The teaching of child health in a medical college in central India

Aware of the importance of a knowledge of children and skill in their care, the World Health Organization and the Government of India have been working together to improve the training and education of the medical student in that subject. To that end the Organization has supported the work of a committee of medical educators, which has studied the teaching of child health and has published an experimental curriculum suitable for use in medical colleges in India ( 'Ad hoc' Committee on Education and Training in Paediatrics; WHO, 1970 , 1971 , 1974 , 1975 ). This article tells of the experience with that curriculum in one medical college in Central India since 1974. It is first necessary to indicate the position of medical education in the country.     

Reversible Myocardial Depression in Survivors of Cardiac Arrest

Three patients under 40-years old who survived cardiac arrest due to ventricular fibrillation were originally diagnosed as having idiopathic dilated cardiomyopathy. Shortly after cardiac arrest, assessment of myocardial function revealed a globally dilated left ventricle in each patient with an estimated ejection fraction between 20% and 30%. Serial assessment of myocardial function, however, showed either normal or near-normal function by 2 weeks postevent. These findings suggest that myocardial stunning due to hypoperfusion during ventricular fibrillation or the effects of transthoracic shocks may result in profound, reversible myocardial depression in survivors of cardiac arrest. Serial evaluation of left ventricular function may be of value in selected survivors of cardiac arrest in order to evaluate time-dependent resolution of myocardial dysfunction and may prevent misdiagnosis of idiopathic dilated cardiomyopathy.     

Holoprosencephaly (A Case Report)

We describe here a rare entity of Holoprosencephaly. The embryogenesis and the diagnostic aspects of this condition are highlighted.     

Participation of adrenal medulla in 6-aminonicotinamide-induced hyperglycaemia in the rat

In fasted rats 6-aminonicotinamide (6-AN) produced delayed hyperglycaemia, the peak effect being seen by 7 h. Fasting plasma insulin concentrations were not significantly altered but liver glycogen concentrations were decreased following treatment with 6-AN. Adrenalectomy, demedullation and pretreatment with reserpine, phentolamine, nicotinamide and nicotinic acid completely blocked the hyperglycaemic response whereas guanethidine and propranolol or oxprenolol were ineffective. Catecholamine concentrations in the adrenal venous plasma were markedly increased by treatment with 6-AN, the peak effect being seen by 5 h. It is concluded that adrenal medullary release, which is slow in onset, is mainly responsible for the development of sustained hyperglycaemia in the rat.     

Decreased Expression of Endometrial Decay Accelerating Factor (DAF), a Complement Regulatory Protein,in Patients With Luteal Phase Defect

PROBLEM : We investigated the level of decay accelerating factor (DAF) in the endometrium of luteal phase defect (LPD) patients, before and after treatment with progesterone. METHODS : Endometrial samples from fourteen normal-cycling controls and six samples from infertility patients with LPD before and four samples after progesterone treatment were stained by anti-DAF IgG using immunohistochemistry. RESULTS : Mean DAF OD in LPD patients was 15% compared to 60% in the control group. The mean DAF OD was 88% after treatment with progesterone. CONCLUSION : Results support interpretation that progesterone upregulates DAF while decreased progesterone may be associated with reduced expression of the DAF in LPD patients.     

Cell-Mediated Immunity to Cytomegalovirus in Pregnant Women

ABSTRACT: Employing the techniques of in vitro lymphocyte transformation (LTF) and complement fixation, cell-mediated immunity (CMI) and antibody to cytomegalovirus (CMV) were studied in pregnant and nonpregnant women. The LTF activity was determined by the whole blood microassay using four strains of CMV (AD-169 and its early antigen [EA], Davis, Veca, and Towne strains), and phytohemagglutinin (PHA). Lymphocyte transformation response to specific CMV antigens at 11–30 weeks of gestation and to nonspecific mitogen (PHA) in all pregnant and postpartum women were found to be significanty depressed compared with the nonpregnant women. The lower LTF responses to CMV antigen and PHA were found in specimens taken from pregnant women at 21–30 weeks of gestation. There were no significant differences in the mean complement-fixing (CF) antibody titers and the percentage of E-rosette-forming T lymphocytes between subjects in various stages of pregnancy. In addition, concanavalin A (Con A)-generated suppressor T cell activity was evaluated in pregnant and nonpregnant women. The suppressor effect of Con A-activated lymphocytes in pregnant women was somewhat higher than in nonpregnant women. These observations suggest that CMV-specific suppression of cellular immunity may play an important role in reactivation of CMV in pregnancy.     

Decreased Gut-associated IgA Levels in Patients with Typhoid Fever

Gut and serum immune responses were studied in twenty-two patients with bacteriologically proved typhoid fever at different stages of the illness and six volunteers after parenteral immunizations with heat-killed typhoid vaccine. Whereas the former group had some specific antibodies in their intestinal aspirates and significant specific antibody responses in their sera, the latter could only mount a serum antibody response. Moreover, the intestinal IgA levels in the patients remained significantly decreased throughout the whole course of the illness, but a rise of IgG and IgM was observed in their jejunal secretions. In contrast, the levels of all the three major classes of serum immunoglobulins IgG, IgM and IgA were raised in the patients, as opposed to the volunteers, in whom only IgG and IgM levels were increased. It was inferred that the subjects with deficit of intestinal IgA, and thus lacking protective mucosal barrier, are more prone to develop typhoid fever.