Serum thyroxine and triiodothyronine levels in newborns: effect of gestational age

Serum T₄ and T₃ were measured in 31 newborns of gestational ages 32–43 weeks. Out of 31, 11 were term, 12 preterm and 8 postterm. Blood samples were taken from cord blood and from peripheral vein at 24 and 72 hours of age. Serum T₄ and T₃ values were low in cord blood samples, raised in 24 hours samples and then declined in 72 hour samples. In pretern newborns cord T₄ and T₃ values were significantly lower and there was a blunted rise and fall in 24 and 72 hours samples as compared to term newborns. In post term newborns cord serum T₄ and T₃ values were significantly raised while in peripheral vein samples difference was statistically insignificant as compared to term newborns. This high incidence of low cord values and transient hypothyroxinemia observed in preterm and postnatal surge of T₄ may give rise to false results while screening for hypothyroidism.     

A study of the indications and changing trends of evisceration in north India

Aim: To study the demographic pattern and indications for evisceration in north India and to evaluate the changing trends over the last decade.
Methods: In a retrospective hospital-based study, case records of all patients who underwent evisceration at Rajendra Prasad Centre for Ophthalmic Sciences from January 1990 to December 1999 were reviewed. The parameters evaluated were the age and sex distribution, the place of residence (urban/rural) and the indications for evisceration. The aetiology responsible for evisceration was determined on the basis of history, clinical examination and investigations as determined from previous records.
Results: One hundred and sixty-four patients had one eye eviscerated during the study period. The mean age of the patients was 51 ± 13.84 years (range 6 months to 90 years). Panophthalmitis was the most common indication for evisceration (78.6%, n  = 129), followed by irreparable globe injury (21.3%, n  = 35). There was a significant decrease in the eviscerations performed due to pano-phthalmitis from 104 cases during the period 1990−1994, to 25 cases in the period 1995−1999.
Conclusion: Panophthalmitis and severe ocular injury are the major indications of evisceration in north India. There has been a significant decrease in the number of eviscerations related to panophthalmitis over the last decade.     

Lack of effect of nizatidine-induced elevation of gastric pH on the oral bioavailability of dapsone in healthy volunteers

STUDY OBJECTIVE: To investigate the effect of histamine2 (H2)-receptor antagonist-induced elevation of gastric pH on oral bioavailability of a single dose of dapsone 100 mg. DESIGN: Prospective, randomized, crossover, open-label, single-dose pharmacokinetic study. SETTING: Teaching hospital. PATIENTS: Sixteen men were enrolled in the study; data from 11 subjects were evaluable. INTERVENTIONS: Participants received two treatments separated by at least 14 days. Treatment A consisted of a single dose of dapsone 100 mg. Treatment B consisted of a single dose of dapsone 100 mg plus two doses of oral nizatidine 300 mg administered 3-4 hours apart to maintain gastric pH above 6.0. Plasma samples collected before and up to 120 hours after dapsone administration were analyzed for dapsone and monoacetyldapsone (MADDS) by high-performance liquid chromatography. Pharmacokinetic parameters were determined by noncompartmental analysis. MEASUREMENTS AND MAIN RESULTS: Gastric pH in the first 6 hours after dapsone administration was above 6.0 for a mean +/- SD of 1.1% +/- 2.9% of the time in the absence of nizatidine and 69.5% +/- 18.0% of the time during nizatidine therapy. The geometric mean dapsone maximum plasma concentration (Cmax) declined by 13% (p<0.01), and median time to Cmax occurred 2 hours later (p<0.01) with nizatidine coadministration compared with dapsone alone. Inclusion of the 90% confidence interval for the mean Cmax ratio within the equivalence interval of 0.8-1.25 demonstrated the lack of clinical significance for this modest decrease in Cmax. Neither the area under the dapsone plasma concentration-time curve from zero to infinity nor the elimination half-life of dapsone were significantly altered by nizatidine. No clinically significant changes were observed in the pharmacokinetics of MADDS with regard to coadministration of nizatidine. CONCLUSION: Elevation of gastric pH by H2-receptor antagonists, such as nizatidine, does not result in clinically important changes in the rate or extent of oral dapsone absorption.     

Lupus erythematosus profundus

A case of lupus erythematosus profundus, with associated mastitis, but without any lesions of discoid lupus erythematosus or systemic lupus erythematosus is being reported.     

Two new diterpenoids, sarcophytins B and C, from the Indian Ocean soft coral Sarcophyton species

Two new diterpenoids, sarcophytins B and C (1, 2), and the previously known sarcophytin (4) have been isolated from the Indian Ocean soft coral Sarcophyton sp. Structures of 1 and 2 were established by spectral data and supported by X-ray analysis of 1.