Higher offspring birth weight predicts the metabolic syndrome in mothers but not fathers 8 years after delivery: the Pune Children's Study

In Europid populations, low birth weight of offspring predicts insulin resistance in the mother and cardiovascular disease in both parents. We investigated the association between birth weight of offspring and obesity and cardiovascular risk in the parents of 477 8-year-old children born at the King Edward Memorial Hospital, Pune, India. Eight years after the birth of the child, mothers (33 years of age, n = 459) of heavier babies were taller and more obese (BMI, fat mass, and waist circumference, all P < 0.001) than mothers of lighter babies. Increasing offspring birth weight predicted higher homeostasis model assessment for insulin resistance (P < 0.01) and metabolic syndrome in mothers (P < 0.001) (adjusted for offspring sex and birth order, maternal age, and socioeconomic status) but not hyperglycemia. Fathers (39 years of age, n = 398) of heavier babies were taller and heavier, independent of maternal size (P < 0.01, both), but were not more insulin resistant. Unlike other reports, lower offspring birth weight did not predict insulin resistance in fathers. Thus, urban Indian parents have a higher risk of being obese 8 years after delivery of a heavier child. Mothers but not fathers of heavier babies also have a higher risk of being insulin resistant and developing the metabolic syndrome. Our findings highlight the need for a better understanding of the relation between fetal growth and future health before contemplating public health interventions to improve fetal growth.     

Niemann Pick disease--a case report

Niemann Pick disease is a rare disorder occuring in paediatric age group. The clinical features, hematological characteristics and autopsy findings in an one year old male diagnosed to have Niemann Pick disease are presented.     

Effect of 'Arogyavardhini' against carbon tetrachloride induced hepatic damage in albino rats

'Arogyavardhini'-an indigenous formulation was evaluated for its hepatoprotective activity in rats, using two models of carbon tetrachloride (CCl4) hepatic damage, one simulating vital hepatitis and the other simulating fatty change. The protective effect was assessed from serum aspartate transaminase (AST) and alkaline phosphatase levels and from histopathological changes in liver. The results revealed that 'Arogyavardhini' (5 mg/100g, PO daily) was effective in minimizing the changes in serum levels of AST and alkaline phosphatase induced by CCI. The protective effect was also evident on histopathological examination.     

Maintaining Equity and Access: Successful Implementation of a Virtual Kidney Transplantation Evaluation

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A monoclonal antibody-based test system for detection of Entamoeba histolytica-specific coproantigen.

BACKGROUND: Diagnosis of amebiasis based on stool microscopy or demonstration of anti-amebic antibodies has limitations. A diagnostic system based on demonstration of the parasite product in clinical specimens holds promise. METHODS: Murine monoclonal antibodies were developed against an Entamoeba histolytica-specific coproantigen. A monoclonal antibody (MoAb) 3D10 was employed in a double-antibody sandwich microELISA system for the detection of amebic coproantigen in fecal specimens. The system was evaluated in three groups of subjects: 63 patients with intestinal amebae, 27 with non-amebic parasitosis, and 57 apparently healthy controls. RESULTS: The MoAb 3D10 belonged to IgG1 isotype and recognized three antigens, with mol. wt. 36, 25 and 17 kDa in the crude extract of E. histolytica (HM1-IMSS), and an amebic coproantigen with MW 36 kDa in the stool supernatant from patients with intestinal amebae. The coproantigen was detected in the stool eluates of 56 (89%) patients with intestinal amebae and in none of the stool eluates from other subjects, thereby giving this system a sensitivity of 89% and specificity of 100% for the detection of intestinal amebae. CONCLUSIONS: This monoclonal antibody recognizes as intact epitope on the E. histolytica-specific coproantigen. The validity of the MoAb-based microELISA system needs to be established.     

Association of apolipoprotein E polymorphisms and dietary factors in colorectal cancer

ApoE single nucleotide polymorphisms (SNPs) Cys112Arg (Epsilon-4), and Arg158Cys (Epsilon-2) have been implicated in cardiovascular and Alzheimer''s disease, but their role in colorectal cancer (CRC) has not been extensively studied. We investigated whether ApoE polymorphisms alone or in combination with dietary factors selectively contribute to mismatch-repair (MMR) proficient (microsatellite stable/low or MSS/L) vs deficient (microsatellite unstable or MSI-H) CRCs. We carried out a case–control study with 906 CRC cases and 911 unaffected controls to examine the associations between ApoE polymorphisms and dietary factors and assessed their contribution to MSS/L and MSI-H CRCs. We used unconditional logistic regression to evaluate the associations between ApoE SNPs, tumour MSI status, and dietary factors after adjusting for age and sex. All statistical tests were two-sided. No significant differences in ApoE genotype frequencies were observed between CRC cases and unaffected controls. We observed that increased dietary intake of total fat, saturated fat, cholesterol, and red meat was significantly associated with CRC. Among non-ApoE4 carriers, 2–4 and >4 red meat servings/week were associated with developing MSS/L CRC (OR=1.51, 95% CI 1.10–2.07 and OR=1.80, 95% CI 1.30–2.48, respectively), whereas among ApoE4 allele carriers, four or more red meat servings/week were associated with MSI-H CRC (OR=4.62, 95% CI 1.20–17.77) when compared with the controls. ApoE isoforms modulate the risk of MSI-H and MSS/L CRCs among high red meat consumers.     

Pediatric percutaneous nephrolithotomy: assessing impact of technical innovations on safety and efficacy.

OBJECTIVES: To assess the safety and efficacy of percutaneous nephrolithotomy (PCNL) in the pediatric age group and the impact of certain technical modification on the ultimate outcome. PATIENTS AND METHODS: We studied 45 renal units in 40 patients under 15 years of age who underwent PCNL at our institute. The average age was 9.2 years (range 11 months-15 years). There were 5 bilateral, 11 multiple, and 9 staghorn calculi. The average calculus size was 2.04 (0.9-4.5) cm. The PCNL was done with an ultrasound-guided peripheral puncture, a planned staged approach in some cases, and minimal tract dilatation with the use of a pediatric nephroscope and a specially designed slender probe for pneumatic intracorporeal lithotripsy. RESULTS: Complete stone clearance was achieved in 41 of the 45 renal units, giving an overall clearance rate of 91%. Minor pyrexia (<100 degrees F/<2 days) was seen in 10 patients, whereas serious pyrexia was seen in 5. One patient had a prolonged leak from the nephrostomy site, which responded to double-J stenting, and one patient had a pelvic perforation with hyponatremia, which responded to conservative treatment. The average fall in hemoglobin was 1.6 g/dL, but none of the patients required blood transfusion. CONCLUSION: We believe that our alterations in the standard technique of PCNL with the use of pediatric instruments can make it a safe and effective option in the modern management of pediatric urolithiasis.     

Catheter-less suprapubic cystolithotomy in children

Bladder stones in children are common in developing countries and the procedure of choice for their removal is suprapubic cystolithotomy. It is standard practice to drain the bladder for a few days post-operatively to prevent urinary leakage. We have observed that, if the bladder is closed meticulously in 2 layers, bladder drainage by means of a catheter is not required. We have analysed 86 children treated by suprapubic cystolithotomy without a catheter. Size of the stones and intra-operative findings were noted and it was found that 85% of the patients had an excellent result; 10% had a satisfactory result and 4.7% were unsatisfactory. The advantages of the procedure and selection of the patients are discussed.