Fetal heart rate characteristics that provide confidence in the diagnosis of fetal well-being

Fetal heart rate monitoring was first used as a clinical tool for the assessment of fetal danger and well-being. In the past decade, basic research has demonstrated the physiologic events associated with most heart rate changes. This review has demonstrated that study and semiquantification of the five analyzable features of an FHR recording can provide a strong reassurance of fetal health. The method has not proven as predictable for defining fetal disease, so additional parameters are needed to define clearly the significance of an abnormal FHR tracing.     

Use of glycosylated hemoglobin as a screen for macrosomia in gestational diabetes

Glycosylated hemoglobin and blood sugar levels in the fasting state and two hours after oral 100 g glucose load were measured in 180 patients. Glycosylated hemoglobin was measured by cation exchange column chromatography, and blood sugar was measured by hexokinase reaction. Patients with an elevated postprandial and/or fasting blood sugar level (positive screen) subsequently underwent three-hour glucose tolerance test. The mean value of glycosylated hemoglobin in patients with a negative screen and normal hemoglobin was 6.17 +/- 0.61%; and the value for glycosylated hemoglobin in patients with class A diabetes and normal hemoglobin electrophoresis was 6.85 +/- 0.73% (P less than .001). A glycosylated hemoglobin value greater than 6.78 (mean + 1 SD) was considered elevated. Glycosylated hemoglobin values were elevated in 21 of 33 patients with gestational diabetes and in 27 of 147 patients with normal blood sugar levels. The sensitivity and specificity of glycosylated hemoglobin for the diagnosis of gestational diabetes were 63.6 and 81.6%, respectively. Fifty percent of patients with an initially elevated glycosylated hemoglobin value delivered macrosomic infants, whereas no patient with a normal glycosylated hemoglobin value had a macrosomic infant. An elevated glycosylated hemoglobin value may alert the obstetrician of a potentially elevated mean blood sugar level and may warrant aggressive management of gestational diabetes.     

Rejuvenating facial massage – a bane or boon?

BACKGROUND: Facial massage is an extremely popular form of beauty treatment and is thought to rejuvenate the skin. We decided to study the benefits and untoward effects of this form of facial beauty treatment. METHODS: One hundred and forty-two women (aged 17-63 years), who had received facial beauty treatment in three well-established beauty parlours in New Delhi, were entered into the study and observed for a period of 12 weeks after the facial beauty treatment. Twenty-seven of the subjects had a repeat facial beauty treatment 4-6 weeks after entry into the study, giving a total of 169 massage episodes observed. Immediate and delayed effects of the beauty treatment were examined. RESULTS: Facial beauty treatment generally consists of three steps: vigorous massaging of the face with creams, steaming (using a hot towel or a steaming gadget), and application of a face mask containing adsorbents and astringents. In our study, the creams used for massage included "off the shelf" creams manufactured by standard cosmetic companies in 95 (56.3%) subjects, herbal creams in 61 (36.1%), and creams containing exotic ingredients, such as gold salts, in 13 (7.7%). Sixty-one (36.1%) patients developed erythema and puffiness within 15 min to 2 h after the beauty treatment. This lasted for 2-6 h. Forty-one (24.3%) women underwent the procedure of comedone extraction after steaming. In 12 (7.1%) of these women, persistent erythema was noticed at the site of comedone extraction. Eight (4.7%) women developed mild dermatitis on the face, 2-7 days after the facial beauty treatment. Patch testing with constituents used in the facial beauty treatment was positive in four patients (herbal cream, 1; witch hazel, 1; orange face pack, 1; and gold cream, 1). In 47 (33.1%) subjects, an acneiform eruption was observed 3-10 weeks after the facial beauty treatment (mean, 6.1 +/- 3 weeks). Thirteen (27.7%) of these subjects had taken the facial beauty treatment for the first time, whereas 34 (72.3%) developed an acneiform eruption after every facial massage. The predominant lesions were deep-seated nodules, although a few comedones, especially closed ones, were present in some patients. Lesions were always present on the cheeks, an area of focus during the facial massage, and healed with hyperpigmentation. The benefits of facial beauty treatment, as mentioned by the subjects, included a feeling of freshness and rejuvenation in 84 (59.1%), keeping the skin supple in 76 (53.5%), feeling of warmth and tightening of the skin in 71 (50%), and delaying the onset of wrinkles in 21 (14.8%). CONCLUSIONS: Although there are several subjective benefits with facial beauty treatment, there may be immediate side-effects, such as erythema and edema, as well as delayed problems, such as dermatitis and acneiform eruption, in about one-third of patients.     

A case report of percutaneous transluminal angioplasty following failure of femoro-popliteal venous bypass graft

This brief case report illustrates the utility of angioplasty in lower-extremity limb salvage situations that often occur following failure of femoro-popliteal bypass grafting, as well as the use of angio-plasty in tibial vessels. It also demonstrates that angioplasty of multiple lesions can be successfully achieved at a single sitting.     

Studies on Australia antigen in India

Abstract. Investigations of the incidence of Australia antigen (HAA) have been carried out in patients with infectious hepatitis and other hepatic diseases, in multitransfused patients and in normal voluntary and paid blood donors in Bombay. The incidence of Au antigen in infectious hepatitis was about 10%, in cases of cirrhosis of the liver 3%, and in lepromatous leprosy cases 12%. Multitransfused patients had an incidence of 10% for antibody to Au antigen. These findings are discussed in light of current available data.     

Synchronous mucosa-associated lymphoid tissue (MALT) lymphomas involving bilateral orbits and breasts: a rare clinical entity

Primary orbital and primary breast lymphomas comprise very small subgroups of extranodal lymphomas. Clinical presentation at both these sites together is extremely rare. We describe a case of bilateral orbital and bilateral breast mucosa-associated lymphoid tissue (MALT) lymphomas with bilateral pre-auricular lymph nodal metastasis. The case history, staging and management for this unusual entity are discussed.     

The contrasting roles of sedimentary plant-derived carbon and black carbon on sediment-spiked hydrophobic organic contaminant bioavailability to Diporeia species and Lumbriculus variegatus

In bioavailability studies, the biota sediment accumulation factor (BSAF) is invoked to describe the thermodynamic partitioning of a hydrophobic organic contaminant (HOC) between the organism lipid and the organic carbon fraction of the sedimentary matrix and accounts for differences in bioavailability among sediments. Bioaccumulation experiments were performed with Lumbriculus variegatus and Diporeia species exposed in seven sediments dosed with 2,4,5,2',4',5'-hexachlorobiphenyl (HCBP) and benzo[a]pyrene (BaP) or pyrene (PY) and 3,4,3',4'-tetrachlorobiphenyl (TCBP). The BSAF values for the nonplanar HCBP were consistent with equilibrium partitioning theory (EQP) and averaged 2.87 for L. variegatus and 1.45 for Diporeia, while the BSAF values for the planar compounds (BaP, PY, TCBP) were generally lower than estimated from EQP (<1). Correcting the BSAF values of the planar compounds for enhanced sorption due to black carbon improved the BSAF values for L. variegatus, generally resulting in values consistent with EQP, but substantial variation remained for Diporeia. The BSAF values for the planar compounds showed significant positive correlations with plant-derived carbon in sediments (lignin and pigments) but were more consistent for L. variegatus than for Diporeia. These correlations imply that compounds sorbed to plant-derived carbon are more bioavailable since this material is more likely ingested providing a second exposure route.