Our understanding of the role of galactose metabolism in the ovary is limited and the pathogenic mechanisms involved in causing primary ovarian insufficiency are unclear. The relative rarity of galactosemia makes it difficult to accumulate data to determine factors defining timing of ovarian dysfunction or treatment/fertility preservation options for this group of women. In this review, we present reproductive challenges faced by women with classic galactosemia, highlight the gaps in our understanding of mechanisms leading to primary ovarian insufficiency in this population, discuss new advances in fertility preservation options, and recommend collaboration between reproductive medicine and metabolic specialists to improve fertility in these women.     

Bispecific antibody based therapeutics: Strengths and challenges

Monoclonal antibody-based targeted therapy has greatly improved treatment options for patients. However, long-term efficacy of such antibodies is limited by resistance mechanisms. New insights into the mechanisms by which tumors evade immune control have driven innovative therapeutic strategies to eliminate cancer by re-directing immune cells to tumors. Advances in protein engineering technology have generated multiple bispecific antibody (BsAb) formats capable of targeting multiple antigens as a single agent. Approval of two BsAb and three check point blocking mAbs represent a paradigm shift in the use of antibody constructs. Since BsAbs can directly target immune cells to tumors, drug resistance and severe adverse effects are much reduced. The wave of next generation “bispecific or multispecific antibodies” has advanced multiple candidates into ongoing clinical trials. In this review, we focus on preclinical and clinical studies in hematological malignancies as well as discuss reasons for the limited success of BsAbs against solid tumors.