Haemoglobinopathy in Andhra Pradesh

Summary Children presenting with pallor, hepatosplenomegaly and other features suggestive of haemolytic disease were investigated for the presence of abnormal haemoglobins. In this effort, 67 cases of thalassaemia major, 118 of, thalassaemia minor, 9 of thalassaemia haemoglobin E disease, 8 of sickle cell anaemia and 98 parents with, the thalassaemia minor trait were detected. None of the cases had migrated from or had ancestors from West Bengal or East Bengal. From the Niloufer Hospital for Women and Children, and the Department of Pediatrics, Osmania Medical College, Hyderabad.     

Changes in proline synthetic and degradative enzymes during matrix-induced cartilage and bone formation

Summary Proline biosynthetic and degradative enzymes are unevenly distributed in differentiated mammalian tissues. Activities of the synthetic enzymes are relatively high in collagenous tissues, whereas activities of the degradative enzymes are high in noncollagenous tissues. In order to further characterize tissue-specific proline biosynthesis and degradation, we have determined proline enzyme activities during cartilage and bone formation induced by demineralized bone matrix. We can thus follow temporal changes in enzyme activity in a single tissue as different cell types develop. Ornithine aminotransferase and pyrroline-5-carboxylate reductase have peaks of activity which correlate with maximal type II collagen synthesis by chondrocytes. Both enzymes also are active during bone formation. In contrast, proline oxidase and pyrroline-5-carboxylate dehydrogenase are present at low levels and do not change as new cell types appear. Arginase activity peaks during the first 3 days and then rapidly decreases by the time cartilage and bone formation begin. These observations further substantiate the importance of proline biosynthesis in collagenous tissues. The close correlation between ornithine aminotransferase activity and type II collagen synthesis suggests that the pathway from ornithine to proline may be especially important during formation of type II collagen.     

Hydroxykynureninuria,a case report

A rare anomaly of tryptophan catabolism was detected in a 5 year old hindu boy, during a search for amino acid disorders in mental retardation     

Safety and immunogenicity of a three dose regimen of two tetravalent live-attenuated dengue vaccines in five- to twelve-year-old Thai children

OBJECTIVE: The safety and immunogenicity of tetravalent live-attenuated dengue vaccines after a three dose vaccination series were evaluated in Thai children. METHOD: One hundred three healthy flavivirus-seronegative schoolchildren ages 5 to 12 years were randomized to receive either dengue vaccine containing 3, 2, 1 and 2 log10 of the 50% cell culture infective dose, respectively, of the live-attenuated dengue vaccine serotypes 1, 2, 3 and 4 per dose (F3212; n = 40) or 3, 3, 1 and 3 log10 of the 50% cell culture infective dose (F3313; n = 42) or purified Vero cell rabies vaccine (control group; n = 21) given in a two dose schedule (3 to 5 months apart). A third dose was administered 8 to 12 months after the second dose to 90 subjects. Safety and immunogenicity were evaluated within 28 days after each injection. RESULTS: No serious adverse event related to the vaccines occurred. Most children experienced mild to moderate fever, rash, headache and myalgia occurring within 12 days after Dose 1 and generally lasting 3 days or less. One subject in Group F3212 had a 1-week dengue-like fever. Reactogenicity was minimal after Doses 2 and 3. Transient mild variations in liver enzymes and hematologic indices were noted mainly after Dose 1. After the third dose 89% of the subjects in Group F3212 seroconverted (neutralizing antibody response, > or =10) to all four serotypes, and all children in Group F3313 seroconverted. CONCLUSION: This study demonstrates a moderate although improvable reactogenicity and high seroconversion rates against the four serotypes of dengue after a three dose schedule of tetravalent live-attenuated dengue vaccine in children.     

Urological injuries during hysterectomies: a 6-year review

AIM: Urological injuries that occur during hysterectomy are a rare but important cause of morbidity. An understanding of the risk factors can help us to reduce their incidence and studying their management and outcome could help us to evolve optimal management strategies. The aim of the present study was to examine the incidence of urological injuries that occur during hysterectomy and to determine the risk factors, management and outcome of such injuries. METHODS: A retrospective analysis of cases of urological injuries sustained during hysterectomies carried out from June 1996 until May 2002, at our institution. The chi-squared test was applied for statistical analysis. RESULTS: The overall incidence of urological injuries was 0.40% (0.28% bladder and 0.12% ureteral). No ureteral injuries occurred during vaginal surgery. The incidence of bladder injury was significantly higher in non-descent vaginal hysterectomies compared with abdominal hysterectomies or vaginal hysterectomies for genital prolapse (P<0.05). Hysterectomy for ovarian malignancies had a significantly higher risk for bladder injuries compared with other indications. Bladder injuries detected during vaginal hysterectomies could be managed through the vaginal route. All the repairs healed successfully. CONCLUSIONS: Non-descent vaginal hysterectomy and hysterectomy for ovarian malignancies have a higher risk of bladder injury. Urological injuries during hysterectomy are uncommon. Early detection and appropriate management ensure successful healing and minimal long-term sequelae.